Mobile Alcohol Primary Prevention: Feasibility with Urban Communter College Students

The first year and possibly as early as the first two to six weeks of college are marked with personal and social transitions that may help to define academic and other behavior for new college students, including alcohol use patterns.1 Evidence suggests that alcohol use by college students negatively affects learning, retention, and graduation,2,3 and is associated with alcohol related unintentional injury, deaths, sexual violence, suicide and other problems.4 Young adults entering college have been found to increase their usage during the transition from high school, particularly for students with certain social characteristics (male sex, history of conduct issues, peer use, etc.).5 Mediators such as coping, alcohol expectancies, drinking motives, and perceived norms have been associated with how college entry impacts first-year alcohol use; of these, alcohol expectancies have been identified as a single-strong mediator.6 Moderators such as race/ethnicity and immigration status also have been identified as significant variables that are associated with use patterns,7,8 and which taken together may produce cumulative hazard as a result of the combined effects of manifold stressors. To date, alcohol interventions with college students overwhelmingly target mandated students. Research is needed to assess the feasibility for delaying alcohol use onset for college freshmen, iv particularly, for commuter students who are not already engaged in alcohol problems, but for whom the ubiquity of advertisement and access may contribute to risk.9Furthermore, much of what is known about college student use is premised on research with white students who are residents of residential campuses. Less study has been done with commuter students, a population which tends to be minority, first-generation, and to vary with respect to foreign nativity. Research is needed to clarify whether use patterns by ethnic minorities, foreign-native and first-generation students can have important long term protective effects, and if current intervention practices are appropriate for this sub-population. This study investigates college alcohol use and tests the feasibility of a mobile primary alcohol prevention on an urban commuter campus using a repeated measures design. Outcomes of the study are the development of a primary prevention mobile alcohol intervention for use with urban commuter college students; and feasibility and acceptability of the intervention to first year urban commuter college students. We hypothesized that abstaining urban commuter students would find the primary prevention approach acceptable for delaying their use of alcohol. Furthermore, we expected intervention students to be less likely than their peers to drink, misuse or change their attitudes about drinking, or engage in other drug use than their peers at one month follow-up. Three central aims of this work are: Aim 1: To systematically analyze data collected by Add Health database to identify factors that may contribute to college student alcohol uptake. Aim 2: To develop a protocol for a mobile primary prevention intervention to delay alcohol uptake by college freshmen who identify as abstaining from alcohol consumption, by adapting an intervention which successfully increased readiness for change for students previously identified for, or at risk of, problem use. Aim 3: To systematically analyze the feasibility (acceptability) for and identify barriers to a mobile primary-prevention intervention delivered through text messaging with a random sample of abstinent urban commuter first-time freshman college students at CUNY –Brooklyn College focusing specifically on analysis of recruitment, retention, and adherence based on thematic analysis of semi-structured interviews to elicit continued alcohol abstinence at one month-month follow-up, compared to a control group. Main outcomes of this work are understanding factors associated with college alcohol initiation, and testing the feasibility of a mobile device for primary alcohol prevention to prolong abstinence among urban commuter college freshmen