2004 — 2015 |
Neighbors, Clayton T |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Social Norms and Alcohol Prevention (Snap) @ University of Washington
[unreadable] DESCRIPTION (provided by applicant): The overall objective of the proposed research is to test the efficacy of computer delivered personalized normative feedback in the prevention and reduction of problem drinking among college students. Despite the wide spread utilization of social norms prevention approaches, methodological confounding has prevented determination of the magnitude and duration of effect of personalized normative feedback. In addition, this research aims to evaluate gender specificity of the normative referent, individual differences in self-determination, and reasons for drinking as moderators of intervention efficacy. This research will also determine the impact of normative information on students who never or rarely drink. College student drinking is largely motivated by social factors, including the perception that heavy drinking is "normal." College students overestimate the alcohol consumption of their peers. This distortion is presumed to cause many students to drink more than they otherwise would. It may also contribute to feelings of alienation and isolation among students who never or rarely drink. Correction of normative misperceptions is the goal of social norms prevention approaches. This research will be conducted at two universities in 3 stages. In stage 1, descriptive drinking norms from both sites will be obtained and incorporated into a web based assessment and intervention program. Stage 2 will implement a 3-year longitudinal efficacy trial among heavy drinking students. Students will be randomly assigned to a single exposure of personalized normative feedback, repeated biannual exposure to feedback, or a control group. Students in the feedback groups will also be randomly assigned to receive gender specific or gender non-specific feedback. Stage 3 will evaluate the impact of normative information on never/rarely drinking students. Students will be randomly assigned to receive social norms marketing messages, personalized normative feedback, or assessment only. Follow-up assessments will determine the impact of normative information at 3-months and 6-months post baseline. All assessments and interventions in stages 2 and 3 will be Internet based. This research will fill important knowledge gaps regarding the use of normative feedback in preventing and reducing problematic drinking and will serve as a prototype for implementing low-cost internet based personalized normative feedback interventions. [unreadable] [unreadable]
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1 |
2007 — 2008 |
Neighbors, Clayton T |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Event Specific Prevention @ University of Washington
[unreadable] DESCRIPTION (provided by applicant): Heavy drinking among college students continues to be an epidemic problem throughout the United States. Brief motivational interventions utilizing personalized feedback have consistently demonstrated reductions in the average number of drinks students consume over time. However, no empirically supported interventions are currently available which specifically target events associated with extreme risk (e.g., 21st birthdays and Spring Break). The availability of an Event-Specific Prevention (ESP) paradigm would represent a novel and important contribution to the prevention field. The proposed research is designed to evaluate ESP interventions modified from existing empirically supported interventions which target drinking more globally. This research will be conducted in 3 stages. In stage 1 (year 1), campus specific prevalence rates of consumption and consequences associated with 21st birthday celebrations and Spring Break will be obtained and incorporated into interventions to be evaluated in stages 2 and 3. Stage 2 (years 1-3) will implement an efficacy trial focused on 21st birthday drinking. Following a baseline assessment two weeks prior to their 21st birthday, students will be randomly assigned to receive event specific web-based personalized feedback, an in-person event specific brief motivational feedback intervention, an in-person non-specific brief motivational feedback intervention or an assessment only control group. Students in the event-specific feedback groups will also be randomly assigned to a friend intervention or no friend intervention condition. Students in the friend intervention conditions will nominate two friends to help them have a safe and enjoyable birthday. Friends will receive a brief web-based intervention providing tools to help them assist the celebrant in reducing the risk of negative alcohol related consequences during the event. Assessments immediately post-intervention and after the 21st birthday will establish intervention efficacy, and assessments at 3, 6, and 9 months and 1 year will establish generalizability and long term intervention effects. Stage 3 (years 2-5) will utilize a design parallel to stage 2 but will focus specifically on Spring Break drinking. In sum, this research will evaluate ESP interventions for two events for which empirically supported interventions are currently unavailable. This research has the potential to establish a new prevention paradigm for problem drinking among college students. [unreadable] [unreadable] [unreadable]
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0.928 |
2014 — 2015 |
Neighbors, Clayton |
R21Activity Code Description: To encourage the development of new research activities in categorical program areas. (Support generally is restricted in level of support and in time.) |
Motivating Recruitment and Efficacy in Normative Feedback Interventions
