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Short-term evaluation of a web-based college alcohol misuse and harm prevention course (College Alc).


Abstract

This study examined the short-term Short-term

Any investments with a maturity of one year or less.


short-term

1. Of or relating to a gain or loss on the value of an asset that has been held less than a specified period of time.
 effects of a web-based alcohol misuse and harm prevention course (College Alc) among incoming freshmen at a California California (kăl'ĭfôr`nyə), most populous state in the United States, located in the Far West; bordered by Oregon (N), Nevada and, across the Colorado River, Arizona (E), Mexico (S), and the Pacific Ocean (W).  public university. Analysis results indicated that at the end of the fall semester se·mes·ter  
n.
One of two divisions of 15 to 18 weeks each of an academic year.



[German, from Latin (cursus) s
, students randomly assigned as·sign  
tr.v. as·signed, as·sign·ing, as·signs
1. To set apart for a particular purpose; designate: assigned a day for the inspection.

2.
 to College Alc (n = 173) had a higher level of alcohol-related knowledge and less positive attitude toward alcohol use than students in the control group (n = 197). Students assigned to College Alc also reported a somewhat higher level of intentions to use strategies to minimize alcohol-related harm. College Alc did not have any effects on other targeted psychosocial psychosocial /psy·cho·so·cial/ (si?ko-so´shul) pertaining to or involving both psychic and social aspects.

psy·cho·so·cial
adj.
Involving aspects of both social and psychological behavior.
 factors (e.g., alcohol expectancies), alcohol use and heavy drinking
  • Heavy drinking may mean drinking large amounts of water or alcohol.
  • Heavy drinking may also mean drinking alcohol to the point of Drunkenness.
, and alcohol-related problems. Observed effect sizes were generally small, suggesting that College Alc may have no effect on students' risk for alcohol misuse and related harm.

Key Words: college students, alcohol use, heavy drinking, harm prevention

INTRODUCTION

The incidence of heavy alcohol use and alcohol-related problems remains unacceptably high among college students. National surveys indicate that approximately 40% of college students report heavy drinking (five or more consecutive alcoholic beverages

Main article: Alcoholic beverage
Fermented beverages
  • Beer
  • Ale
  • Barleywine
  • Bitter ale
) at least once in the prior two weeks (Johnston, O'Malley, & Bachman 2003; Wechsler et al., 2002). It is estimated that alcohol misuse contributes to over 1,400 deaths, over 500,000 unintentional injuries unintentional injury Accidental injury Public health Any injury caused by an accident. See Injury. , and over 600,000 intentional in·ten·tion·al  
adj.
1. Done deliberately; intended: an intentional slight. See Synonyms at voluntary.

2. Having to do with intention.
 injuries among college students each year (Hingson, Heeren, Zakocs, Hopstein, & Wechsler, 2002). Thus, identifying effective strategies to reduce alcohol misuse and alcohol-related harm among college students has become a public health research priority (National Institute on Alcohol Abuse and Alcoholism The National Institute on Alcohol Abuse and Alcoholism (NIAAA), as part of the U.S. National Institutes of Health, supports and conducts biomedical and behavioral research on the causes, consequences, treatment, and prevention of alcoholism and alcohol-related problems.  [NIAAA NIAAA National Institute on Alcohol Abuse and Alcoholism (National Institutes of Health)
NIAAA National Interscholastic Athletic Administrators Association
NIAAA Northwestern Illinois Area Agency on Aging
], 2002a). Several 2010 Health Objectives focus on alcohol use among college students, such as reducing the percentage of college students engaging in heavy or "binge" drinking to 20%, and increasing the percentage of students who receive information on health risk behaviors, including alcohol use, from 6% to 25% (U.S. Department of Health and Human Services Noun 1. Department of Health and Human Services - the United States federal department that administers all federal programs dealing with health and welfare; created in 1979
Health and Human Services, HHS
, 2000).

Although a number of effective intervention A procedure used in a lawsuit by which the court allows a third person who was not originally a party to the suit to become a party, by joining with either the plaintiff or the defendant.  strategies have been identified for students with a history of heavy or problem drinking, less rigorous research has focused on universal prevention strategies that may benefit all students (Larimer & Cronce, 2002; NIAAA, 2002b; Walters, Hester, Chiauzzi, & Miller, 2005). Despite limited research, many universities are now using interactive computer--or web-based programs (e.g., Alcohol Edu) to reach large numbers of students, such as incoming freshmen who are especially vulnerable to alcohol misuse and alcohol-related problems (Gruenewald, Johnson, Light, Lipton, & Saltz, 2003). These programs incorporate some of the features of effective strategies recommended by an NIAAA Advisory Council Task Force, such as (1) personalized per·son·al·ize  
tr.v. per·son·al·ized, per·son·al·iz·ing, per·son·al·iz·es
1. To take (a general remark or characterization) in a personal manner.

