Grant funds one of the largest controlled studies ofbinge drinkers KINGSTON, R.I.-September 28, 1999 — The University of Rhode Island has been awarded a $1.4 million grant from the National Institute on Alcohol Abuse and Alcoholism for research on a promising new program to curb a problem that plagues colleges nationwide – student binge drinking. The grant will fund one of the largest controlled studies on the issue of binge drinking and one with the potential for having a dramatic impact on the student population. The four-year study entitled, “A Proactive Individualized Program for College Drinkers,” will test an innovative, interactive, and proactive prevention program to reduce high-risk alcohol behaviors. The program uses a computerized expert system that provides individualized feedback on some of the most powerful variables known to influence behavior change. The system is based on the internationally known Transtheoretical Model for behavior change developed at URI. “Most students have little or no intention of changing their binge drinking behaviors because they don’t think they have a problem,” said Robert Laforge, URI associate professor of research psychology who has researched alcohol issues for more than 20 years and is principal investigator of the study. “Our initial studies suggest that moving students just one step along in the stages of behavior change – from the ‘Precontemplation’ or the ‘not even thinking about the issue’ stage to the ‘Contemplation’ or ‘considering the issue’ stage – may cut the rate of binge drinking by 50 percent. Right now, at least two thirds of the binge drinkers are in the precontemplation stage, so there’s a tremendous opportunity to reach this population and have a significant impact.” The study will focus on students during a high-risk transition period – the freshmen and sophomore years – who research has shown tend to binge more than older students. More than 1,420 students are expected to participate and will be randomly assigned to one of three groups, and assessed periodically over a three-year period. The URI researchers will measure drinking rates, alcohol behaviors, and alcohol-related problems, to determine whether the targeted behavior change intervention is working. “This grant is one example of the way in which we’re not only changing the culture, but helping students actually learn to change their high risk behaviors along the way. The grant also creates opportunities for students to be actively involved in research that will make a positive difference in the lives of their friends and other college students nationwide,” said URI President Robert L. Carothers. Fueled by the need to find better ways to prevent and treat substance abuse problems at colleges and universities nationwide, the study focuses most closely on the issue of binge drinking which is defined as the consumption of at least four (for women) or five (for men) drinks in a row at one sitting. “This project brings the missing ingredient to the surface in our efforts to address binge drinking,” said URI Dean of Students Fran Cohen. “While the administration develops alternative student programs, enforces its stringent alcohol policies, and generally works to educate students, this program will complement our efforts by delivering the individualized attention students need to help them make healthy decisions about their drinking. “It’s a fresh approach that may lead to a significant outcome for our student body and others nationwide,” she added. “Many well-intentioned health promotion programs fail because they send action-oriented messages to students who are not ready to make a change,” explained Laforge who is also a founding member of the Alcohol Team of the University’s Health Promotion Partnership. “This study will provide messages tailored to the individual student’s level of readiness to change and help to move them along in the process of reducing their high-risk drinking behaviors.” To accomplish this, the program is guided by the Transtheoretical Model of behavior change that has had great success helping people to change other high-risk behaviors such as smoking, improving nutrition and exercise programs, reducing sun exposure, among others. Developed by URI Professor and Cancer Prevention Research Center (CPRC) Director Dr. James O. Prochaska and his colleagues, the model identifies five stages through which individuals move in changing a given behavior. These stages are: Precontemplation, for which the goal is to think more seriously about change; Contemplation, where the goal is to become convinced that change is worthwhile; Preparation, where the goal is to get ready to take action; Action, where the goal is to ‘make your move;’ and Maintenance in which the goal is to continue progress made. The transtheoretical model-based interventions for college binge drinkers match each student’s awareness of drinking as a problem and readiness to change the behavior. Those who are prepared to make a change receive information designed to help them be successful, whereas those less ready to change receive information focused on motivating them to begin the change process. The model, if successful, can be easily shared with and replicated at other colleges. Co-investigators on the grant are Cohen and Prochaska as well as: Psychology Professors Wayne F. Velicer and Joseph Rossi; CPRC Assistant Professor of Research, Colleen A. Redding; Psychology Assistant Professor