PEARLS No. 199, September 2009, written by Brian R McAvoy

Clinical question

How effective is social norms feedback in reducing alcohol misuse in university or college students?  

Bottom line

Interventions delivered using the web or computer, or in individual face-to-face sessions, appeared to reduce alcohol misuse (alcohol-related problems, peak blood alcohol content, drinking frequency and quantity, binge drinking and drinking norms). Significant effects were more apparent for short term outcomes (up to 3 months). The evidence was less convincing for group face-to-face sessions. Mailed and group feedback were on the whole no different than the control intervention. Two large studies showed contradictory results for a social marketing campaign.  

Caveat

Only a small number of good quality studies were available for many of the outcomes and analyses, and most of the studies were from the US. The intensity of the intervention differed between trials as did the control intervention (no intervention, educational leaflets or an alcohol educational session). The review may also lack generalisability due to recruitment into the trials. A large number of studies in this review selected participants from psychology courses or were delivered to students at high-risk (eg, first year students).  

Context

People may believe their peers drink heavily, which influences their drinking. Much of this peer influence is the result of incorrect perceptions. Normative feedback relies on the presentation of information on these misperceptions, about personal drinking profiles, risk factors and normative comparisons. Feedback can be given alone or in addition to individual or group counselling. Individual face-to-face feedback typically involves social norms feedback as just one aspect of a broader motivational interviewing intervention.  

Cochrane Systematic Review

Moreira MT et al. Social norms interventions to reduce alcohol misuse in University or College students. Cochrane Reviews 2009. Issue 3. Article No. CD006748. DOI:10.1002/14651858. CD006748.pub2. This review contains 22 studies involving 7275 participants.