DESCRIPTION (provided by applicant): The current application proposes to evaluate motivational factors associated with recruitment into and efficacy of brief computer-delivered interventions for heavy drinking college students. College students are at increased risk for alcohol misuse compared to other adults, and development of efficacious intervention approaches is an urgent priority for NIAAA. Over the past several years empirical evidence has demonstrated support for computer-based personalized normative feedback (PNF) interventions which correct normative misperceptions of drinking and thereby reduce drinking behavior. Two specific questions which have remained largely unaddressed include whether the effectiveness of computer-based interventions depends on the location in which they are completed, and what is the optimal incentive structure to balance recruitment with motivational biases in intervention trials. A preliminary comparison of findings across several studies suggests that remote PNF interventions may be less effective than in-lab PNF interventions. However, the evidence is not conclusive because no study provides a direct comparison between delivery methods based on random assignment within the same study. This R21 proposes to recruit two cohorts of 240 heavy drinking college students and randomly assign them to a 2 x 2 x 2 repeated measures design. Participants will be randomly assigned to in-lab PNF, remote PNF, in-lab attention control, or remote attention control. Participants will also be randomly assigned to receive no incentive ($0) or an incentive ($30) for participation. Assessments will include baseline, post- intervention, 3-month, and 6-month follow-ups. College students' motivational orientations, incentives, and typical drinking are expected to moderate differences between delivery methods. We expect that students who receive incentives for participating in intervention studies will be more likely to participate, but less likely to reduce drinking because they will be more likely to attribute their participation to extrinsic motivation. Further, students who receive computer-based PNF in the laboratory for no incentive are expected to exhibit the largest reductions in drinking. In contrast, students administered attention-control feedback remotely for an incentive ($30) is expected to exhibit the smallest reductions in drinking. Perceived value of intervention, retention of intervention content, and attribution for participation are expected to mediate incentive effects and differential efficacy of in-lab versus remote delivery. This research is expected to yield theoretical and practical improvements to feedback-based intervention strategies with potential to reduce drinking and related negative consequences with a stronger theoretical basis and at lower cost than have been previously available.
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1 |
2015 — 2019 |
Neighbors, Clayton |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Guilt and Expressive Writing For Reducing Alcohol Use in College Students
DESCRIPTION (provided by applicant): The current application proposes to evaluate expressive writing as a novel intervention for problem drinking among college students. College students are at increased risk for alcohol misuse compared to other adults, and development of efficacious intervention approaches is an urgent priority for NIAAA. The vast majority of individually focused brief interventions targeting college drinking have focused on personalized feedback approaches and recent innovations have largely been limited to finer distinctions of these, which require assessment and programming for implementation. The present research proposes expressive writing as a novel alternative, which has been used extensively in other domains but not as an alcohol intervention strategy. We propose a theoretically-based approach, which incorporates expression of the self-conscious emotion of guilt and the written analogue of change talk as proposed mechanisms of intervention efficacy. We will also examine individual differences in propensity for guilt as a moderator of intervention efficacy. Heavy drinking college students (N=600) will be randomly assigned to one of six expressive writing conditions based on the 2 (alcohol vs. distress) x 2 (guilt vs. no guilt) + 1 (neutral control) + 1 (personalized feedback) design. Participation in the study involves completion of a screening assessment, a baseline assessment, the intervention, post-intervention assessment, and follow-up assessments at one-month, three-months, six- months, and twelve-months. There will be three intervention (expressive writing) prompts to take place every week for three weeks, the first of which will occur immediately following the baseline assessment. All baseline assessments, narrative intervention assignments, and immediate post-tests for all conditions will be conducted in-lab. All other assessments including screening and follow-up assessments will be completed remotely by web. Pilot data has provided some support for a single session of expressive writing in reducing drinking intentions, as well as event-related guilt as a mediator of intervention efficacy. The present research builds on these studies by incorporating multiple sessions and multiple follow-up assessments to evaluate actual changes in drinking and psychological well-being, in a complex experimental design and will evaluate theoretically-based mediators and moderator. If effective, this intervention approach will offer a novel intervention which will not require any pre-assessment or programming of personalized feedback, and would serve as an alternative to existing approaches, which is capable of being more easily disseminated.
