Trial Outcomes & Findings for A Gamified, Social Media Inspired Personalized Normative Feedback Alcohol Intervention for Sexual Minority Women (NCT NCT03884478)

Last Updated: 2023-03-07

Results Overview

At baseline and the 2 month follow-up, items assessing drinking days per week and average drinks per occasion were multiplied in order to compute number of drinks per week. These items come from the Frequency, Quantity, Max (FQM) measure. \[Baer J, S. Etiology and secondary prevention of alcohol problems with young adults. Baer J S, Marlatt G A, McMahon R, J, editors. Newbury Park: Sage; 1993.\] To compute the outcome, the 2 month measure of drinks per week was subtracted from the baseline measure of drinks per week such that a positive value indicates a decrease in consumption during this period and a negative value indicates an increase in consumption during this period.

Recruitment status

COMPLETED

Study phase

Target enrollment

500 participants

Primary outcome timeframe

2 months

Results posted on

2023-03-07

Participant Flow

Players learned about the broader LezParlay competition through 1 of 4 promotion strategies taking place over a 3-month period (11/15/2018 thru 2/15/2019): 1) flyers and promotional items distributed at local LBQ community events in Los Angeles; 2) targeted advertisement campaigns on HER social app, the leading LBQ dating app; 3) an advertisement in the email newsletter of Autostraddle, a popular blog for LBQ women; 4) targeted advertisement campaigns on Google, Facebook, and Instagram.

The 3rd round of LezParlay served as both the screening instrument and baseline assessment for the clinical trial. A total of 1337 women completed the round with the first 912 screened for clinical trial eligibility before the 500 spots in the trial were filled. One enrolled participant randomized to an arm was withdrawn prior to intervention delivery after disclosing to the research team that she had lied about her age and was actually a minor. This resulted in an N of 499.

Participant milestones

Participant milestones
Measure	Alcohol + Stigma Coping PNF Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and two control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on their stigma coping behaviors after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Alcohol + Control PNF Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on one control topic (Relationships) after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Control PNF Participants randomized to the control arm will answer questions about the same topics as participants in the other conditions in Round 3 (Alcohol Use \& Control) and Round 4 (Stigma-Coping \& Control). However, in both Rounds 3 and 4 they will receive gamified PNF on control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.
Baseline to 2 Months Post-intervention STARTED	144	179	177
Baseline to 2 Months Post-intervention COMPLETED	113	146	141
Baseline to 2 Months Post-intervention NOT COMPLETED	31	33	36
Baseline to 4 Months Post-intervention STARTED	144	179	177
Baseline to 4 Months Post-intervention COMPLETED	101	129	126
Baseline to 4 Months Post-intervention NOT COMPLETED	43	50	51

Reasons for withdrawal

Reasons for withdrawal
Measure	Alcohol + Stigma Coping PNF Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and two control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on their stigma coping behaviors after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Alcohol + Control PNF Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on one control topic (Relationships) after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Control PNF Participants randomized to the control arm will answer questions about the same topics as participants in the other conditions in Round 3 (Alcohol Use \& Control) and Round 4 (Stigma-Coping \& Control). However, in both Rounds 3 and 4 they will receive gamified PNF on control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.
Baseline to 2 Months Post-intervention Lost to Follow-up	30	33	36
Baseline to 2 Months Post-intervention Withdrawn by research team	1	0	0
Baseline to 4 Months Post-intervention Lost to Follow-up	42	50	51
Baseline to 4 Months Post-intervention Withdrawn by research team	1	0	0

Baseline Characteristics

1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.

