Skip to main content
NCBI home page
NIHPA Author Manuscripts logoLink to NIHPA Author Manuscripts
. Author manuscript; available in PMC: 2017 Jul 1.
Published in final edited form as: Addict Behav. 2016 Mar 7;58:188–193. doi: 10.1016/j.addbeh.2016.03.001

Do My Peers Approve? Interest in Injunctive Norms Feedback Delivered Online to College Student Drinkers

Jennifer E Merrill 1, Mary Beth Miller 1, Sara G Balestrieri 1, Kate B Carey 1
PMCID: PMC4808338  NIHMSID: NIHMS768490  PMID: 26978277

Abstract

Injunctive norms feedback is promising but understudied as a component of college drinking interventions. The aim of the present study was to demonstrate acceptability of injunctive norms feedback delivered to college drinkers via the web. We examined subjective interest in information reflecting peer approval of four sets of drinking behaviors and outcomes, and correlates of interest in the normative feedback. A sample of 221 young adults enrolled in a 2- or 4-year college or university (ages 18–25 years; 52% female) completed online surveys in which they were asked to rate their interest in each of 11 injunctive norms statements. Participants were randomly assigned to one of four sets of statements regarding peer approval of (a) intoxicated behaviors, (b) safe drinking strategies, (c) drinking-related consequences, and (d) drinking behaviors of potential partners. All items were framed to reflect disapproval of risky behaviors and approval of protective behaviors. Across norm sets, participants found the items to be moderately interesting and interest ratings did not differ across sets. Higher scores on the Alcohol Use Disorders Identification Test (AUDIT), stronger perceived approval of drinking in general (injunctive norms), stronger perceptions of drinking among peers (descriptive norms), and female gender were bivariately correlated with more interest. In multiple regression, female gender, higher AUDIT (consequences subscale), and stronger general drinking injunctive norms remained significantly associated with interest in the pro-moderation statements. An important future direction is to determine whether the presentation of specific types of injunctive norms feedback can result in downward changes in drinking behavior.

Keywords: injunctive norms, normative feedback, alcohol use, college students, intervention content interest

1. Introduction

College alcohol misuse is a public health concern. Approximately 35% of college students report consumption of five or more alcoholic drinks in a row in the last two weeks (Johnston, O’Malley, Bachman, Schulenberg, & Miech, 2015), and as many as 30% report such heavy drinking once a week or more (Martinez, Sher, & Wood, 2014). This pattern of drinking has been associated with a host of negative consequences, from academic difficulties and injuries to accidental death (Hingson, Zha, & Weitzman, 2009). Yet negative consequences fail to deter heavy drinking among college students (Martinez et al., 2014). This may be due in part to college students’ beliefs that such drinking is ‘normal’ and/or ‘accepted.’

The misperception among heavy-drinking college students that personal alcohol use is consistent with typical student drinking (referred to as a “descriptive norm”) is well documented. A number of college student drinking interventions elicit changes in alcohol use outcomes by correcting overestimated descriptive norms (Carey, Scott-Sheldon, Carey, & DeMartini, 2007; Cronce & Larimer, 2011; Reid & Carey, 2015). The perception that one’s peers approve of heavy drinking behaviors (“injunctive norms”) has received less attention in the prevention and intervention literature, but shows promise as an intervention strategy for college student drinking.

Injunctive, rather than descriptive, norms predict drinking-related behaviors prospectively (Larimer, Turner, Mallett, & Geisner, 2004; Mollen, Rimal, Ruiter, Jang, & Kok, 2013). Notably, injunctive norms are amenable to change following even a brief statement describing the attitudes of peers (Prince & Carey, 2010). A recent review of college student drinking interventions identified six studies that measured injunctive norms as a potential mechanism of effect (Reid & Carey, 2015), but only one specifically targeted injunctive norms (Schroeder & Prentice, 1998). While this study did not show change in injunctive norms, Reid and Carey (2015) note that this may be due to the long follow-up (4–6 months) and single-item measure of injunctive norms that may have been insensitive to change. Although they did not target injunctive norms directly, the authors of one other study (Turrisi et al., 2009) did find support for mediation effects through both descriptive and injunctive norms (Prince & Carey, 2010). Since the Reid and Carey (2015) review, Prince, Maisto, Rice, and Carey (2015) conducted the first randomized clinical trial comparing an injunctive norms feedback intervention to descriptive norms feedback, combined feedback, and assessment only. They found that injunctive norms feedback reflecting peer disapproval of consequences resulted in decreased estimates of typical blood alcohol levels and fewer alcohol-related consequences among college students; moreover, the injunctive norms intervention was more effective than the descriptive norms intervention in reducing typical blood alcohol concentrations. Thus, support for injunctive norms as an intervention target for college alcohol misuse is growing.

