(PS1-B28) Enhancing an Electronic Brief Alcohol Intervention with Self-affirmation: A Randomized Controlled Trial with Mandated College Drinkers

Rationale: Young adults who violate campus alcohol policy are often mandated to participate in alcohol misuse prevention interventions. This study aimed to enhance the impact of an established and moderately effective electronic alcohol intervention (personalized normative feedback or PNF) by preceding it with a theory-based self-affirmation exercise. Theory and evidence indicate that affirming the value of the self before exposure to a threatening message should foster a more open-minded appraisal of message content. We predicted that mandated college student drinkers who engaged in a self-affirmation (SA) exercise would demonstrate greater risk reduction as a response to PNF.

Methods: Participants were 484 undergraduates (age 18 – 24, 56% male, 78% White) who were required to participate in an alcohol intervention following a first-time alcohol policy violation. Study participation was voluntary, and monetary compensation was limited to completion of follow-up assessments. After completing a baseline assessment, each was randomized to either self-affirmation (SA, n=256) or attention control (AC, n=227) prior to a computer-delivered PNF intervention. Post-test measures included an affirmation manipulation check; primary alcohol outcomes (past month weekly quantity, peak drinks, binge frequency, consequences) were assessed at 1-, 3-, 6-, 9-, and 12-month follow-ups. The study began before COVID restrictions were in place and continued after students returned to on-campus learning.

Results: Preliminary analyses confirmed that the SA exercise resulted in higher scores on the self-evaluation manipulation check at post-test (4.05 +/- .64 vs 3.01 +/- .69), t(481) = -17.07, p < .001. We used Latent Growth Curve Modeling to test the primary study hypotheses. Covariates included sex, year in school, race, baseline and time-varying COVID indicators, and baseline values of the outcome. Depending on the outcome, linear, quadratic, and piecewise models provided the best fit to the data. Overall reductions in drinking and consequences were observed with significant negative slopes at early follow up (all ps < .05), but the SA manipulation was not associated with intercept or slope factors in the models. COVID at baseline was associated with suppression of drinking and consequences over follow-up.

Conclusion: The participants in this study may have experienced COVID-related life disruptions relevant to the main outcome variables in this study. In this context, the SA exercise did not differentially affect trajectories of alcohol use and consequences, beyond the effect of PNF, despite evidence that the exercise had the predicted effect on participant’s self-evaluations. The lack of SA effects could be attributed to a PNF intervention that is generally accepted among mandated students and did not present a threat to the self.