2. To attribute human or personal qualities to; personify.
 feedback to help students monitor their drinking, correct their misperceptions of drinking norms, and clarify their personal values and attitudes toward alcohol use, and (2) research-based information to challenge students' alcohol expectancies (NIAAA, 2002b). These strategies are grounded in well-known theories of problem and health-related behavior (Ajzen, 1998; Jessor & Jessor, 1977), and have been effective in brief interventions A Brief intervention is a technique, similar to an intervention, to help reduce alcohol misuse. It work in two ways:
  • by getting people to think differently about their alcohol use so that they begin to think about or make changes in their alcohol consumption.
 for high-risk students (Latimer & Cronce, 2002; Maddock & Wood, 2000; Walters et al., 2005).

Whether such approaches can be effective for the general student population in a self-administered interactive computer--or web-based format is not clear, as almost none of the existing universal programs have been evaluated using a randomized ran·dom·ize  
tr.v. ran·dom·ized, ran·dom·iz·ing, ran·dom·iz·es
To make random in arrangement, especially in order to control the variables in an experiment.
 controlled design. Despite limited research on their effectiveness, self-administered computer--and web-based programs like Alcohol Edu have become a popular, relatively inexpensive means by which universities can "educate" large numbers of students about alcohol risks and make some effort to prevent alcohol misuse and alcohol-related problems. Some universities now "mandate" student participation in web-based programs such as Alcohol Edu, but without any incentive such as course credit or some type of sanction sanction, in law and ethics, any inducement to individuals or groups to follow or refrain from following a particular course of conduct. All societies impose sanctions on their members in order to encourage approved behavior.  for not completing the program. Thus, little is know about whether students actually complete these self-administered programs or take them seriously, raising further questions about their potential for preventing alcohol misuse and alcohol-related harm.

The present study was conducted to evaluate an abbreviated (3-hour) non-credit version of a new web-based course known as College Alc. College Alc was developed by Tanglewood Research in collaboration with the University of Nebraska's Educational Telecommunications Network A telecommunications network is a of telecommunications links and nodes arranged so that messages may be passed from one part of the network to another over multiple links and through various nodes.  with funding from NIAAA. The College Alc course and accompanying text were developed to improve knowledge, attitudes, and skills to prevent alcohol misuse and alcohol-related harm, incorporating features of effective prevention strategies noted above that were recommended by the NIAAA Task Force. College Alc can be offered for course credit with an instructor or as an abbreviated non-credit course without an instructor. This study was conducted to determine whether an abbreviated non-credit version of College Alc would have short-term effects on students' alcohol related knowledge, attitudes, expectancies, normative nor·ma·tive  
adj.
Of, relating to, or prescribing a norm or standard: normative grammar.



nor
 beliefs, intentions to minimize harm, drinking behavior, and negative drinking consequences. Based on the underlying theory and prior studies (Graham, Tatterson, Roberts, & Johnson, 2004), we expected that College Alc would have somewhat stronger effects on targeted proximal proximal /prox·i·mal/ (-mil) nearest to a point of reference, as to a center or median line or to the point of attachment or origin.

prox·i·mal
adj.
 outcomes, such as students' alcohol-related knowledge and psychosocial factors (e.g., attitudes, expectancies) relative to alcohol use behaviors.

METHOD

Participants and Procedures

Incoming freshmen at a northern California Northern California, sometimes referred to as NorCal, is the northern portion of the U.S. state of California. The region contains the San Francisco Bay Area, the state capital, Sacramento; as well as the substantial natural beauty of the redwood forests, the northern  public university were invited to participate in the College Alc evaluation study during on-campus orientation sessions and through a letter and e-mail recruitment effort in August 2004. They were informed that if they were at least 18 years old and chose to participate, they would be asked to complete an on-line questionnaire before the beginning of the semester and again at the end of the semester. Students were informed that upon completion of the baseline survey they would be randomly assigned to either take the 3-hour, non-credit College Alc online course or the control group. They were also informed that they would receive a check for $10 for each completed survey and a check for $50 if they completed College Alc.

An e-mail invitation followed the mailed invitation letter with instructions on how to access a secure website that hosted the baseline survey. Once they were logged on, a modified version of the consent form was presented. Students clicked on a "consent" button before they were permitted to begin the survey. The informed consent procedure and a data security protocol were approved by an Institutional Review Board.

Our goal was to obtain a baseline sample size of at least 600 students (300 per condition) based on results of power analyses to detect modest short-term College Alc effects, and assuming a 2530% study attrition rate Noun 1. attrition rate - the rate of shrinkage in size or number
rate of attrition

rate - a magnitude or frequency relative to a time unit; "they traveled at a rate of 55 miles per hour"; "the rate of change was faster than expected"


, which would leave approximately 200 students in each study condition with baseline and follow-up survey data. A total of 622 students participated in the baseline survey.

