Improving Brief Alcohol Interventions With a Behavioral Economic Supplement

University of Memphis

Status: Completed

Conditions: Alcohol Abuse

Treatments: Behavioral: Relaxation Session; Behavioral: Substance-Free Activity Session (SFAS); Behavioral: Brief Motivational Intervention (BMI)

Study type: Interventional

Funder types: Other

Identifiers

NCT02834949

5R01AA020829-03

Details and patient eligibility

About

The purpose of this study is to evaluate the efficacy of a Substance-Free Activity Session (SFAS) as a supplement to a brief motivation intervention (BMI) in reducing alcohol use and alcohol-related consequences in college students.

Full description

BMIs are associated with reductions in alcohol consumption and related problems, but effect sizes are generally small. One BMI trial indicated that behavioral economic variables such as low levels of proportionate substance-free reinforcement and inelastic demand for alcohol predicted poor intervention response, and that participants who successfully reduced their drinking increased their participation in academic and other substance-free activities. A subsequent NIAAA R21 developed a substance-free activity session (SFAS) supplement to traditional alcohol BMIs that attempted to increase engagement in constructive alternatives to drinking by enhancing the salience of delayed rewards (academic and career success) and the patterns of behavior (academic engagement) leading to these outcomes. This study indicated that a two session (alcohol BMI + SFAS) preventive intervention resulted in significantly greater reductions in alcohol problems relative to a two session (alcohol BMI + Relaxation) active control condition. The BMI+ SFAS was also associated with significantly greater reductions in heavy drinking for participants with lower levels of substance-free reinforcement at baseline. This was the first controlled study to demonstrate that a supplement to traditional BMIs can improve outcomes. The current study will extend these promising pilot results by (a) increasing the efficacy of the behavioral economic SFAS by including booster contact, (b) increasing power and generalizability by recruiting 425 students from two universities and including a no-treatment control group, (c) measuring drinking, as well as behavioral economic mechanisms as mediators and moderators of intervention outcomes (delay discounting, alcohol reinforcing efficacy, substance-free reinforcement) at 5 time points over a sixteen month period, and (d) evaluating the economic costs and benefits associated with the SFAS. The goals of the SFAS - increasing student engagement in academic, campus, and career-related activities- are consistent with the priorities of most colleges.

Enrollment: 393 patients

Sex: All

Ages: 18 to 27 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Male and female University of Memphis and University of Missouri
• College freshman or sophomore
• Full time student status
• Report 2 or more heavy drinking episodes (5/4 drinks for men/women) in the past month

Exclusion criteria

• Employed more than 20 hours per week

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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393 participants in 3 patient groups

BMI + SFAS

Experimental group

Description:

Participants first receive a 50-minute standard brief motivational intervention designed to reduce alcohol use. A week later, they will receive the SFAS (Substance-free Activity Session., a 50-minute counseling session designed to increase the salience of the student's academic and career goals, draw attention to the potentially negative relationship between substance use and goal accomplishment, and increase engagement in substance-free alternative activities. The SFAS will be described to participants as the "College Adjustment Session" and the session will be conducted using an MI plus personalized feedback approach.

Treatment:

Behavioral: Brief Motivational Intervention (BMI)

Behavioral: Substance-Free Activity Session (SFAS)

BMI + Relaxation Session

Active Comparator group

Description:

Participants first receive a 50-minute standard brief motivational intervention designed to reduce alcohol use. A week later, they will receive a relaxation training session. In the relaxation training session, the clinician leads the student through a diaphragmatic breathing exercise, followed by a progressive muscle relaxation protocol (\~30 minutes). At the end of the session, participants will be asked about their reaction to the relaxation techniques and provided with relaxation training handouts.

Treatment:

Behavioral: Brief Motivational Intervention (BMI)

Behavioral: Relaxation Session

Assessment

No Intervention group

Description:

Participants will fill out a battery of measures and receive no intervention.