The Journal of Primary Prevention

, Volume 35, Issue 2, pp 75–84 | Cite as

Personalized Feedback as a Universal Prevention Approach for College Drinking: A Randomized Trial of an e-Mail Linked Universal Web-Based Alcohol Intervention

  • Tibor P. Palfai
  • Michael Winter
  • John Lu
  • David Rosenbloom
  • Richard Saitz
Original Paper


Alcohol use among first-year university students continues to be a central health concern. Efforts to address drinking in this population have increasingly relied on web-based interventions, which have the capacity to reach large numbers of students through a convenient and highly utilized medium. Despite evidence for the utility of this approach for reducing hazardous drinking, recent studies that have examined the effectiveness of this approach as a universal prevention strategy in campus-wide studies have produced mixed results. We sought to test the effectiveness of a web-based alcohol intervention as a universal prevention strategy for first-year students. An e-mail invitation linked to a brief, web-based survey on health behaviors was sent to all first-year students during the fall semester. Those who completed the baseline assessment were randomized to receive either a feedback-based alcohol intervention (intervention condition) or feedback about other health-related behaviors such as sleep and nutrition (control condition). A second web-based survey was used to collect follow-up drinking data 5 months later. The number of heavy drinking episodes in the previous month and alcohol-related consequences in the previous 3 months served as the primary dependent variables. Negative binomial regression analyses did not indicate a significant effect of the intervention at follow-up on either heavy drinking episodes or alcohol-related consequences. Analyses of additional drinking outcomes among the subsample of students who reported that they did not drink at baseline showed that those who received the alcohol intervention were subsequently less likely to drink alcohol. These results suggest that web-based alcohol interventions may be a potentially useful method of maintaining abstinence among underage, non-drinking students. Overall, however, results indicate that an e-mail-linked, campus-wide, web-intervention approach to address alcohol use among first-year students may have limited effectiveness as an approach to minimize hazardous drinking over the course of the year.


Alcohol University Computer Freshmen Intervention Internet, e-Mail 



This research was supported in part by National Institute on Alcohol Abuse and Alcoholism Grant P60 AA013759.