While evidence for the efficacy of injunctive norms interventions is accruing, the optimal content of such interventions remains unclear. Interventions that correct descriptive norms do not typically result in changes in injunctive norms (Carey, Henson, Carey, & Maisto, 2010); therefore, specific feedback on peer approval of drinking behaviors seems necessary. However, peers may approve/disapprove of a range of drinking-related behaviors (e.g., negative consequences, protective behavioral strategies), each of which may serve as a source of injunctive norms feedback. Prince and colleagues (2015) chose to provide corrective feedback reflecting peer disapproval of alcohol-related consequences. They presented accurate injunctive norms for the consequences perceived as most acceptable and unacceptable to the participant as well as three particularly high-risk consequences of alcohol consumption (i.e., blacking out, passing out, and sexual regret). College students also misperceive peer approval of use of protective behavioral strategies (DeMartini, Carey, Lao, & Luciano, 2011), suggesting that safe-drinking strategies may also be a target of injunctive norms interventions. However, little is known about student preferences across this range of targets.

Client preferences are a key component of evidence-based practice (APA, 2006) and, theoretically, should lead to better treatment outcomes. A recent meta-analysis showed that taking client preferences into account led to fewer drop-outs and greater improvements in therapy outcomes (Swift, Callahan, & Vollmer, 2011). There is also evidence that college students are responsive to brief interventions that they rate favorably (Murphy et al., 2001). Thus, determining the types of injunctive norms that are most interesting to college students can inform intervention design.

Not all students benefit from alcohol intervention, so it is also important to consider how individual differences may impact interest in injunctive norms feedback. Both sex and history of alcohol use predict differential responses to individualized interventions for college alcohol misuse (Henson, Pearson, & Carey, 2015). This may be driven in part by individual differences in the acceptability of such interventions. Indeed, some research shows that females are more interested in feedback than males (Butler, Silvestri, & Correia, 2014; Miller & Leffingwell, 2013) and binge drinkers are more accepting of personalized feedback than non-binge drinkers (Butler et al., 2014). It is not yet known whether gender and level of drinking involvement are associated with interest in injunctive norms feedback. Understanding for whom injunctive norms feedback is most compelling can help guide the development of interventions for specific populations. Specifically, a link between gender and interest in normative feedback may guide gender-specific tailoring of content, while an association between drinking level and interest may guide decisions on whether to provide such feedback in universal or targeted intervention contexts.

1.1. The Present Study

The aim of this study was to examine interest in (i.e., acceptability of) injunctive norms feedback delivered online to college drinkers. Based on pilot work, we designed four unique sets of injunctive norms feedback, with items representing peer approval of (1) intoxicated behaviors, (2) safe drinking strategies, (3) drinking-related consequences, and (4) drinking behaviors of potential partners. First, we examined participants’ relative interest in feedback across these four different feedback domains, without hypotheses regarding which domain they would find most interesting. Second, we tested correlates of average interest scores (collapsed across domains) at both bivariate and multivariate levels. Specifically, we sought to test hypotheses that females (vs males) and heavier- (vs lighter-) drinking students would find the feedback more interesting, and we conducted exploratory tests of whether interest in the feedback was associated with descriptive and/or injunctive norms. Third, we examined participants’ relative interest in the unique items within each feedback domain. Our overarching goal was to provide future researchers with information that may guide further test and refinement of normative interventions for individuals with various levels of drinking experience.

2. Materials and Method

2.1. Participants

Participants were 221 young adult drinkers (52% female) with an average age of 21.74 years (SD=1.94). Self-reported ethnicities were 70% White, 15% Black or African American, 10% Asian, 1% Native American or Native Alaskan, and 5% “Other.” Nineteen percent identified as Hispanic or Latino.

2.2. Procedures

All procedures were approved by the Brown University Institutional Review Board. Young adults (N=268) were recruited through the Qualtrics online survey company, and 221 provided adequate data to be used in our analytic sample (see Data Cleaning). The Qualtrics research team screened participants for eligibility (i.e., current enrollment in a 2- or 4-year college; age 18–25; and an affirmative response to the question, “Have you consumed alcohol in the last 30 days?”) and collected anonymous data. Participants received incentives (e.g., cash, airline miles, gift cards) from Qualtrics based on the length of the survey, their specific panelist profile, and acquisition difficulty. Eligible participants completed the survey and were randomly assigned, within gender, to provide interest ratings on one of four sets of injunctive norms feedback items (see Measures).

