Use of the Internet for Prevention of Binge Drinking
Use of the Internet for Prevention of Binge Drinking
Aims: There are many consequences of binge drinking compared with light or moderate drinking behaviors. The prevalence rate and intensity of binge drinking is highest among the college-aged population. Given the popularity and high use of the Internet among college students, a novel approach for programming is through Internet-based interventions. The purpose of this study was to conduct a systematic review of Internet-based interventions targeting binge drinking among the college population.
Methods: Eligibility criteria included peer-reviewed articles evaluating Internet-based interventions for binge drinking prevention among college students published between 2000 and 2014. Only English language articles were included. Review articles and articles only explaining intervention pedagogies were not included. After a systematic screening process, a total of 14 articles were included for the final review. Each article was read thoroughly in order to extract the following variables: study design and sample size, average age of participants, underpinning theoretical framework, and intervention description and duration. This review also synthesized a methodological assessment with variables such as outcome measures, sample size justification, number of measurements and use of process evaluations.
Results: All studies but one reported a significant reduction in the frequency and quantity of alcohol consumption and problems related with heavy drinking. Furthermore, Internet-based interventions appeared to be more effective than traditional print-based interventions; however, face-to-face interventions were typically more effective.
Conclusions: This review supports using the Internet as a brief intervention approach that can effectively support efforts to reduce binge drinking among college students.
Alcohol use is a common behavior across many cultures. Reasons for alcohol consumption include relaxation, socializing, rituals and celebrations. Studies suggest that moderate drinking can lead to health benefits. For instance, moderate consumption of wine is associated with a significant decrease in cardiovascular mortality, possibly because moderate consumption of ethanol results in improved lipoprotein metabolism (German and Walzem, 2000). However, health benefits associated with moderate drinking likely are negated when individuals participate in heavy drinking, which creates new health risks. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defined the maximum number of drinks per day that should be consumed to avoid harmful consequences as four for males and three for females. The NIAAA defines binge drinking as a pattern of drinking that could lead to a person's blood alcohol concentration (BAC) level reaching 0.08 g/dl or above. Generally, this occurs if men consume five or more drinks or women consume four or more drinks within 2 h (NIAAA, 2004). The prevalence of binge drinking (28.2%) and number of drinks per day (9.3 drinks) are both highest among the young adult population aged 18–24 years (CDC, 2012). Also, approximately 90% of alcohol consumed in the United States by youth under the legal limit to purchase alcohol (21 years) is consumed during binge drinking (U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention, 2005). College students report a significantly higher level of binge drinking than their same age peers who do not attend college, which suggests that the high rates of binge drinking in this group is not related solely to age (Hingson et al., 2009).
Past studies have reported various health problems related to binge drinking among the college population. The Centers for Disease Control and Prevention (CDC) suggests binge drinking is associated with high blood pressure, cardiovascular diseases, stroke, liver disease, neurological damage, poor control of diabetes and other chronic diseases (US Department of Health and Human Services, 2000). Other health-related consequences of binge drinking include unintentional injuries (e.g. road accident), intentional injuries (e.g. violence), alcohol poisoning, sexually transmitted diseases, unintended pregnancy and sexual dysfunction (CDC, 2014). Each year 1825 deaths of college students aged 18–24 are attributed to alcohol-related unintentional injuries (Hingson et al., 2009). Similarly, 97,000 college students report alcohol-related sexual assault or date rape annually (Hingson et al., 2009). More than 25% of college students experience academic consequences due to drinking, including missing class, doing poorly on exams and assignments, and receiving lower grades (Wechsler et al., 1998). These consequences are significantly higher with binge drinking when compared to moderate drinking. For example, the chance of alcohol impairment for driving is 14 times more likely among binge drinkers compared to non-binge drinkers (Naimi et al., 2003).
Universities and other stakeholders are taking necessary steps to reduce binge drinking among their student bodies. For example, many universities implement strong anti-alcohol policies, give in-class lectures to educate students on the consequences of alcohol, provide peer education and counseling, discourage underage drinking by means of 3 strikes policies, and distribute of alcohol-related information to students through various mediums such as mail, posters and email. In addition, many universities have adapted web-based interventions to address binge-drinking problems among college students (Nelson et al., 2010). Internet-based interventions are an emerging area for public health and health promotion. Since the 2000s, Internet-based interventions have increased in use, and have been implemented in various educational target areas such as diabetes prevention (McKay et al., 2001), nutrition education (Oenema et al., 2001), and heavy drinking (Cunningham et al., 2000).