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1 |
2017 — 2019 |
Neighbors, Clayton Sharp, Carla (co-PI) [⬀] Zvolensky, Michael J. (co-PI) [⬀] |
R34Activity Code Description: To provide support for the initial development of a clinical trial or research project, including the establishment of the research team; the development of tools for data management and oversight of the research; the development of a trial design or experimental research designs and other essential elements of the study or project, such as the protocol, recruitment strategies, procedure manuals and collection of feasibility data. |
Brief Personalized Feedback Intervention For Hazardous Drinking in An Hiv Clinic
? DESCRIPTION (provided by applicant): The objective of the proposed research is test the feasibility of a brief computer-based personalized feedback intervention to reduce heavy alcohol use among HIV+ individuals. Rates of hazardous alcohol use among HIV+ individuals are approximately two times that found in the general population. Hazardous alcohol use contributes to problems with HIV medication adherence, risky sexual behavior, and psychological problems, as well as physical complications (rapid disease progression, medication toxicities, organ failure, and poor viremic control), which may lead to increased risk of transmission and premature death. Yet, HIV+ hazardous alcohol users remain a hard-to-reach and underserved group. There is therefore a critical need to test alternative approaches to the implementation of effective interventions to reduce HIV disease transmission and progression in HIV+ hazardous alcohol users. One novel and promising intervention approach is the use of personalized feedback, which has consistently been found to be efficacious for reducing hazardous alcohol use across a number of populations. Personalized feedback highlights discrepancies between one's own drinking and typical drinking; reframes use in terms of personal, social, financial, health, and other consequences; and offers strategies for reducing use and alcohol-related negative consequences. The proposed research will develop and evaluate the feasibility, acceptability, and potential efficacy of a novel evidence- and computer-based Personalized Feedback Intervention (PFI) among HIV+ hazardous alcohol users in a high volume Houston HIV clinic. The research will include two primary aims. The first aim focuses on development and refinement of an intervention adapted from investigators' previous work to incorporate feedback for HIV+ individuals. Feasibility and acceptability will be established through iterative incorporation of focus group feedback regarding recruitment, assessment, and intervention procedures. The second aim will pilot the intervention to evaluate feasibility and potential efficacy. Outcomes include drinking change processes and behavior, alcohol-related risky sexual behavior, and HIV-related outcomes. The pilot will recruit 150 HIV+ hazardous alcohol users from clinic waiting areas. Participants will be randomly assigned to receive the PFI or to receive feedback unrelated to alcohol use. An underlying premise which will be evaluated through the aims is that the difficulty in reaching hazardous alcohol users who are HIV+ can be addressed with an approach that will not be burdensome to the individuals or to clinic staff. All assessments and procedures will take place in the clinic on tablets or laptop computers. Follow-up assessments will occur at 3 months post-baseline. This research builds on the collaborative work of an experienced team of investigators with complementary expertise supporting all aspects of the proposed research.
