A user-customizable personalized normative feedback intervention for alcohol harm reduction in young adults: Feasibility, acceptability, and preliminary efficacy.

The proposed project entails (1) user-centered development of an innovative web-based intervention to reduce alcohol-related harm among young adults, and (2) pilot testing the intervention to assess indices of acceptability and engagement, as well as preliminary assessment of efficacy, relative to a treatment-as-usual and attention-

matched control conditions. Personalized normative feedback (PNF) – i.e., correcting misperceptions about peers’ alcohol use behaviors and contrasting one’s own use to the actual norms of their peers – is an economic strategy that is widely used on college campuses. Although effects of PNF interventions are consistent, and

generally maintained, the effect sizes can be improved; thus, innovation is needed to further move the needle. The proposed intervention will expand traditional PNFs that generally only provide normative feedback for ‘typical students’ at participants’ university, by providing options for users to customize their experience and explore a

variety of more specific normative feedback modules; for example, providing normative feedback specific to first year students, Hispanic students, or sexual minoritized students (many other modules will be available). This novel paradigm will provide users with a truly personalized and engaging experience in which individuals receive

normative feedback on the referent groups that are most meaningful and interesting to them. Although this customizability is anticipated to increase engagement and efficacy, it will also provide more equitable prevention, as many students may not identify with the ‘typical student’ (e.g., minoritized students) and these students may

be more receptive to feedback that is more aligned with their own identities. Thus, this pilot project will lay the groundwork for a novel customizable personalized normative feedback (CPNF) intervention paradigm whereby users can choose to explore normative feedback for a wider variety of referent groups (as many as they wish to

explore), in addition to typical student norms feedback. In Phase 1 of the pilot project, we will develop and refine the CPNF intervention content, design, and deliverability through a multi-step, iterative process called rapid prototyping (N=30). In line with user centered design, young adults will be incorporated into and provide feedback

on all steps to ensure that a relevant and engaging final product is created. Rapid prototyping allows us to quickly gather user feedback and make changes based on user preferences. Once the intervention is developed and fully programmed, Phase 2 will entail a pilot RCT (N=250) of the CPNF intervention. Aim 2 will specifically

examine feasibility of the CPNF intervention paradigm in terms of acceptability, engagement, interest, and satisfaction, and will examine whether these indices are higher among students who are in most need of this type of intervention (e.g., heavier drinkers). Aim 3 will entail a ‘proof-of-concept’ test of efficacy, relative to

standard PNF and attention-matched control conditions, in terms of reductions in alcohol use and negative consequences assessed at 1- and 3-month follow-ups, and test whether CPNF increases treatment equity for students of marginalized identities (race/ethnicity and sexual/gender minorities), relative to standard PNF.