Baseline characteristics by cohort

PRIMARY outcome

Timeframe: 2 months

Outcome measures

Outcome measures
Measure	Alcohol + Stigma Coping PNF n=113 Participants Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and two control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on their stigma coping behaviors after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Alcohol + Control PNF n=146 Participants Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on one control topic (Relationships) after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Control PNF n=141 Participants Participants randomized to the control arm will answer questions about the same topics as participants in the other conditions in Round 3 (Alcohol Use \& Control) and Round 4 (Stigma-Coping \& Control). However, in both Rounds 3 and 4 they will receive gamified PNF on control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.
Change in Number of Drinks Per Week From Baseline to the the 2 Month Follow-up	2.75 alcoholic drinks per week Standard Deviation 4.30	1.99 alcoholic drinks per week Standard Deviation 4.57	-.68 alcoholic drinks per week Standard Deviation 5.49

PRIMARY outcome

Timeframe: 4 months

At baseline and the 4 month follow-up, items assessing drinking days per week and average drinks per occasion were multiplied in order to compute number of drinks per week. These items come from the Frequency, Quantity, Max (FQM) measure. \[Baer J, S. Etiology and secondary prevention of alcohol problems with young adults. Baer J S, Marlatt G A, McMahon R, J, editors. Newbury Park: Sage; 1993.\] To compute the outcome, the 4 month measure of drinks per week was subtracted from the baseline measure of drinks per week such that a positive value indicates a decrease in consumption during this period and a negative value indicates an increase in consumption during this period.

Outcome measures

Outcome measures
Measure	Alcohol + Stigma Coping PNF n=100 Participants Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and two control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on their stigma coping behaviors after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Alcohol + Control PNF n=127 Participants Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on one control topic (Relationships) after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Control PNF n=126 Participants Participants randomized to the control arm will answer questions about the same topics as participants in the other conditions in Round 3 (Alcohol Use \& Control) and Round 4 (Stigma-Coping \& Control). However, in both Rounds 3 and 4 they will receive gamified PNF on control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.
Change in Number of Drinks Per Week From Baseline to the 4 Month Follow-up	2.52 alcoholic drinks per week Standard Deviation 4.68	1.99 alcoholic drinks per week Standard Deviation 4.57	0.52 alcoholic drinks per week Standard Deviation 5.88

PRIMARY outcome

Timeframe: 2 months

At baseline and the 2 month follow-up, an item assessing the number of maximum drinks on one occasion from the Frequency, Quantity, Max (FQM) measure was used to assess peak drinks on one occasion over the past 30 days. \[Baer J, S. Etiology and secondary prevention of alcohol problems with young adults. Baer J S, Marlatt G A, McMahon R, J, editors. Newbury Park: Sage; 1993.\] To compute the outcome, the 2 month measure of peak drinks was subtracted from the baseline measure of peak drinks such that a positive value indicates a decrease in consumption during this period and a negative value indicates an increase in consumption during this period.

Outcome measures

Outcome measures
Measure	Alcohol + Stigma Coping PNF n=143 Participants Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and two control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on their stigma coping behaviors after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Alcohol + Control PNF n=179 Participants Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on one control topic (Relationships) after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Control PNF n=177 Participants Participants randomized to the control arm will answer questions about the same topics as participants in the other conditions in Round 3 (Alcohol Use \& Control) and Round 4 (Stigma-Coping \& Control). However, in both Rounds 3 and 4 they will receive gamified PNF on control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.
Change in Peak Drinks on One Occasion From Baseline to the 2 Months Follow-up	1.49 alcoholic drinks Standard Deviation 1.78	1.42 alcoholic drinks Standard Deviation 1.86	-.18 alcoholic drinks Standard Deviation 1.92

PRIMARY outcome

Timeframe: 4 months

At baseline and the 4 month follow-up, an item assessing the number of maximum drinks on one occasion from the Frequency, Quantity, Max (FQM) measure was used to assess peak drinks on one occasion over the past 30 days. \[Baer J, S. Etiology and secondary prevention of alcohol problems with young adults. Baer J S, Marlatt G A, McMahon R, J, editors. Newbury Park: Sage; 1993.\] To compute the outcome, the 4 month measure of peak drinks was subtracted from the baseline measure of peak drinks such that a positive value indicates a decrease in consumption during this period and a negative value indicates an increase in consumption during this period.