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1 |
2018 — 2019 |
Neighbors, Clayton |
R21Activity Code Description: To encourage the development of new research activities in categorical program areas. (Support generally is restricted in level of support and in time.) |
Informing Prevention by Modeling Associations Between Physical Activity and Alcohol Consumption
PROJECT SUMMARY/ABSTRACT This research will evaluate levels of association (within and between) and potential moderators (i.e., joint motives and sex differences) of the relationship between physical activity (PA) and alcohol consumption among young adult drinkers. Numerous studies have shown that PA and drinking are positively associated in young adults. Despite this, PA is currently used in interventions to reduce drinking and is promoted as a healthy alternative to drinking. This has critical public health ramifications because a lack of understanding how, why, and for whom these behaviors are positively correlated, at best, weakens the palliative effects of exercise interventions for drinking and, at worst, may be iatrogenic for some individuals. This research will provide clear answers for how, why, and for whom alcohol and PA are positively correlated and will facilitate in the development of innovative prevention strategies by offering personalized feedback based on individual profiles of associations between PA and drinking. Based on our previous work, which indicates that the PA/alcohol association may vary based on self-regulation, and a conceptually integrated, neurobiologically- based framework, we developed and pilot-tested a measure to target joint motives for PA and drinking. We propose that there are two general processes that determine the sequencing of the association between PA and drinking. Alcohol and exercise both engage two forebrain circuits that are critical for effective self- regulation, namely, the reward and the stress systems. The PA?drinking path is expected to reflect reward system activation and be indicative of facets of impulsivity (i.e., work hard, play hard, celebration motives). The drinking?PA path is expected to represent stress system deactivation, where PA serves as a means of reducing negative emotional or physical consequences related to drinking (i.e., guilt, body image motives). In evaluating this framework, we will investigate associations between PA and drinking at daily and weekly levels using an objective measure of PA. We will further examine sex and joint motives associated with the link between alcohol and PA (e.g., work hard, play hard, celebration, body image, guilt), as moderators of these associations and trait-level variables supported in previous studies (e.g., impulsivity, anxiety sensitivity, and BIS/BAS). We will recruit 250 college students from two campuses who report drinking at least once per week. Participants will report daily drinking over 21 days. PA will be assessed continuously using Actical accelerometers. Overall, we anticipate positive associations between PA and drinking and that the temporal sequences of PA and drinking will be influenced by joint drinking and PA motives. Sex differences are expected such that the endorsement of body image and guilt concerns will be more evident and influential among women and work hard, play hard and celebration motives will be more evident and influential for men.
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1 |
2018 — 2021 |
Carey, Kate B [⬀] Dibello, Angelo Michael (co-PI) [⬀] Neighbors, Clayton |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Using Counter Attitudinal Advocacy to Change Drinking Behavior
PROJECT SUMMARY/ABSTRACT The persistence of risky drinking among young adults in college calls for continued efforts to prevent harms related to alcohol. Current prevention interventions have achieved some success, but the majority of those interventions rely on a single mechanism of change: correcting exaggerated drinking norms. We propose to test a novel prevention strategy targeting another mechanism of change: creating attitude-behavior dissonance. To date, changing alcohol-related attitudes and the resulting attitude-behavior discrepancy have not been harnessed as a behavior change strategy for alcohol abuse prevention. Informed by an extensive literature showing strong and consistent associations between alcohol attitudes and drinking behavior, we adapted a brief counter-attitudinal advocacy (CAA) manipulation to the alcohol prevention context. The goals of the proposed research are to demonstrate (a) the utility of CAA to change high volume drinking and related consequences, (b) that attitude change and attitude-behavior dissonance mediates the CAA manipulation effect, and (c) that CAA-induced risk reduction is not inferior to an established intervention based on Personalized Normative Feedback (PNF). To achieve these goals, we propose a pair of studies implemented across two sites. First we conduct an initial survey to document peer behaviors and normative perceptions (N = 500 at each site), required to deliver accurate, campus-specific PNF. Next we conduct an RCT with 2 experimental