"Follow my Finsta": Drinking trajectories in relation to auxiliary Instagram accounts.

OBJECTIVE: This study explored the burgeoning youth practice of possessing a fake, secondary Instagram account known as a "Finsta" in relation to exposure to alcohol-related content and college drinking. PARTICIPANTS: First-year university students with at least a primary Instagram account (N = 296) completed online surveys. METHOD: Surveys assessed whether participants did or did not have a Finsta pre-matriculation (T1), Instagram alcohol content exposure one month into college (T2), and alcohol use at T1 and near the end of the first year (T3). RESULTS: Moderated mediation analysis revealed that having a Finsta at T1 was associated with greater exposure to alcohol-related posts at T2 and, for male but not female students, predicted heavier drinking at T3. CONCLUSION: Findings are consistent with previous results suggesting that males may be more behaviorally impacted by peers' depictions of alcohol use on social media. This carries implications for social media-based intervention efforts targeting first-year students.

An examination of the prospective associations between objectively assessed exposure to alcohol-related Instagram content, alcohol-specific cognitions, and first-year college drinking.

Previous research suggests that exposure to alcohol-related content on social media sites (SMSs) may inflate perceptions of drinking norms, thereby increasing drinking among college students and potentially undermining popular social norms-based alcohol interventions. However, prior research on exposure has used subjective measures of alcohol exposure and has focused mostly on Facebook. The current study focused on Instagram, a popular SMS among college students, and utilized objective time tracking and newsfeed sampling methods to rigorously examine the prospective relationship between exposure to alcohol-related Instagram content (ARIC), alcohol cognitions, and drinking. Participants were 309 matriculating college students (Mage = 18.1, SD = 0.26; 62.1% female; 46.9% White/Caucasian; 17.5% Hispanic) who had their Instagram use tracked and newsfeeds sampled via a macro several times during the transition into college (August & September), and completed a baseline survey and two follow-up surveys. A sequential mediation model examined theoretically derived pathways between objective ARIC exposure and alcohol use. Results revealed that objective ARIC exposure during the transition to college was positively associated with drinking at the end of the first year of college, and subjective frequency of ARIC exposure mediated this relationship between objective ARIC exposure and later drinking. Subjective frequency of ARIC exposure also mediated the association between objective ARIC exposure and perceptions of descriptive norms, which, in turn, predicted later drinking. These findings illustrate that greater objective ARIC exposure during the transition into college may increase risky drinking over the first year via increased subjective frequency of ARIC and elevated perceptions of drinking norms. Priority directions for future research are discussed and several novel ways in which social norms-based interventions for first-year students may be enhanced to better combat ARIC-related influences are introduced.

Examining interactions within the theory of planned behavior in the prediction of intentions to engage in cannabis-related driving behaviors.

Objective: As marijuana use becomes more available to college students through increasing legal reform, this paper seeks to examine intentions for driving under the influence of cannabis (DUIC) and riding with a high driver (RWHD) through the lens of the theory of planned behavior (TPB) and assess potential interactions between personal attitudes, subjective norms, perceived behavioral control (PBC), and sex. Participants: Undergraduate college students (N = 311) completed online surveys in September, 2013. Method: Participants self-reported their attitudes toward DUIC, subjective norms, PBC, past DUIC and RWHD, and intentions to DUIC and RWHD. Results: Participants' attitudes toward DUIC, subjective norms, and PBC were strongly associated with intentions to DUIC and RWHD bivariately. In regression models, attitudes and PBC were both positively and significantly related to intentions to DUIC and RWHD. Conclusions: DUIC and RWHD are concerns for college populations. Targeting personal attitudes and perceived behavioral control via interventions may reduce these behaviors.

Leveraging copresence to increase the effectiveness of gamified personalized normative feedback.

Virtual copresence, or the sense of being with others in an online space, is a feeling induced on many apps and websites through user avatars and browsable profile pages. Despite the small/modest effect sizes observed in popular web-based personalized normative feedback (PNF) alcohol interventions for college students, previous research has yet to consider how copresence might boost efficacy. This study builds on previous PNF gamification work to investigate whether specific copresence features (visual and text-based information about peers) increase PNF's ability to reduce alcohol use relative to a standard PNF condition and a gamified PNF condition. Copresence and perceptions of drinking norms (average drinks, peak drinks, and binge episodes) were assessed during a 3-week period following random assignment of college students (N = 235) to 1 of the 4 web-based PNF conditions (Standard PNF, Gamified PNF Only, Gamified PNF + Visual Copresence, and Gamified PNF + Maximum Copresence). These conditions asked the same questions about drinking and delivered identical PNF on alcohol use, but differed in the level of visual and text-based information about peers. Overall, only the gamified condition that featured maximum copresence significantly reduced drinking outcomes relative to standard PNF. However, conditional effects were moderated by pre-intervention drinking. Among heavier pre-intervention drinkers, both gamified conditions that featured copresence significantly improved upon Standard PNF in reducing alcohol use at follow-up. Findings suggest that including social media-like copresence features to visually represent and provide basic information about the peers contributing to the norms can enhance the efficacy of gamified PNF interventions, especially among high-risk heavy drinkers.

