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Program Profile: Alcohol Literacy Challenge

Evidence Rating: Promising - More than one study Promising - More than one study

Date: This profile was posted on January 28, 2019

Program Summary

This program consists of a single-session, group-delivered intervention for high school and college students, which is designed to alter alcohol expectancies and lower alcohol use. The program is rated Promising. The program was shown to have a statistically significant effect on modifying alcohol expectancy processes and reducing alcohol consumption in college students; however, there was no statistically significant impact on high school students.

This program’s rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Description

Program Goals
The Alcohol Literacy Challenge (ALC) is a single-session, group-delivered intervention for college and high school students that challenges participants’ alcohol expectancies. Alcohol expectancies are the ways in which individuals perceive that alcohol will affect them or alter their experiences while drinking. Beliefs held about alcohol are linked to alcohol consumption, and research suggests that changing beliefs about alcohol can change individuals’ consumption patterns (Dunn and Goldman 1998; 2000). The goals of the program are to change students’ alcohol expectancies and lower alcohol use.

Target Population
ALC can be tailored to either college or high school students (ages 14 to 24), who drink alcohol heavily or are underage. For college students, the program was specifically tailored to the high-risk Greek community (i.e., fraternities and sororities).

Program Theory
Alcohol expectancies develop before regular drinking habits and correlate with the amount of alcohol consumed regularly (Dunn and Goldman 1998; 2000). Changing an individual’s expectancy about the positive and arousing effects of alcohol has been linked to positive changes in alcohol consumption (Dunn, Lau, and Cruz 2000).

Program Components
ALC uses a media literacy approach to challenge students’ associations of positive alcohol expectancies, which are promoted by media advertising, to decrease the positive reinforcing value of alcohol. The curriculum is designed not to erase former expectancies of alcohol, but rather to introduce new information about its negative effects.

ALC provides students with a summary of empirical research that attempts to distinguish between the pharmacological and expectancy effects of alcohol. Students then view four alcohol advertisement videos (approximately 1.5 to 2 minutes long) and are asked to identify positive and arousing alcohol expectancies in each advertisement. The expectancies are contrasted with the scientific evidence previously presented. Participants discuss the difference between the expectancies shown in the advertisements and the pharmacological effects of alcohol consumption.

Evaluation Outcomes

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Overall, the three studies of the Alcohol Literacy Challenge (ALC) showed mixed results. While two studies of college students in fraternities and sororities showed statistically significant differences between the treatment and control groups, the study on high school students found no statistically significant effects. Overall, the preponderance of evidence suggests the program did have the intended effects.

Study 1
Average Weekly Peak Blood Alcohol Content
The Fried (2010) study of fraternity and sorority members showed that the ALC intervention reduced the average weekly peak blood alcohol content experienced by the treatment group after 1 month, compared with the control group. This difference was statistically significant.

Average Drinks per Sitting
The ALC intervention lowered the average number of drinks per sitting consumed by the treatment group after 1 month, compared with the control group. This difference was statistically significant.

Average Drinking Days per Week
The ALC intervention also lowered the average number of drinking days per week for the treatment group after 1 month, compared with the control group. This difference was statistically significant.

Average Drinks per Week
The ALC intervention also lowered the average number of drinks per week consumed by the treatment group after 1 month, compared with the control group. This difference was statistically significant.

Peak Drinks per Sitting
The ALC intervention lowered the peak number of drinks per sitting consumed by the treatment group after 1 month, compared with the control group. This difference was statistically significant.

Study 2
Mean Blood Alcohol Content
The Fried and Dunn (2012) study of fraternity members showed that the ALC intervention lowered mean blood alcohol content for the treatment group after 4 weeks, compared with the control group. This difference was statistically significant.

Mean Drinks per Sitting
The ALC intervention decreased the mean drinks per sitting of the treatment group after 4 weeks, compared with the control group. This difference was statistically significant.

Peak Drinks per Sitting
The ALC intervention decreased the peak drinks per sitting of the treatment group after 4 weeks, compared with the control group. This difference was statistically significant.

Binge Episodes
The ALC intervention also decreased the number of binge episodes of the treatment group after 4 weeks, compared with the control group. This difference was statistically significant.

