The dangers of drinking games in teens: Can online alcohol interventions help?
Adolescents who use alcohol commonly participate in so called “drinking games,” which substantially increase risk for negative consequences, as dangerous amounts of alcohol can be consumed. Given the link between drinking game participation and high-risk drinking behaviors, developing more specific interventions is key. This study tested whether an electronically delivered personalized feedback intervention could reduce both participation in drinking games and drinking game-related alcohol use.
Although interventions targeting college students’ drinking game participation have shown mixed results, some have demonstrated benefits such as reduced drinking game participation and decreased alcohol use. For example, eCHECKUP TO GO, an online brief alcohol intervention that provides personalized normative feedback, has proven efficacious for reducing alcohol use and problems among college students. Alcohol Wise, an online intervention that includes eCHECKUP TO GO, resulted in significant reductions in drinking game participation and high-risk drinking behaviors among college students. However, few interventions have been specifically tailored for high school students. This study tested an adapted version of eCHECKUP TO GO designed to address drinking game participation in high school seniors, a group with markedly higher alcohol use levels relative to their younger high school counterparts. The researchers hypothesized that students receiving the intervention would report decreased frequency of participation in drinking games, decreased number of drinks consumed while playing drinking games, and decreased total number of drinks consumed on occasions when playing drinking games at the 30-day follow up relative to students in the control group, and that these drinking reductions would be sustained within intervention participants at 6 months.
HOW WAS THIS STUDY CONDUCTED?
This study was a randomized control trial testing the efficacy of a brief online alcohol intervention on drinking game participation at 1-month and 6-month follow-ups in 109 high school seniors recruited from two urban high schools in the Northwest as part of a larger trial, where classes made up the units randomized rather than individual participants – a common design in school-based interventions. Parents were mailed letters from the schools with study details and consent forms. Students whose parents consented were then recruited from core classes during the first month of the fall semester, whereby they could provide assent prior to completing the online baseline survey. To be eligible, students had to have reported at least 1 binge drinking episode in the 2 weeks prior to the baseline assessment. Students were randomized at the classroom level to either the 30-minute online intervention module (i.e., eCHECKUP TO GO; n = 72) or an assessment only control (n = 37).
The eCHECKUP TO GO intervention consisted of an online assessment to capture basic demographic information, alcohol-related behaviors, and knowledge and beliefs about alcohol to inform personalized feedback delivered back to the participant via text, graphs, and video recordings. Feedback provided includes elements related to the students drinking and how this compares to their peers (i.e., other students at their school), consequences of alcohol use, personal risk factors, as well as information on protective behavioral strategies that students could use to mitigate alcohol-related consequences.
Primary outcomes included drinking game participation frequency, number of drinks consumed while playing drinking games, and total number of drinks consumed on occasions when playing drinking games (i.e., including before, during, and after playing drinking games) and were assessed via online surveys at baseline, 1-month, and 6-month follow ups. To assess drinking game participation, students were presented with a definition of drinking games (“Playing games where drinking is part of the known rules, or where chugging is involved. The object of the game is either to avoid drinking or to show that you can drink a lot. A secondary aim is to get others to drink a lot”) and asked to report how frequently they participated in drinking games over the past month, how many drinks they typically consumed while playing drinking games, and how many total drinks they typically consumed on occasion when they participated in drinking games. The Daily Drinking Questionnaire was used to measured how many alcoholic drinks students consumed in a typical week. The Quantity/Frequency/Peak Questionnaire was used to assess the frequency with which students consumed alcohol and was measured on a 0 to 7 scale ranging from “Do not drink alcohol” to “Every day.” The researchers employed longitudinal analyses to account for whether changes in outcomes differed across conditions at 1-month and 6-month follow-ups, controlling for covariates such as baseline alcohol consumption levels.
The intervention did not reduce how frequently students played drinking games
The online intervention did not result in decreased frequency of participating in drinking games among high school seniors. See Figure below.
