TO APPEAL TO DIFFERENT SUB-GROUPS OF STUDENTS
TO BE DISTRIBUTED AT LOYOLA MARYMOUNT & UNIVERSITY OF HOUSTON EVENTS FOR FIRST-YEARS
ABOUT THE CLINICAL TRIAL
Despite concerted efforts, high risk drinking remains a significant problem on college campuses. Further, the transition into college is an identified critical period in which risky drinking patterns are often established and serious negative consequences occur. Colleges commonly employ Normative Re-Education (NR), a promising intervention approach focused on correcting over-estimated peer drinking norms, to reduce alcohol risk in first-year students. However, the most cost-effective and scalable NR strategies, including web-based personalized normative feedback (PNF) interventions, have yielded only modest reductions in drinking. Several issues have been identified that may explain these relatively small effects. For example, students often question the credibility of the normative data, the content fails to capture students’ attention, and heavy drinkers often react to feedback defensively. These issues are not surprising as, unlike social media and digital gaming applications that capture and sustain young adults’ attention, web-based PNF formats lack the sophisticated digital graphics, social interactivity, and other dynamic features to which students have become accustomed. Further, colleges often make participation mandatory or offer incentives to enroll students in current interventions, likely a detriment to student motivation and thus intervention effectiveness.
Our new gamified, social media inspired, incognito approach to PNF addresses these issues by delivering alcohol PNF within a fun smartphone app that tests first-year students’ perceptions of college life and classmates’ attitudes and behaviors on a weekly basis across the first semester of college. Integrating features from popular social media platforms and evidence-based digital game mechanics (e.g., co-presence, a wager-based system of points, and chance-based uncertainty), the app also features enhanced PNF and includes several novel features informed by longstanding cognitive and social psychological theories. Five pilot studies support the ability of this gamified, app-based, incognito alcohol intervention strategy to engage first-year college students and reduce drinking more effectively than existing NR approaches.
This project will evaluate the gamified app as a low cost, self-sustaining, alcohol intervention approach in a large multi-site (LMU and UH) randomized controlled trial with three cohorts of N=400 first-year students per site (N=2,400 total). Student participants will play the app weekly over the 12 weeks of their first semester in college. Additionally, students not enrolled in the RCT study will also play throughout the 12-week period (≈300 per site per cohort; ≈1800 total), testing their knowledge and understanding of peer behavior, receiving feedback, and competing for prizes with the RCT participants. Each week, all players will answer questions of interest on three topics about first-year students’ attitudes and behaviors (alcohol and partying, health, drinking-related consequences, sex, studying etc.) generated by the student players. They will also guess how “typical” students answered the same questions and wager points on how close to the correct answer (group norm) their guess is. Further, they will rate the behaviors of others and, then, submit and vote on questions for subsequent rounds. At the end of each week, players will receive enhanced PNF feedback on two of the topics, as well as receive feedback on how other preferred-sex students rated their individual behavior (preferred-sex injunctive norms). Innovatively, the study’s design, which randomizes RCT participants to one of three levels of alcohol feedback (0%, 33%, 66%), will evaluate the effectiveness of alcohol feedback delivered in the app relative to feedback on control topics and identify the optimal doses of on-going alcohol feedback to be delivered to different types of student drinkers (nondrinker, light drinker, moderate to heavy drinker). Among the non-RCT additional players on each campus, confidential user data will evaluate the sustainability of app play in an ecologically valid setting consistent with how colleges might cost-effectively offer this game in the future, in the absence of individual incentives. As a naturalistic intervention able to organically attract student participation at minimal cost, this smartphone application represents a potentially powerful new paradigm for college alcohol prevention by integrating social media and gamified elements to deliver credible, engaging and impactful content.
- Earle, A.M., LaBrie, J.W., Boyle, S.C., Smith, D. (2018) In pursuit of a self-sustaining college alcohol intervention: Deploying gamified PNF in the real world. Addictive Behaviors, 80, 71-81. https://doi.org/10.1016/j.addbeh.2018.01.005
- Boyle, S.C., Earle, A.M., McCabe, N., LaBrie, J.W. (2018) Increasing chace-based uncertainty reduces heavy drinkers’ cognitive reactance to web-based personalized normative feedback. Journal of Studies on Alcohol and Drugs, 79(4), 601-610. https://doi.org/10.15288/jsad.2018.79.601
- Boyle, S.C., Earle, A.M., LaBrie, J.W., Smith, D.J. (2017) PNF 2.0? Initial evidence that gamification can increase the efficacy of brief, web-based personalized normative feedback alcohol interventions. Addictive Behaviors, 67, 8-17. http://dx.doi.org/10.1016/j.addbeh.2016.11.024