Increasing Chance-Based Uncertainty Reduces Heavy Drinkers' Cognitive Reactance to Web-Based Personalized Normative Feedback.

OBJECTIVE: Despite its prominence in the health communication literature, psychological reactance has rarely been considered as a factor that may undermine web-based Personalized Normative Feedback (PNF) alcohol interventions for college students. This study built on recent gamification work to examine how chance-based uncertainty, a popular game mechanic associated with motivation and attention in digital games for learning, might be leveraged to reduce the psychological reactance experienced by heavy drinking students receiving alcohol PNF, thereby leading to larger reductions in their alcohol consumption. METHOD: Psychological reactance, perceptions of norms, and drinking behaviors were assessed during a 3-week period following random assignment of binge drinking students (N = 141, 51% female) into one of four web-based PNF conditions. These conditions asked the same questions about drinking and delivered identical PNF on alcohol use but differed in whether animated slot-machine spinners appeared to select participants' question and feedback topics as well as the number of additional topics (beyond alcohol) on which questions were asked and PNF was delivered. RESULTS: All conditions similarly reduced drinking norms but differed in the degree to which they aroused cognitive reactance and reduced drinking. Relative to a no-spinner alcohol-only condition, increasing chance-based uncertainty by giving question and feedback topics the appearance of being selected by gamelike spinners substantially reduced cognitive reactance, which, in turn, reduced drinking 20 days later. Overall, participants experienced the least cognitive reactance when spinners first selected three question topics and later selected two of these topics to deliver feedback on. CONCLUSIONS: Findings suggest that introducing chance-based uncertainty through gamelike spinners, asking questions about multiple topics, and delivering feedback on additional topics unrelated to alcohol together work to reduce the degree to which the task feels like an alcohol intervention overtly aimed at reducing consumption, thereby making the alcohol PNF more effective among heavy drinking students.

Heavy Episodic Drinking Is Associated With Poorer Bone Health in Adolescent and Young Adult Women.

OBJECTIVE: Osteoporosis is a costly bone disease characterized by low bone mineral density (BMD) that primarily affects postmenopausal women. One factor that may lead to osteoporosis is a failure to reach peak bone mass (PBM) in early adulthood. In older adults and animal models, heavy episodic drinking (HED) has been found to predict failure to reach PBM. However, this relationship has yet to be investigated in adolescent human females. METHOD: Female college students (N = 87; 60% White) reported age at menarche, hormonal contraceptive use, physical activity, smoking habits, and HED history via an online survey and then received a dual energy x-ray absorptiometry bone scan to assess both lean body mass and BMD at the lumbar spine. RESULTS: Frequent HED (having four or more drinks within 2 hours on 115 or more occasions since the start of high school, which is approximately equal to 1.6 episodes per month over this period) was associated with decreased vertebral BMD even when variables most commonly associated with bone health (lean body mass, physical activity, age at menarche, smoking, and oral contraception use) were controlled for. However, early HED initiation (beginning HED at age 15 years or younger) was not significantly related to BMD. CONCLUSIONS: This is the first study to assess the impacts of early HED initiation and frequent HED during adolescence on the bone health of young women. Results suggest frequency of HED before reaching PBM, but not age at initiation, may be negatively related to skeletal health during young adulthood. These findings encourage research into the association between HED and BMD in late adolescence.

What "likes" have got to do with it: Exposure to peers' alcohol-related posts and perceptions of injunctive drinking norms.

OBJECTIVE: Examine 1) whether observed social reinforcements (i.e., "likes") received by peers' alcohol-related social media posts are related to first-year college students' perceptions of peer approval for risky drinking behaviors; and 2) whether associations are moderated by students' alcohol use status. PARTICIPANTS: First-year university students (N = 296) completed an online survey in September, 2014. METHOD: Participants reported their own alcohol use, friends' alcohol use, perceptions of the typical student's approval for risky drinking, and ranked 10 types of social media posts in terms of the relative numbers of "likes" received when posted by peers. RESULTS: Observed social reinforcement (i.e., "likes") for peers' alcohol-related posts predicted perceptions of peer approval for risky drinking behaviors among non-drinking students, but not drinking students. CONCLUSIONS: For first-year college students who have not yet initiated drinking, observing peers' alcohol-related posts to receive abundant "likes" may increase perceptions of peer approval for risky drinking.

