Randomized controlled trial of a very brief, multicomponent web-based alcohol intervention for undergraduates with a focus on protective behavioral strategies

Objective: THRIVE (Kypri et al., 2009; 2013; 2014), a very brief, freely-available, multi-component web-based alcohol intervention originally developed and tested among students in Australia and New Zealand, was tested in the United States. We also evaluated effects of systematically varying the protective behavioral strategies (PBS) component of the intervention to include shorter, focused lists of Direct (e.g., alternating alcoholic with non-alcoholic drinks) or Indirect (e.g., looking out for friends) strategies. Method: Undergraduates with past-month heavy drinking (N=208) were randomized to education/assessment Control or 1 of 3 US-THRIVE variants including Direct PBS only, Indirect PBS only, or Full (Direct and Indirect PBS). Results: After 1 month, compared to the Control condition, Full condition participants reported fewer drinks per week (rate ratio [RR]=.62) and lower peak drinking (RR=.74). The Indirect-only condition reported reduced peak drinking (RR=.74) and a trend toward fewer drinks per week (RR=.78). Changes in drinking relative to Control were significant through 6 months for the Full and Indirect-only conditions. There were no significant differences between the Direct-only and Control conditions. US-THRIVE was not associated with decreased heavy drinking or alcohol-related problems relative to Control. Conclusions: To our knowledge this was the first study to systematically vary the types of PBS provided in an intervention. Initial results suggest US-THRIVE is efficacious. Compared to Control, presenting Indirect PBS only as part of US-THRIVE was associated with lower drinks per week and peak past 30-day drinking. Targeting Indirect PBS may be more appropriate for non-treatment-seeking young adults receiving a brief intervention.