National Social Norms Institute

Articles by Year - 2009

Croom, K., Lewis, D., Marchell, T., Lesser, M. L., Reyna, V.F., Kubicki-Bedford, L., et al. (2009). Impact of an online alcohol education course on behavior and harm for incoming first-year college students: Short-term evaluation of a randomized trial. Journal of American College Health, 57 (4), 445-454. go to summary

Cross, J.E. & Peisner, W. (2009). RECOGNIZE: A social norms campaign to reduce rumor spreading in a junior high school. Professional School Counseling, 12 (5), 365. go to summary

DeJong, W., Schneider, S.K., Towvim, L.G., Murphy, M.J., Doerr, E.E., Simonsen, N.R., et al. (2009). A multisite randomized trial of social norms marketing campaigns to reduce college student drinking: A replication failure. Substance Abuse, 30 (2), 127-140. go to abstract

Doumas, D.M., McKinley, L. L., & Book, P. (2009). Evaluation of two web-based alcohol interventions for mandated college students. Journal of Substance Abuse Treatment, 36, 65-74. go to summary

Grossbard, J., Hummer, J., LaBrie, J., Pederson, E., & Neighbors, C. (2009). Is Substance Abuse a Team Sport? Attraction to Team, Perceived Norms, and Alcohol and Marijuana Use Among Male and Female Intercollegiate Athletes. Journal of Applied Sport Psychology, 21 (3), 247-261. go to summary

Keller, A. & Bauerle, J. (2009). Using a logic model to relate the strategic to the tactical in program planning and evaluation: An illustration based on social norms interventions. American Journal of Health Promotion, in press. go to summary

Keller, A., Frye, L., Bauerle, J., & Turner, J.C. (2009). Legal ages for purchase and consumption of alcohol and heavy drinking among college students in Canada, Europe, and the United States. Substance Abuse, 30, 248-252. go to summary

LaBrie, J.W., Cail, J., Hummer, J.F., Lac, A., & Neighbors, C. (2009). What men want: the role of reflective opposite-sex normative preferences in alcohol use among college women. Psychology of Addictive Behavior, 23 (1), 157-162. go to summary

LaBrie, J.W., Hummer, J.F., Huchting, K.K., & Neighbors, C. (2009). A brief live interactive normative group intervention using wireless keypads to reduce drinking and alcohol consequences in college student athletes. Drug and Alcohol Review, 28, 40-47. go to summary

Latkin, C., Donnell, D., Celentano, D.D., Aramrattna, A., Liu, T.Y., Vongchak, T. et al. (2009). Relationships between social norms, social network characteristics, and HIV behaviors in Thailand and the United States. Health Psychology, 28 (3), 323-329. go to summary

Moreira, M.T., Smith, L.A., & Foxcroft, D. (2009). Social norms interventions to reduce alcohol misuse in university or college students. Cochrane Database of Systematic Reviews 2009, 3, CD006748. go to summary

Schmidt, E., Kiss, S.M., & Lokanc-Diluzio, W. (2009). Changing social norms: A mass media campaign for youth ages 12-18. Canadian Journal of Public Health. Revue Canadienne de Sante Publique, 100 (1), 41-45. go to abstract

Walters, S.T.,Vader, A.M., Harris, T.R., Field, C.A., & Jouriles, E.N. (2009). Dismantling motivational interviewing and feedback for college drinkers: a randomized clinical trial. Journal of Consulting and Clinical Psychology, 77 (1), 64-73. go to summary

Allen, J.D., Mohllajee, A., Shelton, R.C., Othus, M. K.D., Fontenot, H.B., & Hanna, R. (2009). Stage of adoption of the human papillomavirus vaccine among college women. Preventive Medicine, in press, corrected proof. return to list

