Effectiveness of mailbased eSBI to university students

1. Effectiveness of mailbasedeSBI to university students An RCT studyamong 2858 third term college students att Linköping University, Sweden Professor Preben Bendtsen, Institution of Medicine and Health, Linköping University, Sweden

2. Background • College and university students in most parts of the world may not drink veryfrequentbuttheyhave to drink excessivelywhenthey drink alcohol • Earlier studies from swedenconfirms this since 51% of female and 70 % of male students reportedengaging in heavy episodicdrinkingdefines as 5/4 or more standard drinks (12 gram of alcohol)

3. How to reach students? • Social norms interventions • Social norms refers to our preception and beliefs what is ”normal” behaviour in the people close to us, and that these beliefs influence our behaviour • Misperceptions takes place when there is an underestimation or overestimation of the prevalence of behaviours/attitudes in a population/group • Social norms intervention aims to correct such misunderstanding – hopefully leading to a change in the behaviour

4. Computerizedpersonalized normative feedback • Can provides students with information aboutactual student drinking norms • Can offer a comparisonbetween the students drinkingpattern and the actualdrinking norm • Can offer a personal drinkingprofile with relevant advice • Can be delived in variousways • Via email with an invitation to participate at a later stage in a special setting where the computerized test i performed • Via email with a hyperlink to a computerized test that is done on the students own computer • In a student healthcare setting

5. Currentevidense for computerized normative interventions to college students • Cochranereview by Moreira MT – juli 2009 • 22 RCT wasincluded in the reviewinvolving 7275 college or university students • Computerized interventions was the mosteffectivemeans of reaching students and showed an effect on: • At 3 month: Alcoholrelated problems, Peak BAC, drinkingfrequency, drinkingquantity and drinking norm • At 6 month: Alcoholrelated problems, drinkingfrequency, drinkingquantity, Binge drinking Effectsizesaround 0,3-0,4

6. eSBi to university students in Sweden • All third term university students at Linköping university was offered to perform a computerized alcohol habit test on their own computer via an email

7. The content of the email Dear student For you who are a student at the third term at faculty of Medical Science Becoming a university student often entails a number of new challenges, work-related as well as socially. Most students may also experience during their studies the strongly rooted alcohol culture prevailing in the student world. This mail contains a link to a test which enables you to get an overview of your alcohol habits. The test takes about 5-10 minutes to carry out and you will get a survey of your habits immediately after finishing the test. To access the test click the link below, which contains a coded link to the computer test. This means that no one else can trace your answers. Doing the test is of course completely voluntary. Your answers will be treated confidentially and you can break off the test whenever you want. The test cannot be traced to your person. Click here to take survey ! The test is part of a development project in cooperation between Student Health Care at a number of universities in Sweden and the National Institute of Public Health. Professor PrebenBendtsen, coordinator for Lifestyle Intervention Research Group at Linköping University, has developed the test based on previous research in the field. If you have any questions about the test you can mail goran.larsson@vxu.se at the Växjö University Student Health Centre or call Göran Larsson at 0470-70 82 66 or mail info@alexit.se to reach those who have programmed the actual test. If you want further information on alcohol-related issues you are welcome to contact the Student Health Centre at Växjö University. We hope you will take the chance to test your alcohol habits! Best regards, the Student Health Care Centre, Växjö University.

8. Välkommen! Gå vidare Välkommen! Här får du möjlighet att testa och se om, och i så fall hur, dina alkoholvanor har förändrats sedan sist. Testet tar ca 5 minuter. När du besvarat alla frågor presenteras en sammanställning av dina alkoholvanor. Du avgör själv om/hur du vill gå vidare med resultatet.

9. Bakgrundsdata Gå vidare Tillbaka Är du kvinna eller man? • Kvinna • Man Ange din ålder • 18-20 • 36-40 • 21-25 • 41-45 • 26-30 • 46-50 • 31-35 • 51- Vid vilken fakultet studerar du? • Utbildnings-vetenskap • TekFak • FilFak • HU

10. Veckokonsumtion • Standardglas, exempel • 1 standardglas • 1 burk folköl (50 cl) • 1 glas vin (15 cl) • 4 cl sprit • 1 flaska starköl/starkcider/alkoläsk (33 cl) • 1.5 standardglas • 1 burk starköl/stor stark 5% (50 cl) • 2 standardglas • 1 burk starköl 7-8 % (50 cl) • 3 standardglas • 1 burk starköl 10% (50 cl) • 7.5 standardglas • 1 flaska vin (75 cl) Gå vidare Tillbaka Hur mycket dricker du under en typisk vecka? Måndag Tisdag Onsdag Torsdag Fredag Lördag Söndag Hur många standardglas?

11. Konsekvenser Gå vidare Tillbaka Har dina alkoholvanor fått negativa konsekvenser? • Nej, inga • Ja, för: • Studierna • Ekonomin • Relationen till familj och vänner • Att jag hamnat i situationer jag ångrat • Sömnen • Min psykiska hälsa • Att jag har skadat mig fysiskt • Att jag hamnat i bråk/blivit utsatt för våld

12. Short feedback

14. 2 858 students were invited to participate by mail Students who were categorized as non-risky drinkers at baseline n=464 3 students had very high weekly consumption 1 120 students completed the test Intervention group n=330 Control group n=323 Agreed to participate n=148 Agreed to participate n=145 Response at 3 months n=125 Response at 3 months n=114 6 month follow-up Response from baseline and 3 months N=80 6 month follow-up Response from baseline and 3 months N=78 Response rate

18. Effectiveness of the two types of feedbackBaseline and 3 month

19. Effectiveness of the two types of feedbackBaseline and 6 month

20. Conclusion • Email based computerized screening appears to have an effect on heavy episodic drinking and higesth BAC but not on the total weekly consumption in the present study on third term students • No difference was found between a short feedback, only summarizing the students drinking in relation to sensible drinking limits, and a more comprehensive normative feedback. Why no difference was found is unclear • Future studies should include a true control group not beeing assessed at baseline – and strive to have a higher attrition rate