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Social norms information for alcohol misuse in university and college students

Foxtrot DR et al. (2015)

Cochrane Database of Systematic Reviews - https://doi.org/10.1002/14651858.CD006748.pub4

Evidence Categories

  • Care setting: College/University Setting
  • Population group: Young adults (18-25)
  • Intervention: Media Intervention
  • Intervention: Psychosocial interventions
  • Intervention: Education Interventions
  • Outcome: Change in drug/alcohol consumption

Type of Evidence

Systematic Review

Aims

"To determine whether social norms interventions reduce alcohol‐related negative consequences, alcohol misuse or alcohol consumption when compared with a control (ranging from assessment only/no intervention to other educational or psychosocial interventions) among university and college students."

Findings

"A total of 70 studies (44,958 participants) were included in the review, and 63 studies (42,784 participants) in the meta‐analyses. Overall, the risk of bias assessment showed that these studies provided moderate or low quality evidence. Outcomes at four or more months post‐intervention were of particular interest to assess when effects were sustained beyond the immediate short term. We have reported pooled effects across delivery modes only for those analyses for which heterogeneity across delivery modes is not substantial (I2 < 50%). Alcohol‐related problems at four or more months: IFF standardised mean difference (SMD) ‐0.14, 95% confidence interval (CI) ‐0.24 to ‐0.04 (participants = 2327; studies = 11; moderate quality evidence), equivalent to a decrease of 1.28 points in the 69‐point alcohol problems scale score. No effects were found for WF or MF. Binge drinking at four or more months: results pooled across delivery modes: SMD ‐0.06, 95% CI ‐0.11 to ‐0.02 (participants = 11,292; studies = 16; moderate quality evidence), equivalent to 2.7% fewer binge drinkers if 30‐day prevalence is 43.9%. Drinking quantity at four or more months: results pooled across delivery modes: SMD ‐0.08, 95% CI ‐0.12 to ‐0.04 (participants = 21,169; studies = 32; moderate quality evidence), equivalent to a reduction of 0.9 drinks consumed each week, from a baseline of 13.7 drinks per week. Drinking frequency at four or more months: WF SMD ‐0.11, 95% CI ‐0.17 to ‐0.04 (participants = 9929; studies = 10; moderate quality evidence), equivalent to a decrease of 0.17 drinking days/wk, from a baseline of 2.74 days/wk; IFF SMD ‐0.21, 95% CI ‐0.31 to ‐0.10 (participants = 1464; studies = 8; moderate quality evidence), equivalent to a decrease of 0.32 drinking days/wk, from a baseline of 2.74 days/wk. No effects were found for GFF or MC. Estimated blood alcohol concentration (BAC) at four or more months: peak BAC results pooled across delivery modes: SMD ‐0.08, 95% CI ‐0.17 to 0.00 (participants = 7198; studies = 11; low quality evidence), equivalent to a reduction in peak BAC from an average of 0.144% to 0.135%. No effects were found for typical BAC with IFF."

Conclusions

"The results of this review indicate that no substantive meaningful benefits are associated with social norms interventions for prevention of alcohol misuse among college/university students. Although some significant effects were found, we interpret the effect sizes as too small, given the measurement scales used in the studies included in this review, to be of relevance for policy or practice. Moreover, the significant effects are not consistent for all misuse measures, heterogeneity was a problem in some analyses and bias cannot be discounted as a potential cause of these findings."