Outcome measures

Outcome measures
Measure	Alcohol + Stigma Coping PNF n=113 Participants Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and two control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on their stigma coping behaviors after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Alcohol + Control PNF n=146 Participants Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on one control topic (Relationships) after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Control PNF n=126 Participants Participants randomized to the control arm will answer questions about the same topics as participants in the other conditions in Round 3 (Alcohol Use \& Control) and Round 4 (Stigma-Coping \& Control). However, in both Rounds 3 and 4 they will receive gamified PNF on control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.
Change in Peak Drinks on One Occasion From Baseline to the 4 Month Follow-up	.82 alcoholic drinks Standard Deviation 1.71	.61 alcoholic drinks Standard Deviation 1.46	.08 alcoholic drinks Standard Deviation 2.06

PRIMARY outcome

Timeframe: 2 months

At baseline and the 2 month follow-up, a single item assessed the number of negative alcohol-related consequences experienced out of a list of 8 common negative alcohol-related consequences. This item is adapted from Riley BB, Hughes TL, Wilsnack SC. Validating a hazardous drinking index in a sample of sexual minority women: Reliability, validity, and predictive accuracy. Substance Use and Misuse. 2017;52(1):43-51. doi: 10.1080/10826084.2016.1214150.\] To compute the outcome, the 2 month measure of negative consequences was subtracted from the baseline measure of negative consequences such that a positive value indicates a decrease in consequences during this period and a negative value indicates an increase in consequences during this period.

Outcome measures

Outcome measures
Measure	Alcohol + Stigma Coping PNF n=113 Participants Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and two control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on their stigma coping behaviors after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Alcohol + Control PNF n=146 Participants Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on one control topic (Relationships) after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Control PNF n=141 Participants Participants randomized to the control arm will answer questions about the same topics as participants in the other conditions in Round 3 (Alcohol Use \& Control) and Round 4 (Stigma-Coping \& Control). However, in both Rounds 3 and 4 they will receive gamified PNF on control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.
Change in Number of Negative Alcohol-related Consequences From Baseline to the 2 Month Follow-up	.23 negative consequences Standard Deviation 1.82	.25 negative consequences Standard Deviation 1.56	-.76 negative consequences Standard Deviation 1.68

PRIMARY outcome

Timeframe: 4 months

At baseline and the 4 month follow-up, a single item assessed the number of negative alcohol-related consequences experienced out of a list of 8 common negative alcohol-related consequences. This item is adapted from Riley BB, Hughes TL, Wilsnack SC. Validating a hazardous drinking index in a sample of sexual minority women: Reliability, validity, and predictive accuracy. Substance Use and Misuse. 2017;52(1):43-51. doi: 10.1080/10826084.2016.1214150.\] To compute the outcome, the 4 month measure of negative consequences was subtracted from the baseline measure of negative consequences such that a positive value indicates a decrease in consequences during this period and a negative value indicates an increase in consequences during this period.

Outcome measures

Outcome measures
Measure	Alcohol + Stigma Coping PNF n=100 Participants Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and two control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on their stigma coping behaviors after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Alcohol + Control PNF n=127 Participants Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on one control topic (Relationships) after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Control PNF n=126 Participants Participants randomized to the control arm will answer questions about the same topics as participants in the other conditions in Round 3 (Alcohol Use \& Control) and Round 4 (Stigma-Coping \& Control). However, in both Rounds 3 and 4 they will receive gamified PNF on control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.
Change in Number of Negative Alcohol-related Consequences From Baseline to the 4 Month Follow-up	.34 negative consequences Standard Deviation 1.55	.21 negative consequences Standard Deviation 1.56	-.67 negative consequences Standard Deviation 1.59

Adverse Events

Alcohol + Stigma Coping PNF

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Alcohol + Control PNF

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Control PNF

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Sarah C. Boyle, Senior Research Scientist

Loyola Marymount University

Phone: 3105686681

Email: [email protected]

Results disclosure agreements

Principal investigator is a sponsor employee
Publication restrictions are in place