In pursuit of a self-sustaining college alcohol intervention: Deploying gamified PNF in the real world.

Our recent work (Boyle, Earle, LaBrie, & Smith, 2017) showed that the efficacy of personalized normative feedback-based (PNF) college alcohol interventions can be improved through the addition of gamified elements including points, chance, competition, and personal avatars. However, participants in that study were compensated with subject pool credit. In the current study, we piloted an upgraded, smartphone-based version of the game, which was designed to be truly self-sustaining (i.e., engaging enough that students play voluntarily without the presence of external motivators). First-year students were invited to play the game weekly for six rounds, with participants submitting and voting on their own questions each week and receiving a novel type of feedback in addition to standard descriptive PNF: opposite peers' judgments of participants' self-reported drinking behavior, or reflective norms. With no play-based incentives, 222 first-year college students voluntarily played the game, CampusGANDR. ANCOVA models revealed that, relative to participants randomized to receive feedback on control topics during the three intervention rounds, those who received both descriptive and reflective feedback on peer alcohol use had significantly reduced normative perceptions and reduced alcohol use two months post intervention. This was especially true among heavy drinkers. The results suggest that our gamified "GANDR" approach shows promise as a self-sustaining intervention and, further, that high-risk drinkers may benefit disproportionately from this methodology. Thus, self-sustaining interventions represent an encouraging avenue for future research and development and may hold the potential to impact risky college drinking on a large scale.

PNF 2.0? Initial evidence that gamification can increase the efficacy of brief, web-based personalized normative feedback alcohol interventions.

Gamified interventions exploit the motivational characteristics of a game in order to provide prevention information and promote behavior change. Despite the modest effect sizes observed in increasingly popular web-based personalized normative feedback (PNF) alcohol interventions for college students, previous research has yet to consider how gamification might be used to enhance efficacy. This study examines whether a novel, gamified PNF intervention format, which includes a point-based reward system, the element of chance, and personal icons to visually represent users, is more effective in reducing short-term alcohol use than the standard web-based style of PNF currently used on college campuses. Two-hundred and thirty-seven college students were randomly assigned to receive either a standard brief, web-based PNF alcohol intervention or the same alcohol intervention components delivered within a Facebook-connected social game called CampusGANDR (Gamified Alcohol Norm Discovery and Readjustment). In both study conditions participants answered identical questions about their perceptions of peer drinking norms and own drinking and then received the same PNF slides. Two weeks following PNF delivery, participants again reported their perceptions of peers' alcohol use and own drinking. Students in the CampusGANDR condition reported significantly reduced peer drinking norms and alcohol use at the two-week follow-up relative to students who received identical PNF delivered by standard online survey. Further, a mediation model demonstrated that this effect was driven by larger reductions in perceived drinking norms among participants assigned to receive CampusGANDR, relative to control. As web-based PNF is becoming an increasingly universal prevention strategy, findings from this study suggest gamification may represent one method by which intervention efficacy could be substantially improved. The potential methodological and economic benefits associated with gamified PNF interventions are emphasized and directions for future research are discussed.

Facebook dethroned: Revealing the more likely social media destinations for college students' depictions of underage drinking.

Studies examining representations of college drinking on social media have almost exclusively focused on Facebook. However, recent research suggests college students may be more influenced by peers' alcohol-related posts on Instagram and Snapchat, two image-based platforms popular among this demographic. One potential explanation for this differential influence is that qualitative distinctions in the types of alcohol-related content posted by students on these three platforms may exist. Informed by undergraduate focus groups, this study examined the hypothesis that, of the three platforms, students tend to use Instagram most often for photos glamourizing drinking and Snapchat for incriminating photos of alcohol misuse and negative consequences. Undergraduate research assistants aided investigators in developing hypothetical vignettes and photographic examples of posts both glamorizing and depicting negative consequences associated with college drinking. In an online survey, vignette and photo stimuli were followed by counterbalanced paired comparisons that presented each possible pair of social media platforms. Undergraduates (N=196) selected the platform from each pair on which they would be more likely to see each post. Generalized Bradley-Terry models examined the probabilities of platform selections. As predicted, Instagram was seen as the most probable destination (and Facebook least probable) for photos depicting alcohol use as attractive and glamorous. Conversely, Snapchat was selected as the most probable destination (and Facebook least probable) for items depicting negative consequences associated with heavy drinking. Results suggest researchers aiming to mitigate the potential influences associated with college students' glamorous and consequential alcohol-related photos posted social media posts should shift their focus from Facebook to Instagram and Snapchat.