Mean Drinking Days per Week
The ALC intervention decreased the mean number of drinking days per week of the treatment group after 4 weeks, compared with the control group. This difference was statistically significant.

Study 3
Mean Blood Alcohol Content
The Dietz (2016) study of high school students showed that the ALC intervention did not have a statistically significant effect on mean blood alcohol content after 30 days.

Peak Blood Alcohol Content
The ALC intervention did not have a statistically significant effect on peak blood alcohol content after 30 days.

Average Drinks per Sitting
The ALC intervention did not have a statistically significant effect on average drinks per sitting after 30 days.

Peak Drinks per Sitting
The ALC intervention also did not have a statistically significant effect on peak drinks per sitting after 30 days.

Weekly Peak Drinks per Sitting
The ALC intervention did not have a statistically significant effect on weekly peak drinks per sitting after 30 day
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Evaluation Methodology

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Study 1
Fried (2010) conducted a quasi-experimental study at a large state university in Orlando, Florida to study the effectiveness of the Alcohol Literacy Challenge (ALC). Participants were eligible for the study if they were members of one of four fraternities or four sororities. The study author administered either the expectancy challenge presentation to the treatment group or the educational presentation to the control group during a prescheduled chapter meeting. Those in the treatment group received an Alcohol Expectancy Challenge presentation, which presented pharmacological effects of alcohol and challenged students’ positive expectancies regarding alcohol. The control group received an educational presentation of similar length.

The mean age of the 525 participants was 19.76 years. Forty-nine percent were male, and approximately 83 percent were white, 12.9 percent were Hispanic, 1.3 percent were Asian American, 0.3 percent were African American, and 2.5 percent were of other race/ethnicity. At baseline, no statistically significant differences were found between groups based on age, class standing, ethnicity, average weekly peak blood alcohol content (BAC), average drinks per sitting, or average drinking days per week. There were also no statistically significant differences in alcohol expectancies on the Comprehensive Effects of Alcohol Scale (CEOA) for six of the seven subscales (sociability, tension reduction, liquid courage, sexuality, cognitive/behavioral impairment, and risk and aggression). There was a statistically significant difference between the two groups on the self-perception subscale. This difference was taken into account in interpreting overall results.

Alcohol consumption was measured using the retrospective, self-report, timeline follow-back procedure. Alcohol expectancies were measured using the CEOA, a factor model-based expectancy measure. Follow-up data was collected 4 weeks after the initial presentation. Of the 525 participants who completed baseline measures, 354 (67.4 percent) completed follow-up measures. The study author used a 2 (experimental, control) x 2 (pretest, posttest) x 2 (male, female) mixed analysis of variance on the seven subscales of the CEOA and on drinking behavior, and conducted subgroup analyses by looking at differences between male and female students.

Study 2
Fried and Dunn (2012) conducted a randomized controlled trial at a large state university in Orlando, Florida. Participants were members of fraternities at the university. The treatment group received the ALC intervention, and the control group received a media literacy presentation on advertisements for personal appearance products. The presentations were both 50 minutes.

Four fraternity chapters were included in the study and were randomly assigned to the ALC condition (two chapters, n = 148) or the control condition (two chapters, n = 102). Of the 235 participants who completed baseline data, 209 completed the 4-week follow-up data. The mean age of participants was 19.95 years. Approximately 78.5 percent identified as white, 15.3 percent as Hispanic, 1.4 percent as Asian American, 1 percent as African American, and 3.3 percent as other. There were no statistically significant differences between the groups on age, class standing, or ethnicity at baseline. There was a statistically significant main effect for peak BAC, mean drinks per sitting, and peak drinks per sitting between groups. There was also a statistically significant main effect for the self-perception subscale of the CEOA. Baseline differences between groups were taken into account during later analyses.

Daily alcohol consumption for the 4 weeks prior to baseline and follow up was measured using the retrospective, self-report, timeline follow-back procedure. Alcohol expectancies were measured using the CEOA. Between-group differences in alcohol expectancies and alcohol consumption were analyzed using ANCOVAs with baseline alcohol expectancies or baseline alcohol consumption as covariates. The study authors did not conduct subgroup analyses.