Objective:
Certain types of human papillomavirus (HPV) can cause cervical and other cancers. Gardasil, a vaccine that protects against HPV types responsible for 70% of cervical cancers, is available to females ages 9–26. This study assessed factors associated with the intention of female college students ages 18–22 to obtain the Gardasil vaccine and provides insights into the cognitive, attitudinal, and normative beliefs that shape HPV vaccine intentions.
Method:
In 2007, female students (n = 1,401) enrolled full time at a private New England University in the U.S. completed an on-line survey that assessed: (1) knowledge and awareness of HPV and the HPV vaccine; (2) perceived susceptibility to HPV, genital warts and cervical cancer; (3) perceived severity of HPV, genital warts and cervical cancer, 4) perceived vaccine benefits/barriers, (6) social (peers receipt of HPV vaccine) and subjective (perceptions that significant others approve of vaccination) norms, and stage of vaccine adoption. Participants provided information about demographic characteristics, and were asked about their current relationship status, sexual activity, Pap smear utilization, history of sexually transmitted infections (STI), and contraceptive use.
Results:
The majority of participants had previously heard of HPV and the vaccine (93% and 87%, respectively), though some misperceptions about the virus were prevalent. About half (53%) of respondents were planning to be vaccinated; 45% planned to obtain the vaccine after 30 days (contemplation), 8 % planned to obtain the vaccine within 30 days (preparation), and 12% had received the vaccine (action). About 15% of respondents were undecided and 7% had decided against vaccination. Another 13% had never even heard of the vaccine (pre-contemplation). These results are largely consistent with studies conducted to date which show that among college-aged women, 65% (Gerend and Magloire, 2008) to 74% (Boehner et al., 2003) say they would accept vaccination.

Individuals who were undecided about vaccination and those not planning to be vaccinated in the near future (contemplators) had low ratings of perceived severity of HPV infection, compared with other groups. Those who had already obtained the vaccine (action) had the lowest ratings of barriers to vaccination. Finally, those who were planning to be vaccinated at some point in the future (contemplators, preparation) and those who had already been vaccinated (action) were more likely to report that their significant others supported vaccination (subjective norms).

The factor most strongly associated with vaccine intentions was social norms; the perception that peers were planning to be vaccinated or already had been vaccinated. It is possible that those who refused the vaccine may be concerned that the vaccine may actually cause HPV infection. Alternatively, given that the other stage groups (with the exception of those undecided) all had higher subjective norms than individuals in this group, it may be that those who decided against vaccination were pressured by significant others not to obtain the vaccine.
Conclusions:
The findings suggest the college students should be a priority audience for HPV-related educational interventions and campaigns. Acceptance of the vaccine was high, although misconceptions about viral transmission, availability of treatment, and the role of Pap tests were common. Perceived norms were strongly associated with intentions. Interventions on college campuses should stress vaccination as a normative behavior, provide information about viral transmission, and stress the role of continued Pap screening. Although awareness of HPV is high, this does not translate into accurate knowledge about how to protect themselves from the virus
(Gerend and Magloire, 2008; Tiro et al., 2007). Successful efforts to promote HPV vaccination might begin by assessing stage of readiness, and focusing intervention efforts on supporting stepwise movement of participants along the stage continuum.
Implications for the Field:
The results support the notion that tailoring educational messages or strategies by stage of adoption may be useful. Given the strong correlation between social and subjective norms and later stages of adoption, it may be useful to develop peer-led interventions to promote subjective norms or to design programs that portray screening as a normative behavior to reach those in earlier stages of change. Interventions are needed to promote uptake among those who are undecided and to address barriers for those who have decided against vaccination. Given the relationship between subjective norms and vaccine intentions, peer-led education on college campuses should be considered.

Cimini, M. D., Martens, M. P., Larimer, M. E., Kilmer, J. R., Neighbors, C., & Monserrat, J. M. (2009). Assessing the effectiveness of peer-facilitated interventions addressing high-risk drinking among judicially mandated college students. Journal of Studies on Alcohol & Drugs, Supplement 16, 57-66. return to list

