Dr. Mark Gold’s Research You Can Use
Binge drinking is a distinctly problematic pattern on college campuses. As per a survey by the National Institute of Alcohol Abuse and Alcoholism (NIAAA), an estimated two out of every five college students of all ages, which roughly translates to more than 40 percent, reported binge drinking at least once in the past two weeks. A recent study aimed to predict the intention to change from binge drinking to responsible drinking among a sample of American college students.
Binge drinking and initiating a lasting change
Binge drinking is defined as a pattern of excessive alcohol consumption over a short period of time. A “binge” is typically indicated in an instance when the drinker’s blood alcohol concentration reaches or exceeds 0.08 grams per 100 grams of blood. The Substance Abuse and Mental Health Services Administration classifies binge drinking as 5 or more drinks for men and 4 or more drinks for women over a time period of about 2 hours.
About 60 percent of college students, aged 18 to 24 years, reported consuming alcohol in the past month. Harmful and underage college drinking are significant public health problems, and they exact a tremendous toll on the intellectual, personal and social lives of students on campuses across the nation. Binge drinking is further associated with numerous adverse consequences such as suicide attempts, risky sexual encounters, property damage, driving under the influence, altercations with law enforcement, and impaired academic performance.
Even though various brief interventional studies, conducted over the past decade, have highlighted a variety of personal and environmental causes of persistent binge drinking in college students, these short-lived interventions remained relatively ineffective. Hence, there has existed a need for newer theories that focus upon multilevel behavioral factors, especially theoretical concepts that affect long-term behavioral changes.
This study aimed to utilize the multi-theory model of health behavior change to predict the initiation and maintenance of responsible drinking or abstinence among binge-drinking students in a population sample drawn from a large southern public university.
“Prior studies have shown that convincing people to change their behavior requires a comprehensive approach,” stated Manoj Sharma, MBBS, Ph.D., a professor of behavioral health at Jackson State University and lead researcher on this study. “As difficult as it is for people to adopt new behaviors, it is even harder for them to sustain those changes.”
Multi-theory Model (MTM) of health behavior change
The MTM health behavior theory utilizes a combination of evidence-based constructs established through previous theories to address behavioral fluctuations at multifaceted levels. The MTM avoids overlap among constructs, acknowledging both short-term and long-term behavioral changes, prioritizes cultural feasibility and accommodates interventions with limited resources.
It comprises of a 2-component health behavior change pattern: initiation of behavior change and maintenance of this behavior. This initiation of behavior change begins with the decision to abstain from drinking, quit binge drinking, or start drinking responsibly. Maintenance of this behavior refers to the sustenance in abstaining or continuing efforts to drink responsibly.
As per the MTM, the following constructs are important for initiation of responsible drinking:
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- Participatory dialogue where advantages supersede disadvantages
- Internal or external behavioral confidence influences future behavior
- Fluctuations in the physical environment entail the removal or reduction
For sustenance of behavior change, the following constructs are necessary:
- Emotional transformation toward responsible drinking
- Practice for change that involves constant reflection on the need for responsible drinking
- Changes in the social environment
This is the first study of its kind to test the predictive potential of the MTM in explaining behavioral fluctuations from binge drinking to responsible drinking.
The study
This cross-sectional study recruited students via email and information was gathered through an MTM-based online questionnaire.
Responses were collected over a period of three weeks. Undergraduate and graduate students who reported binge drinking over the past month and were aged 18 years or older were also included in the study.
The survey comprised of 39 items, used to predict intention to switch from binge drinking to responsible drinking or abstinence. Responsible drinking was classified as consuming one or two alcoholic drinks on a particular occasion or drinking no more than one alcoholic beverage per day for women and two per day for men. These 39 items ranged from assessing study eligibility to determining sociodemographic characteristics and measuring the MTM constructs for initiation and sustenance. Answers were rated by the 5-point Likert scales from 0 (never/not sure at all) to 4 (always/completely sure).
A total of 289 students participated. Based upon the hierarchical regression modeling, gender, race/ethnicity, behavioral confidence, and changes in the physical environment were linked with intended initiation for drinking responsibly or abstinence. Women and non-white college students were found to be more receptive to this change.
Why is this important?
The study helped bring forward empirical evidence for MTM constructs that can be effectively utilized in the inculcation of the intention to drink responsibly or abstain among college students who binge drink. The affirmation of such an effective predictive model is potentially valuable in the designing of future interventions aiming to improve responsible drinking behavior in the college student population.
Data analyses further revealed that the constructs suggested for initiation of change were significant, and the full model predicted 26.4 percent of the variance in the intention to initiate change. This is considered a substantial value for a behavioral study.
Among sustenance model constructs, practice for change was proven a significant indicator for intention to sustain change, deeming it an essential factor to be included in future interventive measures. Healthcare professionals and college wellness programs need to focus on improving patients’ self-awareness of drinking tendencies and encourage active reflection.
Given the high prevalence of binge drinking in college students, interventions are clearly crucial. MTM offers a range of targeted constructs that offer an advantage for designing brief and precise interventions. In a primary care setting, primary care physicians, college wellness programs and other health care professionals have limited time with the patient.
This makes researching the most efficient and effective constructs even more critical.
An evidence-based guide to clinical practice should be applied to health behavior change, and this study brings forward MTM as an evidence-based model to direct predictive empirical framework for not just large-scale interventions, but also to provide guidance for individual-scale interventions in clinical practice.
Meanwhile, teaching responsible drinking and aiding students in enhancing their behavioral confidence to drink responsibility needs to be emphasized. Small manageable steps such as educating patients about what entails responsible for drinking or handing out guidelines that outline the responsible rate of alcohol consumption and discussing preventative measures can be a good start.
References:
1. https://www.ncbi.nlm.nih.gov/pubmed/29987315
2. http://jaoa.org/article.aspx?articleid=2687950
3. https://www.sciencedaily.com/releases/2018/07/180716130727.htm
4. https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking
About the Author:
Mark S. Gold, M.D. served as Professor, the Donald Dizney Eminent Scholar, Distinguished Professor and Chair of Psychiatry from 1990-2014. Dr. Gold was the first Faculty from the College of Medicine to be selected as a University-wide Distinguished Alumni Professor and served as the 17th University of Florida’s Distinguished Alumni Professor.
Learn more about Mark S. Gold, MD
About the Transcript Editor:
Sana Ahmed is a journalist and social media savvy content writer with extensive research, print and on-air interview skills. She has previously worked as staff writer for a renowned rehabilitation institute, a content writer for a marketing agency, an editor for a business magazine and been an on-air news broadcaster.
Sana graduated with a Bachelors in Economics and Management from London School of Economics and began a career of research and writing right after. Her recent work has largely been focused upon mental health and addiction recovery.
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Published on February 26, 2019
Reviewed by Jacquelyn Ekern, MS, LPC on February 26, 2019
Published on AddictionHope.com