Study 3
Dietz (2016) conducted a randomized controlled trial at two public high schools within the Orange County Public Schools district in central Florida. Participants were juniors and seniors in high school, and the intervention was delivered during their regularly scheduled government or economics classes. The treatment group received the ALC; the control group received a similarly structured presentation about body image. The presentations were both 45 minutes.

A total of 180 high school students participated in the evaluation. The sample was 57 percent female, and 62 percent identified as white, 27 percent as Hispanic, 18.9 percent as African American, 4.4 percent as Asian or Southeast Asian, 2.7 percent as Hawaiian/Pacific Islander, 1.7 percent as American Indian or Alaska Native, and 10 percent as biracial or other. No statistically significant differences were found between groups on demographic variables, baseline expectancies, or baseline alcohol consumption.

Alcohol consumption was measured using the timeline follow-back procedure to recall drinking behavior over the last 30 days. Alcohol expectancies were measured using the CEOA. A mixed-model application of GLM, using baseline alcohol expectancies or baseline alcohol consumption as a covariate, was used to analyze between-group differences. The study author was independent of the program. The study author conducted subgroup analyses on differences between male and female students.
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Cost

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There is no cost information available for this program.
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Other Information

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Fried (2010) conducted subgroup analyses to determine whether statistically significant differences were observed between male and female college students. There was a statistically significant three-way interaction across group, time, and gender for average weekly blood alcohol content. Males in the treatment group showed a greater decrease in weekly average blood alcohol content than males in the control group. Females in the treatment group decreased their weekly average blood alcohol content, while females in the control group increased their weekly average blood alcohol content. Dietz (2016) also conducted subgroup analyses to determine whether statistically significant differences were observed between male and female high school students, but the results were nonsignificant.
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Evidence-Base (Studies Reviewed)

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These sources were used in the development of the program profile:

Study 1
Fried, Abigail. 2010. “Evaluation of an Expectancy Challenge Presentation in Reducing High-Risk Alcohol Use Among Greek Affiliated College Students.” Master’s thesis. Orlando, FL: University of Central Florida.
https://stars.library.ucf.edu/cgi/viewcontent.cgi?referer=https://scholar.google.com/&httpsredir=1&article=5428&context=etd

Study 2
Fried, Abigail B., and Michael E. Dunn. 2012. “The Expectancy Challenge Alcohol Literacy Curriculum (ECALC): A Single Session Group Intervention to Reduce Alcohol Use.” Psychology of Addictive Behaviors 26(3):615.

Study 3
Dietz, Alyssa. 2016. “Evaluation of the Expectancy Challenge Alcohol Literacy Curriculum (ECALC) for High School Students.” PhD diss. Orlando, FL: University of Central Florida.
https://stars.library.ucf.edu/cgi/viewcontent.cgi?referer=https://scholar.google.com/&httpsredir=1&article=6099&context=etd
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Additional References

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These sources were used in the development of the program profile:

Dunn, Michael E., and M.S. Goldman. 1998. “Age and Drinking-Related Differences in the Memory Organization of Alcohol Expectancies in 3rd-, 6th-, 9th-, and 12th-Grade Children.” Journal of Consulting and Clinical Psychology 66:579–85.

Dunn, Michael E., and M.S. Goldman. 2000. “Age and Drinking-Related Differences in Alcohol Expectancies of Children Assessed as Free-Word-Association Responses.” Alcoholism: Clinical and Experimental Research 24:1639–1646.

Dunn, Michael E., C.H. Lau, and I.Y. Cruz.  2000. “Changes in Activation of Alcohol Expectancies in Memory in Relation to Changes in Alcohol Use After Participation in an Expectancy Challenge Program.” Experimental and Clinical Psychopharmacology 8:566–75.
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Program Snapshot

Age: 14 - 24

Gender: Both

Race/Ethnicity: Black, American Indians/Alaska Native, Asian/Pacific Islander, Hispanic, White, Other

Geography: Suburban

Setting (Delivery): School, Campus

Program Type: Classroom Curricula, Alcohol and Drug Prevention

Current Program Status: Active

Listed by Other Directories: Model Programs Guide, National Registry of Evidence-based Programs and Practices

Training and TA Provider:
Tracy Juechter
Director of Sales and Marketing
Alcohol Literacy Challenge
Phone: 505.690.3272
Website
Email