The feedback items included in each condition were chosen based on college student approval ratings from a separate pilot survey (unpublished data). In the spring of 2014, 233 participants (63% female, 47% freshmen) at a large northeastern university were recruited from introductory psychology classes to complete a half-hour survey in exchange for academic credit. The survey assessed personal acceptability of 44 behaviors derived from the Intoxicated Behaviors Inventory (Westmaas, Moeller, & Woicik, 2007), 26 consequences derived primarily from the Brief Young Adult Alcohol Consequences Questionnaire (BYAACQ) (Kahler, Strong, & Read, 2005), and 27 protective behavioral strategies (Sugarman & Carey, 2007). Participants were also asked to indicate (on a four-point scale) how much they agreed/disagreed that they would find it attractive if someone engaged in a range of “positive” (e.g., refusing a drink) and “negative” drinking behaviors (e.g., acting sloppy) that were identified in qualitative interviews (Terry, Garey, & Carey, 2014). Approval/acceptability/attractiveness ratings were examined. Items included in the present study were those that (1) had higher pro-moderation endorsements (i.e., disapproval of intoxicated behaviors, consequences, and unattractive behaviors; approval of protective behavioral strategies), (2) elicited discrepancies between self and other approval ratings, and (3) could be readily formulated into a feedback item that our team collectively agreed would be of interest to young adults.

2.3. Measures

2.3.1. Demographics

Gender, age, year in school, race and ethnicity were assessed.

2.3.2. Alcohol Consumption

After a standard drink was defined (12 oz. of beer; 5 oz. of wine; or 1 oz. of liquor), participants completed a modified version of the Daily Drinking Questionnaire (Collins, Parks, & Marlatt, 1985), assessing alcohol use over the past month. The sum of drink entries on each day of a daily grid was used to represent drinks per typical week. Participants also indicated the number of times in the past 30 days they consumed five (men)/four (women) or more drinks on one occasion.

2.3.3. Alcohol Use Disorders Identification Test (AUDIT)

The Alcohol Use Disorders Identification Test (AUDIT) (Allen, Litten, Fertig, & Babor, 1997; Saunders, Aasland, Babor, de la Fuente, & Grant, 1993), a 10-item screen for hazardous alcohol consumption, was used to assess past-year problems with alcohol. Three items assessed frequency of consumption, and seven assessed the frequency of consequences. Total scores ranged from 0 to 40. The AUDIT is a valid measure of at-risk college student drinking (e.g., DeMartini & Carey, 2009, 2012). Alpha was .87 for the total scale, .75 for the consumption scale, and .89 for the consequences scale.

2.3.4. General Injunctive Norms

General injunctive drinking norms were measured with the mean of three items (Kahler, Read, Wood, & Palfai, 2003), each rated on a scale from 1 (strongly disapprove) to 5 (strongly approve). Participants indicated how they thought most college students feel about (a) drinking, (b) drinking 4 (females)/5 (males) or more drinks in one night, and (c) getting drunk. Alpha was .85.

2.3.5. Descriptive Norms

Descriptive drinking norms were measured with the mean of three items (Turrisi, Mastroleo, Mallett, Larimer, & Kilmer, 2007). Participants indicated how many college students they believe engage in each of three behaviors (drinking alcohol, getting drunk once a month, and drinking to get drunk; α = .79) on a scale from 1 (none) to 5 (nearly all).

2.3.6. Interest in Injunctive Norms Feedback

In each of the four conditions, participants indicated their approval of 11 drinking-related behaviors (see Table 1 for text of all items). Instructions read, “We ask your help in evaluating information being considered for inclusion in alcohol education programs for young adults who drink. Your feedback will help us identify information that other students will find interesting, informative, and useful. All of the following statements are true, based on a 2014 survey of more than 200 college students. Please read each statement and indicate how interesting you personally find the information.” Participants rated each item using the anchors 1 (not at all interesting), 2 (mildly interesting), 3 (moderately interesting), and 4 (very interesting). Interest scores across items were averaged.

Table 1.

