A new systematic review of data published in more than 40 studies of freshman alcohol interventions finds that there are many effective ways for colleges to mitigate common drinking patterns and problems among new students.
Based on their findings, published online Jan. 20 in the Journal of Consulting and Clinical Psychology, the team of researchers at Brown University and The Miriam Hospital recommend that colleges screen all freshmen within their first few weeks for alcohol risk and offer effective combinations of interventions for those who report drinking.
"Adoption of our recommended strategies would enable colleges to become more proactive - that is, targeting interventions to those students who have initiated alcohol use and may experience some alcohol-related problems but before their alcohol use meets criteria for alcohol dependence or abuse," said study lead author Lori Scott-Sheldon, a psychiatry and human behavior assistant professor (research) at Brown and researcher in the Centers for Behavioral and Preventive Medicine at The Miriam.
Even the best interventions studied don't completely stop freshman from drinking, but even their "small effect sizes" can have a large impact when implemened broadly - a phenomenon known as the "Prevention Paradox." That is, small changes on the individual level sum to large effects on the population of students on a campus.
"College drinking is one of those cases where the majority of harms or alcohol-related problems that accumulate on a campus can be attributed not to the relatively small number of really problematic drinkers, but to the majority of moderate drinkers because there are so many of them," said co-author Kate Carey, a professor in the Brown University School of Public Health. "Thus small effect sizes mean that any given person may change just a little as a result of an intervention, but when we expand the effects to the whole freshman class we would expect prevention programs like those we reviewed to have a public health impact."
Multiple techniques
In the analysis, the team examined the efficacy of 62 interventions delivered in randomized, controlled clinical trials involving more than 24,000 freshmen around the country over the last decade. The researchers looked for patterns emerging from these trials that would reveal which interventions reduce drinking amount and frequency and reduce alcohol-related problems.
The single technique that provided the broadest benefits was providing students with a personalized feedback report that can include details such as how self-reported drinking compares to peers, the financial cost of alcohol consumed, the calories consumed, and sometimes even blood-alcohol levels. Laying out this kind of information significantly helped students to reduce the dimensions of drinking frequency, quantity, and alcohol-related problems.
In general, however, Scott-Sheldon, Carey and their colleagues found that different intervention techniques affected different things.
For example, challenging students' alcohol-related expectancies, for instance by sorting out what popular aspects of drinking are really related to alcohol versus the social context of partying, significantly reduced the incidence of alcohol-related problems, but didn't significantly affect alcohol quantity, frequency of drinking days or frequency of heavy drinking.
Interventions that combined several techniques proved most effective because they accumulated the differing efficacy of the multiple techniques.
"Interventions with four or more components-were the most effective at reducing first-year students' alcohol consumption and alcohol-related problems," the researchers wrote.
