Brief alcohol intervention for college drinkers: How brief is?

Abstract

Objective

Brief interventions for college student drinkers have been shown to be effective in reducing the amount of alcohol consumed as well as the number of alcohol-related problems. However, the duration of brief interventions varies substantially across studies.

Method

In the present study 114 undergraduate students who drank alcohol heavily were randomly assigned to a 10-minute brief intervention, a 50-minute brief intervention, or assessment-only control. The content of the active interventions was based on the same concept, and both interventions incorporated motivational interviewing components. Participants were assessed at baseline and 4-week post intervention on quantity of alcohol use, alcohol-related problems, and protective behavioral strategies.

Results

As hypothesized, there was a significant difference between participants in the 10-minute intervention and control condition regarding their alcohol consumption at 4-week follow up. However, there was no significant difference between the 50-minute intervention and the control condition on alcohol consumption. There were also no significant differences between active intervention conditions, and neither intervention showed advantages for reducing problems or increasing protective behaviors relative to the control condition.

Conclusions

Results suggest a very brief intervention can impact short-term alcohol use outcomes, with potentially no advantage of longer interventions for this population.

Introduction

Heavy drinking poses a major problem on college campuses (Wechsler, Lee, Kuo & Lee, 2000). In 2005, 44.7% of college students reported heavy drinking in the past month, an increase from 41.7% in 1999 (Hingson, Zha & Weitzman, 2009). Heavy drinking is also associated with high risk and illegal behaviors (Abbey, 2002, Cooper, 2002, Wechsler et al., 1998).

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Task Force on College Drinking Prevention, components of a successful college drinking intervention are: motivational enhancement, cognitive-behavioral intervention, and skills training (United States Department of Health and Human Services (USDHHS), National Institute of Alcohol Abuse and Alcoholism, 2002). Brief Alcohol Screening and Intervention for College Students (BASICS) is a brief motivational intervention (BMI) incorporating all of these elements (Dimeff, Baer, Kivlahan & Marlatt, 1999). BASICS and related BMIs have been found to be efficacious in numerous studies (Marlatt et al., 1998, Larimer & Cronce, 2002, Larimer & Cronce, 2007, Carey et al., 2007).

Unfortunately, there is a scarcity of research investigating mechanisms of action of BMIs (Walters & Neighbors, 2005), and several questions persist regarding necessary elements of such interventions (e.g., Saunders, Kypri, Walters, Laforge & Larimer, 2004). One question concerns the sufficient length or dosage of intervention necessary to produce effects (Larimer, in Saunders et al., 2004). For example, both Marlatt et al. (1998) and Dimeff and McNeely (2000) found BMIs to be efficacious in reducing college student alcohol use and problems. However, length of the BMIs (i.e. 50 minutes in Marlatt et al. and 5 minutes in Dimeff & McNally) and delivery method (i.e. health practitioner in medical setting versus clinical psychology graduate student in mental health clinic) differed between studies. Findings suggest both 5- and 50-minute BMIs successfully reduce alcohol use and consequences. However, no studies to date have directly compared the efficacy of different lengths of the same intervention in college populations.

Research with other populations suggests that longer and shorter interventions may achieve similar outcomes in adult problem drinkers (Wutzke, Conigrave, Saunders & Hall, 2002). Preliminary evidence also suggests shorter interventions may achieve better results in some populations. Petry, Weinstock, Ledgerwood and Morasco (2008) randomly assigned adults with gambling problems to: a) 10-minutes of brief advice (BA); b) one session of Motivational Enhancement Therapy (MET); c) one session of MET plus 3 sessions of Cognitive Behavioral Therapy; and d) assessment only control. At 6-week follow up, only the BA condition, as compared to control, lead to significant reductions in gambling. Participants in the BA condition also showed clinically significant reductions in gambling at 9-month follow up.

These studies suggest that, at least for adult nondependent drinkers and problem gamblers, short interventions may be at least as effective as longer ones. Still, this question has not been tested with college populations. If a shorter interventions is as effective as a longer intervention, the least invasive and burdensome treatment should be employed (Sobell & Sobell, 2000). Additionally, it is reasonable to assume shorter interventions are less costly than longer ones; thus, shorter interventions are a more economically prudent choice if both are found to be equally effective.

The present study addressed this question through conducting a clinical trial with heavy drinking college students randomized to a 10-minute BMI, a 50-minute BMI, or a six week wait-list control group. Both BMIs were based on BASICS (Dimeff et al., 1999). We assessed participants’ drinking, drinking related problems, and protective behavioral strategies 4 weeks post intervention (both intervention groups) and 4 weeks post assessment (control group) to determine efficacy of the interventions in comparison to each other and to the control group. We hypothesized that both the 50-minute and 10-minute BMIs would produce significantly greater reductions in alcohol use and related problems and significantly greater increases in use of protective behavioral strategies than the control condition. We further tested whether the 50-minute BMI would be more efficacious than the 10-minute BMI on these outcomes.