Interest ratings for injunctive norms feedback at the item and domain level

Intoxicated Behaviors (N = 48 raters) M SD
2/3 of college students disapprove of getting drunk to the point where a person has difficulty walking. 2.59a 1.07
Losing something valuable when drunk is unacceptable to 8 out of 10 college students. 2.68 1.14
Damaging someone’s property when drunk is considered unacceptable by 9 out of 10 college students. 2.73 1.16
95% of college students consider getting physically aggressive when drunk to be highly unacceptable. 2.74c,d 1.01
Slurring speech when drunk is unacceptable to more than half of college students. 2.79b 1.00
Becoming verbally aggressive when drunk is unacceptable to more than 9 out of 10 college students. 2.91 1.10
Three-quarters of college students disapprove of going farther in a hookup than someone wants to when drunk. 2.96 1.01
Most students (more than 8 out of 10) do not approve of taking additional drugs when drunk. 2.98 0.93
9 out of 10 college students say it is unacceptable to encourage or force another person to drink. 3.02 1.01
Cheating on a girlfriend/boyfriend when drunk is highly unacceptable to more than 8 out of 10 college students. 3.11d 1.05
Not using a condom during sex because of intoxication is unacceptable for more than 9 out of 10 college students. 3.17a,b,c 1.00
Mean across items 2.89 0.73
Consequences (N = 51 raters)
Nearly 9 in 10 college students disapprove of someone doing impulsive things when drunk that are later regretted. 2.69a 0.93
Most (95%) of college students disapprove of neglecting obligations as a result of drinking (3 out of 4 strongly disapprove). 2.72b 0.95
2 out of 3 college students highly disapprove when a drunk person becomes rude or insulting. 2.76 1.09
7 out of 10 college students disapprove of someone saying or doing embarrassing things as a result of drinking. 2.80 0.99
More than 9 out of 10 college students disapprove of letting drinking affect the quality of work or school. 2.80c 0.97
4 out of 5 college students disapprove of someone drinking to the point of feeling sick or throwing up. 2.80 0.96
3 out of 4 college students strongly disapprove when a person’s drinking creates problems with loved ones. 2.86 1.03
9 out of 10 college students disapprove of someone drinking to the point of passing out. 2.94 1.00
Nearly 9 in 10 college students disapprove of drinking so much that one doesn’t remember long stretches of time. 2.96 0.90
9 out of 10 college students strongly disapprove of driving a car after having too much to drink. 3.14a,b,c 1.01
Mean across items 2.85 0.80
Attractiveness (N = 61 raters)
Almost half of college students think that revealing too much private information when drunk is very unattractive. 2.69 1.01
9 out of 10 college students would find a person unattractive who said embarrassing or hurtful things when drunk. 2.75 1.03
3 out of 5 college students think that being able to drink without getting drunk is attractive. 2.76 1.01
80% of college students think that acting sloppy (stumbling, slurring speech) because of drinking is VERY unattractive. 2.83 1.01
More than 9 out of 10 college students find it attractive when someone stops drinking before becoming sloppy. 2.83 0.96
More than 4 out of 5 college students think that behaving in a sexually aggressive manner (persistent sexual contact or comments) when drinking is unattractive. 2.85 1.07
Knowing how to drink without becoming embarrassing or rude is attractive to 9 out of 10 college students. 2.85 0.95
More than 6 out of 10 college students strongly agree that having the self-confidence to refuse a drink at a party is attractive. 2.86 0.97
Enjoying yourself without doing things you regret is VERY attractive to 7 out of 10 college students. 2.95 0.94
More than 9 out of 10 college students find it attractive when a person knows how to have a good time without getting drunk. 3.02 0.97
9 out of 10 college students would find a person who took advantage of someone intoxicated to have sex VERY unattractive. 3.03 0.99
Mean across items 2.85 0.73
Protective Behavioral Strategies (N = 54 raters)
Three-quarters of students strongly approve of counting drinks to keep track so that they do not get too intoxicated. 2.68a,b 0.96
More than 7 out of 10 students approve of choosing not to pregame. 2.71d,e 1.00
9 out of 10 college students approve of spacing drinks over time and alternative alcoholic and non-alcoholic drinks to manage intoxication levels. 2.81c 0.92
9 out of 10 college students approve of setting an upper limit for drinks. 2.89 0.99
Stopping drinking at a predetermined time is acceptable to 85% of college students. 2.92 0.96
Nearly all college students think it is a good idea to eat before or while they are drinking. 3.02 0.88
More than 8 out of 10 college students approve of avoiding heavy drinking situations. 3.08b,e 0.91
Over 9 out of 10 college students approve of limiting cash on hand or not carrying credit cards when going out to drink. 3.09 0.94
8 out of 10 college students approve of choosing not to do shots. 3.09 1.01
9 out of 10 college students approve of asking a friend to let them know when they have had enough to drink. 3.12 0.89
87% of college students say that it is acceptable to refuse drinks. 3.21a,c,d 0.97
Mean across items 2.97 0.66
Open in a new tab

Note. Matching superscript letters indicate significant pairwise comparisons at p ≤ .005.

3. Results

3.1. Data Cleaning

We took several steps to increase our confidence in the integrity of the data from this online sample. Two hundred sixty eight participants were randomized to one of the four sets of injunctive norms feedback items. Sixteen participants were excluded for skipping or incorrectly responding to test questions (e.g., “Regardless of your favorite color, choose black”), and five were excluded for careless responding (e.g., nonsensical values, repetitive answer choices). An additional 26 participants were dropped due to failure to rate at least 6 out of the 11 norms feedback items. Thus, we retained data from 221 participants for analyses.

