Doctor of Psychology (Clinical)
School of Psychology
Utpala-Kumar, Ranjani, Effects of an e-postcard intervention to reduce alcohol consumption in Australian university students who are heavy episodic drinkers, Doctor of Psychology (Clinical) thesis, School of Psychology, University of Wollongong, 2009. http://ro.uow.edu.au/theses/3559
Heavy episodic drinking (HED), also commonly referred to as “binge drinking”, has been identified as a problematic drinking pattern among young people in many countries, including Australia. It is a leading cause of unintentional injury and death among 18-24 year old college students in the USA (Hingson, Heeren, Zakocs, Kopstein & Wechsler, 2002). Over one third of Australian university students report that they have sustained an injury as a result of their drinking (Roche & Watt, 1999). It has been proposed that most college students overestimate the amount that their peers drink and this misperception of the norm tends to lead students to drink more in an effort to keep up with the perception of what others drink (Carter & Kahnweiler, 2000).
Study 1 aimed to determine the incidence of heavy episodic drinking in an Australian university and examined the relationship that negative consequences as well positive expectancies had on students’ drinking. The present research defined heavy episodic drinking as the consumption of 5 standard drinks for males and 4 for females on one occasion. The perceived norms hypothesis was tested to understand whether students overestimate the drinking of their peers. Students were recruited from residence halls and through the School of Psychology with an estimated response rate of about 12%. They completed a questionnaire about their alcohol consumption and associated attitudes and behaviours. Of the 303 respondents, nearly 40% of the respondents were classified as frequent heavy episodic drinkers (HEDs) where males consumed 5+ standard drinks in one occasion (4+ for females) six or more times in a month. Overall, three-quarters of students in this sample reported drinking at levels that placed them at elevated risk for future health damage in terms of the AUDIT assessment of risk (Babor, Kranzler & Lauerman, 1989). Alcohol expectancies were higher in frequent HEDs and they also experienced more negative consequences as result of their own drinking and that of others. Students who engaged in heavy episodic drinking also tended to underestimate their own drinking when comparing themselves to other university students.
Study 2 was conducted in order to be able to provide relevant normative data to support an intervention that was designed to reduce the levels of HED (Study 3). A brief online survey that comprised of six questions was circulated to students by email through their faculties. For this study, the response rate is estimated at approximately 9%. Results from this study indicated that 5.8% of the total sample of 2082 respondents never consumed alcohol. Males consumed alcohol more frequently than females and also tended to consume greater quantities. This pattern was also true for HED, with males engaging in HED on an average of 1.38 times per week (SD = 1.41) and females on an average of 0.91 times per week (SD = 1.11). Males also consumed more standard drinks per typical HED occasion than females.
Study 3 involved development of an email “postcard” intervention aimed at reducing alcohol consumption among university students by providing them with accurate normative data as well as additional information about alcohol and its effects. The study recruited 119 student participants who were all HEDs. They were randomly allocated to one of three conditions: control, generic or personalised. Measures were completed at pretest, posttest (three months after pre), and 6 month follow-up. Respondents in the control condition completed an assessment of their alcohol consumption and related behaviours at each of the three time points. Respondents in the generic condition completed the assessments and received normative feedback as well as 10 weekly e-postcards with generic information about the effects of alcohol, how to estimate blood alcohol levels, costs of drinking, and protective strategies that can be used to avoid alcohol-related negative consequences. Respondents in the personalised condition received e-postcards with the same theme as participants in the generic condition every week. However, in the personalised condition the e-postcard was individualised based on each participant’s responses to the baseline assessment. The intervention did not appear to have an impact on students’ drinking. Quantity of alcohol consumption significantly decreased over time, but there were no significant differences between any of the groups on the outcome measures. Further, there were no changes in students’ reported experience of alcohol-related negative consequences. It is notable that nearly 54% of students in the present sample were in the Precontemplation stage of change and while there was a significant shift to Contemplation at posttest, this change was not sustained at follow-up. Overall, students did not rate each of the weekly e-postcards as being particularly useful. Females endorsed e-postcards that gave information on personalised normative feedback, information about standard drinks, identifying protective behaviours and information on calorie content of alcohol as being more useful than males did. It is recommended that feedback such as this along with a greater emphasis on motivational strategies be integrated into future interventions to improve their effectiveness.