Following the completion of the baseline survey, students were randomly assigned to either the College Alc (n = 310) or control group (n = 312). A stratified stratified /strat·i·fied/ (strat´i-fid) formed or arranged in layers.

strat·i·fied
adj.
Arranged in the form of layers or strata.
 randomization randomization (ranˈ·d·m  procedure was used based on five alcohol use levels (lifetime abstainers, past-year but not lifetime abstinence abstinence: see fasting; temperance movements. , past-year but no past-month alcohol use, past-month alcohol use but no heavy drinking, and any heavy drinking in the past month) to ensure an equal balance of drinking levels in the treatment and control groups at baseline.

Students assigned to the College Alc condition were asked via email to complete the course during the first six weeks of the fall semester. Weekly e-mail reminders were sent to students who hadn't started or completed the course. Approximately one month after the course was closed, all 622 students who completed the baseline were sent an e-mail invitation to participate in the follow-up survey. Of those, 370 completed the follow-up survey and provided complete data for all study variables; 173 of these students were in the College Alc group and 197 were in the control group. Of the students in the College Alc group, 81 completed all five units, 4 completed four units, 4 completed three units, 6 completed two units, 5 completed one unit, and 73 did not complete any units.

College Alc

Topics of the five College Alc units are: College Alcohol Use, Harm Prevention, How it Works (processes by which alcohol affects the brain and behavior), Risky Business (driving, sex, violence), and Practical Solutions. Each unit includes graphics (including a streaming video A one-way video transmission over a data network. It is widely used on the Web as well as company networks to play video clips and video broadcasts. Computers in home networks stream video to digital media hubs connected to a home theater.  clip) and text, interactive animations, online assignments, readings, and a quiz A quiz is a form of game or mind sport in which the players (as individuals or in teams) attempt to answer questions correctly. Quizzes are also brief assessments used in education and similar fields to measure growth in knowledge, abilities, and/or skills. . An online text written by experts in the field accompanies the course (Fearnow-Kenney & Wyrick, 2004, 2005).

All units of the course provide students with content, written assignments, and quizzes designed to improve and test their general knowledge of alcohol processes such as how it affects the brain, how it is absorbed and metabolized, factors affecting absorption and metabolism metabolism, sum of all biochemical processes involved in life. Two subcategories of metabolism are anabolism, the building up of complex organic molecules from simpler precursors, and catabolism, the breakdown of complex substances into simpler molecules, often , sources of influence on drinking behavior, signs of acute and long-term drinking problems, and how to help and/or get help.

Normative beliefs are targeted in several ways. First, students are asked to complete an anonymous survey that measures their perceptions of drinking by other students. These data are summarized for the class and students learn about their peers' level of drinking and attitudes toward alcohol use. Second, students are asked to complete a daily drinking and cost analysis log, which allows them to monitor their own drinking and view a chart that compares their drinking behavior to the class average. Third, students are encouraged to post several of the written assignments and journal entries on the course bulletin board and read the entries of other students. Additionally, social norms is a topic in several of the readings.

Attitudes toward alcohol use are targeted through course bulletin board activities that support interaction between students. Journal entries in each unit allow students to consider the topic presented and their thoughts about it. The "My Stance" journal and bulletin board entries are another way for students to clarify their own attitudes toward alcohol use and gain a better understanding of other students' attitudes.

Alcohol expectancies are targeted in Unit 4: Risky Business. The course text includes a chapter on alcohol expectancies and their influence on drinking behavior, especially as it relates to drunk driving, sexual behavior sexual behavior A person's sexual practices–ie, whether he/she engages in heterosexual or homosexual activity. See Sex life, Sexual life. , and violence. Research on alcohol expectancy A mere hope, based upon no direct provision, promise, or trust. An expectancy is the possibility of receiving a thing, rather than having a vested interest in it.

The term has been applied to situations where an individual hopes and expects to receive something, generally
 challenges is also described. Students are encouraged to consider the expectancies they may hold regarding alcohol use and how those expectancies might influence their behavior regardless of how much alcohol they actually drink.

The course attempts to increase intentions to minimize harm by clearly defining what harm prevention is and presenting a variety of ways that students, college administrators, and the surrounding sur·round  
tr.v. sur·round·ed, sur·round·ing, sur·rounds
1. To extend on all sides of simultaneously; encircle.

2. To enclose or confine on all sides so as to bar escape or outside communication.

n.
 community can minimize alcohol-related harm. A harm prevention plan is assigned to help students think through typical scenarios where harm could be prevented (e.g., setting a limit on number of drinks, avoiding drinking games, planning not to drive after drinking or ride with a driver who has been drinking).

