Donna M. Kazemi

A Systematic Review of the mHealth Interventions to Prevent Alcohol and Substance Abuse

Substance abuse in young adults is a public health issue with costs to the individual and society. There is mounting evidence that the increased uses of mHealth approaches have promise as a way to facilitate reductions in substance use. This systematic review evaluated the recent body of research on mHealth-based interventions for substance use, with aims of (a) examining the functionality and effectiveness of these interventions, (b) evaluating the available research on the effectiveness of these interventions for substance use, and (c) evaluating the design, methodology, results, theoretical grounding, limitations, and implications of each study. We identified eligible studies by searching electronic databases using Boolean methods. The reviewed studies (N = 12) indicated that that a wide range of Internet-based, text messaging, and smartphone application interventions have been developed to address substance use. Interventions had an assortment of features; participants in each study highlighted the ease and convenience of the interventions; and the majority of studies provided support for the efficacy of mHealth in reducing substance use. Mobile technology is a promising tool for reducing substance use and warrants further development. Future practice including the use of mHealth interventions can be an integral part of reducing substance use.

Integrating mHealth mobile applications to reduce high risk drinking among underage students

Objective: College students embrace mobile cell phones (MCPs) as a primary communication and entertainment device. The aim of this study was to investigate college students’ perceptions toward using mHealth technology to deliver interventions to prevent high-risk drinking and associated consequences. Design/setting: Four focus group interviews were conducted during the spring and fall of 2011 at a large public university in the southeastern United States of America (USA) to collect data on the applicability of mHealth technology to alcohol-prevention programmes. The participants were students currently enrolled in a face-to-face alcohol-prevention programme. Method: Thematic analysis of the content in the transcriptions was used to analyse the focus group responses using a codebook. Results: Four major themes emerged which were: (1) education and usability; (2) Skype capabilities; (3) enhanced social networking; and (4) use for tracking and feedback. All of the participants said they would join an alcohol-intervention programme that incorporated mHealth mobile technology as a primary mode of communication. Conclusions: The positive responses to the use of mobile applications indicate that use of interactive, real-time technology would be valuable to college students. Given the cost of face-to-face delivery of interventions, the findings are encouraging and support further exploration of the application of mHealth technology. Mobile technologies (mHealth) could provide a more effective delivery of alcohol-intervention programmes and increase the accessibility, relevance, and value of alcohol-intervention programmes.

Alcohol screening and brief interventions for college freshmen.

This study examined the effectiveness of the Brief Alcohol Screening and Intervention for College Students using theory-driven harm reduction brief motivational interviewing (BMI) for decreasing high-risk drinking and negative consequences. Three surveys were administered to 102 volunteer freshmen college students at baseline and 3 months postintervention. The BMI intervention was administered at baseline and 2 weeks later. Descriptive statistics and summary graphs were used to determine longitudinal changes in drinking quantity, frequency, and negative outcomes. Number of drinks, hours of drinking, and negative consequences decreased, indicating a significant decrease in alcohol consumption and negative consequences. This study contributes valuable implications for the design of theory-driven harm reduction, evidence-based interventions for high-risk drinking among freshmen college students.

Effects of Motivational Interviewing Intervention on Blackouts Among College Freshmen

PURPOSE Alcohol and illicit drug abuse is a serious public health issue facing college students. This study examined the impact of motivational interviewing (MI) as an intervention on the rate of blackouts among freshmen who engaged in high-risk drinking and illicit drug use. DESIGN A sample of 188 volunteer freshmen from a university were administered the Daily Drinking Questionnaire, the Rutgers Alcohol Problem Index, and the Government Performance and Results Act at baseline and again at 6 months postintervention. MI was applied at baseline and then again at 2 weeks, 3 months, and 6 months. METHODS Generalized estimated equations and logistic regression models were used to determine associations between the rate of blackouts and time, ethnicity, gender, illicit drug use, and alcohol consumption. FINDINGS At 6 months, the rate of blackouts decreased from 40% at baseline to 16% (p < .0001). The average number, time, and days of drinking and frequency of drug use also decreased significantly (p < .0001). An association between rate of blackouts and gender was observed, but not with ethnicity. CONCLUSIONS MI had an impact on reducing alcohol consumption and the rate of blackouts among college freshmen who were engaging in high-risk drinking and illicit drug use. CLINICAL RELEVANCE The findings support the importance of using MI with freshmen college students to decrease drinking and the associated negative consequences, including blackouts, which has particular relevance for advanced practice registered nurses, physicians, and community health nurses who conduct MI as an intervention with college students.

