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Brief Motivational Interventions for College Student Drinking May Not Be as Powerful as We Think: An Individual Participant‐Level Data Meta‐Analysis
Author(s) -
Huh David,
Mun EunYoung,
Larimer Mary E.,
White Helene R.,
Ray Anne E.,
Rhew Isaac C.,
Kim SuYoung,
Jiao Yang,
Atkins David C.
Publication year - 2015
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/acer.12714
Subject(s) - psychological intervention , meta analysis , psychology , randomized controlled trial , multilevel model , intervention (counseling) , sample size determination , clinical psychology , experience sampling method , repeated measures design , medicine , statistics , social psychology , mathematics , psychiatry , surgery
Background For over 2 decades, brief motivational interventions ( BMI s) have been implemented on college campuses to reduce heavy drinking and related negative consequences. Such interventions include in‐person motivational interviews ( MI s), 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 BMI s, 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 BMI s. 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 BMI s for college drinking prevention and intervention and suggests a need for the development of more effective intervention strategies.