Measures

All measures described below were included in both the baseline and follow-up surveys. Surveys took approximately 20 minutes to complete. Internal consistency In statistics and research, internal consistency is a measure based on the correlations between different items on the same test (or the same subscale on a larger test). It measures whether several items that propose to measure the same general construct produce similar scores.  and/or test-retest reliability test-retest reliability Psychology A measure of the ability of a psychologic testing instrument to yield the same result for a single Pt at 2 different test periods, which are closely spaced so that any variation detected reflects reliability of the instrument  coefficients are reported for all measures. Test-retest reliability coefficients are based only on students in the control group (n = 197) due to potential College Alc effects. With two exceptions (alcohol-related knowledge and intentions to use strategies to minimize alcohol-related harm), all of the measures are identical or very similar to measures of the same constructs used in national surveys such as Monitoring the Future Monitoring the Future is an annual survey given to 50,000 8th, 10th and 12th graders in the United States to determine drug use trends and patterns. The survey started in 1975, with 12th graders. It was expanded in 1991 to include 8th and 10th graders as well.  (Johnston, O'Malley, & Bachman 2003).

Alcohol Use and Heavy Drinking. Frequency of alcohol use in the past month was measured by asking students, "During the past 30 days on how many days did you have alcohol (beer, wine, liquor liquor /li·quor/ (lik´er) (li´kwor) pl. liquors, liquo´res   [L.]
1. a liquid, especially an aqueous solution containing a medicinal substance.

2.
, etc.)?" Seven possible response options ranged from "0 days" to "all 30 days" with corresponding values from 1 to 7. A dichotomous di·chot·o·mous  
adj.
1. Divided or dividing into two parts or classifications.

2. Characterized by dichotomy.



di·chot
 variable was also created to represent students who had and had not consumed con·sume  
v. con·sumed, con·sum·ing, con·sumes

v.tr.
1. To take in as food; eat or drink up. See Synonyms at eat.

2.
a.
 any alcohol in the past 30 days. Students also were asked, "During the past 30 days how many times have you had five or more drinks at a sitting?" Six possible response options ranged from "none" to "10 or more times" with corresponding values from 1 to 6. Similarly, students were asked about the frequency of feeling drunk in the past 30 days. The test-retest reliability coefficients for these three measures were .68, .60, and .48 (p < .001), respectively.

Alcohol-Related Knowledge. To assess students' knowledge of alcohol topics covered in the College Alc course, 20 multiple-choice questions were included in the surveys. For example, students were asked to identify the correct ending for this statement: "The primary aim of alcohol harm reduction strategies is ... (a) to promote abstinence from alcohol, (b) to promote responsible alcohol use, (c) to teach alcoholics to control their drinking, or (d) to diminish negative consequences of intoxication intoxication, condition of body tissue affected by a poisonous substance. Poisonous materials, or toxins, are to be found in heavy metals such as lead and mercury, in drugs, in chemicals such as alcohol and carbon tetrachloride, in gases such as carbon monoxide, and ." The percentage of correct response choices for the 20 questions was determined for each student with a higher value representing greater alcohol competency COMPETENCY, evidence. The legal fitness or ability of a witness to be heard on the trial of a cause. This term is also applied to written or other evidence which may be legally given on such trial, as, depositions, letters, account-books, and the like.
     2.
. The test-retest reliability coefficient coefficient /co·ef·fi·cient/ (ko?ah-fish´int)
1. an expression of the change or effect produced by variation in certain factors, or of the ratio between two different quantities.

2.
 was .49 (p < .001).

Positive Alcohol Expectancies. A five-item scale was used to assess students' positive alcohol expectancies. Students were asked, "How likely or unlikely is it that the following things would happen to you personally if you were to drink 3 or 4 alcoholic beverages? (a) Find it easier to express feelings; (b) Be more confident; (c) Worry less about what other people think of you; (d) Relax in social situations; and (e) Make it easier to act upon your feelings." Response options ranged from "very unlikely" to "very likely" with corresponding values from 1 to 4. A mean response score was computed for each student, with a higher value representing more positive alcohol expectancies ([alpha] = 0.87, test-retest r = .40,p < .001).

Negative Alcohol Expectancies. A five-item scale was used to assess students' negative alcohol expectancies. Students were asked, "How likely or unlikely is it that the following things would happen to you personally, if you were to drink 3 or 4 alcoholic beverages? (a) Have problems with school or work performance; (b) Get nauseated nau·se·at·ed
adj.
Affected with nausea.
 or vomit vomit /vom·it/ (vom´it)
1. to eject stomach contents through the mouth.

