Wednesday, March 11, 2009

Online Alcohol Intervention and Prevention Programs

Online Alcohol Intervention and Prevention Programs

by Katie Howard

Learning Objectives

This Public Health Informatics Wiki will help readers:
  1. Provide a general overview of alcohol intervention web-based programs.
  2. Identify the types of alcohol prevention and intervention programs that can be best conducted online.
  3. Identify key components of online alcohol programs.
  4. List at least three positives and three negative aspects of alcohol intervention web-based programs.

Web-based Alcohol Abuse Prevention Programs

Web-based interventions for primary and secondary prevention of alcohol abuse have become increasingly popular. These websites tend to target either high-risk groups or those who abuse alcohol. Interventions are not usually designed to address issues surrounding alcoholism or alcohol addiction since this diagnosis tends to have different and more severe consequences surrounding physical and psychosocial health (Moyer, Finney, Swearingen, & Vergun, 2001). Web-based interventions can help to identify behavioral patterns that lead to or cause alcohol abuse. These interventions are usually for people who are entering college as undergraduates or for people who have been identified as alcohol abusers.

Alcohol Abuse and College Students

College students have been identified as an at-risk group for binge drinking and alcohol abuse. Hingson, Heeren, Winter, and Wechsler (2005) randomly sampled thousands of college students to determine typical drinking behavior. The study used the typical definition of binge drinking which is five or more drinks for men and four or more drinks for women in a single drinking session. They found that 23 percent of students had binge drank three or more times in the past two weeks. In addition, after conducting an ethnographic survey of past studies, the researchers revealed that college students may be at greater risk than other people in the same age group due to the following reasons:
  • 43.2 percent of college students binge drank at least once in the following year while 39.8 percent of same-age noncollege participants.
  • 31.4 percent of college students drove under the influence of alcohol in the last year while only 23.7 percent of those same-age noncollege participants did so.
Since undergraduate college students tend to exhibit higher rates of drinking, alcohol abuse, and related high-risk behavior, university and public health officials have designed and implemented interventions to prevent as well as stop alcohol abuse among college students.

Usefulness of Brief Interventions

Brief interventions have been shown to be successful among the general population. In a meta-analysis of brief interventions, which includes face-to-face contact with a health care provider or educator for people suffering from alcohol abuse, a significant positive impact was found to be present on subjects’ drinking patterns (Moyer, Finney, Swearingen, &Vergun, 2001). However, brief interventions were not more effective than controlled interventions where individuals with severe alcohol abuse problems were included and a single session of advice was not found to be useful for patients with severe drinking problems (ibid). This information is encouraging in terms of the possible success of online interventions to prevent and intervene when low to moderate alcohol abuse is present. Online interventions are brief in nature and are designed to inform the participant of the possible problem. The program can also help them identify ways to drink moderately or abstain from alcohol consumption.

The Nature of Online Alcohol Abuse Interventions

Several online interventions exist that are specifically geared towards college students. These include websites such as and College Alc, whose effectiveness has been reviewed in peer-review journals. These programs must be bought by participating universities, and students are then given access to the websites. One advantage of this is that they are tailored specifically for college students, but they are not available to the general public.

Chiauzzi, et al. (2005) analyzed the effectiveness of Alcohol that provides primary intervention about risks associated with drinking and a self-evaluation based on the BASICS model. The self-evaluation helps to tailor the website to content so that it is appropriate for each individual. Chiauzzi, et al. (2005) found that students who came in at the pre-contemplation stage reduced their consumption of alcohol at a significantly larger proportion than low-motivation to change drinkers. This program can be used to raise awareness among college students who never considered the serious consequences of alcohol consumption or thought about how their personal consumption may be affecting their academics, health, and social interactions. At follow-up, was shown to reduce rates of drinking are a greater rate that the control group which students visited websites that contained information about the risks of drinking once a week for four weeks (ibid).

College Alc or is another website that has been tested in a semi-experimental setting. This program allows colleges to customize the website for their students. The prevention strategy focuses on identifying alcohol abuse and its consequences as well as environmental factors, like the college’s policies, and law enforcement, and social situations, that may contribute to excessive alcohol consumption. College Alc reduced participants’ self-reported rates of heavy drinking, experiences of drunkenness, and negative alcohol-related consequences in the last 30 days, but the affect was relatively small (Bersamin, Paschall, Fearnow-Kenney, & Wyrick, 2007). No effect was found on students who did not consume alcohol before entering the program (ibid).

Some websites not geared specifically towards students include a very similar pattern to these programs: a self-assessments and followed bypersonalized feedback about drinking patters. A good example of this type of website is: This website is put together by the Center for Addiction and Mental Health. After completing a self-assessment, each user is given information on how drinking impacts such as the amount money spent buying alcohol, time spent intoxicated and calories consumed over the last year. Also, the website includes a personalized estimate of the likelihood of injury and other negative consequences based on the individual’s drinking habits. Cunningham, Humphreys, Koski-Jannes and Cordingley (2005) conducted a small study on the effectiveness of this website to reduce high risk drinking. They found that alone the website did reduce high risk drinking, but in conjunction with written materials, the intervention was more successful. When colleges use online alcohol prevention and intervention programs, handing out additional materials may increase the effectiveness of the program and some programs, such as College Alc, do offer textbooks and other materials to supplement their website.

Summary of Key Components and Benefits

The Center for Addiction and Mental Health’s assessment, College Alc and all contain key components which should be present in an alcohol abuse prevention and intervention program. These key components are:
  • Assessment of individual’s current drinking patterns
  • Summary or specialized feedback based on assessment
  • Identification of risks associated with drinking and possible environmental influences
These can be important tools in helping students find motivation to cut back on drinking. Some advantages of online programs are that they can reach a large number of students, provide individual feedback, and have been shown to reduce drinking rates. Students also may be more likely to be honest about their drinking patterns in an anonymous, private setting than in a classroom or health care setting. These programs however are not appropriate for those who meet the clinical definition of an alcoholic and these are often the people who suffer the most serious consequences of alcohol consumption. Also, the startup cost of the individualized programs for college students can be expensive and these programs may not address the individual’s complex psychosocial reasons for abusing alcohol. Overall, these interventions seem to be important tools in helping to prevent and curb binge drinking on college campuses.

Additional Websites:
Academic Resources:
Bearsamin M., Paschall, M. J., Fearnow-Kenney, M., & Wyrick, D. (2007). Effectiveness of a web-based
alcohol-misuse and harm-prevention course among high- and low-risk students. Journal of American College Health. 55(4): 247-254.
Chiauzzi, E., Green, T. C., Lord, S., Thum, C., & Goldstein, M. (2005). My student body: A high-risk drinking prevention web site for college students. Journal of American College Health. 53(6): 263-274.
Cunningham, J. A., Humphreys, K., Koski-Jannes, A., & Cordingley, J. (2005). Internet and paper self-help materials for problem drinking: Is there an additive effect? Addictive Behaviors. 30(8):1517-1523. Retrieved November 20, 2007 from doi:10.1016/j.addbeh.2005.03.003.
Hingston, R., Heeren, T., Winter, M., & Wechsler, H. (2005). Magnitude of Alcohol-Related Mortality and Morbidity
Among U.S. College Students: Changes from 1998 to 2001. Annual Review of Public Health. 26:259-79.
Moyer, A., Finney, J. W., Swearingen, C. E., & Vergun, P. (2001). Brief interventions for alcohol problems: A
meta-analytic review of controlled investigations in treatment-seeking and non-treatment-seeking populations.
Addictions. 97: 279-292.
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