Binge Drinking Among Underage College Students: Role of Impulsivity and the Transtheoretical Model

&NA; A major public health problem facing American colleges is binge drinking by students with adverse effects on academic achievement and self‐fulfillment. The short‐term negative consequences of binge drinking include memory loss, hangovers, and blackouts. Binge drinking has been related to campus problems, suicides, violence, sexually transmitted diseases (STDs), heightened aggression, automobile accidents, property damage, and academic failure. This study investigated the relationship of impulsivity to readiness to change binge drinking behavior among college students attending a 4‐year university. The theoretical formulation for the study was based on Prochaska and DiClementes transtheoretical model. Participants were volunteer undergraduate college students from a state‐supported Southeastern University. The students were recruited from undergraduate classrooms, fraternities, and sororities. The volunteer participants were 248 undergraduate college students enrolled in a 4‐year university in the southeastern United States. This study consists of a subgroup, 131 of the 248 participants which were 93 binge drinkers and 38 nondrinkers. Three surveys were administered: the Student Alcohol Questionnaire (SAQ), Barratts Impulsivity Scale (BIS‐11), and the Brief Readiness to Change Questionnaire (BRCQ). Impulsivity was significantly correlated with binge drinking and the transtheoretical stages of change. Impulsivity can result in a lack of inhibitory control, which is a risk factor for binge drinking. The results of this study suggest that impulsivity may interfere with intentional behavioral change. This study may have valuable implications for the current and future design of alcohol prevention programs at institutions of higher education.

Relationship of body mass index to alcohol consumption in college freshmen

OBJECTIVE Assess the relationship between body mass index (BMI) and drinking in college freshman. METHOD College freshman (N = 199) at a university completed the drinking questionnaires. Drinking amount and the alcohol problem index (RAPI) served as outcomes, and BMI was the independent variable. RESULTS RAPI scores were associated with gender, amount of drinking, and BMI (P < 0.001, F = 13.44). Increase of RAPI with drinking amount was larger for females (slope = 0.06) than for males (slope = 0.03). CONCLUSION This information can be helpful when providing health promotion strategies to college students regarding nutrition modifications that would be most beneficial for their health.

Personality Risk Factors and Readiness to Change in Mandated and Voluntary College Students Enrolled in an Alcohol Intervention Program

This study compared personality risk factors and readiness to change drinking behavior among mandated and volunteer college students. The sample (N = 583) completed three measures of motivation to change and personality risk factors at baseline, 3 months, and 6 months between 2011 and 2012. Linear mixed models were used to determine an association of continuous outcome variable(s) with covariates over time. Participants in the action stage had lower impulsivity scores. Gender was significant, with females showing the highest anxiety and lowest sensation seeking. The findings indicate a number of future directions to advance innovative alcohol intervention and treatment programs on college campuses.

Brief motivational interviewing to reduce alcohol consumption among freshmen: secondary effects on polydrug use

Background & Aims: This study investigated high-risk drinking and polydrug use (PU) over 6 months for freshmen college students. Methods: The Brief Alcohol Screening and Intervention for College Students (BASICS) brief motivational interviewing (BMI) intervention was implemented at a public university as a 3-year programme designed to reduce underage drinking among freshmen with a secondary focus on PU. Participants were 299 freshmen from a state-supported university. Participants attended baseline visit, 2-week, 3- and 6-month visits. Analysis: Paired t-tests were used to determine the differences between alcohol consumption at different time points. McNemar’s test was used to compare correlated proportions. Results: At the baseline, 30% of the participants were drinking and using illicit drugs, compared with 25% at the sixth month visit. Conclusion: The findings suggest that a decrease in alcohol consumption will also reduce the probability of PU. These findings can assist in developing health professional strategies for effective use of BMI interventions aimed at alcohol and PU.

Outcomes of a Targeted Capacity Expansion (TCE) Brief Motivational Intervention for High-Risk Drinking Freshmen: Pilot Study Comparison at Baseline and 6 Months

This longitudinal pilot study investigated the effectiveness of a Brief Alcohol Screening and Intervention for College Students (BASICS) Brief Motivational Intervention (BMI) in decreasing the quantity and frequency of high-risk drinking and associated negative consequences for freshmen. The treatment effects of the intervention (n = 110) were obtained using a quasi-experimental design. Alcohol consumption and risk behaviors were assessed for the intervention and the control group. Freshmen students who received the intervention reported a greater decrease in alcohol consumption and negative consequences than freshmen students assigned to the control group. This study supported the effectiveness of the BASICS BMI intervention for freshmen students with high-risk drinking behaviors. This pilot study has implications for the sustainability of the intervention for freshmen students and supports further research for the remaining 2-year intervention program.

Systematic review of surveillance by social media platforms for illicit drug use.

Background The use of social media (SM) as a surveillance tool of global illicit drug use is limited. To address this limitation, a systematic review of literature focused on the ability of SM to better recognize illicit drug use trends was addressed. Methods A search was conducted in databases: PubMed, CINAHL via Ebsco, PsychINFO via Ebsco, Medline via Ebsco, ERIC, Cochrane Library, Science Direct, ABI/INFORM Complete and Communication and Mass Media Complete. Included studies were original research published in peer‐reviewed journals between January 2005 and June 2015 that primarily focused on collecting data from SM platforms to track trends in illicit drug use. Excluded were studies focused on purchasing prescription drugs from illicit online pharmacies. Results Selected studies used a range of SM tools/applications, including message boards, Twitter and blog/forums/platform discussions. Limitations included relevance, a lack of standardized surveillance systems and a lack of efficient algorithms to isolate relevant items. Conclusion Illicit drug use is a worldwide problem, and the rise of global social networking sites has led to the evolution of a readily accessible surveillance tool. Systematic approaches need to be developed to efficiently extract and analyze illicit drug content from social networks to supplement effective prevention programs.