3.2. Interest across Injunctive Norms Domains

Descriptive statistics were used to examine participants’ relative interest in the four different domains. Across all four domains, the average level of interest was 3 (“moderately interesting,” see Table 1). An ANOVA revealed no significant differences in interest ratings between sets, F(3, 210) = 0.32, p = .81.1

3.3. Correlates of Interest

For correlational analyses, we collapsed interest scores across conditions (M = 2.89, SD = 0.73). Means and standard deviations of correlates, as well as their bivariate correlations with interest scores, are shown in Table 2. Our hypothesis that heavier-drinking participants would find the feedback more interesting was partially supported. Participants who were more interested in the injunctive norms feedback had higher total and consequence subscale scores on the AUDIT. However, interest was not significantly correlated with drinks consumed per typical week or the AUDIT alcohol use subscale.2 As hypothesized, interest in the injunctive norms feedback was higher among females (M = 3.01, SD = 0.70) than males (M = 2.76, SD = 0.73), t(212) = 2.47, p = .014. Additionally, participants who were more interested in injunctive norms feedback had stronger general injunctive norms for drinking (belief that others are more approving of drinking) and stronger descriptive norms for drinking (belief that others drink more).

Table 2.

Descriptives and bivariate correlations with average interest scores across items in a set

M SD r with interest p
Sex .168* .014
AUDIT total 10.86 7.70 .165* .016
 AUDIT consequences 5.42 6.29 .174* .011
 AUDIT use 5.44 2.44 .073 .287
Quantity on typical week 11.49 11.09 .005 .938
Injunctive Norms 3.87 0.82 .208** .002
Descriptive Norms 3.65 0.73 .136* .047
Open in a new tab

Note: a point biserial correlation was used for the correlation between sex and interest

We conducted a multiple regression model, predicting interest scores from the correlates that were significantly associated with interest at the bivariate level, in order to examine unique predictors of interest [F(4, 208)=5.71, p<.01, Adjusted R2=.08]. Female gender (B=.25, β = .17, p=.01), higher AUDIT consequence scores (B=.02, β=.18, p=.01), and stronger general injunctive norms (B=.15, β=.17, p=.02) remained significantly associated with interest in the multivariate context; descriptive norms did not (B=.03, β=.03, p=.73).

3.4. Interest in Unique Items within each Domain

Finally, we examined interest in each of the individual items within each domain. We conducted a repeated measures MANOVA, with each domain’s 11 interest scores as the within-persons factor and the domain received as the between-persons factor. This is not a “traditional” repeated measures test because a different piece of normative feedback was provided in each of the 11 norms items; however, respondents provided the same rating of interest for each of those items, so a within-subjects effect could be interpreted as differentiation of interest among the items. There was a significant within-domain effect (F [10]=3.23, p<.001), suggesting that participants reported varying interest levels across the items within each set. Pairwise comparisons were used to determine where differences among items were observed (Table 1), using a more stringent p-value of .005, given multiple comparisons.

4. Discussion

Injunctive norms feedback shows promise as an intervention strategy for reducing alcohol use among college drinkers, but the optimal content of such feedback needs to be determined. The present study represents a step toward developing injunctive norms interventions that are acceptable to college drinkers. We designed four unique sets of injunctive norms feedback using actual norms data from one college student sample and tested interest in that feedback in a separate sample. This strategy allowed us to examine (a) relative interest both across and within potential feedback domains and (b) correlates of student interest in injunctive norms feedback. This preliminary work suggests that the construction and delivery of injunctive norms feedback seems both feasible and acceptable, though degree of acceptability may depend on the specific item and drinker characteristics.

On average, participants rated all feedback items as moderately interesting. Participants did not express more or less interest in the four different feedback domains used in this study. Rather, they reported similar interest in learning how peers disapprove of intoxicated behaviors/consequences and approve of protective strategies, suggesting that the valence of the item was not a factor. Similarly, items framed in terms of attractiveness were just as interesting as those framed in terms of approval/disapproval. This suggests that students are interested in learning about their peers’ opinions on a range of domains. In examining within-person differences across items, we found that some items were rated as significantly more interesting than others (Table 1). We recommend that content items similar to these be examined in further research as potential sources of feedback.

We found evidence for three correlates of interest in injunctive norms. Consistent with hypotheses and previous research (Butler et al., 2014; Miller & Leffingwell, 2013), females were more interested in feedback than males. It is possible that women rely less on drinking-related activities for social reinforcement (Borsari & Carey, 2006) and, therefore, respond more openly to information that seems to discourage heavy alcohol use. Assuming interest in the feedback would be linked to outcomes, females might be expected to respond more favorably to injunctive norms feedback interventions, though this has yet to be tested.