Objective:
This study examined the effectiveness of three peer-facilitated brief alcohol interventions--small group motivational interviewing, motivationally enhanced peer theater, and an interactive alcohol-education program--with students engaging in high-risk drinking who were referred for alcohol policy violations.
Method:
Undergraduate students referred for alcohol policy violations (N = 695) at a large northeastern public university were randomized to one of the three conditions. Six-month follow-up data were collected on drinking frequency and quantity, negative consequences, use of protective behaviors, and perceptions of peers' drinking norms.
Results:
There were no statistically significant overall pre-post effects or treatment effects. However, exploratory analyses indicated that decreases in perceived norms and increases in use of protective behavioral strategies were associated with reductions in alcohol use and alcohol-related problems at follow-up (p < .01). Conclusions: The presence of nonsignificant pre-post or main effects is, in part, consistent with recent research indicating that sanctioned college students may immediately reduce drinking in response to citation and that brief interventions may not contribute to additional behavioral change. The presence of statistically significant correlations between alcohol use and related problems with corrections in norms misperceptions and increased use of protective behaviors at the individual level holds promise for both research and practice. The integration of elements addressing social norms and use of protective behaviors within brief cognitive-behavioral intervention protocols delivered by trained peer facilitators warrants further study using randomized clinical trials.

Croom, K., Lewis, D., Marchell, T., Lesser, M.L., Reyna, V.F., Kubicki-Bedford, L., et al. (2009). Impact of an online alcohol education course on behavior and harm for incoming first-year college students: Short-term evaluation of a randomized trial. Journal of American College Health, 57 (4), 445-454. return to list

Objective:
This study examined the short-term effectiveness of AlcoholEdu for College, a Web-based alcohol education program for entering freshmen. The program’s goal is to increase students’ knowledge about alcohol and to alter attitudes and behavior related to alcohol use. The study was the first randomized prospective controlled delay treatment study of AlcoholEdu and the authors sought to determine its efficacy in reducing problem drinking.
Method:
Study participants were 3,216 incoming first-year students at a mid-sized, rural, elite, private university in the Northeast. Students were randomized to a control (n = 1,608) or intervention group (n = 1,608) in June, 2006. Controls completed a survey and knowledge test the summer before college; 4 to 6 weeks after arrival on campus, they completed a follow- up survey of behaviors and harms followed by an invitation to complete the online course. Intervention students completed the pre-course survey and test, the online AlcoholEdu course, and final exam priorto coming to campus. This was followed by a survey 4 to 6 weeks after arrival on campus. Both groups also received printed materials highlighting the university’s alcohol policy. A number of primary outcome variables were assessed, including the prevalence of (1) alcohol use, (2) high-risk behavior, (3) protective behavior, and (4) harm experienced.
Results:
When all 1,891 students were included in the analysis, the AlcoholEdu intervention had little impact on the behavior of first-year students or the harm associated with alcohol use. Pre-course examination scores were similar for both groups. The “college effect” was apparent in both groups, as drinking and high-risk behaviors increased during the transition to college. Protective behavior decreased and alcohol-associated harm increased in students in both the control and interventions groups.
Two significant differences were observed between the control and intervention groups. With regard to “playing drinking games,” approximately 20% of students in both groups played drinking games at the beginning of the study. In the follow-up survey, students who had received the intervention had a lower tendency to play drinking games than their control counterparts (33.2% vs 39.3%, intervention vs. control group, respectively, p = .0146). However, students who had received the intervention also had a higher likelihood of failure to use safe sex practices (p = .0056).
Although the intervention group showed significantly higher alcohol-related post-course knowledge compared to the control group, protective behavior, risk-related behavior, high-risk drinking, and alcohol-related harm did not favor the intervention group, with the sole exception of playing drinking games. There was no significant difference between the intervention and control groups across a variety of behavioral outcomes.
Conclusions:
The 2006 edition of AlcoholEdu did not appear to significantly affect many of the targeted behavioral outcomes. Protective behavior, risk-related behavior, high-risk drinking, and alcohol-related harm did not favor the intervention group, with the sole exception of playing drinking games. For some comparisons, risk-related behavior, such as failure to use safe-sex practices, and negative outcomes, such as hangovers, were greater in the intervention group as compared with the control group. Alcohol knowledge alone was insufficient to mitigate alcohol-related high-risk behaviors in this student population.
Implications for the Field:
Despite limited empirical support for their effectiveness, Web-based alcohol education and prevention programs have been increasingly used as one of the primary tools to provide information and feedback to students regarding their use and misuse of alcohol to mitigate high-risk behavior and harm and to increase protective behavior. Many institutions have adopted these curriculum products for incoming first-year students, because they are perceived to be a “best practice” approach to reducing alcohol- related risks among students. The current study found that AlcoholEdu led to an increase in alcohol-related knowledge among students on a population basis, but that the results did not support the course’s ultimate goal of reducing alcohol-related high-risk behavior or harm. Knowledge acquisition alone appears to be insufficient to achieve short-term behavioral change.