2. matter expelled from the stomach by the mouth.
; (c) Fight or argue with friends; (d) Drive under the influence; and (e) Do something you later regretted." Response options ranged from "very unlikely" to "very likely" with corresponding values from 1 to 4. A mean response score was computed for each student with a higher value representing more negative alcohol expectancies ([alpha] = 0.81, test-retest r = .62, p < .001).

Normative Beliefs. To assess prescriptive pre·scrip·tive  
adj.
1. Sanctioned or authorized by long-standing custom or usage.

2. Making or giving injunctions, directions, laws, or rules.

3. Law Acquired by or based on uninterrupted possession.
 norms, students were asked, "How would your closest friends feel about you having one or two drinks of an alcoholic beverage alcoholic beverage

Any fermented liquor, such as wine, beer, or distilled liquor, that contains ethyl alcohol, or ethanol, as an intoxicating agent. When an alcoholic beverage is ingested, the alcohol is rapidly absorbed in the stomach and intestines because it does not
 (beer, wine, liquor) nearly every day?" and "How would your closest friends feel about you having five or more drinks in one sitting?" Five possible responses to these questions ranged from "They would strongly disapprove dis·ap·prove  
v. dis·ap·proved, dis·ap·prov·ing, dis·ap·proves

v.tr.
1. To have an unfavorable opinion of; condemn.

2. To refuse to approve; reject.

v.intr.
" to "They would strongly approve." Corresponding response values ranged from 1 to 5. A mean response score was computed for each student, with a higher score representing greater perceived approval of alcohol use and heavy drinking by peers (r for these two items = .58,p < .01, test-retest r = .73,p < .001).

A six-item scale was used to assess descriptive norms. Students were asked, "How often do (a) your closest friends consume enough alcohol to get drunk to become intoxicated.

See also: Get
 (including beer, wine, wine coolers, and mixed drinks)?" This question was repeated for (b) other college students, (c) fraternity member, (c) sorority sorority: see fraternity.  members, (d) intercollegiate in·ter·col·le·giate  
adj.
Involving or representing two or more colleges.

Adj. 1. intercollegiate - used of competition between colleges or universities; "intercollegiate basketball"
 athletes, and (e) residence hall (dorm) students. Seven possible responses ranged from "never" to "nearly every day". Corresponding response values ranged from 1 to 7. A mean response score was computed for each student with a higher score representing greater perceived heavy alcohol use among college peers ([alpha] = 0.85, test-retest r = .51, p < .001).

Positive Attitudes Toward Alcohol Use and Heavy Drinking. A four-item scale was used to assess students' attitudes towards alcohol use. Students were asked, "How would you feel about your close friends having one or two drinks of an alcoholic beverage (beer, wine, liquor) nearly every day?", "How would you feel about your close friends having five or more drinks in one sitting?", "How do you feel about people (18 and over) having one or two drinks nearly every day?" and "How do you feel about people (18 and over) having four or five drinks nearly every day?" Five possible response options for each question ranged from "I would strongly disapprove" to "I would strongly approve" with corresponding values from 1 to 5. A mean response score was computed for each student with a higher value representing a more positive attitude towards alcohol use and heavy drinking ([alpha] = 0.79, test-retest r = .64,p < .001).

Intentions to Minimize Alcohol-Related Harm. An eight-item scale was used to assess students' intentions to minimize alcohol-related harm. Students were asked, "How likely are you to ... (a) set limits on how many drinks you're going to have on a night out or at a party? (b) discourage a date or friend who is under the influence of alcohol from driving? (c) make plans to avoid driving after drinking? (d) alternate drinking alcoholic alcoholic /al·co·hol·ic/ (al?kah-hol´ik)
1. pertaining to or containing alcohol.

2. a person suffering from alcoholism.


al·co·hol·ic
adj.
1.
 and non-alcoholic beverages
See also:
A non-alcoholic beverage is a beverage that contains no alcohol. Such drinks are generally drunk for refreshment, or to quench people's thirst.
? (e) eat before and/or during drinking? (f) keep track of how many drinks you are consuming? (g) pace drinks to one or fewer per hour? and (h) avoid drinking games?" Response options ranged from "very unlikely" to "very likely" with corresponding values from 1 to 4. A mean response score was computed for each student with a higher value representing greater intentions to minimize alcohol-related harm ([alpha] = 0.76, test-retest r = .47, p < .001).

Negative Alcohol-Related Consequences. A 27-item index was used to assess negative alcohol-related consequences among students who reported any alcohol use in the past 30 days. Students were asked, for example, "In the past 30 days, how often has your drinking caused you to ... (a) get nauseated or vomit? (b) feel tired or hungover? (c) get physically injured in·jure  
tr.v. in·jured, in·jur·ing, in·jures
1. To cause physical harm to; hurt.