Measure	Alcohol + Stigma Coping PNF n=143 Participants Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and two control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on their stigma coping behaviors after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Alcohol + Control PNF n=179 Participants Participants randomized to this condition will receive gamified personalized normative feedback on their alcohol use after answering questions about alcohol use and control topics in Round 3. Then, in the very next Round of the competition (Round 4), these participants will receive gamified personalized normative feedback on one control topic (Relationships) after answering questions about their stigma coping behaviors and two control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Control PNF n=177 Participants Participants randomized to the control arm will answer questions about the same topics as participants in the other conditions in Round 3 (Alcohol Use \& Control) and Round 4 (Stigma-Coping \& Control). However, in both Rounds 3 and 4 they will receive gamified PNF on control topics. Personalized Normative Feedback: Personalized Normative Feedback (PNF) is a popular social norms-based intervention strategy which presents individuals with a personalized, individual report designed to correct misperceived peer norms using a graphical display. Bar charts compare actual alcohol use statistics for the peer group to A) participants' estimates of peer drinking and, B) their own self-reported drinking.	Total n=499 Participants Total of all reporting groups
Age, Continuous	29.73 years STANDARD_DEVIATION 7.15 • n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	30.37 years STANDARD_DEVIATION 7.75 • n=7 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	29.47 years STANDARD_DEVIATION 7.03 • n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	29.87 years STANDARD_DEVIATION 7.32 • n=4 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.
Sex: Female, Male Female	143 Participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	179 Participants n=7 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	177 Participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	499 Participants n=4 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.
Sex: Female, Male Male	0 Participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	0 Participants n=7 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	0 Participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	0 Participants n=4 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.
Ethnicity (NIH/OMB) Hispanic or Latino	37 Participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	46 Participants n=7 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	40 Participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	123 Participants n=4 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.
Ethnicity (NIH/OMB) Not Hispanic or Latino	106 Participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	133 Participants n=7 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	137 Participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	376 Participants n=4 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.
Ethnicity (NIH/OMB) Unknown or Not Reported	0 Participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	0 Participants n=7 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	0 Participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	0 Participants n=4 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.
Race (NIH/OMB) American Indian or Alaska Native	4 Participants n=5 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	5 Participants n=7 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	4 Participants n=5 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	13 Participants n=4 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study
Race (NIH/OMB) Asian	6 Participants n=5 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	16 Participants n=7 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	17 Participants n=5 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	39 Participants n=4 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	1 Participants n=5 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	1 Participants n=7 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	0 Participants n=5 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	2 Participants n=4 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study
Race (NIH/OMB) Black or African American	19 Participants n=5 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	25 Participants n=7 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	26 Participants n=5 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	70 Participants n=4 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study
Race (NIH/OMB) White	78 Participants n=5 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	91 Participants n=7 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	99 Participants n=5 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	268 Participants n=4 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study
Race (NIH/OMB) More than one race	35 Participants n=5 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	41 Participants n=7 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	31 Participants n=5 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	107 Participants n=4 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study
Race (NIH/OMB) Unknown or Not Reported	0 Participants n=5 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	0 Participants n=7 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	0 Participants n=5 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study	0 Participants n=4 Participants • 1 participant disclosed being a minor after enrollment and was withdrawn from the study
Region of Enrollment United States	143 participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	179 participants n=7 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	177 participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	499 participants n=4 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.
Sexual Identity Lesbian	89 Participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	108 Participants n=7 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	94 Participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	291 Participants n=4 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.
Sexual Identity Bisexual	29 Participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	39 Participants n=7 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	48 Participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	116 Participants n=4 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.
Sexual Identity Queer	25 Participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	32 Participants n=7 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	35 Participants n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	92 Participants n=4 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.
Interpersonal Sexual Minority Stigma Exposure	.62 units on a scale (range 0 low to 2 high) STANDARD_DEVIATION .70 • n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	.56 units on a scale (range 0 low to 2 high) STANDARD_DEVIATION .66 • n=7 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	.66 units on a scale (range 0 low to 2 high) STANDARD_DEVIATION .69 • n=5 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.	.61 units on a scale (range 0 low to 2 high) STANDARD_DEVIATION .69 • n=4 Participants • 1 participant randomized to the Alcohol + Stigma Coping PNF condition disclosed being a minor after study enrollment. This participant was was withdrawn from the study and their data was excluded from analysis.