Cross, J.E. & Peisner, W. (2009). RECOGNIZE: A social norms campaign to reduce rumor spreading in a junior high school. Professional School Counseling, 12 (5), 365. return to list

This article studied changes in rumor spreading and perceptions of peers' rumor spreading among students at one public junior high school following a social norms marketing campaign. Results of the study show that perceptions of peer rumor spreading fell following the campaign, but self-reports of rumor spreading did not decrease. Results suggest that a social norms marketing campaign conducted by a professional school counselor and delivered to students in a junior high can reduce misperceptions of negative social behaviors.

A 14-site randomized trial tested the effectiveness of social norms marketing (SNM) campaigns, which present accurate student survey data in order to correct misperceptions of subjective drinking norms and thereby drive down alcohol use. Cross-sectional student surveys were conducted by mail at baseline and at posttest 3 years later. Hierarchical linear modeling was applied to examine multiple drinking outcomes, taking into account the nonindependence of students grouped in the same college. Controlling for other predictors, having a SNM campaign was not significantly associated with lower perceptions of student drinking levels or lower self-reported alcohol consumption. This study failed to replicate a previous multisite randomized trial of SNM campaigns, which showed that students attending institutions with a SNM campaign had a lower relative risk of alcohol consumption than students attending control group institutions (W. DeJong et al. J Stud Alcohol. 2006;67:868-879). Additional research is needed to explore whether SNM campaigns are less effective in campus communities with relatively high alcohol retail outlet density.

Doumas, D.M., McKinley, L.L., & Book, P. (2009). Evaluation of two web-based alcohol interventions for mandated college students. Journal of Substance Abuse Treatment, 36, 65-74. return to list

Objective:
This study evaluated the efficacy of two Web-based interventions aimed at reducing heavy drinking and alcohol-related problems in mandated college students. In addition, the study examined changes in peer drinking estimates as a mediator of the effects of the intervention on changes in drinking.
Method:
Participants in the study were students who were referred to University Counseling Services for violating the University policy for alcohol and other drugs from Spring 2006 to Spring 2007. Participants were primarily freshmen and ranged in age from 18 to 24. Mandated students (n = 76) were randomly assigned to one of two conditions: Web-based personalized normative feedback (WPNF) or Web-based education (WE) based on a computer-generated random numbers table. Participants in the WPNF condition completed a 15-minute Web-based program designed to reduce high-risk drinking by providing personalized feedback and normative data regarding drinking and the risks associated with drinking. Participants in the WE group completed a commercially available educational program called Judicial Educator that was developed for students receiving disciplinary sanctions.
            Once the intervention was completed, students set up an appointment for a 30-day follow-up session. During the 30-minute follow-up session, participants completed follow-up questionnaires and then participated in a brief counseling session. Students were assessed on alcohol consumption, typical quantity of weekly drinking, alcohol-related problems, and drinking estimates for typical college students.
Results:
Results indicated that mandated students in the WPNF condition reported significantly greater reductions in weekly drinking quantity, peak alcohol consumption, and frequency of drinking to intoxication than students in the WE condition at a 30-day follow-up. Mandated students in the WPNF group reported a 40% reduction in weekly drinking quantity, a 20% reduction in peak drinking levels, and an 18% reduction in frequency of drinking to intoxication compared to 18%, 5%, and 10% reductions in these drinking variables, respectively, in the WE condition. In addition, mandated students in the WPNF group reported a 53% reduction in alcohol-related problems compared to a 42% reduction in the WE group.
            The results of the study also indicated mandated students estimated that typical college students drink more than their own self-reported drinking. Despite their involvement in alcohol consumption resulting in a sanction, mandated students overestimated levels of college student weekly drinking relative to their own drinking at the baseline assessment, believing typical students drink twice as much as they drink themselves.
            Mandated students receiving personalized normative feedback also adjusted their beliefs about peer drinking downward. Mandated students receiving accurate information about typical college student drinking reported a reduction in the perception of typical student drinking at the 30-day follow-up relative to the mandated students who did not receive normative data. Results also indicated changes in estimates of typical college student drinking from baseline to the 30-day follow-up mediated the effect of the intervention on changes in drinking quantity. The authors did not find a significant reduction in alcohol-related problems for either intervention condition.
Conclusions:
These findings are consistent with previous research on Web-based feedback programs for college students indicating that Web-based personalized feedback as an early intervention program are effective in reducing heavy drinking in college students and brief interventions providing in-person normative feedback are effective for mandated students.
Implications for the Field:
Results of this study have important implications for developing early intervention programs for mandated college students. Because of the low cost, ease of dissemination, and efficacy associated with Web-based personalized feedback, this type of programming is ideal for both large colleges and universities and campuses that do not have many intervention resources.

