Improving Brief Alcohol Interventions With a Behavioral Economic Supplement

BMIs are associated with reductions in alcohol consumption and related problems, but effect
sizes are generally small. One BMI trial indicated that behavioral economic variables such as
low levels of proportionate substance-free reinforcement and inelastic demand for alcohol
predicted poor intervention response, and that participants who successfully reduced their
drinking increased their participation in academic and other substance-free activities. A
subsequent NIAAA R21 developed a substance-free activity session (SFAS) supplement to
traditional alcohol BMIs that attempted to increase engagement in constructive alternatives
to drinking by enhancing the salience of delayed rewards (academic and career success) and
the patterns of behavior (academic engagement) leading to these outcomes. This study
indicated that a two session (alcohol BMI + SFAS) preventive intervention resulted in
significantly greater reductions in alcohol problems relative to a two session (alcohol BMI +
Relaxation) active control condition. The BMI+ SFAS was also associated with significantly
greater reductions in heavy drinking for participants with lower levels of substance-free
reinforcement at baseline. This was the first controlled study to demonstrate that a
supplement to traditional BMIs can improve outcomes. The current study will extend these
promising pilot results by (a) increasing the efficacy of the behavioral economic SFAS by
including booster contact, (b) increasing power and generalizability by recruiting 425
students from two universities and including a no-treatment control group, (c) measuring
drinking, as well as behavioral economic mechanisms as mediators and moderators of
intervention outcomes (delay discounting, alcohol reinforcing efficacy, substance-free
reinforcement) at 5 time points over a sixteen month period, and (d) evaluating the economic
costs and benefits associated with the SFAS. The goals of the SFAS - increasing student
engagement in academic, campus, and career-related activities- are consistent with the
priorities of most colleges.

Inclusion Criteria:

- Male and female University of Memphis and University of Missouri

- College freshman or sophomore

- Full time student status

- Report 2 or more heavy drinking episodes (5/4 drinks for men/women) in the past month

Exclusion Criteria:

- Employed more than 20 hours per week