Reducing High Risk Drinking by Using Personalized  Blood Alcohol Cards

Presented at the 2001 American Psychological Association Annual Convention
Luis G. Manzo, Ph.D., University of Notre Dame
Karen J. Forbes, Ph.D., Lafayette College

OVERVIEW
Previous studies of high risk drinking among college students have found that fairly simple, brief interventions with students who engage in high risk drinking can have a significant effect on the reduction of alcohol-related consequences (Agostinelli, Brown, & Miller, 1995, Baer, Marlatt, Kivlihan, Fromme, Larimer, & Williams, 1992; Bien, Miller, & Tonigan, 1993; Murgraff, White, & Phillips, 1996; Walters, 2000). Several of these approaches (Agostinelli et al., 1995; Murgraff, White, & Phillips, 1996; Walters, 2000) involved only written, mailed feedback with no individual contact between counselors and students. Not only have these brief interventions been effective in reducing the target behavior of high risk drinking, but they also appear to be cost effective in regard to the limited staff and funding resources usually available at college and university counseling centers. The Brief Alcohol Screening and Intervention for College Students (BASICS; Dimeff, Baer, Kivlihan, & Marlatt. 1999), is an empirically validated, brief intervention designed to reduce harm associated with high risk drinking in college students. A component of the BASICS program which does not require face-to-face interaction is the distribution of a pocket-sized card with a blood alcohol concentration chart to each student based on his or her weight and gender. The present study was undertaken to determine if mailing students  personalized BAC cards and written instructions alone would be effective in reducing high risk drinking as well as in preventing the occurrence of problems for those students who may be just beginning to develop more serious problems with alcohol.

METHODOLOGY
One hundred and eighteen (females n = 79 and males n = 39) participants were recruited from within sections of an Introductory Psychology course taught at a small private college in the Northeast. Participants were randomly assigned to either an experimental (n=60) or control group (n=58).  Each student completed a series of counterbalanced measures including a questionnaire with questions about gender, age, race/ethnicity, and weight, the Rutgers Alcohol Problem Index ( RAPI: White & Labouvie, 1989) which assesses alcohol-related problems which commonly occur in a student population, and a Timeline Follow-Back assessment (Sobell & Sobell, 1992) in which participants use a calendar-type form to provide a context for reporting their drinking patterns over the past month.  The Timeline Follow-Back calendar was modified so that participants could record the number of days they consumed alcohol, the number of standard drinks consumed on each drinking day, and the number of hours they spent drinking.  The information contained on the Timeline-Follow Back calendar and each participant's gender and weight were used to determine the approximate blood alcohol concentration for each participant during each drinking occasion.  For each participant, the number of drinking occasions in which his or her BAC was above .06 was calculated.  Additionally, a ratio was calculated which reflected the percentage of time that each participant consumed alcohol as compared to the percentage of time his or her BAC surpassed .06.

Students in the experimental group received a personalized blood alcohol card and a brochure via campus mail.  The brochure, entitled  “Staying in the Zone," designed especially for this study, explained how participants could effectively use the BAC card to estimate their BAC and to reduce their risk from alcohol by drinking within their  “green zone.”   The green zone on each card represents when the individual’s blood alcohol concentration is below .06. Those in the control group received no additional information regarding alcohol use.   One month after the initial assessment, ninety-six participants (female n=68 & male n=28; experimental n=53 & control n=43) completed the same measures and a number of additional questions about their perception of the usefulness of the BAC cards.

RESULTS and CONCLUSIONS
Ninety-six participants completed the follow-up assessments.  Of these 96 participants, 18 (female n=15 & male n=3; experimental n=6 & control n=12) reported that they did not consume any alcohol and thus were eliminated from future analyses.  Thus, analyses were conducted on 78 participants  (experimental group: female n=34 & male n=14, total n=48; control group: female n=18 & male n=12, total n = 30).  A 2 (experimental/control group)  x 2 (percentage of time BAC was above .06 for time 1 and 2)  repeated measures analysis of variance showed a non-significant main effect for percentage of time BAC was above .06 over time, F ( 1, 76) = .413, p = .523 (Table 1).   However, there was an interaction between treatment group and percentage of time BAC was above .06 for time 1 and 2 that approached significance, F (1, 76) = 3.819, p = .054 (Figure 1). Post hoc analyses revealed significant differences between the two groups at time 2, F ( 1, 76) = 4.83, p = .031. Those participants who received personalized BAC cards reduced the average time their BAC surpassed .06 by approximately 8% (time 1: M =   64.96, SD = 34.39: time 2: M = 59 .91, SD = 32.28) , whereas those in the control group increased the percentage of time their BAC surpassed .06 by approximately 15% (time 1: M =  65.93, SD = 34.24: time 2; M =75.93, SD = 32.07). A 2 (experimental v. control) X 2 (time) repeated measures ANOVA with total RAPI score as the dependent variable produced no significant effects:main effects: F(1,70) =.168, P=.68  NS; interaction effects: F(1,70) = .823, P=.824  NS. (note: Differences in df among analyses reflect missing data).

These results suggest that the BAC cards and brochures may curb the increase in high-risk alcohol consumption that would otherwise occur over the course of the semester. This simple, inexpensive intervention appears to hold promise as a way to reduce high risk drinking among college students and lends support to earlier findings that face to face meetings with a counselor are not required in order to effect change. However the lack of a diverse sample highlights the need for replication of these results with students from a variety of racial and ethnic backgrounds and class years.

REFERENCES

Agostinelli, G., Brown, J.M., & Miller, W.R. (1995). Effects of normative feedback on consumption among heavy drinking college students. Journal of Drug Education, 25, 31-40.

Baer, J.S., Marlatt, G.A., Kivlahan, D.R., Fromme, K., Larimer, M.E., & Williams, E. (1992). An experimental test of  three methods of alcohol risk reduction with young adults. Journal of Consulting and Clinical Psychology, 60, 974-979.

Dimeff, L.A., Baer, J.S., Kivlahan, D.R., & Marlatt, G.A. (1999). Brief alcohol screening and intervention for college  students: A harm reduction approach. New York: Guilford Press.

Murgraff, V., White, D., & Phillips, K. (1996). Moderating binge drinking: It is possible to change behavior if you plan it in advance. Alcohol and Alcoholism, 31, 577-5822

Sobell, L.C. & Sobell, M.B. (1992). Timeline follow-back. A technique for assessing self-reported alcohol consumption.  In R. Litten &  J. Allen (Eds.). Measuring Alcohol Consumption (pp.41-69). The Humana Press.

Walters, S.T. (2000). In praise of feedback: An effective intervention for college students who are heavy drinkers. Journal of American College Health, 48, 235-238.

White, H.R. & Labouvie, E.W. (1989). Towards the assessment of adolescent problem drinking. Journal of Studies on Alcohol, 50, 30-37.

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