Alcohol eCHECKUP TO GO provides normative feedback that corrects college students’ perceptions about peer alcohol consumption relative to their own alcohol consumption to prevent and reduce problem drinking.
Alcohol eCHECKUP TO GO, also called e-CHUG, is a screening and brief motivational intervention to address high-risk drinking behavior among college students. Users complete an assessment and receive feedback about quantity and frequency of their drinking, drinking norm comparisons, their estimated level of risk, money they spent on drinks per month, and cigarettes smoked monthly. The system also supplies referrals to local resources. The intervention has been primarily evaluated with college students, with preliminary evaluation with first-year high school students. The intervention is available for the military, health organizations, corporations, and communities.
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Social Norming Theory
Young Adults (18-30)
Summary: Researchers recruited 106 first year college students reported at least one heavy drinking episode to participate in a randomized controlled trial comparing Alcohol eCHECKUP TO GO to an assessment-only control group. Participants were sent links to complete the baseline and follow-up assessments and the intervention by email. Participants completed assessments of past-week alcohol consumption, past 30-day peak blood alcohol concentration (BAC), and perceptions of their own drinking relative to peers’ drinking at baseline (perceived norms), 8-weeks follow-up, and 16-weeks follow-up. Participants in the intervention group experienced reductions in weekly alcohol consumption and peak BAC between baseline and eight weeks, but the effects diminished by 16 weeks. Perceived norms mediated the effect of the intervention on drinks per week and peak BAC such that improvements in perceived norms in the intervention group resulted in improved drinking behavior.
Take Away: Alcohol eCHECKUP TO GO may accelerate reductions in drinking in college students and may do so through improvement of perceived norms.
Reducing alcohol use in first-year university students: Evaluation of a web-based personalized feedback program.
Summary: Researchers recruited 80 first-year college students from first year seminars. Participants were randomized to Alcohol eCHECKUP TO GO or to an assessment-only control group, and were identified as either high or low-risk drinkers. Participants completed assessments of alcohol consumption, alcohol related problems, and frequency of binge drinking at baseline and 3 month follow-up. Assessments and the intervention were completed during first year seminar sessions. Reductions in weekly alcohol consumption and frequency of drinking to intoxication were greater among high-risk participants that received Alcohol eCHECKUP TO GO than among high-risk participants in the control group. High risk participants in the intervention group also reported fewer alcohol related problems than high-risk participants in the control group. High risk participants in the intervention group reduced their reports of alcohol related problems by 30% and high-risk participants in the control group increased their reports of alcohol related problems by 84%.
Take Away: First year college students with high-risk drinking behavior who received Alcohol eCHECKUP TO GO reported improved alcohol consumption behavior relative to a control group.
Reducing heavy drinking among first year intercollegiate athletes: A randomized controlled trial of web-based normative feedback.
Summary: Researchers recruited 113 first-year intercollegiate athletes and randomized them to receive Alcohol eCHECKUP TO GO (n=62) or to a control group (n=51) that were directed to an educational website about alcohol without normative feedback. Athletes were recruited from first-year seminars offered to athletes. Participants completed assessments and their respective interventions during seminar sessions. Students who did not agree to participate were given an alternative activity. Participants completed assessments of alcohol consumption (weekly drinks consumed, frequency of drinking to intoxication, peak alcohol consumption), frequency of binge drinking, perceptions of other college students’ alcohol consumption, and perceptions of other collegiate athletes’ alcohol consumption at baseline and 3 months. Participants were classified as high- or low-risk drinkers based on frequency of binge drinking. High-risk participants in the intervention group reduced their alcohol consumption more than high-risk participants in the control group. Among high-risk participants, reductions in perceived college student and collegiate athlete alcohol consumption were higher in the intervention group than in the control group. Among low-risk participants, alcohol consumption and perceived norms were similar among intervention and control groups. Perceived norms mediated the interventions’ effect on changes in alcohol consumption.
Take Away: Alcohol eCHECKUP TO GO may improve alcohol consumption among college athletes who are high-risk drinkers through their perceptions of peers’ alcohol consumption.
