Heavy alcohol consumption and sexual assault are interrelated issues among college women. Brief mobile-based interventions address these problems by overcoming traditional barriers such as cost and stigma and have demonstrated efficacy in reducing distress and alcohol use in the short term. However, maintaining long-term outcomes remains a persistent challenge, which has been found to depend on skill utilization—individuals’ engagement with and application of intervention content. In this regard, prior research has yielded mixed findings: while some studies have indicated that skill utilization predicts alcohol outcomes more strongly than session length, other studies have found no significant effects. Moreover, the majority of evidence has been derived from in-person interventions, leaving the role of skill utilization in mobile-based settings unclear. Therefore, the present study aims to examine the impact of skill utilization on alcohol use outcomes over a six-month period following a brief mobile-based intervention among heavy-drinking college women with sexual assault histories.
This study examined 77 college women from a large metropolitan university in the Pacific Northwest who had a lifetime history of sexual assault and met heavy drinking criteria (at least two heavy drinking episodes in the past month and seven or more standard drinks weekly). Participants completed a baseline survey and were randomized to either an intervention or assessment-only control condition; those in the intervention condition received 14 consecutive days of brief online skill modules (5-10 minutes each) after daily surveys, with seven modules targeting emotion regulation and seven focusing on alcohol reduction strategies. Follow-up surveys were administered post-treatment and at 1-month and 6-month post-treatment to assess alcohol use and skill utilization. Multilevel mixed-effects logistic regression models evaluated associations between skill utilization and two alcohol outcomes: weekly drinking threshold and heavy drinking threshold.
Analysis of weekly drinking outcomes (Model 1) revealed that women were more likely to be below the weekly drinking threshold (seven drinks per week) at the 6-month follow-up, and women who utilized alcohol reduction strategies more frequently on average were more likely to remain below the threshold throughout the follow-up period, with these effects remaining stable over time. Analysis of heavy drinking outcomes (Model 2) showed that women were more likely to be below the heavy drinking threshold at the 1-month follow-up, and women who utilized emotion regulation skills more frequently were more likely to remain below the threshold overall. However, time-varying effects emerged at the 6-month follow-up, revealing contrasting patterns whereby greater-than-usual use of emotion regulation skills marginally increased heavy drinking risk, while greater-than-usual use of alcohol reduction strategies marginally decreased heavy drinking risk.
Takeaway: Consistent use of alcohol reduction strategies appears to be a key mechanism through which mobile-based interventions reduce risky drinking among college women with sexual assault histories.