Internet-based interventions have the potential to provide additional benefits over the traditional methods of delivery of health promotion interventions. They are able to reach large populations in a cost effective manner (Walters et al., 2005), are convenient in delivering automated and tailored messages with less maintenance, can be more efficient in maintaining anonymity and privacy, and can provide participants with flexibility in terms of location and time of participation (Fotheringham et al., 2000). Also, emerging technologies have made it possible to incorporate interactive components to better facilitate individualized needs for intervention.
Currently, the population with the highest access to the Internet in the USA is the young adult and college students. According to the PEW Research center (PEW, 2014), 97% of college students have access to the Internet. Considering the benefits of Internet-based interventions and the wide access to the Internet among students, colleges have adopted and attempted various Internet-based interventions to reduce binge drinking behavior and overall alcohol consumption. However, little research has been done to review these efforts, and to date, there are a few systematic reviews that summarize the benefits, difficulties, and limitations of implementing Internet-based interventions to reduce binge drinking among college students (Bewick et al., 2008; White et al., 2010; Khadjesari et al., 2011). To illustrate this paper's contribution, it is important to note how this review is situated within existing review studies. Past reviews have analyzed Internet-based interventions for alcohol using behavior in more 'general' terms rather than binge drinking specifically (Bewick et al., 2008; Khadjesari et al., 2011). Other reviews also have suggested that Internet-based intervention is an effective approach, however they failed to assess the effectiveness of Internet-based interventions in a systematic manner (Kypri et al., 2005; White, 2006). Given the growth of Internet-based interventions for preventing binge drinking among college students, it is timely that a systematic review focusing on this issue should be carried out.
The purpose of this study was to analyze available evidence by utilizing established systematic review techniques to provide systematic appraisal of the Internet-based interventions aimed at reducing binge drinking among the college population.
Abstract and Introduction
Abstract
Aims: There are many consequences of binge drinking compared with light or moderate drinking behaviors. The prevalence rate and intensity of binge drinking is highest among the college-aged population. Given the popularity and high use of the Internet among college students, a novel approach for programming is through Internet-based interventions. The purpose of this study was to conduct a systematic review of Internet-based interventions targeting binge drinking among the college population.
Methods: Eligibility criteria included peer-reviewed articles evaluating Internet-based interventions for binge drinking prevention among college students published between 2000 and 2014. Only English language articles were included. Review articles and articles only explaining intervention pedagogies were not included. After a systematic screening process, a total of 14 articles were included for the final review. Each article was read thoroughly in order to extract the following variables: study design and sample size, average age of participants, underpinning theoretical framework, and intervention description and duration. This review also synthesized a methodological assessment with variables such as outcome measures, sample size justification, number of measurements and use of process evaluations.
Results: All studies but one reported a significant reduction in the frequency and quantity of alcohol consumption and problems related with heavy drinking. Furthermore, Internet-based interventions appeared to be more effective than traditional print-based interventions; however, face-to-face interventions were typically more effective.
Conclusions: This review supports using the Internet as a brief intervention approach that can effectively support efforts to reduce binge drinking among college students.
Introduction
Alcohol use is a common behavior across many cultures. Reasons for alcohol consumption include relaxation, socializing, rituals and celebrations. Studies suggest that moderate drinking can lead to health benefits. For instance, moderate consumption of wine is associated with a significant decrease in cardiovascular mortality, possibly because moderate consumption of ethanol results in improved lipoprotein metabolism (German and Walzem, 2000). However, health benefits associated with moderate drinking likely are negated when individuals participate in heavy drinking, which creates new health risks. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defined the maximum number of drinks per day that should be consumed to avoid harmful consequences as four for males and three for females. The NIAAA defines binge drinking as a pattern of drinking that could lead to a person's blood alcohol concentration (BAC) level reaching 0.08 g/dl or above. Generally, this occurs if men consume five or more drinks or women consume four or more drinks within 2 h (NIAAA, 2004). The prevalence of binge drinking (28.2%) and number of drinks per day (9.3 drinks) are both highest among the young adult population aged 18–24 years (CDC, 2012). Also, approximately 90% of alcohol consumed in the United States by youth under the legal limit to purchase alcohol (21 years) is consumed during binge drinking (U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention, 2005). College students report a significantly higher level of binge drinking than their same age peers who do not attend college, which suggests that the high rates of binge drinking in this group is not related solely to age (Hingson et al., 2009).
