A new study tested the feasibility, acceptability, and preliminary efficacy of a social norms text messaging intervention to correct misperceptions in drinking norms and reduce risky drinking among college students. Participants were 68 second-year U.S. college students who met the NIAAA criteria for risky drinking and used text messaging at least weekly. Individuals were excluded from this study if they disclosed they were in treatment for alcohol use disorder or scored 20 or higher on the alcohol use disorders identification test (AUDIT). All participants completed a baseline survey, on which they reported their demographic information, number of drinks consumed per drinking day in the past month, past-month frequency of heavy episodic drinking (HED), estimated past-month peak blood alcohol concentration (BAC), and past-month alcohol-related consequences. Participants were also asked to estimate the number of drinks a typical student of their own gender consumed per drinking day (descriptive norm), as well as the level of approval or disapproval they believed their peers had for drinking, drinking 5 or more drinks on one occasion, and getting drunk (injunctive norms). Participants were then randomly assigned to either the experimental group (in which they received daily text messages regarding injunctive and descriptive norms for drinking, alcohol consequences, and protective behavioral strategies) or a control group (in which participants received a daily fun fact text message). Both groups received daily text messages for 28 days and then completed a follow-up survey of normative perceptions and drinking behaviors. Participants also reported their levels of interest in each text message and their overall satisfaction with the intervention. The authors used t-tests to analyze between-group differences and within-group changes in outcomes. ANCOVAs with baseline levels of the outcome as a covariate were used to compare pre- and post-test means. Results indicated control group participants rated the fun facts as more interesting than experimental group participants rated their text messages, but both groups reported overall satisfaction with the program. ANCOVAs revealed no significant group differences at follow-up. Within-group t-tests showed significant reductions in experimental group reported frequency of HED, estimated peak BAC, and reported consequences. Both groups significantly reduced in injunctive drinking norms and the control group significantly reduced in drinking norms. Between-group effect sizes showed the experimental group reported larger reductions in frequency of HED, estimated peak BAC, alcohol consequences, and injunctive norms, while the control group reported larger reductions in typical number of drinks consumed per drinking day and descriptive norms. The authors believed there was contamination between the groups caused by participants sharing the text messages with friends.
Take away: In this small, randomized controlled trial of a text message intervention to correct descriptive and injunctive drinking norms, all participants found the program to be acceptable and satisfactory. Although no between-group differences in drinking behaviors were observed at follow-up, participants in the experimental group showed significant reductions in risky drinking behaviors and injunctive drinking norms from baseline to follow-up.