A parent-based intervention reduces heavy episodic drinking among first-year college students.

A randomized controlled trial tested an interactive normative feedback-based intervention-codenamed "FITSTART"-delivered to groups of 50-100 parents of matriculating college students. The 60-min session motivated parents to alter their alcohol-related communication by correcting normative misperceptions (e.g., about how approving other parents are of student drinking) with live-generated data. Then, tips were provided on discussing drinking effectively. Incoming students (N = 331; 62.2% female) completed baseline measures prior to new-student orientation. Next, at parent orientation in June, these students' parents were assigned to either FITSTART or a control session. Finally, 4 months later, students completed a follow-up survey. Results revealed that students whose parents received FITSTART during the summer consumed less alcohol and were less likely to engage in heavy episodic drinking (HED) during the first month of college. These effects were mediated by FITSTART students' lower perceptions of their parents' approval of alcohol consumption. Further, FITSTART students who were not drinkers in high school were less likely to initiate drinking and to start experiencing negative consequences during the first month of college, where FITSTART students who had been drinkers in high school experienced fewer consequences overall and were significantly more likely to report that they did not experience any consequences whatsoever during the first month of college. Importantly, FITSTART is the first parent-based intervention to impact HED, one of the most well-studied indicators of risky drinking. Thus, interactive group normative feedback with parents is a promising approach for reducing college alcohol risk. (PsycINFO Database Record

The Upside of Helicopter Parenting: Engaging Parents to Reduce First-Year Student Drinking.

University personnel tend to view "helicopter" parents as problematic. This paper presents an alternative view in which these highly engaged parents can instead be utilized productively. We describe and assess the fidelity of a novel program in which involved parents were effectively leveraged to mitigate student alcohol-related risk. The feasibility of utilizing similar programs at other schools is discussed as are implications for alcohol risk prevention.

Online personalized normative alcohol feedback for parents of first-year college students.

This study examined the efficacy of a personalized normative feedback (PNF) alcohol intervention for parents of students transitioning into college. A sample of 399 parent-student dyads were recruited to take part in the intervention during the summer prior to matriculation. Parents were randomly assigned to receive either normative feedback regarding student drinking and other college parents' alcohol-related communication or general college health norm information. Students completed measures of alcohol use, alcohol consequences, and parent-child alcohol-specific communication both 1 and 6 months after matriculation. The results indicated that in comparison with the control condition parents who received PNF reported immediate changes in their perceptions of other parents' behaviors; however, these changes in parent perceived norms did not translate into long-term changes in student drinking behaviors or parent-child communication. Findings highlight the need to consider content beyond normative feedback for parent based alcohol intervention. (PsycINFO Database Record

Is Prepartying a Cause of Heavy Drinking and Consequences Rather Than Just a Correlate? A Longitudinal Look at the Relationship Between Prepartying, Alcohol Approval, and Subsequent Drinking and Consequences.

BACKGROUND: Prepartying, or drinking before an event where more alcohol may or may not be consumed, has been positioned in the literature as a behavior engaged in by heavy drinkers. However, recent findings suggest that prepartying may confer distinct risks, potentially causing students to become heavier drinkers over time. OBJECTIVES: The goals of this study were to disentangle the longitudinal relationships between prepartying, general and episodic alcohol consumption, and alcohol-related consequences by investigating (1) whether prepartying is associated with future consequences above and beyond current alcohol consumption habits and (2) whether augmentations in approval for alcohol and related increases in drinking mediate this relationship. METHODS: One-hundred and ninety-five undergraduates completed online questionnaires at baseline, 6 months, and 12 months later. RESULTS: Prepartying frequency was more strongly related to alcohol-related consequences one year later than was overall or episodic drinking. In addition, a path mediation model confirmed our hypothesis that this relationship is due to gradual increases in drinking which occur as a result of more approving attitudes toward alcohol brought on by exposure to prepartying. Conclusion/Importance: Findings suggest a new model for conceptualizing the relationship between prepartying, drinking, and consequences whereby students who get involved in prepartying may witness slow increases in their approval for alcohol use and, as a result, consumption. Importantly, results suggest that the increases in drinking displayed by prepartiers over the course of a year may account for the strong relationship between prepartying and later consequences. Prevention and intervention initiatives may benefit from directly targeting prepartying as a means of tempering risky alcohol use trajectories during one's college tenure.