Expectancy Challenge Interventions to Reduce Alcohol Consumption Among High School and College Students: A Meta-Analysis

Objective: Alcohol expectancies are a critical factor in the development of problematic alcohol use. Expectancy challenge (EC) interventions aim to manipulate positive alcohol expectancies to reduce or prevent alcohol use among young people. The present meta-analysis investigated the effects of ECs at changing expectations and alcohol use among high school and college students, and moderating effects of study and individual characteristics on these changes. Method: A total of 23 EC studies (N = 4,122; mean age = 19.0; 57% males) was included as they reported enough information to calculate effect sizes, had a control condition that did not receive an active intervention, and were presented as of August 1, 2020. Two independent coders coded relevant variables and calculated effect sizes at posttest using a random-effects model. Results: ECs showed significant yet small effects at modifying alcohol consumption and alcohol expectancies in the desired direction (g's ranged from −.18 to −.42). Changes in social, tension, liquid courage, and risk aggression expectancies explained significant variance in change in alcohol use. The effects of ECs at changing social, sexual, tension, and liquid courage expectancies were stronger among college students compared to high school students. More favorable results were observed for interventions delivered at a higher dose. Conclusions: ECs targeting high school and college students produce small effects at reducing alcohol use and changing alcohol expectancies. Future efforts are needed to determine under which circumstances and among which subgroups ECs are expected to produce greater effects. Public Health Significance Statement This meta-analysis suggests that EC interventions modestly reduce alcohol use among college and high school students, and that ECs that target college students and that are delivered at a higher dose can produce more favorable effects.