Decreasing heavy drinking in first-year students: Evaluation of a web-based personalized feedback program administered during orientation.
Summary: Researchers recruited 350 participants from two first year summer orientation sections. Each section was randomly assigned to Alcohol eCHECKUP TO GO or to an assessment-only control group. Participants completed the baseline assessment and intervention during the summer orientation and were sent a link to complete a 3-month follow-up. Participants completed assessments of alcohol consumption, consequences of alcohol consumption, and binge drinking at baseline and 3-months. Participants were classified as high- or low-risk drinkers based on binge drinking behavior. Participants in the intervention group with high-risk drinking experienced greater reductions in number of drinks consumed in one occasion in the past three months and the number of occasions of drinking to intoxication than their contemporaries in the control group. High-risk participants in the intervention group reduced peak drinking and drinking to intoxication by 58% and 65% respectively, while the control group experienced increases of 11% and 15%. Among high-risk participants, the intervention group reported fewer alcohol-related consequences at follow-up than high-risk participants in the control group. Results for low-risk participants were nonsignificant.
Take Away: This study provides further evidence that Alcohol eCHECKUP TO GO improves alcohol consumption in first-year students who report high-risk drinking.
Reducing high-risk drinking in mandated college students: Evaluation of two personalized normative feedback interventions.
Summary: Researchers recruited 135 students who had violated university alcohol policy to compare Alcohol eCHECKUP TO GO with internet-based self-guided normative feedback to Alcohol eCHECKUP TO GO with normative feedback from a counsellor. Students referred for counseling after violating alcohol policy made an appointment with counseling services within the next two weeks to enroll in the study, complete the baseline assessment, and their respective intervention. Participants received an email a semester later inviting them to complete the follow-up assessment. Participants completed assessments of alcohol consumption, alcohol-related consequences, and perceptions of peer alcohol consumption at baseline and follow-up. Follow-up assessments were administered in the semester after the initial violation occurred, an average of 8 months after baseline. Participants who received feedback from a counselor reported significantly lower levels of weekly drinking and binge drinking at follow-up than participants who received self-guided feedback. Significantly greater reductions in perceptions of peers’ weekly drinking and binge drinking were seen in the group that received feedback from a counselor compared to self-guided feedback. Changes in perceptions of peer alcohol consumption and binge drinking partially mediated the effects of the intervention on weekly alcohol consumption and binge drinking, respectively.
Take Away: Supporting Alcohol eCHECKUP TO GO with feedback from a counselor can improve its effects on alcohol consumption and perceptions of peer alcohol consumption relative to the self-guided intervention.
Evaluation of web-based and counsellor-delivered feedback interventions for mandated college students.
Summary: Researchers randomized 56 students who violated university alcohol policy and were referred to the study to receive Alcohol eCHECKUP TO GO or Alcohol eCHECKUP TO GO with additional feedback from a counsellor. Students who had violated university alcohol policy were given instructions to make an appointment with counseling services within two weeks of the violation. During the appointment, participants were enrolled in the study and completed baseline assessments and their respective interventions. Participants made a second appointment, 30 days after their initial appointment, to complete follow-up assessments and did a final review of their alcohol consumption and related concerns with a master’s counseling student. Participants completed assessments of alcohol consumption (weekly alcohol consumption, peak consumption, frequency of drinking to intoxication) and alcohol-related consequences at baseline and 30-days follow-up. Participants in both groups experienced significant reductions in alcohol consumption and alcohol related consequences. There were no significant differences between groups in reductions in alcohol consumption or alcohol-related consequences.
Take Away: Alcohol eCHECKUP TO GO with self-guided feedback was as effective as Alcohol eCHECKUP TO GO with counselor feedback.
A comparison of computer-assisted and self-management programs for reducing alcohol use among students in first year experience courses.