This research examined the role of attraction to one's team in predicting alcohol and marijuana use among intercollegiate athletes. Attraction to team and alcohol-related information were collected via an online survey and marijuana use-related information was gathered in a live setting. We investigated the influence of attraction to one's team above and beyond the influence of gender and perceived norms, and attraction to team as a moderator of these relationships. Attraction to one's team accounted for significant variance in marijuana use, and alcohol-related consequences after controlling for alcohol consumption. Regression analyses revealed significant interactions between gender, attraction to team, and norms in predicting alcohol and marijuana use. Stronger attraction to one's team may increase alcohol use but decrease marijuana use among male athletes, suggesting the importance of attraction to team when developing interventions for athletes.

Logic models are a ubiquitous tool for specifying the tactics – including implementation and evaluation -- of interventions in the public health, health and social behaviors arenas. Similarly, social norms interventions are a common strategy, particularly in college settings, to address hazardous drinking and other dangerous or asocial behaviors. This paper illustrates an extension of logic models to include strategic as well as tactical components, using a specific example developed for social norms interventions. Placing the evaluation of projects within the context of this kind of logic model addresses issues related to the lack of a research design to evaluate effectiveness.

Heavy drinking and associated negative consequences remain a serious problem among college students. In a secondary analysis of data from two published study, the authors examine the correlation between minimum legal age to purchase and/or consume alcohol and rates of heavy drinking among college students in 22 countries. The published studies use identical definitions of heavy drinking and similar methodologies. In the study of 20 European countries and the United States, there is a positive correlation between prevalence of heavy drinking and both minimum legal purchase age (r = .34) and minimum legal drinking age (r = .19); in the study of Canada and the United States, there is a perfect positive correlation (r = 1.0). Examination of this evidence does not support the conclusion that a lower minimum legal age for purchase and/or consumption of alcoholic beverages is a protective factor for decreasing heavy drinking among college students.