2. To cause damage to; impair.

3.
? and (d) hurt another person emotionally or physically?" For each question, six possible response options ranged from "never" to "10+ times" with corresponding values from 0 to 12. Response values were centered for response categories with ranges ("3-5 times" = 4, "6-9 times" = 7.5, "10+ times" = 12) to approximate the actual number of negative consequences in the past 30 days. A summative Adj. 1. summative - of or relating to a summation or produced by summation
summational

additive - characterized or produced by addition; "an additive process"
 score was computed for each student with a higher value representing more negative alcohol-related consequences in the past 30 days. The test-retest reliability, coefficient was .54 (p < .001).

Data Analysis

Preliminary analyses (t-tests) were conducted to assess the equivalence of College Alc and control groups at baseline. Analyses of covariance Covariance

A measure of the degree to which returns on two risky assets move in tandem. A positive covariance means that asset returns move together. A negative covariance means returns vary inversely.
 (ANCOVAs) were then conducted to examine short-term effects of College Alc on alcohol-related knowledge, attitudinal, and behavioral behavioral

pertaining to behavior.


behavioral disorders
see vice.

behavioral seizure
see psychomotor seizure.
 outcomes measured at the end of the fall semester. Following the "intent-to-treat" protocol, all students assigned to the College Alc condition were included in the analyses, regardless of whether they completed the course. We used a statistical significance threshold of .01 for ANCOVAs to avoid Type I errors (i.e., rejecting null hypothesis null hypothesis,
n theoretical assumption that a given therapy will have results not statistically different from another treatment.

null hypothesis,
n
 when it is true) that may result with a large number of statistical tests. In addition to tests of statistical significance, effect sizes were calculated to assess the magnitude of College Alc effects for each dependent variable.

RESULTS

Baseline Characteristics baseline characteristic Medical practice An initial finding or value in a Pt, before any formal intervention  and Comparisons

Characteristics of the total study sample and the College Alc and control groups are provided in Table 1. The mean age was 18.06 (SD = 0.31) with 48% male, 42% Asian, 30% white, 16% Hispanic, 3% Black, and 8% other. Thirty-eight percent of the students reported any alcohol use in the past month while 23% reported any heavy drinking in the past month.

The College Alc and control groups were not significantly different at baseline with respect to almost all of the demographic, psychosocial, and behavioral variables. However, a significantly smaller percentage of Black students (p < .05) who completed baseline and follow-up surveys were in the College Alc group relative to the control group. Therefore, a Black race/ethnicity dummy variable This article is not about "dummy variables" as that term is usually understood in mathematics. See free variables and bound variables.

In regression analysis, a dummy variable
 and the corresponding baseline measure for each dependent variable were included as covariates in subsequent analyses.

College Alc Effects

ANCOVA ANCOVA Analysis of Covariance  results (Table 2) indicated no statistically significant differences between the College Alc and control groups for follow-up measures of past-month alcohol use and heavy drinking. Students assigned to the College Alc condition did have somewhat lower mean frequencies of alcohol use in the past 30 days (1.64 vs. 1.77, p = .14), having five or more drinks in the past 30 days (1.43 vs. 1.58, p = .11), and getting drunk in the past 30 days (1.35 vs. 1.45, p = .13). Effect sizes for these behavioral outcomes were small (< 0.2).

College Alc had significant though modest effects on students' alcohol-related knowledge and attitudes toward alcohol use, but had no effect at the .01 level on any of the psychosocial variables (alcohol expectancies, normative beliefs, and intentions to minimize alcohol-related harm). Students assigned to the College Alc condition had a higher percentage of correct answers to alcohol knowledge questions (43% vs. 38%,p < .01) and a lower mean level of positive attitudes toward alcohol use (1.70 vs. 1.88, p < .01). The mean level of intentions to use alcohol-related harm prevention strategies also was somewhat higher for students assigned to College Alc relative to those in the control group (3.25 vs. 3.14, p = .05). Effect sizes for these outcomes were small to moderate (0.21-0.41).

DISCUSSION

Computer--and web-based programs aimed at preventing alcohol misuse and alcohol-related harm are now being used by many colleges and universities despite limited research on their effectiveness. This study was one of the first to evaluate such a strategy (College Alc) using a randomized controlled design. Our findings suggest that the abbreviated non-credit version of College Alc had small to moderate effects on students' alcohol-related knowledge and attitudes toward alcohol use, but did not have any effect on other psychosocial variables (e.g., alcohol expectancies), though a trend was observed for intentions to minimize alcohol-related harm. College Alc also had no effect on past-month alcohol use and heavy drinking and alcohol-related problems. These findings suggest that the 3-hour, non-credit version of College Alc may have no effect on students' risk for alcohol misuse and alcohol-related problems.