Support for the hypothesis that heavier-drinking individuals would find the feedback more interesting depended on the definition of alcohol involvement. Acceptability of injunctive norms feedback did not differ by typical consumption (e.g., drinks per week, AUDIT alcohol use subscale). However, the total AUDIT score was significantly associated with interest. Though inconsistent with our hypothesis, such a finding bodes well for the utility of injunctive norms feedback as an intervention for a range of drinkers. Moreover, drinkers that experienced more problems related to drinking (as measured by the consequences subscale of the AUDIT) expressed more interest in information indicating that other students (a) do not approve of drinking problems, (b) perceive intoxicated behaviors as unattractive, and (c) think it is acceptable to use protective behavioral strategies. This is consistent with studies in which binge drinkers were more accepting of personalized feedback than non-binge drinkers (Butler et al., 2014). Collectively, findings suggest that the drinkers who are most in need of intervention (those with more problems) are also most interested in normative feedback; however, acceptability is not limited only to light or heavy drinkers.

Students who, on average, believed that their peers approved of heavy drinking (i.e., had higher general injunctive norms) were also more interested in the feedback. For these students, prior beliefs may have been challenged by the feedback, which was designed to reflect disapproval of risky drinking behaviors. This is consistent with evidence that novel information on a familiar topic is most interesting (Teigen, 1985). Again, this bodes well for future examinations of injunctive norms as an intervention component: those with greater misperceptions of peer approval may be most interested in injunctive norms feedback. On the other hand, while higher descriptive norms were associated with stronger interest in bivariate analyses, this effect disappeared in multivariate analyses that accounted for gender, alcohol consequences, and general injunctive norms. This highlights the specificity of the association between norms and interest in norms feedback only injunctive norms were uniquely associated with interest in injunctive norms feedback.

4.1. Limitations and Future Directions

We acknowledge the limitations of the present study. First, we provided feedback to a relatively small sample. Future research that tests effectiveness of injunctive norms interventions should administer these items to a larger sample for norms documentation. Second, we used a between-subjects design to minimize respondent burden; as a result, we could not compare items sets within subjects, which would have been a more sensitive test of differential levels of interest. Third, the descriptive and general injunctive norms measures were completed after reading the injunctive norms feedback items. Thus, it is possible that feedback influenced the assessment of normative perceptions. Fourth, we used an online survey panel, which gave us little oversight of data collection. Replication is necessary to determine the generalizability of these findings.

This study represents an initial step in designing an injunctive norms feedback intervention that is acceptable to participants. Among next steps, qualitative research may be useful in gathering more student feedback on the content of injunctive norms items. Given the correlates of interest demonstrated in this study, it is recommended to stratify focus groups or individual interviews by gender and/or level of alcohol involvement. Importantly, interest in feedback does not equate to effectiveness of feedback. Testing whether presentation of injunctive norms feedback items such as those used in the present study results in actual change in perceived norms and drinking outcomes is an important next step.

4.2. Conclusion

This study is the first to evaluate interest in injunctive norms feedback designed to reduce college student drinking and alcohol-related consequences. We established that we can use student survey responses to generate items that reflect pro-moderation norms, which were moderately interesting to college-attending drinkers. Respondents rated each of the item sets as equivalently interesting, suggesting that any could be used in corrective norms interventions. Using this type of normative feedback may be of particular interest to females, those with high AUDIT consequence scores, and those with strong injunctive norms. As we could not determine whether exposure to any of these sets of norms led to reductions in drinking, future longitudinal research should examine the impact of injunctive norms feedback on drinking levels.

Highlights.

  • Developed and tested interest in four sets of injunctive norms feedback items

  • College student drinkers were moderately interested in injunctive norms feedback

  • Females and more problematic drinkers were more interested in normative feedback

  • Higher injunctive but not descriptive norms associated with greater interest

Acknowledgments

Role of Funding Sources

Funding for this study including training support from NIAAA (K01 AA022938) to Dr. Jennifer Merrill, and training support from NIAAA to Dr. Mary Beth Miller (T32 AA007459). NIAAA had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

The authors would like to thank Dr. Angelo DiBello for consultation on data analysis for this manuscript.

Footnotes

1

The majority of this sample (76.9%, n=170) reported at least one past month heavy drinking episode (i.e., 5+ drinks in a single sitting for men/4+ for women). Among this subset of heavy drinkers, there also were no significant differences in interest across domains, and patterns of findings on interest scores at the item and scale level were similar to those observed in the full sample.

2

We also tested interactions between gender and each of the other variables (AUDIT, typical weekly drinking, injunctive norms, descriptive norms) on interest level. No significant interactions emerged suggesting that these variables were not more strongly associated with interest for males or females.