Past studies have reported various health problems related to binge drinking among the college population. The Centers for Disease Control and Prevention (CDC) suggests binge drinking is associated with high blood pressure, cardiovascular diseases, stroke, liver disease, neurological damage, poor control of diabetes and other chronic diseases (US Department of Health and Human Services, 2000). Other health-related consequences of binge drinking include unintentional injuries (e.g. road accident), intentional injuries (e.g. violence), alcohol poisoning, sexually transmitted diseases, unintended pregnancy and sexual dysfunction (CDC, 2014). Each year 1825 deaths of college students aged 18–24 are attributed to alcohol-related unintentional injuries (Hingson et al., 2009). Similarly, 97,000 college students report alcohol-related sexual assault or date rape annually (Hingson et al., 2009). More than 25% of college students experience academic consequences due to drinking, including missing class, doing poorly on exams and assignments, and receiving lower grades (Wechsler et al., 1998). These consequences are significantly higher with binge drinking when compared to moderate drinking. For example, the chance of alcohol impairment for driving is 14 times more likely among binge drinkers compared to non-binge drinkers (Naimi et al., 2003).
Universities and other stakeholders are taking necessary steps to reduce binge drinking among their student bodies. For example, many universities implement strong anti-alcohol policies, give in-class lectures to educate students on the consequences of alcohol, provide peer education and counseling, discourage underage drinking by means of 3 strikes policies, and distribute of alcohol-related information to students through various mediums such as mail, posters and email. In addition, many universities have adapted web-based interventions to address binge-drinking problems among college students (Nelson et al., 2010). Internet-based interventions are an emerging area for public health and health promotion. Since the 2000s, Internet-based interventions have increased in use, and have been implemented in various educational target areas such as diabetes prevention (McKay et al., 2001), nutrition education (Oenema et al., 2001), and heavy drinking (Cunningham et al., 2000).
Internet-based interventions have the potential to provide additional benefits over the traditional methods of delivery of health promotion interventions. They are able to reach large populations in a cost effective manner (Walters et al., 2005), are convenient in delivering automated and tailored messages with less maintenance, can be more efficient in maintaining anonymity and privacy, and can provide participants with flexibility in terms of location and time of participation (Fotheringham et al., 2000). Also, emerging technologies have made it possible to incorporate interactive components to better facilitate individualized needs for intervention.
Currently, the population with the highest access to the Internet in the USA is the young adult and college students. According to the PEW Research center (PEW, 2014), 97% of college students have access to the Internet. Considering the benefits of Internet-based interventions and the wide access to the Internet among students, colleges have adopted and attempted various Internet-based interventions to reduce binge drinking behavior and overall alcohol consumption. However, little research has been done to review these efforts, and to date, there are a few systematic reviews that summarize the benefits, difficulties, and limitations of implementing Internet-based interventions to reduce binge drinking among college students (Bewick et al., 2008; White et al., 2010; Khadjesari et al., 2011). To illustrate this paper's contribution, it is important to note how this review is situated within existing review studies. Past reviews have analyzed Internet-based interventions for alcohol using behavior in more 'general' terms rather than binge drinking specifically (Bewick et al., 2008; Khadjesari et al., 2011). Other reviews also have suggested that Internet-based intervention is an effective approach, however they failed to assess the effectiveness of Internet-based interventions in a systematic manner (Kypri et al., 2005; White, 2006). Given the growth of Internet-based interventions for preventing binge drinking among college students, it is timely that a systematic review focusing on this issue should be carried out.
The purpose of this study was to analyze available evidence by utilizing established systematic review techniques to provide systematic appraisal of the Internet-based interventions aimed at reducing binge drinking among the college population.
Source...