Additional analyses were conducted to compare students who completed all five sections of College Alc (n = 81) versus those in the control group. Results of those analyses were very similar to results reported in Table 2, casting further doubt on the effectiveness of College Alc. Findings of this study are comparable to a recent evaluation of the 45-minute CD-ROM CD-ROM: see compact disc.
CD-ROM
 in full compact disc read-only memory

Type of computer storage medium that is read optically (e.g., by a laser).
 Alcohol 101 program reported by Donahue and colleagues (2004) and other universal or less-intensive educational alcohol abuse prevention programs developed for college students (Graham, Tatterson, Roberts, & Johnson, 2004; Maddock & Wood, 2000).

This study suggests that even with a monetary incentive, many students will choose not to participate in a self-administered web--or computer-based alcohol misuse and harm prevention program, which may limit the potential of this approach for preventing alcohol misuse and alcohol-related problems. Although some universities claim that programs like AlcoholEdu are now "mandatory" for incoming freshmen, there is often little incentive for students to participate or take the program seriously. In recruiting a university for this study, it quickly became apparent that colleges and universities are reluctant to mandate alcohol courses or programs for the general student population, though most schools we approached were willing to offer College Alc as an elective elective

non-urgent; at an elected time, e.g. of surgery.

elective adjective Referring to that which is planned or undertaken by choice and without urgency, as in elective surgery, see there noun Graduate education noun
 or encourage students to complete the abbreviated non-credit version of College Alc. Without an adequate incentive (e.g., course credit), even students who "complete" a web-based course like College Alc may not take the course seriously.

Findings of this study should be considered in light of several limitations. Because our sample was not representative, study findings may not generalize generalize /gen·er·al·ize/ (-iz)
1. to spread throughout the body, as when local disease becomes systemic.

2. to form a general principle; to reason inductively.
 to other college freshmen. Attrition Attrition

The reduction in staff and employees in a company through normal means, such as retirement and resignation. This is natural in any business and industry.

Notes:
 from the study may have biased analyses results in unknown ways. A larger sample size probably would have provided more statistical power to detect modest College Alc effects on psychosocial and behavioral outcomes, though the magnitude of effects may not be affected by increasing the sample size. As noted above, College Alc was implemented with less-than-ideal fidelity (i.e., limited student participation, no course credit or instructor to provide structure, feedback, and help to motivate students), which may have limited its effectiveness.

Although findings of this study suggest that the abbreviated noncredit non·cred·it  
adj.
Of, relating to, or constituting an educational course that does not offer credit toward an academic degree.
 version of College Alc may not have an effect on student-level risk for alcohol misuse and related harm, it may nevertheless complement other campus-wide strategies aimed at reducing the incidence of alcohol misuse and related problems at the campus level. More randomized controlled studies are needed to determine whether our findings are reliable. Additional research is also needed to determine whether College Alc is more or less effective for students at elevated risk for alcohol misuse and related harm (i.e., regular drinkers, members of Greek organizations) relative to infrequent in·fre·quent  
adj.
1. Not occurring regularly; occasional or rare: an infrequent guest.

2.
 drinkers or abstainers, and whether a more comprehensive for-credit version of College Alc is more effective than the abbreviated non-credit version of College Alc examined in this study.

Author Note

Mallie J. Paschall, Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California Berkeley is a city on the east shore of San Francisco Bay in Northern California, in the United States. Its neighbors to the south are the cities of Oakland and Emeryville. To the north is the city of Albany and the unincorporated community of Kensington. ; Melina Bersamin, Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California; Melodie Fearnow-Kenney, Tanglewood Research Inc., Greensboro, North Carolina “Greensboro” redirects here. For other uses, see Greensboro (disambiguation).
Greensboro, North Carolina (IPA: [ɡɹiːnsbʌɹəʊ]) is a city in the U.S. state of North Carolina.
; David Wyrick, Tanglewood Research Inc., Greensboro, North Carolina; David Currey, Pacific Institute for Research and Evaluation, Chapel Hill, North Carolina Chapel Hill is a town in North Carolina and the home of the University of North Carolina at Chapel Hill (UNC-CH), the oldest state-supported university in the United States. As of the 2000 census, it had a population of 48,715. As of 2004 its estimated population was 52,440. .

This study was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (NIAAA Grant 5 R44 AA12874).