Summary: Researchers recruited ten instructors to deliver Alcohol eCHECKUP TO GO, a self-management intervention for alcohol use, or an exercise-focused control program as a part of their first-year experience courses. From the ten instructors’ courses, 103 first year students were recruited to compare the three programs. Participants were randomized by class and the program was delivered during a class session. Participants in the Alcohol eCHECKUP TO GO condition completed the online program and then participated in a group discussion of the results. After the programs were delivered, researchers returned once a week for at least five weeks to administer assessments. Participants completed baseline assessments of typical alcohol consumption, how much they drank during the last major drinking occasion and over how long, drinking circumstances, reasons for drinking, and exercise behavior. Researchers estimated blood alcohol content based on participants’ reported drinking behavior at baseline. Participants also completed weekly assessments of recent alcohol consumption and exercise behavior. The program received was not related to changes in drinking behavior. Estimated blood alcohol content was related to more alcohol consumption after the intervention. There was an interaction between baseline blood alcohol content’s effect on later alcohol consumption and program condition. Participants with high estimated blood alcohol content in the self-management condition and the control exercise-focused condition reported higher alcohol consumption after the intervention, but participants who received Alcohol eCHECKUP TO GO did not.
Take Away: Alcohol eCHECKUP TO GO may be beneficial for preventing increases in alcohol consumption in first year students who are already heavy drinkers.
Feedback-based alcohol interventions for mandated students: An effectiveness study of three modalities.
Summary: Researchers recruited 173 university students who had been mandated to complete an alcohol intervention for violating university alcohol policy. Students were brought into university counseling services to complete screening, enroll in the study, and complete baseline assessments. Students were ineligible if they met criteria for alcohol dependence or had received counseling for substance use before. Researchers randomized participants to use Alcohol eCHECKUP TO GO or to receive an in-person intervention for alcohol consumption individually or as a part of a group. Participants returned for subsequent sessions to complete their respective interventions and were sent an invitation to complete the follow-up by email. The group and individual in-person interventions were 2-hour motivational interventions that provided personalized feedback. Participants completed assessments of alcohol consumption (past 4-week drinks consumed during each drinking occasion) and alcohol-related consequences at baseline and 3 months. Researchers used participants’ reported alcohol consumption to calculate blood alcohol content (BAC) for each drinking occasion. There were significant reductions in alcohol-related consequences at follow-up for both groups. At follow up, Participants in the individual intervention group reported a significant reduction in peak BAC and peak alcohol consumption over the previous four weeks.
Take Away: Alcohol eCHECKUP TO GO and an in-person individual intervention both reduced alcohol-related consequences, but unlike the in-person intervention, Alcohol eCHECKUP TO GO did not result in significant reductions in alcohol consumption.
A test of efficacy of a brief web-based personalized feedback intervention to reduce drinking among ninth grade students.
Summary: Researchers evaluated Alcohol eCHECKUP TO GO among 9th grade students. Participating 9th grade students received the same program that had been previously evaluated among university students, but the user interface, normative feedback, and resource referrals were tailored to the high schoolers. Researchers recruited 513 9th graders from two middle schools. Schools were randomly assigned to administer Alcohol eCHECKUP TO GO or their regular alcohol and substance use education (standard of care). Participants completed the intervention during normal class periods, participants without assent or parental consent to participate were given an alternative activity. At baseline and 3-months, participants completed assessments of alcohol use, alcohol related consequences, perceptions of peer alcohol consumption, positive expectancies about alcohol effects, and beliefs about alcohol. Relative to standard education, participants in the intervention reported greater reductions in positive expectancies about alcohol at follow-up. The control group significantly increased positive beliefs about alcohol and frequency of drinking more than the intervention group. Intervention participants also reported fewer alcohol-related consequences than those in standard care. There were no significant differences in perceptions of peer alcohol consumption or weekly drinking quantity.
Take Away: Compared to standard substance use education, Alcohol eCHECKUP TO GO may reduce positive expectations about alcohol effects and reduce alcohol consumption and drinking frequency in 9th grade students.
Reducing alcohol use among 9th grade students: 6 month outcomes of a brief, web-based intervention.
Summary: Participants who had completed the baseline survey were invited to complete a six-month follow-up survey. Of the 513 9th grade students initially recruited to evaluate Alcohol eCHECKUP TO GO, 358 completed the 6-month assessment that included measures of frequency of drinking and alcohol-related consequences. There were no significant differences in the outcomes of interest over time or between groups.
