Using Counter Attitudinal Advocacy to Change Drinking Behavior

NCT ID: NCT04042909

Last Updated: 2025-05-16

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 591 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2019-11-12
• Study Completion Date: 2023-01-30

Brief Summary

High volume drinking by young adults has proven resistant to change, so new approaches are needed. We adapt a theory-based attitude change strategy for use in alcohol prevention. This research tests the impact of brief writing and advocacy activities on subsequent drinking and negative consequences.

Detailed Description

The persistence of risky drinking among young adults in college calls for continued efforts to prevent harms related to alcohol. Many prevention interventions rely on a primary mechanism of change: correcting exaggerated drinking norms. We propose to test a novel prevention strategy targeting another mechanism of change: creating attitude-behavior dissonance. To date, attitude change activities have not been harnessed as a behavior change strategy for alcohol abuse prevention, so this study adapts counter-attitudinal advocacy (CAA) to the alcohol prevention context. The goals of the proposed research are to demonstrate (a) the utility of CAA to change high volume drinking and related consequences, (b) that attitude change and attitude-behavior dissonance mediates the CAA manipulation effect, and (c) that CAA-induced risk reduction is not inferior to an established intervention based on Personalized Normative Feedback (PNF). A pair of studies will be implemented across two sites. First surveys to document peer behaviors and normative perceptions (N = 500 at each site) will be conducted, in order to deliver accurate, campus-specific PNF. The next study consists of a randomized controlled trial (RCT) with 2 experimental conditions (CAA and PNF) and a 3rd assessment only control condition to determine the impact of CAA on alcohol outcomes. For the RCT, a total of 600 heavy drinking students who have endorsed alcohol-related negative consequences will be recruited. Alcohol outcomes will be assessed at 1-, 3-, and 6-month follow-ups to test hypotheses that, relative to assessment only control, the CAA manipulation will decrease alcohol consumption and consequences. We will also test the hypothesis that CAA condition will be no less efficacious than (i.e., not inferior to) the PNF condition. The RCT also allows tests of hypotheses about effect moderators and mediators. This study will demonstrate the generalizability of CAA activities to the alcohol prevention context, as well as their generalizability across demographically different settings. Implications for the public health include establishing the efficacy of a new approach for reducing high volume drinking and related consequences among young adults.

Conditions

Alcohol Drinking; Alcohol Abuse

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: DOUBLE

Study Groups

Counter Attitudinal Advocacy

Participants in this arm will articulate ways to avoid alcohol-related consequences using self-generated protective strategies and publicly state those strategies.

Group Type: EXPERIMENTAL

Counter Attitudinal Advocacy

Intervention Type: BEHAVIORAL

same as Counter Attitudinal Advocacy arm

Personalized Normative Feedback

Participants in this arm will view personalized normative feedback regarding their 1) own drinking quantity and frequency of drinking, 2) perceptions of typical drinking by same-sex students' on campus (i.e., perceived descriptive norms), and 3) actual drinking rates by same-sex students' on campus (i.e., actual descriptive norms).

Group Type: ACTIVE_COMPARATOR

Personalized Normative Feedback

Intervention Type: BEHAVIORAL

same as Personalized Normative Feedback arm

Assessment-only Control

Participants in this arm will not receive any intervention.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Counter Attitudinal Advocacy

same as Counter Attitudinal Advocacy arm

Intervention Type: BEHAVIORAL

Personalized Normative Feedback

same as Personalized Normative Feedback arm

Intervention Type: BEHAVIORAL

Other Intervention Names

CAA; PNF

Eligibility Criteria

Inclusion Criteria

• Age 18-26
• Male or female student at Brown University or University of Houston
• Past month heavy episodic drinking (for men, >5 drinks in one day, for women >4 drinks in one day)
• At least two self-reported negative consequences from drinking in the past month

Exclusion Criteria

• status as a second semester Senior

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 26 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

NIH

Sponsor Role: collaborator

University of Houston

OTHER

Sponsor Role: collaborator

Brown University

OTHER

Sponsor Role: lead

Responsible Party

Kate Carey

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Kate B Carey, PhD

Role: PRINCIPAL_INVESTIGATOR

Brown University

Locations

Brown University

Providence, Rhode Island, United States

University of Houston

Houston, Texas, United States

Countries

United States

References

Carey KB, DiBello AM, Hatch MR, Weinstein AP, Neighbors C. Efficacy of counter-attitudinal advocacy and personalized feedback for heavy-drinking college students. J Consult Clin Psychol. 2025 May;93(5):357-368. doi: 10.1037/ccp0000949. Epub 2025 Mar 13.

Reference Type: DERIVED

PMID: 40080603 (View on PubMed)

Provided Documents

Document Type: Study Protocol, Statistical Analysis Plan, and Informed Consent Form

View Document

Other Identifiers

R01AA025043

Identifier Type: NIH

Identifier Source: secondary_id

View Link

1809002214

Identifier Type: -

Identifier Source: org_study_id