Pragmatic randomized controlled trial of a web-based intervention for alcohol use among Brazilian college students: Motivation as a moderating effect
Abstract
Background Web-based personalized normative feedback (PNF) interventions are less effective than their laboratory versions. Participant motivation may account for this reduced effect, but there is only a limited amount of research into the influence of motivation on PNF effectiveness. We evaluated the effectiveness of a web-based PNF in reducing alcohol use and consequences among college students with different motivation levels.Methods Pragmatic randomized controlled trial among Brazilian college drinkers aged 18-30 years (N = 4460). Participants were randomized to a Control or PNF group and followed-up after one (T1), three (T2) and six (T3) months. Outcomes were: AUDIT score (primary outcome), the number of consequences, and the typical number of drinks. Motivation for receiving the intervention was assessed with a visual analog scale (range: 0-10). Generalized mixed models assessed intervention effects via two paradigms: observed cases and attrition models.Results PNF reduced the number of typical drinks at T1 (OR = 0.71, p = 0.002), T2 (OR = 0.60, p < 0.001) and T3 (OR = 0.68, p = 0.016), compared to the control. Motivated students (score ≥3) receiving PNF also reduced the number of typical drinks at T1 (OR = 0.60, p < 0.001), T2 (OR = 0.55, p < 0.001) and T3 (OR = 0.56, p = 0.001), compared to the control. However, the attrition models were more robust at T1 and T2. In contrast, low-motivated students receiving the PNF increased AUDIT score at T3 (b = 1.49, p < 0.001).Conclusions The intervention reduced alcohol use, and motivation for receiving the intervention moderated the intervention effects. Motivated students reduced their typical alcohol use, whereas low-motivated students increased their AUDIT score.
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Web-based personalized normative feedback (PNF) interventions showed conflicting results in 2 studies with similar populations.
“Web-based, personalized normative feedback (PNF) interventions showed conflicting results in 2 studies with similar populations [30,34].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [34]
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- Authors
- Bedendo, A., Ferri, C. P., de Souza, A. A. L., Andrade, A. L. M., & Noto, A. R.
- Affiliations
- University of York (GB)
- Universidade Federal de São Paulo (BR)
- Pontifícia Universidade Católica de Campinas (BR)
- Corresponding author
- Bedendo, André
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2019-06
- Volume
- 199
- Pages
- 92-100
- ISSN
- 0376-8716 (ISSN-L)
- OpenAlex
- W2939473435
- Cited by
- 36
- References
- 60
- Citations by year
- 2025: 5 · 2024: 3 · 2022: 7 · 2021: 15 · 2020: 4 · 2019: 1
- FWCI
- 5.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- Funders
- São Paulo Research Foundation (2013/20341-7; 2015/19472-5)
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- Associação Fundo de Incentivo à Pesquisa
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Social Sciences › Arts and Humanities › Literature and Literary Theory › Media Influence and Health
- Keywords
- personalized normative feedback, online intervention, alcohol consumption, university students, motivation, moderating effect, AUDIT score, alcohol-related consequences
- MeSH terms
- Alcohol Drinking in College, Adolescent, Adult, Brazil, Female, Humans, Male, Motivation, Students, Universities, Internet, Feedback, Psychological, Young Adult, Early Medical Intervention
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