Brief Motivational Interventions for College Student Drinking May Not Be as Powerful as We Think: An Individual Participant-Level Data Meta-Analysis

17 de abril de 20154min
  1. David Huh1,*,
  2. Eun-Young Mun2,
  3. Mary E. Larimer1,
  4. Helene R. White2,
  5. Anne E. Ray2,
  6. Isaac C. Rhew1,
  7. Su-Young Kim3,
  8. Yang Jiao2 and
  9. David C. Atkins1

Article first published online: 14 APR 2015

DOI: 10.1111/acer.12714

http://onlinelibrary.wiley.com/doi/10.1111/acer.12714/abstract?campaign=woletoc&dmmsmid=93331&dmmspid=21805070&dmmsuid=2433569

Keywords:

  • Integrative Data Analysis;
  • Meta-Analysis;
  • Brief Motivational Interventions;
  • College Drinking;
  • Bayesian Multilevel Models

Background

For over 2 decades, brief motivational interventions (BMIs) have been implemented on college campuses to reduce heavy drinking and related negative consequences. Such interventions include in-person motivational interviews (MIs), often incorporating personalized feedback (PF), and stand-alone PF interventions delivered via mail, computer, or the Web. Both narrative and meta-analytic reviews using aggregate data from published studies suggest at least short-term efficacy of BMIs, although overall effect sizes have been small.

Methods

This study was an individual participant-level data (IPD) meta-analysis of 17 randomized clinical trials evaluating BMIs. Unlike typical meta-analysis based on summary data, IPD meta-analysis allows for an analysis that correctly accommodates the sampling, sample characteristics, and distributions of the pooled data. In particular, highly skewed distributions with many zeroes are typical for drinking outcomes, but have not been adequately accounted for in existing studies. Data are from Project INTEGRATE, one of the largest IPD meta-analysis projects to date in alcohol intervention research, representing 6,713 individuals each with 2 to 5 repeated measures up to 12 months postbaseline.

Results

We used Bayesian multilevel over dispersed Poisson hurdle models to estimate intervention effects on drinks per week and peak drinking, and Gaussian models for alcohol problems. Estimates of overall intervention effects were very small and not statistically significant for any of the outcomes. We further conducted post hoc comparisons of 3 intervention types (individual MI with PF, PF only, and group MI) versus control. There was a small, statistically significant reduction in alcohol problems among participants who received an individual MI with PF. Short-term and long-term results were similar.

Conclusions

This study questions the efficacy and magnitude of effects of BMIs for college drinking prevention and intervention and suggests a need for the development of more effective intervention strategies.


Sobre a UNIAD

A Unidade de Pesquisa em álcool e Drogas (UNIAD) foi fundada em 1994 pelo Prof. Dr. Ronaldo Laranjeira e John Dunn, recém-chegados da Inglaterra. A criação contou, na época, com o apoio do Departamento de Psiquiatria da UNIFESP. Inicialmente (1994-1996) funcionou dentro do Complexo Hospital São Paulo, com o objetivo de atender funcionários dependentes.



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