Using E-Mail Boosters to Maintain Change After Brief Alcohol Interventions for Mandated College Students: A Randomized Controlled Trial

Objective: Brief motivational interventions (BMIs) reduce drinking in the short term, but these initial effects often decay. We tested the hypothesis that theory-based e-mail boosters would promote maintenance of change after a BMI. Method: Participants were students (N = 568; 72% male) who violated campus alcohol policy and were mandated to participate in an alcohol-risk-reduction program. Participants provided baseline data, received a BMI, and then completed a 1-month post-BMI survey. Next, they were randomized to receive 12 booster e-mails that contained either (a) alcohol norms or (b) structurally equivalent general health information (control). Alcohol consumption and alcohol-related consequences were assessed at baseline, 1, 3, 5, 8, and 12 months. Results: As expected, we observed significant reductions in both consumption and consequences after the BMI (ps < .01), and groups were equivalent at baseline and at 1-month post-BMI, prior to randomization (ps > .05). Latent growth curve models revealed no condition effects on changes in the latent consumption variable from 1- to 12-month follow-ups (b = .01, SE = .01, p > .05). Unexpectedly, a main effect of the condition emerged for self-reported consequences (b = .03, SE = .01, p = .01); we observed more consequences after boosters containing alcohol norms than general health information. Outcomes were not moderated by sex, consumption at baseline or 1 month, or e-mail exposure, and there was no mediation by descriptive norms, injunctive norms, or peer communication. Conclusions: Contrary to predictions, e-mail boosters with corrective norms content did not improve outcomes after a BMI. What is the public health significance of this article? To address the observation that the effects of brief alcohol interventions fade over time, this study tested the effects of postintervention booster messages delivered via e-mail. We designed a set of e-mail boosters that reinforced moderate drinking norms. The e-mail boosters did not improve the maintenance of drinking reductions. Continued efforts are needed to promote lasting reductions in drinking after brief alcohol interventions.