  1. Babor, T. F., De La Fuente, J. R., Saunders, J., & Grant, M. (1992). AUDIT: The alcohol use disorders identification test. Guidelines for use in primary health care. Geneva: World Health Organization.Google Scholar
  2. Baer, J. S., Kivlahan, D. R., Blume, A. W., McKnight, P., & Marlatt, G. A. (2001). Brief intervention for heavy drinking college students: 4-year follow-up and natural history. American Journal of Public Health, 91, 1310–1316.PubMedCrossRefGoogle Scholar
  3. Barnett, N. P., Murphy, J. G., Colby, S. M., & Monti, P. M. (2007). Efficacy of counselor vs. computer-delivered intervention with mandated college students. Addictive Behaviors, 32, 2529–2548.PubMedCentralPubMedCrossRefGoogle Scholar
  4. Borsari, B., Murphy, J. G., & Barnett, N. P. (2007). Predictors of alcohol use during the first year of college: Implications for prevention. Addictive Behaviors, 32, 2062–2086.PubMedCentralPubMedCrossRefGoogle Scholar
  5. Carey, K. B., Henson, J. H., Carey, M. P., & Maisto, S. A. (2009). Computer versus in-person intervention for students violating campus alcohol policy. Journal of Consulting and Clinical Psychology, 77, 74–87.PubMedCentralPubMedCrossRefGoogle Scholar
  6. Carey, K. B., Scott-Sheldon, L. A. J., Carey, M. P., & DeMartini, K. S. (2007). Individual-level interventions to reduce college student drinking: A meta-analytic review. Addictive Behaviors, 32, 2469–2494.PubMedCentralPubMedCrossRefGoogle Scholar
  7. Carey, K. B., Scott-Sheldon, L. A. J., Elliott, J. C., Garey, L., & Carey, M. P. (2012). Face-to-face versus computer-delivered alcohol interventions for college drinkers: A meta-analytic review, 1998 to 2010. Clinical Psychology Review, 32, 690–703.PubMedCentralPubMedCrossRefGoogle Scholar
  8. Cunningham, J. A., Hendershot, C. S., Murphy, M., & Neighbors, C. (2012). Pragmatic randomized controlled trial of providing access to a brief personalized alcohol feedback intervention in university students. Addiction Science and Clinical Practice, 7, 21.PubMedCrossRefGoogle Scholar
  9. Dimeff, L. A., Baer, J. S., Kivlahan, D. R., & Marlatt, G. A. (1999). Brief alcohol screening and intervention for college students (BASICS): A harm reduction approach. New York: Guilford Press.Google Scholar
  10. Ekman, D. S., Andersson, A., Nilsen, P., Stahlbrandt, H., Johansson, A. L., & Bendtsen, P. (2011). Electronic screening and brief intervention for risky drinking in Swedish university students—a randomized controlled trial. Addictive Behaviors, 36, 654–659.PubMedCrossRefGoogle Scholar
  11. Elliott, J. C., Carey, K. B., & Bolles, J. R. (2008). Computer-based interventions for college drinking: A qualitative review. Addictive Behaviors, 33, 994–1005.PubMedCentralPubMedCrossRefGoogle Scholar
  12. Hingson, R. W., Heeren, T., Zakocs, R. C., Kopstein, A., & Wechsler, H. (2002). Magnitude of alcohol-related mortality and morbidity among US college students ages 18–24. Journal of Studies on Alcohol, 63, 136–144.PubMedGoogle Scholar
  13. Hustad, J. T. P., Barnett, N. P., Borsari, B., & Jackson, K. M. (2010). Web-based alcohol prevention for incoming college students: A randomized controlled trial. Addictive Behaviors, 35, 183–189.PubMedCentralPubMedCrossRefGoogle Scholar
  14. Kypri, K., Samaranayaka, A., Connor, J., Langley, J. D., & Maclennan, B. (2011). Non-response bias in a web-based health behavior survey of New Zealand tertiary students. Preventive Medicine, 53, 274–277.PubMedCrossRefGoogle Scholar
  15. Kypri, K., Saunders, J. B., Williams, S., McGee, R. O., Langley, J. D., Cashell-Smith, M. L., et al. (2004). Web-based screening screening and brief intervention for hazardous drinking: A randomized controlled trial. Addiction, 99, 1410–1417.PubMedCrossRefGoogle Scholar
  16. Laguilles, J. S., Williams, E. A., & Saunders, D. B. (2011). Can lottery incentives boost web survey response rates? Findings from four experiments. Research in Higher Education, 52, 537–553.CrossRefGoogle Scholar
  17. Larimer, M. E., Lee, C. M., Klimer, J. R., et al. (2007). Personalized mailed feedback for college drinking prevention: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 75, 285–295.PubMedCentralPubMedCrossRefGoogle Scholar
  18. Lewis, M. A., & Neighbors, C. (2007). Optimizing personalized normative feedback: The use of gender-specific referents. Journal of Studies on Alcohol and Drugs, 68, 228–237.PubMedCentralPubMedGoogle Scholar
  19. National Institute on Alcohol Abuse and Alcoholism (2007). Helping patients who drink too much: a clinician’s guide: Updated 2005 Edition. Bethesda, MD: National Institutes of Health.Google Scholar
  20. Neighbors, C., Jensen, M., Tidwell, J., Walter, T., Fossos, N., & Lewis, M. A. (2011). Social norms interventions for light and non-drinking students. Group Process and Intergroup Relations, 14, 651–669.CrossRefGoogle Scholar
  21. Neighbors, C., Larimer, M. E., & Lewis, M. A. (2004). Targeting misperceptions of descriptive drinking norms: Efficacy of a computer-delivered personalized normative feedback intervention. Journal of Consulting and Clinical Psychology, 72, 434–447.PubMedCrossRefGoogle Scholar
  22. Neighbors, C., Lewis, M. A., Atkins, D. C., Jensen, M. M., Walter, T., Fossos, N., et al. (2010). Efficacy of web-based personalized normative feedback: A two-year randomized controlled trial. Journal of Consulting and Clinical Psychology, 78, 898–911.PubMedCrossRefGoogle Scholar
  23. Paschall, M. J., Antin, T., Ringwalt, C. L., & Saltz, R. F. (2011). Effects of AlcoholEdu for College on alcohol-related problems among freshmen: A randomized multicampus trial. Journal of Studies on Alcohol and Drugs, 72, 642–650.PubMedGoogle Scholar
  24. Read, J. P., Kahler, C. W., Strong, D. R., & Colder, C. R. (2006). Development and preliminary validation of the young adult alcohol consequences questionnaire. Journal of Studies on Alcohol, 67, 169–177.PubMedGoogle Scholar
  25. Saitz, R., Palfai, T. P., Freedner, N., et al. (2007). Screening and brief intervention online for college students: The iHealth study. Alcohol and Alcoholism, 42, 28–36.PubMedCrossRefGoogle Scholar
  26. Schulenberg, J. E., & Maggs, J. L. (2002). A developmental perspective on alcohol use and heavy drinking during adolescence and the transition to young adulthood. Journal of Studies on Alcohol (Suppl.), 14, 54–70.Google Scholar
  27. Vik, P. W., Carrello, P., Tate, S. R., & Field, C. (2000). Progression of consequences among heavy drinking college students. Psychology of Addictive Behaviors, 14, 91–101.PubMedCrossRefGoogle Scholar
  28. Walters, S. T., & Neighbors, C. (2005). Feedback intervention for college alcohol misuse: What, why, and for whom? Addictive Behaviors, 30, 1168–1182.PubMedCentralPubMedCrossRefGoogle Scholar
  29. Walters, S. T., Vader, A. M., & Harris, T. R. (2007). A controlled trial of web-based feedback for heavy drinking college students. Prevention Science, 8, 83–88.PubMedCrossRefGoogle Scholar
  30. Wechsler, H., Lee, J. E., Kuo, M., & Lee, H. (2000). College binge drinking in the 1990s: A continuing problem: Results of the Harvard School of Public Health 1999 College Alcohol Study. Journal of American College Health, 48, 199–210.PubMedCrossRefGoogle Scholar
  31. Werch, C. E., & Owen, D. M. (2002). Iatrogenic effects of alcohol and drug prevention programs. Journal of Studies on Alcohol, 63, 581–590.PubMedGoogle Scholar
  32. Wood, M. D., Fairlie, A. M., Borsari, B., Capone, C., Laforge, R., & Carmona-Barros, R. C. (2010). Brief motivational and parent interventions for college students: A randomized factorial study. Journal of Consulting and Clinical Psychology, 78, 349–361.PubMedCentralPubMedCrossRefGoogle Scholar
  33. Zisserson, R. N., Palfai, T. P., & Saitz, R. (2007). No-contact interventions for unhealthy college drinking: Efficacy of alternatives to person-delivered approaches. Substance Abuse, 28, 119–131.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Tibor P. Palfai
    • 1
  • Michael Winter
    • 1
  • John Lu
    • 1
  • David Rosenbloom
    • 1
  • Richard Saitz
    • 1
  1. 1.Department of PsychologyBoston UniversityBostonUSA

Personalised recommendations