Mark Wood; and John S. Baer of the University of Washington. The NIAAA grant is only the latest received by URI for its alcohol research and intervention work. URI has also been awarded $600,000 in grants since 1990 to fund alcohol education and prevention programs. URI Alcohol Research Grant Questions and Answers Is binge drinking a problem? College administrators consider alcohol abuse the number one problem on campuses nationwide. Heavy drinking is related to a host of other problems – sexual assault, property damage, missed classes, and accidents. College students themselves typically have little awareness that binge drinking is a problem, or are not motivated to change. How big is the problem with binge drinking? Almost half of all college students report heavy episodic or binge drinking, and about 20 percent do so frequently. Freshmen and sophomores are even more likely to engage in experimental and hazardous drinking than are older students. Our research has shown that over two thirds of college student binge drinkers do not intend to change their drinking behaviors in the near future. What is unique about this research project? This study focuses on testing a promising new low-cost means to help college drinkers reduce harmful or risky drinking behaviors. As such, it does not rely on the environmental or policy initiatives undertaken by college administrators, but rather complements these efforts by assisting each individual in making healthy decisions about their drinking. Many well-intentioned health promotion programs fail because they send action-oriented messages to students who are not ready to make a change. This study will provide messages tailored to the individual student’s level of readiness to change. The program was developed to address the needs of the entire population of college drinker, with intervention messages matched to each drinker’s level of risk and readiness to move them along in the process of change. It uses expert system-based technology to deliver a low-cost individualized behavior change program designed to reduce the period in which college students engage in high risk drinking behaviors. The intervention is based on an adaptation of the Transtheoretical Model of Behavior change, developed by URI Professor James Prochaska and colleagues, and is modeled after successful programs that have helped thousands to change their smoking behaviors, increase exercise, and change dietary and other health risks. What is the purpose of the study? The purpose of the study is to test a program that is designed to help young college students to reduce the damage and shorten the length of time that they spend experimenting with high risk drinking behaviors – binge drinking, driving/riding under the influence, etc. The study will evaluate a low-cost computer-assisted method of delivering health-promoting feedback designed to reduce the frequency and intensity of hazardous drinking behaviors among students at risk. What is the primary goal? The primary goal of the study is to help college students reduce the frequency and intensity of harmful drinking, and to shorten or eliminate the period after entering college when students will engage in risky drinking behaviors. In effect, to accelerate the maturing process of these young students by moving the population along the stages of change. What evidence do you have that your study will work? We have found that those students who engage in high risk drinking and have the highest number of alcohol problems, are also the least ready to change their drinking patterns. We estimate that by moving students in the Precontemplation stage (over two thirds of all binge drinkers) just one stage to Contemplation, we can cut the rate of binge drinking and related problems in half. Who will be the target of the study? Approximately, 2,800 freshmen and sophomore students will be eligible to participate. 1400 volunteers will be randomly assigned to intervention study. This study will focus on the highest risk group; freshmen and sophomore students who are current drinkers or who indicate that they intend to begin drinking in the coming year. How will the study be conducted? This is a four-year randomized controlled study that is designed to evaluate the effectiveness of a low-cost cognitive-behavioral intervention designed to help each drinker to be ready to reduce their high risk alcohol behaviors. Each student will be asked to complete a standardized survey over the telephone, and the treatment group will receive individualized feedback reports in the mail following the survey assessment. The intervention will use standardized measures and computer expert system technology to provide feedback to student drinkers that is matched to the motivational readiness and individual risk profiles of each student. The rates of high risk drinking behaviors and alcohol problems will be compared one and two years after the intervention period to evaluate the effectiveness of the intervention. How does URI compare with other colleges? URI undergraduates binge drink at rates similar to other public colleges across the nation. On the plus side, surveys of URI undergraduates conducted by the Harvard School of Public Health in 1993 and 1997 indicate that binge drinking at URI has decreased by about 13 percent. Still, approximately half of URI students report binge drinking. For More Information: Linda Acciardo, 401-874-2116 or Jhodi Redlich, 401-874-2116