The intervention did, however, improve alcohol use during drinking games
Participants assigned to the intervention condition experienced significant reductions in the number of drinks consumed while playing drinking games from baseline to the 30-day follow-up. There were no differences between groups from the 30-day follow-up to 6 months or from baseline to 6 months. See Figure below.
Similarly, on number of drinks consumed on drinking game occasions (not during only the drinking game itself), the intervention group had a greater decrease than control from baseline to 30-day follow-up. But no significant differences between groups were observed from the 30-day follow-up to 6 months or baseline to 6 months. Of note, however, when examining only the change within group, the intervention significantly decreased drinks on drinking game occasions from baseline to 6-month follow-up, while the control stayed the same over time. See Figure below.
WHAT ARE THE IMPLICATIONS OF THE STUDY FINDINGS?
This study evaluated the efficacy of an online alcohol intervention providing personalized feedback to high school seniors for reducing their frequency of playing drinking games, quantity of alcohol consumed while playing drinking games, and total amount of alcohol consumed on occasions involving drinking games. Results indicate that while the intervention did not reduce the frequency with which students participated in drinking games, it did result in decreases in quantity of alcohol consumed while playing drinking games and on occasions when drinking games took place.
Findings from this study align with prior research on eCHECKUP TO GO, which has demonstrated that the online intervention is an effective, low-cost tool for reducing quantity of alcohol use among adolescent and young adults – at least for a while. While prior studies have primarily focused on the program’s efficacy in addressing alcohol use among college students, this study extends that to hazardous alcohol use during drinking games among high school students. Prior research on eCHECKUP TO GO has shown mixed results regarding its effectiveness for reducing frequency of alcohol consumption among youth and young adults. Similarly, this study found that the online intervention did not reduce how often high school seniors participated in drinking games. This suggests that eCHECKUP TO GO might benefit from incorporating additional components aimed at reducing the frequency of alcohol consumption, alongside its existing focus on minimizing the quantity of alcohol consumed and harms associated with hazardous drinking. At the same time, it is possible that personalized normative feedback-based interventions like these – that also offer tips on ways to reduce harms when drinking, called protective behavioral strategies – are best suited to help manage the intensity of alcohol use when it occurs, but are not as helpful when it comes to days of alcohol use.
Also consistent with prior evidence on eCHECKUP TO GO, this intervention’s effectiveness in reducing the quantity of alcohol consumed relative to the control group was most pronounced at the short-term 30-day follow-up. However, this study also demonstrated that reductions in the total quantity of alcohol consumed on occasions involving drinking games were sustained for up to 6 months in the intervention group. It is worth noting that high school seniors participated in the online program at the start of the school year, with the 6-month follow-up occurring while they were still in high school. Future research should investigate whether these reductions persist post-graduation, both for students who transition to college and those who do not. For instance, many students transitioning to college face newfound independence from parental oversight and exposure to an environment characterized by heightened alcohol-related behaviors and associated risks. Developing interventions that successfully reduce alcohol use and harms among high school seniors – and maintain their effects through the college years and beyond – could yield significant public health benefits.
This study recruited a small, predominantly white female sample from two high schools in a single US region, limiting generalizability of the findings. Future iterations with larger, more diverse samples are warranted.
This study relied on self-reports of alcohol use from adolescents and may be subject to a number of reporting biases (e.g., social desirability bias), despite efforts to ensure confidentiality and reduce bias. It is unlikely, however, that such bias would have been different between the groups.
The intervention was compared to an assessment-only control and future efforts are needed to compare eCHECK UP TO GO to active comparison conditions among high school seniors.
BOTTOM LINE
The eCHECK UP TO GO intervention did not result in reductions in frequency of participation in drinking games, but it did result in significant reductions in quantity of alcohol consumed while playing drinking games from baseline to 30 days and in total number of drinks consumed on occasions in which drinking games were played from baseline to 30 days and baseline to 6 months. Reductions for the intervention group in quantity of alcohol consumed while playing drinking games and on occasions when drinking games were played were significantly greater than those observed in the control condition from baseline to 30 days. Findings suggest the brief online alcohol intervention may be able to help reduce harms associated with hazardous drinking among high school students participating in drinking games at least in the short-term.
