Evaluation of an Internet-based alcohol misuse prevention course for college freshmen: findings of a randomized multi-campus trial

Abstract

Background: Internet-based alcohol misuse prevention programs are now used by many universities. One popular 2- to 3-hour online course known as AlcoholEdu for College is typically required for all incoming freshmen and thus constitutes a campus-level strategy to reduce student alcohol misuse.

Purpose: Multi-campus study to evaluate the effectiveness of an Internet-based alcohol misuse prevention course.

Design: RCT with 30 universities: 21 entered the study in Fall 2007, nine in Fall 2008. Fifteen were randomly assigned to receive the online course and the other 15 were assigned to the control condition. The course was implemented by intervention schools during the late summer and/or fall semester. Cross-sectional surveys of freshmen were conducted at each university, beginning prior to the intervention in Spring 2008-2009; post-intervention surveys were administered in Fall 2008-2009 and Spring 2009-2010.

Setting/participants: Public and private universities of varying sizes across the U.S. Random samples of 200 freshmen per campus were invited to participate in online surveys for the evaluation. Overall survey response rates ranged from 44% to 48% (M ≈ 90 participants per campus).

Intervention: The online course includes five modules; the first four (Part I) are typically offered in the late summer before matriculation, and the fifth (Part II) in early fall. Course content includes defining a standard drink, physiologic effects of alcohol, the need to monitor blood alcohol level, social influences on alcohol use, alcohol laws, personalized normative feedback, and alcohol harm-reduction strategies. Students must pass an exam after Part I to advance to Part II.

Main outcome measures: Past-30-day alcohol use, average number of drinks per occasion, and binge drinking.

Results: Multilevel intent-to-treat analyses indicated significant reductions in the frequency of past-30-day alcohol use (beta = -0.64, p<0.05) and binge drinking (beta = -0.26, p<0.05) during the fall semester immediately after completion of the course. However, these effects did not persist when assessed in the spring semester. Post hoc comparisons suggested stronger course effects on these outcomes at colleges with higher rates of student course completion. No course effects were observed for average number of drinks per occasion or prevalence of binge drinking, regardless of the campus course completion rate.

Conclusions: This study provides initial evidence that the Internet-based alcohol misuse prevention course has beneficial short-term effects on hazardous drinking behavior among first-year college students, which should be reinforced through effective environmental prevention strategies.

Trial registration: ClinicalTrials.gov NCT01382979.

Figure 1. Consort flow chart illustrating study design

Figure 2

Trends in the frequency of past-30-day alcohol use and binge drinking Note: Adjusted means, by study condition (a, b) and level of student participation in the online course (c, d)