The goal of this study is to implement an adaptive preventive intervention that optimizes the transition from universal to indicated resources to reduce heavy drinking and related consequences among college students. Using a sequential multiple assignment
randomized trial (SMART) design (N=700 college students), the major goals of this project are to:
Aim 1 (Primary). Examine the main effect of adaptive preventive intervention (API) vs. assessment only. We hypothesize that students who receive a first-semester API?which includes universal PNF+SM (delivered prior to vs. after the start of college), and then the offer of indicated services (via mBridge vs. automated tailored email) for heavy drinkers?will have reduced binge drinking (primary outcome) and consequences and health services utilization (secondary outcomes) up to one year later.
Aim 2 (Secondary). Identify the most effective and cost-effective API of the four embedded in the SMART. We hypothesize that the API that provides PNF+SM before college followed by mBridge for heavy drinkers will lead to the lowest frequency of heavy drinking and to greatest cost-effectiveness. This analysis will also provide estimates of the component effects of (a) the timing for PNF+SM universal prevention, and (b) the strategy (mBridge [vs. automated]) for motivating students who continue to drink heavily to utilize additional resources.
Aim 3 (Tertiary). Identify how to optimize the API by examining moderators, specifically pre-college (a) alcohol use norms or (b) intentions for college drinking on the effect of the timing of PNF+SM and college (c) high-intensity drinking (i.e., 8/10+ drinks) vs. binge (4/5+ drinks) on the transition to indicated intervention.