Article - post-print
For over two decades, brief motivational interventions (BMIs) have been implemented on college campuses to reduce heavy drinking and related negative consequences. Such interventions include in-person motivational interviews (MIs), 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 BMIs, although overall effect sizes have been small.
The present study was an individual participant-level data (IPD) meta-analysis of 17 randomized clinical trials evaluating BMIs. 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 two to five repeated measures up to 12 months post-baseline.
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 three intervention types (Individual MI with PF, PF only, and Group MI) vs. 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.
The present study questions the efficacy and magnitude of effects of BMIs for college drinking prevention and intervention and suggests a need for the development of more effective intervention strategies.
This is an author-manuscript of an article accepted for publication in Alcoholism, Clinical and Experimental Research following peer review. The version of record: Huh, D., Mun, E.-Y., Larimer, M. E., White, H. R., Ray, A. E., Rhew, I. C., … Atkins, D. C. (2015). Brief motivational interventions for college student drinking may not be as powerful as we think: An individual participant-level data meta-analysis. Alcoholism, Clinical and Experimental Research, 39(5), 919–931 is available online at: http://doi.org/10.1111/acer.12714.
Huh, D., Mun, E.-Y., Larimer, M. E., White, H. R., Ray, A. E., Rhew, I. C., … Atkins, D. C. (2015). Brief motivational interventions for college student drinking may not be as powerful as we think: An individual participant-level data meta-analysis. Alcoholism, Clinical and Experimental Research, 39(5), 919–931. http://doi.org/10.1111/acer.12714