conditions (CAA and PNF) and a 3rd assessment only control condition to determine the impact of CAA on alcohol outcomes. For the RCT, we will recruit a total of 600 heavy drinking students who endorse >2 alcohol-related negative consequence. Based on pilot work, we designed a prompt to elicit counter-attitudinal statements in favor of moderate drinking. Drawing from the college intervention literature, we will also use a standard PNF condition as a comparison. We will collect alcohol outcomes at 1-, 3-, and 6-month follow-ups. We will test hypotheses that, relative to assessment only control, the CAA manipulation will (a) increase positive moderate drinking attitudes, (b) decrease positive heavy drinking attitudes, (c) increase attitude- behavior dissonance, and (d) decrease drinks per drinking day, binge frequency, peak BAC, and alcohol consequences, and increase PBS. We will also test the hypothesis that CAA condition will be no less efficacious than (i.e., not inferior to) the PNF condition in reducing drinks per drinking day, binge frequency, peak BAC, and alcohol consequences. In addition, we will test hypotheses about participant characteristics (drinker identity, preference for consistency) that might moderate the influence of the CAA manipulations on drinking behaviors. This study will demonstrate the generalizability of attitude change theory and CAA methods to the alcohol prevention context, as well as their generalizability across demographically different settings. Implications for the public health include establishing the efficacy of a new approach for reducing high volume drinking and related consequences among young adults engaging in at-risk drinking.
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0.966 |
2019 — 2021 |
Labrie, Joseph W Neighbors, Clayton |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Revolutionizing Normative Re-Education: Delivering Enhanced Pnf Within a Social Media Inspired Game About College Life @ Loyola Marymount University
Project Summary NIAAA identifies first-year college students as a high-risk group for heavy drinking and harmful consequences. Further, these students' perceptions of their peers' drinking (descriptive norms) are strong predictors of their own alcohol use and those norms are consistently misperceived; students overestimate peer drinking behavior, leading them to drink more themselves. Most universities require incoming students to complete remotely- delivered interventions to correct these misperceptions, known as Normative Re-education programs. However, the main risk-reduction approach in these programs, personalized normative feedback (PNF), suffers from limitations that have impeded large reductions in student alcohol use and consequences. Our pilot work has introduced a new smartphone-based app called CampusGANDR that delivers PNF within a weekly game about college life. During the game students submit questions, vote on their favorite questions, answer these questions, and win or lose points based on the accuracy of their responses. A major innovation of CampusGANDR is that it draws on recent literature in the field of gamification, adding features like points, leader boards, and chance-based uncertainty to make PNF more interesting, believable, and palatable to students. Further, we have successfully invited students to play the game voluntarily, rather than offering monetary compensation for taking part or making participation mandatory like most current programs and research initiatives. In the context of CampusGANDR students view feedback because they are intrinsically motivated, rather than extrinsically motivated, to do so. Based on extensive pilot work, the current proposal seeks to: 1) evaluate the efficacy of CampusGANDR in a large-scale multi-site trial; 2) identify the optimal dosage of alcohol feedback to deliver within CampusGANDR for correcting norms and reducing alcohol use among students who differ in alcohol use (non-drinkers, light to moderate drinkers, and heavy drinkers); 3) examine person-level moderators of intervention efficacy; and 4) evaluate the sustainability of CampusGANDR among students who use the app but aren't recruited into the study. During the first year of the project we will work with an award-winning app development company to design and program a fully-functional versions of the CampusGANDR app. Next, 2,400 first-year students will be recruited across three cohorts at two distinctly different campuses (Loyola Marymount University and the University of Houston) to play CampusGANDR for 12 weeks and to complete 4 surveys about their alcohol use and personality variables. Students who are not sampled into the survey study will still be able to take part in CampusGANDR, and their app usage data will be employed to measure the organic churn rate and viral growth coefficient of the app. The project will result in cutting-edge native smartphone (IOS, Android) and web-versions of the app able to dynamically tailor the dosage of alcohol feedback delivered based on students' alcohol experience at the point of matriculation.
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0.948 |