Contributors

Dr. Kate Carey designed the study and oversaw data collection. Dr. Carey and Dr. Jennifer Merrill conceptualized the research question. Dr. Merrill conducted the statistical analysis and wrote the first draft of the manuscript. Dr. Mary Beth Miller assisted with literature searches and manuscript drafts, and Sara Balestrieri assisted with data collection and manuscript drafts. All authors contributed to and have approved the final manuscript.

Conflict of Interest

All authors declare that they have no conflicts of interest.

Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

References

  1. Allen JP, Litten RZ, Fertig JB, Babor T. A review of research on the Alcohol Use Disorders Identification Test (AUDIT) Alcoholism: Clinical and Experimental Research. 1997;21(4):613–619. Retrieved from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9194913. [PubMed] [Google Scholar]
  2. American Psychological Association Presidential Task Force on Evidence-Based Practice. Evidence-based practice in psychology. American Psychologist. 2006;61:271–285. [Google Scholar]
  3. Borsari B, Carey KB. How the quality of peer relationships influences college alcohol use. Drug and Alcohol Review. 2006;25(4):361–370. doi: 10.1080/09595230600741339. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Butler LH, Silvestri MM, Correia CJ. Student perceptions of specific components within a personalized feedback intervention. Psychol Addict Behav. 2014;28(2):614–618. doi: 10.1037/a0036485. [DOI] [PubMed] [Google Scholar]
  5. Carey KB, Henson JM, Carey MP, Maisto SA. Perceived norms mediate effects of a brief motivational intervention for sanctioned college drinkers. Clinical Psychology: Science and Practice. 2010;17(1):58–71. doi: 10.1111/j.1468-2850.2009.01194.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Carey KB, Scott-Sheldon LAJ, Carey MP, DeMartini KS. Individual-level interventions to reduce college student drinking: A meta-analytic review. Addictive Behaviors. 2007;32(11):2469–2494. doi: 10.1016/j.addbeh.2007.05.004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Collins RL, Parks GA, Marlatt GA. Social determinants of alcohol consumption: The effects of social interaction and model status on the self-administration of alcohol. Journal of Consulting and Clinical Psychology. 1985;53(2):189–200. doi: 10.1037/0022-006X.53.2.189. [DOI] [PubMed] [Google Scholar]
  8. Cronce JM, Larimer ME. Individual-focused approaches to the prevention of college student drinking. Alcohol Research & Health. 2011;34:210–221. [PMC free article] [PubMed] [Google Scholar]
  9. DeMartini KS, Carey KB. Correlates of AUDIT risk status for male and female college students. Journal of American College Health. 2009;58(3):233–239. doi: 10.1080/07448480903295342. [DOI] [PubMed] [Google Scholar]
  10. DeMartini KS, Carey KB. Optimizing the use of the AUDIT for alcohol screening in college students. Psychological Assessment. 2012;24(4):954–963. doi: 10.1037/a0028519. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. DeMartini KS, Carey KB, Lao K, Luciano M. Injunctive norms for alcohol-related consequences and protective behavioral strategies: Effects of gender and year in school. Addictive Behaviors. 2011;36(4):347–353. doi: 10.1016/j.addbeh.2010.12.009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Henson JM, Pearson MR, Carey KB. Defining and characterizing differences in college alcohol intervention efficacy: A growth mixture modeling application. J Consult Clin Psychol. 2015;83(2):370–381. doi: 10.1037/a0038897. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Hingson R, Zha W, Weitzman E. Magnitude of and trends in alcohol-related mortality and morbidity among U.S. college students ages 18–24, 1998–2005. Journal of Studies on Alcohol and Drugs. 2009;(Suppl 16):12–20. doi: 10.15288/jsads.2009.s16.12. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE, Miech RA. Monitoring the Future national survey results on drug use, 1975–2014: Volume 2, College students and adults ages 19–55. Ann Arbor: The University of Michigan; 2015. [Google Scholar]
  15. Kahler CW, Read JP, Wood MD, Palfai TP. Social environmental selection as a mediator of gender, ethnic, and personality effects on college student drinking. Psychology of Addictive Behaviors. 2003;17(3):226–234. doi: 10.1037/0893-164x.17.3.226. [DOI] [PubMed] [Google Scholar]
  16. Kahler CW, Strong DR, Read JP. Toward efficient and comprehensive measurement of the alcohol problems continuum in college students: The brief young adult alcohol consequences questionnaire. Alcoholism: Clinical Experimental Research. 2005;29(7):1180–1189. doi: 10.1097/01.ALC.0000171940.95813.A5. [DOI] [PubMed] [Google Scholar]
