JMIR Publications

ABSTRACT

Background:

In most Western countries, excessive alcohol intake among university students is a cause of concern. The majority of students view drinking as a cornerstone of university life, and many find it difficult to go against the dominant drinking culture. While digital health interventions have been shown to reduce drinking among university students, no intervention has been aimed at changing the overall university drinking culture. This intervention provided the students with tools that helped them make pre-commitment strategies and change their views on the social norms that prevent excessive alcohol intake.

Objective:

Our objective is to evaluate the impact of an intervention aimed at reducing the excessive drinking culture among Danish university students. As a secondary outcome, we measured the impact of the intervention on two individual motivational factors for participating in the drinking culture at the university: alcohol consumption as both a personal benefit and a facilitator of socialization.

Methods:

To evaluate the impact of the intervention, we conducted a cluster randomized controlled experiment among university students at Aarhus University. The students were stratified by gender and self-reported binge drinking. Each student was assigned to either a control or an intervention group. A baseline questionnaire was sent to the participants when school started in September 2019, and a follow-up questionnaire was sent out two months later. The primary outcomes were measured with the Alcohol Use Disorder Identification Test (questions 1-3). To examine the mechanisms underlying the effect, we analyzed two motivational factors for participating in the drinking culture at the university: alcohol consumption as both and a personal benefit and a facilitator of socialization.

Results:

In total 961 students signed up, and 509 of them completed the follow-up questionnaire. Compared to the students in the control group, the students in the intervention group had a 15.8% (P<.001) reduction on their monthly level of alcohol intake two months after the intervention. The result is driven by a large effect on male and first-year students. The intervention had no effect on binge drinking, alcohol addiction, or severely harmful alcohol consumption. Our results also showed that while the students in the intervention group found it less difficult to say “no” to drinking there were no difference in the assessment of being part of the student environment between the students in the intervention and control Group.

Conclusions:

The intervention had a significant and reducing impact on the students’ monthly alcohol intake. That the effect of the intervention was largest among the young and first-year students, who will be the responsible for the drinking culture at the University in the coming years, suggest that small nudging-based interventions can potentially have significant long-term beneficial effects. Clinical Trial: American Economic Association’s registry for randomized trials with RCT ID: AEARCTR-0004703. https://www.socialscienceregistry.org/trials/4703.