The efficacy of Personalized Normative Feedback interventions across addictions: A systematic review and meta-analysis

Personalized Normative Feedback (PNF) may help address addictive disorders. PNF highlights discrepancies between perceived and actual peer norms, juxtaposed against self-reported behavior. PNF can be self-directed and cost-efficient. Our study estimates the efficacy of PNF alone, and in combination with other self-directed interventions, to address frequency and symptom severity of hazardous alcohol use, problem gambling, illicit drug and tobacco use. We searched electronic databases, grey literature, and reference lists of included articles, for randomized controlled trials published in English (January 2000-August 2019). We assessed study quality using the Cochrane Risk of Bias tool. Thirty-four studies met inclusion criteria (k = 28 alcohol, k = 3 gambling, k = 3 cannabis, k = 0 tobacco). Thirty studies provided suitable data for meta-analyses. PNF alone, and with additional interventions, reduced short-term alcohol frequency and symptom severity. PNF with additional interventions reduced short-term gambling symptom severity. Effect sizes were small. PNF did not alter illicit drug use. Findings highlight the efficacy of PNF to address alcohol frequency and symptom severity. The limited number of studies suggest further research is needed to ascertain the efficacy of PNF for gambling and illicit drug use. Cost-effectiveness analyses are required to determine the scale of PNF needed to justify its use in various settings.

Reducing Alcohol Use Among High School Athletes: A Randomized Controlled Trial of a Brief, Web-Based Personalized Normative Feedback Intervention

High school athletes are at risk for heavy alcohol use, which is associated with consequences that may negatively impact performance and eligibility to participate in sports. This study evaluated the efficacy of a web-based personalized normative feedback intervention on reducing alcohol use among high school athletes in their senior year. Class periods were randomized to the intervention or an assessment-only control group. Athletes completed surveys at baseline and at a 6-week follow-up. They were classified as high-risk or low-risk drinkers based on baseline reports of binge drinking. Results indicated that for athletes classified as high-risk drinkers, those in the intervention group reported significantly greater reductions in quantity of weekly drinking and peak drinking quantity compared with those in the assessment-only control group. There were no significant intervention effects for frequency of alcohol use. Findings support the efficacy of web-based personalized normative feedback intervention for reducing alcohol use among high school senior athletes.

A Gamified, Social Media Inspired, Personalized Normative Feedback Alcohol Intervention for Sexual Minority Women: Protocol for a Hybrid Trial (Preprint)

BACKGROUND Sexual minority women (SMW) are more likely to drink alcohol, engage in heavy drinking, and experience alcohol-related problems than are heterosexual women. Yet, to date, culturally tailored interventions for this population have been slow to emerge. OBJECTIVE This Type I Effectiveness/Implementation Trial examines the feasibility and efficacy of a gamified, culturally tailored, personalized normative feedback (PNF) alcohol intervention for SMW. METHODS The core components of a PNF intervention were delivered within LezParlay, a fun, social media inspired, digital competition designed to challenge negative stereotypes about lesbian, bisexual, and queer women and increase visibility. Following two rounds of play by a large cohort of SMW, a sub-sample of 500 drinkers already taking part in the competition were invited to participate in an evaluation study. Study participants were randomized to receive 1 of 3 unique sequences of PNF (i.e., Alcohol & Stigma-Coping, Alcohol & Control, or Control topics only) over 2 intervention rounds. RESULTS Analyses will evaluate whether PNF on alcohol use reduced participants’ drinking and negative consequences 2 and 4 months post-intervention, examine whether providing PNF on stigma-coping behaviors in addition to alcohol use further reduces alcohol use and consequences beyond alcohol PNF alone, identify mediators and moderators of intervention efficacy, and examine broader LezParlay app engagement, acceptability, and perceived benefits. CONCLUSIONS This “incognito” intervention approach is uniquely oriented toward engaging and preventing alcohol-related risks among community populations of SMW who may view their heavy drinking as normative and not in need of change due to the visibility of alcohol use in sexual minority community spaces. Thus, the present intervention strategy diverges from, and is intended to compliment more intensive programs being developed to meet the needs of SMW already motivated to reduce their consumption. CLINICALTRIAL ClinicalTrials.gov NCT03884478; https://clinicaltrials.gov/ct2/show/NCT03884478