  17. Larimer ME, Turner AP, Mallett KA, Geisner IM. Predicting Drinking Behavior and Alcohol-Related Problems Among Fraternity and Sorority Members: Examining the Role of Descriptive and Injunctive Norms. Psychology of Addictive Behaviors. 2004;18(3):203–212. doi: 10.1037/0893-164x.18.3.203. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Martinez JA, Sher KJ, Wood PK. Drinking consequences and subsequent drinking in college students over 4 years. Psychol Addict Behav. 2014;28(4):1240–1245. doi: 10.1037/a0038352. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Miller MB, Leffingwell TR. What do college student drinkers want to know? Student perceptions of alcohol-related feedback. Psychology of Addictive Behaviors. 2013;27(1):214–222. doi: 10.1037/a0031380. [DOI] [PubMed] [Google Scholar]
  20. Mollen S, Rimal RN, Ruiter RA, Jang SA, Kok G. Intervening or interfering? The influence of injunctive and descriptive norms on intervention behaviours in alcohol consumption contexts. Psychology & Health. 2013;28:561–578. doi: 10.1080/08870446.2012.752827. [DOI] [PubMed] [Google Scholar]
  21. Murphy JG, Duchnick JJ, Vuchinich RE, Davison JW, Karg RS, Olson AM, … Coffey TT. Relative efficacy of a brief motivational intervention for college student drinkers. Psychology of Addictive Behaviors. 2001;15(4):373–379. doi: 10.1037/0893-164x.15.4.373. [DOI] [PubMed] [Google Scholar]
  22. Prince MA, Carey KB. The malleability of injunctive norms among college students. Addictive Behaviors. 2010;35(11):940–947. doi: 10.1016/j.addbeh.2010.06.006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Prince MA, Maisto SA, Rice SL, Carey KB. Development of a Face-to-Face Injunctive Norms Brief Motivational Intervention for College Drinkers and Preliminary Outcomes. Psychol Addict Behav. 2015 doi: 10.1037/adb0000118. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Reid AE, Carey KB. Interventions to reduce college student drinking: State of the evidence for mechanisms of behavior change. Clin Psychol Rev. 2015;40:213–224. doi: 10.1016/j.cpr.2015.06.006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction. 1993;88(6):791–804. doi: 10.1111/j.1360-0443.1993.tb02093.x. Retrieved from http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=8329970. [DOI] [PubMed] [Google Scholar]
  26. Schroeder CM, Prentice DA. Exposing pluralistic ignorance to reduce alcohol use among college students. Journal of Applied Social Psychology. 1998;28(23):2150–2180. doi: 10.1111/j.1559-1816.1998.tb01365.x. [DOI] [Google Scholar]
  27. Sugarman DE, Carey KB. The relationship between drinking control strategies and college student alcohol use. Psychology of Addictive Behaviors. 2007;21(3):338–345. doi: 10.1037/0893-164X.21.3.338. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-13102-007&site=ehost-livedesugarm@syr.edu. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Swift JK, Callahan JL, Vollmer BM. Preferences. Journal of Clinical Psychology. 2011;67(2):155–165. doi: 10.1002/jclp.20759. [DOI] [PubMed] [Google Scholar]
  29. Teigen K. The novel and the familiar: Sources of interest in verbal information. Current Psychology. 1985;4(3):224–238. doi: 10.1007/BF02686573. [DOI] [Google Scholar]
  30. Terry DL, Garey L, Carey KB. Where do college drinkers draw the line? A qualitative study. Journal of College Student Development. 2014;55(1):63–74. doi: 10.1353/csd.2014.0000. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Turrisi R, Larimer ME, Mallett KA, Kilmer JR, Ray AE, Mastroleo NR, … Montoya H. A randomized clinical trial evaluating a combined alcohol intervention for high-risk college students. Journal of Studies on Alcohol and Drugs. 2009;70(4):555–567. doi: 10.15288/jsad.2009.70.555. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2009-09219-009&site=ehost-liverturrisi@psu.edu. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Turrisi R, Mastroleo NR, Mallett KA, Larimer ME, Kilmer JR. Examination of the mediational influences of peer norms, environmental influences, and parent communications on heavy drinking in athletes and nonathletes. Psychology of Addictive Behaviors. 2007;21(4):453–461. doi: 10.1037/0893-164X.21.4.453. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Westmaas J, Moeller S, Woicik PB. Validation of a measure of college students’ intoxicated behaviors: Associations with alcohol outcome expectancies, drinking motives, and personality. Journal of American College Health. 2007;55(4):227–237. doi: 10.3200/JACH.55.4.227-237. [DOI] [PubMed] [Google Scholar]

RESOURCES