Computer versus in-person intervention for students violating campus alcohol policy

Abstract

In this study, the authors evaluated the efficacy of a brief motivational intervention (BMI) and a computerized program for reducing drinking and related problems among college students sanctioned for alcohol violations. Referred students (N = 198, 46% women), stratified by gender, were randomly assigned to a BMI or to the Alcohol 101 Plus computer program. Data obtained at baseline, 1, 6, and 12 months were used to evaluate intervention efficacy. Planned analyses revealed 3 primary findings. First, women who received the BMI reduced drinking more than did women who received the computer intervention; in contrast, men's drinking reductions did not differ by condition. Second, readiness to change and hazardous drinking status predicted drinking reductions at 1 month postintervention, regardless of intervention. Third, by 1 year, drinking returned to presanction (baseline) levels, with no differences in recidivism between groups. Exploratory analyses revealed an overall mean reduction in drinking immediately after the sanction event and before taking part in an intervention. Furthermore, after the self-initiated reductions prompted by the sanction were accounted for, participation in the BMI but not the computer intervention was found to produce additional reduction in drinking and related consequences.

Figure 1

Participation flow diagram. BMI = brief motivational intervention; 101+ = Alcohol 101 Plus.

Figure 2

Piecewise latent growth model, which through proper specification of the factor loadings estimates three distinct components of change: presanction drinking, the change in alcohol use from the presanction baseline to the 1-month follow-up (intervention effect), and the change in alcohol use across the 1-, 6-, and 12-month follow-ups (postintervention change). Omitted factor loadings are fixed at 0, and factor scores are interpreted just as with standard regression. The Presanction Drinking factor scores estimate drinking when all other factor loadings are 0. The remaining two factors are interpreted as slopes (i.e., expected change). Therefore, the intervention effect factor scores estimate slopes from 0 (presanction) to 1 (1 month), and the Postintervention Change factor scores estimate slopes from 0 (now 1 month) through the 6-month and 12-month follow-ups. Intervention status is used to predict each of these three aspects of the fitted growth function. BMI = brief motivational intervention; Alcohol 101 = Alcohol 101 Plus.

Figure 3

Piecewise factor-of-curve (PFOC) model, which estimates three distinct piecewise latent growth models for the three items with presanction, postsanction, and postintervention values available (i.e., drinks per drinking day, drinks per typical week, and peak blood alcohol concentration [BAC]; see top half of Figure 3). In the bottom half of Figure 3, the PFOC model combines the three individual piecewise latent growth models into second-order factors (i.e., weighted averages) that depict composite change from (a) presanction drinking during the month prior to the sanction event to (b) postsanction drinking during the weeks following the sanction event and finally to (c) postintervention drinking, assessed at the 1-month follow-up. BMI = brief motivational intervention; 101 = Alcohol 101 Plus.

Figure 4

Expected values for drinks in the heaviest week of the last month, by gender and condition, showing change from presanction, labeled Month 0, to 1 month, labeled Month 1 (i.e., the combined response to sanction and intervention); and slopes across 1-month, 6-month, and 12-month follow-ups. BMI = brief motivational intervention; Alch101 = Alcohol 101 Plus.

Figure 5

Raw means for single item outcomes measured at presanction (the month prior to sanction event), postsanction (the weeks between sanction event and first study assessment), and postintervention (the month between intervention and 1-month follow-up), by gender and condition. W = women; 101 = Alcohol 101 Plus; BMI = brief motivational intervention; M = men; BAC = blood alcohol concentration.