Take Away: Effects of Alcohol eCHECKUP TO GO at 3 months were not maintained at 6 months, suggesting short-term efficacy of Alcohol eCHECKUP TO GO.
Web-based personalized feedback: Is this an appropriate approach for reducing drinking among high school students?
Summary: As a part of a larger evaluation of Alcohol eCHECKUP TO GO for 9th grade students, researchers recruited 159 9th grade students from two high schools that administered eCHECKUP TO GO. In the larger study, two schools were randomly assigned to receive Alcohol eCHECKUP TO GO; a third school received usual alcohol and substance use education. Students completed baseline assessments during a class session and completed the intervention and post-intervention assessment during class the next day. Researchers evaluated perceptions of utility and user-friendliness of Alcohol eCHECKUP TO GO. Participants completed an assessment of alcohol consumption during the baseline assessment. Participants’ perceptions of the utility and user-friendliness of the intervention were evaluated after completing the intervention. Most participants felt that the intervention was easy to use (94%), easy to read (94%), useful (79%), interesting (73%), and helpful (72%). Most participants reported that they learned something (84%) and would recommend the intervention to others (74%). Participants who reported having consumed alcohol at baseline were more likely to report that the intervention was useful and that they would recommend it to others than participants who reported not consuming alcohol at baseline.
Take Away: Alcohol eCHECKUP TO GO was useful and user friendly to ninth graders, those who had reported consuming alcohol.
The eCHECKUP TO GO for high school: Impact on risk factors and protective behavioral strategies for alcohol use.
Summary: Researchers recruited 346 12th graders from two high schools to evaluate Alcohol eCHECKUP TO GO for high school students. Parents were sent a consent form to sign and return. Students whose parents had provided consent were given the opportunity to provide their assent and participate during a class period. Participants were randomized by class period to receive Alcohol eCHECKUP TO GO or to an assessment-only control group. As part of a class period, participants who provided assent took the baseline survey and participants in the intervention group completed Alcohol eCHECKUP TO GO after baseline. Participants completed assessments at baseline and follow-up to assess perceptions of peer alcohol consumption, beliefs about alcohol, positive expectations about alcohol, and protective behavior strategies to reduce risky drinking. Follow-up was intended to occur at 30-days, but one school had to administer the follow-up assessment at 6-weeks due to scheduling. The intervention group reported less positive beliefs about alcohol consumption than the control group but this effect was only seen for females. Female participants in the intervention group reported significant decreases in perceptions of peer alcohol consumption, less positive beliefs about alcohol and positive expectations of alcohol consumption than those in the control group.
Take Away: Alcohol eCHECKUP TO GO may be effective at improving alcohol-related perceptions and beliefs in female 12th graders, but no effects were seen for male 12th graders.
Text messaging as an adjunct to a web-based intervention for college student alcohol use: A preliminary study.
Summary: Researchers recruited 111 college students online to compare Alcohol eCHECKUP TO GO with text message support, Alcohol eCHECKUP TO GO alone, and an assessment-only control condition. Students who reported at least one heavy drinking occasion in the past month or at least one alcohol-related consequence were recruited in exchange for class credit. Participants in the text message supported intervention condition received daily text messages for one month. On heavy drinking days (Thursday, Friday, Saturday), the text messages were about principles reviewed in eCHECKUP TO GO; messages for the rest of the week were about health and wellbeing. Participants completed assessments of alcohol consumption and alcohol related consequences at baseline and 1-month follow-up. Participants in the text message-supported intervention group reported fewer heavy drinking occasions at follow-up compared than the assessment-only control group. The text message-supported intervention group also reported fewer drinks consumed at follow-up than the intervention-only group or control group. There were no significant differences in alcohol-related consequences or alcohol consumption between the intervention-only and control groups.
Take Away: Supporting Alcohol eCHECKUP TO GO with text messages may offer an advantage over the intervention alone at reducing the number of drinks consumed on weekends.