Objective:
This study examined opposite-sex reflective drinking norms of heterosexual female students and the extent that these reflective norms influence female alcohol consumption.
Method:
A random sample of 7,000 students stratified across class year and equally portioned from two universities (a private mid-size and a large public university on the west coast) were invited to complete a Web-based survey during the fall semester of 2007. Of these, 3,753 students completed the survey. Only heterosexual students (96.3%, N =3616) were included in the final sample.
Female participants responded to two sets of questions assessing perceptions of opposite sex (male) drinking preferences. The first set assessed more traditional normative alcohol use variables utilizing open-ended question format, while the second set assessed the perceived level of drinking valued by typical college males for various types of relationships found in the college environment. Participants began by answering two open-ended questions to assess their perceptions about the amount males prefer their female friends to drink. They were then asked to answer three questions referring to perceived preferences of college males regarding drinking behavior of a female friend, sexual partner, and dating partner.
Male participants answered the same questions, stating their actual preferences of the amount of alcohol they prefer their female friends, sexual partners, and dating partners to drink.
Norms were assessed by asking heterosexual women to state their perception of males’ expectations of women’s drinking, and their accuracy was assessed by comparing these expectations to heterosexual males’ actual preferences.
Results:
Results showed that females overestimate the amount of alcohol males want their female friends, dating partners, and sexual partners to drink, and that this misperception was associated with a woman’s actual drinking behavior, even after controlling for demographic factors and perceived same-sex norms. Furthermore, analyses of female perceptions showed that a large percentage of women mistakenly believe that males want them to drink to risky levels. This is particularly the case within the friendship and sexual contexts, where additional analyses showed that 26.1% of women stated that men would most likely want to be friends with a woman who drinks 5 or more drinks, and 16.7% stated that men would be the most sexually attracted to the same. Both estimates are nearly double men’s actual preferences for that behavior. Analyses of male preferences showed that college men prefer their female friends and sexual partners to drink more than the women they are dating.
Conclusion:
That females’ perceptions of what men desire women to drink account for their drinking, while controlling for same-sex norms, highlights the role of reflective norms in understanding college women’s drinking. In the context of the well-established normative influence of same-sex peers, this finding offers unique insight into college women’s motivations for drinking. Although the exact mechanism of this social effect is still unclear, the literature suggests that it may relate to both a greater concern with the development and maintenance of social relationships as well as the widespread belief that men find it attractive and sexually appealing when a woman can drink as much as a man does. If it is the case that women’s drinking is related to the development of social relationships, then these misperceptions may be encouraging women to drink to risky levels. These results suggest that reflective normative feedback may offer a powerful new tool for female-targeted interventions.
Implications for the field:
The study is the first to quantify the difference between the amount heterosexual women believe men want them to drink, and the drinking behaviors that heterosexual men actually prefer. That these misperceptions are associated with a women’s drinking, over and above same sex peer norms, suggest that they may be a new important explanatory factor for college women’s alcohol use that needs further exploration and understanding.

Objective:
This study extended the research of group-specific normative feedback interventions among salient campus groups with heightened risk. In particular, this study used a live interactive normative group intervention using wireless keypads and focused on student athletes and how their perceptions of their peers influenced their drinking behavior.
Method:
This research used normative feedback that was obtained using wireless keypad technology during a live session, within sex-specific student athlete groups, to extend the proof of concept of using this brief interactive intervention. Participants included 660 intercollegiate athletes from all varsity athletic teams at two, private, mid-size universities. The mean age was 19.6 years old; 61.2% were in season, 56.1% were female, and 72.1% were white. Participants completed an initial Web-based survey followed by a group intervention two weeks later. The survey assessed the athletes’ attitudes towards drinking and injunctive norms, participant drinking behavior and descriptive norms, and alcohol consequences.
Intervention data was gathered in vivo using computerized handheld keypads into which group members entered in personal responses to a series of alcohol-related questions. The questions assessed perceptions of normative group behavior and attitudes as well as actual individual behavior and attitudes. The data was then immediately presented back to the participants in graphical form to illustrate discrepancies between perceived and actual group norms. Participants were able to determine their own alcohol use compared with their group-specific peers, as well as if their perceptions about others in their group were discrepant. Follow-up surveys were administered online at 1 and 2 month post-interventions and addressed changes in misperceptions, negative alcohol-related consequences, and alcohol use.
Results:
Results revealed that at the one month post-intervention, perceived group norms, behavior, attitudes and consequences reduced compared with baseline. These reductions were maintained at the two-month follow-up. Latent growth modeling suggested that the reductions in perceived norms and attitudes were associated with reductions in individual drinking behavior and negative consequences. Results showed that student athletes overestimated all descriptive and injunctive norm items. Follow-up analyses indicated that reduction in drinking outcomes, norms, and attitudes, were evident from baseline to one month. The results suggest that changes in attitudes, descriptive norms and injunctive norms were all strongly associated with changes in drinking.
Conclusion:
These results are among the first to suggest the effectiveness of a live, interactive, group-based normative alcohol intervention among student athletes. Student misconceptions of peer alcohol consumption were challenged in a live feedback setting, which authenticated the presence of misperceptions that were held by the group and allowed for homogenous exposure across participants.
Implications for the field:

The findings support further trialing to test the efficacy of a brief live interactive group intervention (BLING) with other groups of high-risk drinkers. Colleges may also want to use wireless handheld devices with tight-knit or high-risk drinking groups (like incoming freshman) to disrupt the development and sway of alcohol misperceptions.

