In the second random effects model we carried out a sensitivity analysis using multiple imputation. Responses were summed to provide an alcohol-related problems score (range 10 to 20 with a higher score indicating more problems). The intervention group will receive the brief personalized normative feedback via email within a few weeks of completing the assessment and will be followed up at 6 months, along with the first control group. The author(s) declare that they have no competing interests. In the first random effects model we treated all missing values as missing at random (MAR). The brief personalised normative feedback (PNF) emailed to each participant in the intervention group one to two weeks post-baseline comprised the results of their drinking behaviour assessment compared with, in an easy to read graphical format, average levels of drinking amongst their student peer group. Kypri also suggested that a social desirability response bias may have influenced the results. Wrote the paper: DRF MTM RO. Clues as to the differences in effect across different studies might lie in the differences in intervention content and delivery. For the proportions of students exceeding 21 units a week (men) or 14 units a week (women), we used generalized linear mixed models with the xtlogit procedure. Personalised normative feedback (PNF) aims to correct this misperception by providing information about personal drinking levels and patterns compared with norms in similar aged peer groups. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. On the other hand, this study was a large pragmatic randomised trial with design, sampling, recruitment and follow-up characteristics that are similar to other large European trials [44]–[46]. Previous reviews have examined PNF in combination with other components but not as a stand-alone intervention. Yes 5. For more information about PLOS Subject Areas, click Affiliation In the analysis, respondents were scored 1 if they were over these levels, otherwise 0. Yes Recruitment, follow-up and attrition are described in Figure 1. The feedback also provided general information about alcohol and how it might affect them at their current drinking levels, including how long it could take to return to a zero blood alcohol level after a typical drinking occasion. This randomized controlled trial evaluated a computer-delivered, norms-based personalized feedback intervention which systematically varied the focus on whether specific drinking behaviors were described as common or uncommon (a descriptive norm), whether the drinking behaviors were healthy versus unhealthy, and whether the drinking behaviors were positively or negatively framed (an injunctive norm). This randomized controlled trial evaluated a computer-delivered, norms-based personalized feedback intervention which systematically varied the focus on whether specific drinking behaviors were described as common or uncommon (a descriptive norm), whether the drinking behaviors were healthy versus unhealthy, and whether the drinking behaviors were positively or negatively framed (an injunctive norm). The study utilised a Solomon three group randomised controlled trial design [27], with one intervention and two control groups to control separately for intervention and for measurement effects. PNF is intended to raise motivation for behaviour change [16], [17] and has been highlighted as a promising intervention by the British Government Behavioural Insight Team [18], [19]. We calculated normative misperception from two variables: the number of alcoholic drinks (“yourself” and “students in your year”) respondents felt were on average consumed at parties or social events. Sliwinski (2002) suggested that personalized normative feedback develops discrepancy by making student’s drinking behaviors sa-lient, by providing them a context in which to evaluate their drinking, and by highlighting the inconsistency between current behavior and both normative and personal standards. Kypri K, Langley J, Saunders J, Cashell-Smith M: Assessment may conceal therapeutic benefit: findings from a randomized controlled trial for hazardous drinking. PubMed Google Scholar. Multivariate analyses will be conducted with gender, nationality, University year (one and two), social desirability and study country as covariates. Analyzed the data: RO DRF MTM. PubMed  Individual-level strategies aim to produce changes in attitudes or behaviors related to alcohol use rather than the environments in which alcohol use occurs. Our results fail to replicate the findings of the New Zealand, Australian and U.S. trials of brief, web-based, social normative feedback [40]–[42]. Received unwanted sexual advances. Yes No, Is the Subject Area "Questionnaires" applicable to this article? Funding: MTM was supported by a fellowship from the Portuguese Foundation for Science and Technology. Statistical tests of difference in proportions or mean difference tests (or non-parametric equivalents) will be used to test differences between intervention and control groups. 10.1111/j.1360-0443.2006.01632.x. Addiction. Respondents also completed a drinking diary about a “typical week”, where they indicated the number of drinks/units they usually drink on each day of the week, and this was used to calculate the number of units consumed each week. Personalised normative feedback (PNF) aims to correct this misperception by providing information about personal drinking levels and patterns compared with norms in similar aged peer groups. Social desirability responsiveness was also assessed using the short form of the Marlowe Crown scale 2 [37]. This group is likely to be a minority so the sample size has to be increased to ensure sufficient numbers of this high risk group to enable robust statistical analysis with power =.9 and α = .05 (2-tailed tests) and taking account of expected participation and attrition rates. DRF declares that his Department has received funding from the alcohol industry for prevention projects, and that he is a Trustee of the alcohol-industry funded Drinkaware Trust. Randomisation is achieved by concealed centrally-allocated computer generated random numbers. Data are collected at baseline, six months and 12 months. A Solomon Three Group Design will be used. Studies have shown that university/college students tend to have an exaggerated view of the quantities of alcohol being consumed by their peers. Research has demonstrated that when compared with more distal referents, proximal referents are more effective for preventing student alcohol misuse and related problems [35], [49], [50]. The innovative design and sampling aspects of this study: the Solomon three-group design to test for measurement effects, and the whole sample and higher risk sub-sample analyses to test the prevention paradox prediction, were illuminating. Therefore an effective prevention programme that has a significant impact on alcohol related problems amongst young people would be very important. Therefore, other problems were measured in a newly-developed self-reported scale with nine possible problems, listed on a yes/no scale: 1. Data from the ESPAD Project. Data will be analysed by a researcher blinded to experimental group. Moreira, T., Foxcroft, D.R. At the same time, binge drinking rates amongst young people are high in the UK and Holland, and are increasing in the UK where alcohol related violence and crime is a major cause for concern. A copy of the online questionnaire is available for download [30]. California Privacy Statement, In the full population analyses 111/122 universities and 876/1751 individuals were followed up and analysed at 6-months, and 107/122 universities and 718/1751 individuals at 12-months. Springer Nature. 