Main outcomes of M-bridge: A sequential multiple assignment randomized trial (SMART) for developing an adaptive...

Area of Science:

• Public Health
• Psychology
• Intervention Science

Background:

• College students face significant alcohol-related risks during their transition.
• Adaptive Preventive Interventions (APIs) aim to mitigate these risks efficiently.
• A sequential multiple assignment randomized trial (SMART) design was employed to test intervention components.

Purpose of the Study:

• To evaluate the efficacy of an API compared to a control group for reducing first-year student binge drinking.
• To compare different intervention sequences within the API.
• To identify moderators of intervention effects, particularly for students at higher risk.

Main Methods:

• A SMART design with two randomizations: intervention timing and bridging strategy for heavy drinkers.
• Participants (N=891) received personalized normative feedback and self-monitoring.
• Outcomes measured included binge drinking frequency, alcohol consequences, and health services utilization.

Main Results:

• The overall API did not show significant effects compared to the control group.
• No significant differences were found between the embedded API variations.
• Heavy drinkers receiving a resource email showed increased health services utilization compared to those invited to health coaching.
• Students intending to join Greek life demonstrated a smaller increase in binge drinking with the API.

Conclusions:

• While the universal API lacked overall efficacy, targeted strategies show promise.
• Resource emails may be an effective, low-intensity intervention for heavy-drinking college students.
• Interventions may be more effective for specific subgroups, such as students entering Greek life.