Objective:
Social norms have been associated with a wide range of health behaviors. In this study, the authors examined whether the social norms of HIV risk behaviors are clustered within social networks and whether the norms of network members are linked to the risk behaviors of their social network members.
Design:
Data were collected from the baseline assessment of 354 networks with 933 participants in a network-oriented HIV prevention intervention targeting injection drug users in Philadelphia, United States, and Chiang Mai, Thailand.
Main Outcome Measures:
Four descriptive HIV risk norms of sharing needles, cookers, and cotton and front- or back-loading among friends who inject were assessed.
Results:
Three of 4 injection risk norms (sharing needle, cookers, and cotton) were found to be significantly clustered. In Philadelphia, 1 network member’s (the index participant) norms of sharing needles and front- or back-loading were found to be significantly associated with the network members’ risk behaviors, and the norm of sharing cotton was marginally associated. Conclusion:
The results of this study suggest that among injection drug users, social norms are clustered within networks; social networks are a meaningful level of analyses for understanding how social norms lead to risk behaviors, providing important data for intervening to reduce injection-related HIV risks.

Mallett, K.A., Bachrach, R.L., & Turrisi, R. (2009). Examining the unique influence of interpersonal and intrapersonal drinking perceptions on alcohol consumption among college students. Journal of Studies on Alcohol & Drugs, 70 (20), 178-185. return to list

Objective: Interventions for college student drinking often incorporate interpersonal factors such as descriptive and/or injunctive norms to correct misperceptions about campus drinking (e.g., BASICS [Brief Alcohol Screening and Intervention for College Students] and social-norms campaigns). Some interventions also focus on intra-personal factors of alcohol consumption, which can be considered as ones own perception of drinking, ones attitude toward drinking, and ones intended outcome related to drinking. The current study sought to extend previous work by examining relationships between both inter- and intrapersonal perceptions of drinking and reported drinking behavior. Method: College students (N = 303) completed questionnaires assessing drinking behaviors, perceptions of other students attitudes toward drinking (i.e., injunctive norms), their perception of the quantity and frequency of student/friend drinking (i.e., descriptive norms), and their attitudes and perceptions toward their own alcohol consumption (i.e., intrapersonal factors). Results: Multiple regressions were used to analyze the unique influence between inter- and intrapersonal drinking perceptions and drinking behavior. Conclusions: Among the interpersonal perceptions of drinking, only closest friend's drinking significantly predicted alcohol consumption, whereas all three intrapersonal factors significantly predicted alcohol consumption. Suggestions for enhancing college student drinking interventions are discussed.

Misuse of alcohol can result in disabilities and death. Alcohol also leads to accidents, fights and unprotected sex. Young people aged 15 to 24 years contribute a high proportion to this burden. University students may not drink as frequently as their non-university peers but they have a tendency to drink excessively when they do. Social norms refer to our perceptions and beliefs about what is 'normal' behaviour. People may believe that their peers drink heavily, which influences their drinking, yet much of peer influence is the result of incorrect perceptions. Normative feedback relies on the presentation of information on these misperceptions, about personal drinking profiles, risk factors, and normative comparisons. Feedback can be given alone or in addition to individual or group counselling. This systematic review was based on 22 controlled trials involving 7275 college or university students randomly assigned to the social norms intervention or a control group. Interventions delivered using the web or computer, or in individual face-to-face sessions, appeared to reduce alcohol misuse. The evidence was less convincing for group face-to-face sessions. Mailed and group feedback were on the whole no different than with the control intervention. Two large studies showed contradictory results for a social marketing campaign. Only a small number of good quality studies were available for many of the outcomes and analyses, and most of the studies were from the USA. The intensity of the intervention differed between trials as did the control intervention, which was no intervention, educational leaflets or an alcohol educational session. Individual face-to-face feedback typically involved social norms feedback as just one aspect of a broader motivational interviewing intervention. Locations where alcohol outlet density is higher may promote higher consumption through more frequent alcohol promotions and easier access to alcohol, so the effectiveness of an intervention designed to reduce drinking could be expected to be lower in these areas.