1963, Boston: Houghton Mifflin, Barbro A, Björn H, François B, Marie C, Anna K, Anastasios F, Sabrina M, Alojz N, Januzs S, Marcis T: Alcohol and Drug Use Among European 17–18 Year Old Students. 10.1111/j.1360-0443.2005.01294.x. No, Is the Subject Area "Motivation" applicable to this article? Normative feedback as an approach to alcohol misuse prevention is based on Social Norming Theory. Undergraduate students in year one and two of their course will be invited to participate via poster, flyer, email or via university student information systems at the beginning of the academic year 2007/8. Individual-Level Strategies. After 12 months this group had significantly lower alcohol-related problem scores than controls. There is also a question about whether PNF is effective over and above the simple alcohol screening/assessment test that itself raises awareness about alcohol consumption [23]. Correspondence to 2002, 164-172. Cochrane Database of Systematic Reviews. To examine the effectiveness of brief personalized normative feedback in reducing alcohol related problems in first and second year university undergraduate students, To compare the effectiveness of brief personalized normative feedback between students in England and students in Portugal. Information will also be provided on the money that they might be spending on alcohol and also the calories they might be consuming at their current drinking levels. This trial will provide information on the effectiveness of an on-line personalized normative feedback intervention for alcohol misuse in university students. Campbell D, Stanley J: Experimental and quasi-experimental designs for research. The brief personalised normative feedback given to each intervention group participant will comprise the results of their drinking behaviour assessment alongside information about alcohol and how it might affect them at their current drinking levels. Required emergency medical treatment; 7. Information about how much students actually consume, accurate statistics about the frequency of negative consequences among them and basic information relating to alcohol are part of the approach [4]. PLOS ONE promises fair, rigorous peer review, Both authors have contributed to the development of this protocol. The objective of the trial was to assess the effectiveness of PNF with college students for the prevention of alcohol misuse. In conclusion, our results show no evidence for the effectiveness of personalised normative feedback for the prevention of alcohol misuse and alcohol-related problems in a UK student population. Tom Arnett, Research Fellow at the ... old PD — what PD has been or used to be — I think a positive development is we see more and more PD becoming more personalized to teachers’ needs. Online personalized normative feedback (PNF) interventions have been found to reduce college drinking, yet few studies have investigated the effect of event-specific PNF on drinking. Intention to treat was applied in all analyses. The reason(s) for the inconsistent findings between our study and some other studies is not clear. Grateful thanks to Dr Gil Lopes for developing the web-based technology for this study. 2001, Geneva: World Health Organization, 57-. Random effects models [29], [30] allow the incorporation of all participants with at least 1 follow-up observation. BMJ. No additional external funding was received for this study. Therefore, a second objective was to assess the effectiveness of whole population PNF versus PNF for high-risk drinkers only. However, Kypri has not been able to establish whether the normative feedback intervention, or simply measuring drinking behaviour using the alcohol use disorders identification test (AUDIT) screening tool, was the active ingredient accounting for this effect. The aim of the trial is to determine the effectiveness of an on-line personalized feedback intervention for reducing alcohol consumption amongst undergraduate University students when compared with a control group, in both the UK and Portugal. Define the impact of brief interventions when used at intakes of extended treatment https://doi.org/10.1371/journal.pone.0044120.t001, https://doi.org/10.1371/journal.pone.0044120.t002. Google Scholar, Perkins HW: Social Norms and the Prevention of Alcohol Misuses in Collegiate Contexts. The feedback will also compare their drinking – in graphical format – to the drinking of their student peers. A more conventional Solomon four group design was not possible given that the intervention required baseline information in order to personalise feedback to each participant. Although Kypri [9] and others have targeted high risk drinkers, the prevention paradox states that more harm comes from those at lower levels of risk, and Rossow [10] has recently demonstrated that this paradox holds, albeit to a lesser extent, for heavy episodic drinking and acute harms. Six- and twelve-month follow-up analysis in the high risk sub-sample showed no effects of the intervention, at either time-point (Tables 3 and 4) and in both the completed case analysis and the multiple imputation analysis, for most outcomes. No, Is the Subject Area "Traumatic injury risk factors" applicable to this article? We were not able to collect information about reasons for non-completion of follow-up questionnaires. broad scope, and wide readership – a perfect fit for your research every time. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, https://doi.org/10.1371/journal.pone.0044120, http://www.cabinetoffice.gov.uk/sites/default/files/resources/Behaviour-Change-Insight-Team-Annual-Update_acc.pdf, http://www.camh.net/About_Addiction_Mental_Health/Drug_and_Addiction_Information/evaluate_your_drinking.html, https://docs.google.com/folder/d/0B6qFfRezLfa4SlYyWVB6MHZwTEU/edit, http://wwwaddiction-ssaorg/2011/McCambridgeJ%20Presentationppt. Yes Norms clarification has been identified as an effective component of college student drinking interventions, prompting research on norms clarification as a single-component intervention known as Personalized Normative Feedback (PNF). Young people who engage in one problem behaviour (e.g. Again, only weekly drinking had a significant effect at six-months (OR = 0.440, 95% CI 0.245, 0.788), but not at 12-months (OR = 0.770, 95% CI 0.495, 1.197). There is a potential risk to internal validity from the low follow-up rates achieved in our study, although students unavailable for follow-up were similar across groups with regard to sex, age and baseline drinking status, and the multiple imputation sensitivity analysis did not produce any marked or systematic changes in treatment effect sizes or significance.