Online feedback helps college drinkers cut down

NEW YORK (Reuters Health) - A Web-based program can encourage college students who are drinking too much to moderate themselves a bit, according to a new report in the Archives of Internal Medicine.

A month after participating in the program, undergrads who had reported risky alcohol use were drinking less often, consuming less alcohol when they did drink, and drinking less overall, Dr. Kypros Kypri of the University of Newcastle in Callaghan, New South Wales, Australia and colleagues found. Some differences persisted six months later.

Heavy drinking and binge drinking are common among university students, who often don't see their alcohol use as a problem, Kypri and his colleagues state in their report. Brief interventions, such as mailed personalized feedback or a single 15- to 30-minute in-person counseling session, have been shown to help college kids cut down on their drinking and avoid problems with alcohol, they add.

A few studies have looked at delivering brief interventions by the Internet, which is becoming increasingly common, but have had limitations, the researchers add, for example including only a small number of students or following up for only a short amount of time.

In the current study, the researchers invited 13,000 students to participate in a Web-based test to screen for problematic alcohol use. Among the 7,234 students who agreed to participate, 2,435 had scores indicating "hazardous/harmful" drinking. These students were randomly assigned to a 10-minute motivational assessment with personalized feedback, all Web-based; or a control group who received no intervention.

Feedback included the student's Alcohol Use Disorders Identification Test (AUDIT) score; an estimate of the student's blood alcohol concentration during his or her heaviest drinking bout in the past four weeks; information on the effects of various blood alcohol concentrations on behavior, physiology and car crash risk; and a graph comparing the student's own alcohol use with that of their peers of the same age and gender. Links to sites offering help with alcohol use and smoking cessation also were provided.

A month after the intervention, the researchers found, the students in the intervention group were drinking 17% less alcohol than those in the control group; six months later, they were drinking 11% less. Most of the difference was due to the fact that students drank less frequently after the intervention.

However, the differences were modest; for example, one month after the intervention, the group who had received feedback were averaging six drinking days for the previous four weeks, six drinks per typical occasion, and eight drinks a week, compared to seven, six and 10 for the control group.

One month after the intervention, 54.1% of the intervention students were binge drinking-defined as four drinks in one sitting for women and six per sitting for men--compared to 58.6% of the control group, which wasn't statistically significant.

But differences in heavy drinking, defined as more than 14 drinks a week for women or more than 28 drinks a week for men, were significant. At one month, 15.1% of the intervention group were drinking heavily, compared to 22.1% of the control group; at six months, 18.7% of intervention students were drinking heavily, and 25% of control group students were.

At six months, 19% of the students who had received the feedback said they reduced the amount of alcohol they had consumed because of the program, compared to 5.8% of the group who didn't receive feedback.

A month after the intervention, 22% of the study participants had dropped out, and 35% had dropped out by six months, which is higher than the drop-out rate in studies using in-person counseling.

"The lack of face-to-face interaction and the taking of the intervention out of the health care setting may have reduced its potency," the researchers write. "Nonetheless, there is now evidence that the general approach can be replicated cross-culturally and that it produces significant benefits for modest costs of implementation."

They point out that the reduction in drinking at six months that they found is similar to the 13% reduction seen with brief interventions delivered by primary care practitioners.

SOURCE: Archives of Internal Medicine, September 14, 2009.