Abstract:
Objective:
To create a mass media campaign that endeavours to a) denormalize tobacco use among youth aged 12-18, b) empower youth to stay
tobacco product free, and c) increase awareness of the dangers of tobacco use, while using positive messaging.
Participants:
Target age group was youth between the ages of 12 and 18 years.
Setting:
The mass media campaign was developed, implemented, and evaluated within the city of Calgary.
Intervention:
The mass media campaign consisted of posters for schools and other venues frequented by youth (e.g., community centres, libraries,
fitness centres, restaurants, movie theatres), posters for transit (e.g., bus shelters, LRT shelters, back of bus) print advertisements, television/radio public
service announcements, an interactive community website for youth, a media launch event, promotional items, and organizational efforts to crosspromote
the campaign. The creative concept was based on intercept interviews, focus group testing, and other research conducted by the campaign’s
creative team and youth volunteers in order to identify the key elements of this campaign.
Outcomes:
A total of 149 students completed both a baseline and follow-up survey to evaluate the marketing activities of the campaign. A total of 27
youth participated in prototype testing to compare this positive-messaging campaign with negative-toned tobacco reduction campaigns. Six
stakeholders/partners participated in stakeholder interviews to assess their thoughts and learnings regarding the campaign process.
Conclusion:
The evaluation respondents viewed the campaign positively and showed strong recall of the messaging.

Objective:
This study was a dismantling trial of Motivational Interviewing (MI) and feedback among heavy-drinking college students. The study tested which intervention format(s) would lead to greater reductions in drinking compared with assessment only (AO), whether an in-person motivational interviewing with feedback (MIF) intervention would have an effect over feedback that was delivered without human contact, and whether the inclusion of feedback would improve the effectiveness of MI.
Method:
After an initial screening, 279 heavy-drinking students from a medium-size private university in the southern United States were randomized to (a) personalized Web feedback only, (b) a single MI session without a personalized feedback report, (c) a single MI session with a personalized feedback report, or (d) assessment only. Participants were at least 18 years old and reported at least one heavy drinking episode in the past two weeks. Measures were completed online at a baseline assessment, as well as at 3- and 6-month follow-up assessments. Outcome measures included alcohol consumption and alcohol related problems. Potential mediators included normative perceptions and protective behaviors; potential moderators included readiness to change, drinking severity, and demographic variables. Personalized feedback was modified from the electronic Check-Up to Go. The feedback included a quantity and frequency summary of drinking behavior, comparison to U.S. adult and campus norms, level of risk, estimated dollar amount and percentage of income spent on alcohol, and local referral resources. Students in the feedback only condition received the feedback immediately on the computer screen after the participant completed the baseline assessment. Those in the motivational interviewing feedback group received their feedback profile during the motivational interviewing session.
Results:
After 6 months, MI with feedback (MIF) significantly reduced drinking, as compared with assessment only (effect size=.54), MI without feedback (effect size=.63), and feedback alone (effect size=.48). Participants in the MIF group reported consuming fewer drinks per week, had fewer alcohol-related problems, and had a lower peak BAC than participants in the AO, FBO, and MIO measures. Norm perceptions mediated the effect of the intervention, with participants in the MIF condition becoming more accurate in their normative drinking estimates and changes in norm perceptions being linked to changes in drinking behavior. The researchers did not find that sex, race or ethnicity, readiness to change, or baseline drinking severity moderated the effect of the intervention. Neither MI alone nor feedback alone differed from assessment only.
Conclusions:
MI with feedback appears to be a robust intervention for reducing drinking and may be mediated by changes in normative perceptions. The findings suggest that the inclusion of both an in-person MI session and feedback profile is more potent than either feedback alone or MI alone in this population. The findings about the effectiveness of the typical MI format (MIF) support the existing literature on the effectiveness of this intervention.
Implications for the field:
Campus alcohol prevention or education programs should include MI with feedback to reduce the amount of heavy-drinking college students. Other researchers might want to consider ways to best disseminate such findings on MI and MIF studies.



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