Correspondence concerning this article should be addressed to Mallie J. Paschall, Prevention Research Center, Pacific Institute for Research and Evaluation, 1995 University Ave., Suite 450, Berkeley, California 94704, Phone: (510) 883-5753, Fax: (510) 644-0594, email: paschall@pire.org

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Table 1
Baseline Sample Characteristics, Mean (SD) or Percentage

                                                 Total     Collehe Alc
Variable                                       (N = 370)     (n = 173

Male (%)                                         47.6          49.1
Age                                           18.06 (.31)  18.06 (.33)
Hispanic (%)                                     16.5          17.9
Asian (%)                                        41.6          39.3
White (1/6)                                      30.3          34.1
Black (%)                                         3.5          1.2
Other (%)                                         8.1          7.5
Frequency of alcohol use in past 30 days      1.65(l.04)    1.59 (.98)
Frequency of having five or more
  drinks in past 30 days                      1.38 (.94)    1.34 (.88)
Frequency of getting drunk in past 30 days    1.35 (.78)    1.31 (.72)
Alcohol knowledge score (% correct)           35.4 (11.5)  35.6 (11.1)
Positive attitudes toward alcohol use         1.76 (.67)    1.76 (.67)
Positive alcohol expectancies                 2.77 (.81)    2.80 (.80)
Negative alcohol expectancies                 2.56 (.85)    2.57 (.80)
Normative beliefs: Prescriptive norms         2.37 (l.0)    2.36 (1.0)
Normative beliefs: Descriptive norms          4.72 (l.1)    4.71 (1.1)
Intentions to minimize alcohol-related harm   3.30 (.51)    3.32 (.48)
Negative drinking consequences (a)            5.30 (8.70)  6.55 (14.32)

                                              Control Group
Variable                                       (n = 197)

Male (%)                                         46.2
Age                                           18.06 (.30)
Hispanic (%)                                     15.2
Asian (%)                                        43.7
White (1/6)                                      26.9
Black (%)                                        5.6*
Other (%)                                         8.6
Frequency of alcohol use in past 30 days      1.70(l.09)
Frequency of having five or more
  drinks in past 30 days                      1.41 (.98)
Frequency of getting drunk in past 30 days    1.38 (.82)
Alcohol knowledge score (% correct)           35.3 (11.9)
Positive attitudes toward alcohol use         1.76 (.66)
Positive alcohol expectancies                 2.74 (.81)
Negative alcohol expectancies                 2.56 (.89)
Normative beliefs: Prescriptive norms         2.38 (l.0)
Normative beliefs: Descriptive norms          4.73 (1.1)
Intentions to minimize alcohol-related harm   3.28 (.54)
Negative drinking consequences (a)            5.84 (11.17)

(a) Based on students who engaged in any alcohol use in the
last 30 days: College Alc n = 60, Control n = 79.

* p < .05.

Table 2 Adjusted Mean (SD) or Percentage for Each Outcome
Variable, by Study Condition

                               College Alc   Control Group
Variable                       (n = 173)     (n = 197)

Frequency of alcohol
  use in past 30 days           1.64 (.82)    1.77 (.81)
Frequency of having five or
  more drinks in past 30 days   1.43 (.87)    1.58 (.87)
Frequency of getting
  drunk in past 30 days         1.35 (.64)    1.45 (.65)
Alcohol knowledge
  score (% correct)            42.9 (15.3)   37.5 (11.9)
Positive attitudes
  toward alcohol use            1.70 (.57)    1.88 (.56)
Positive alcohol expectancies   2.74 (.74)    2.77 (.73)
Negative alcohol expectancies   2.53 (.66)    2.44 (.66)
Normative beliefs:
  Prescriptive norms            2.38 (.98)    2.44 (1.0)
Normative beliefs:
  Descriptive norms             4.83 (.96)    4.77 (l.0)
Intentions to minimize
  alcohol-related harm          3.26 (.54)    3.14 (.55)
Negative drinking
  consequences (b)             6.03 (20.29)  9.10 (18.80)

                               Effect        p-value
Variable                       Size (a)

Frequency of alcohol
  use in past 30 days              .15           .14
Frequency of having five or
  more drinks in past 30 days      .17           .11
Frequency of getting
  drunk in past 30 days            .16           .13
Alcohol knowledge
  score (% correct)                .41           .00
Positive attitudes
  toward alcohol use               .33           .00
Positive alcohol expectancies      .05           .64
Negative alcohol expectancies      .14           .17
Normative beliefs:
  Prescriptive norms               .06           .37
Normative beliefs:
  Descriptive norms                .06           .48
Intentions to minimize
  alcohol-related harm             .21           .05
Negative drinking
  consequences (b)                 .16           .14

Note: Means and percentages are adjusted for corresponding baseline
covariates and race/ethnicity.
(a) Effect sizes were calculated using the following
formula: [M.sub.College Alc] - [M.sub.control]/[SD.sub.control]

Based on students who engaged in any drinking in the last 30 days:
College Alc n = 61, Control n = 81.
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No portion of this article can be reproduced without the express written permission from the copyright holder.
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Title Annotation:COLLEGE ALCOHOL MISUSE AND HARM PREVENTION
Author:Currey, David
Publication:Journal of Alcohol & Drug Education
Date:Sep 1, 2006
Words:5372
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