For individuals and families seeking recovery: For parents of teenagers using alcohol, online programs like eCHECKUP TO GO may help to reduce hazardous drinking associated with playing drinking games. Advocacy efforts to encourage the adoption of alcohol prevention programming in high schools across the nation could help to expand the reach of these interventions, potentially reducing alcohol-related harms experienced by adolescents and their families.
For treatment professionals and treatment systems: This study highlights the potential for school-based alcohol prevention programming to reduce hazardous alcohol use among high school students. Treatment systems should seek to build collaborative relationships with schools to integrate empirically supported interventions like eCHECKUP TO GO into their prevention efforts and to help expand innovative, scalable prevention program offerings.
For scientists: Findings from this study indicate that a school-delivered online adolescent alcohol use intervention may be helpful in reducing quantity of alcohol consumed while playing drinking games and total number of drinks consumed on occasions when drinking games are played. Alcohol reductions were primarily observed from baseline to 30 days, with some effects lasting for total number of drinks consumed on occasions when drinking games were played up to 6 months. However, it is not known whether such reductions in quantity of alcohol consumed will last. Additionally, this study relied on a small sample of predominantly White females from two high schools in a single US region. Future randomized controlled trials with larger, more diverse samples and longer-term follow-ups lasting beyond high school graduation are needed to understand if the online alcohol intervention is helpful for reducing alcohol-related harms beyond high school and into young adulthood, a period marked by substantial increases in alcohol consumption and associated consequences.
For policy makers: Supporting the implementation of low-cost, scalable interventions like eCHECKUP TO GO in high schools may significantly reduce hazardous drinking associated with drinking game participation among high school seniors, contributing broad public health and societal benefits. Increased funding to understand whether these online programs promote sustained drinking reductions beyond high school graduation and to bolster these interventions for assisting high school graduates in making the transition out of high school and into young adulthood are warranted.
Although interventions targeting college students’ drinking game participation have shown mixed results, some have demonstrated benefits such as reduced drinking game participation and decreased alcohol use. For example, eCHECKUP TO GO, an online brief alcohol intervention that provides personalized normative feedback, has proven efficacious for reducing alcohol use and problems among college students. Alcohol Wise, an online intervention that includes eCHECKUP TO GO, resulted in significant reductions in drinking game participation and high-risk drinking behaviors among college students. However, few interventions have been specifically tailored for high school students. This study tested an adapted version of eCHECKUP TO GO designed to address drinking game participation in high school seniors, a group with markedly higher alcohol use levels relative to their younger high school counterparts. The researchers hypothesized that students receiving the intervention would report decreased frequency of participation in drinking games, decreased number of drinks consumed while playing drinking games, and decreased total number of drinks consumed on occasions when playing drinking games at the 30-day follow up relative to students in the control group, and that these drinking reductions would be sustained within intervention participants at 6 months.
HOW WAS THIS STUDY CONDUCTED?
This study was a randomized control trial testing the efficacy of a brief online alcohol intervention on drinking game participation at 1-month and 6-month follow-ups in 109 high school seniors recruited from two urban high schools in the Northwest as part of a larger trial, where classes made up the units randomized rather than individual participants – a common design in school-based interventions. Parents were mailed letters from the schools with study details and consent forms. Students whose parents consented were then recruited from core classes during the first month of the fall semester, whereby they could provide assent prior to completing the online baseline survey. To be eligible, students had to have reported at least 1 binge drinking episode in the 2 weeks prior to the baseline assessment. Students were randomized at the classroom level to either the 30-minute online intervention module (i.e., eCHECKUP TO GO; n = 72) or an assessment only control (n = 37).
The eCHECKUP TO GO intervention consisted of an online assessment to capture basic demographic information, alcohol-related behaviors, and knowledge and beliefs about alcohol to inform personalized feedback delivered back to the participant via text, graphs, and video recordings. Feedback provided includes elements related to the students drinking and how this compares to their peers (i.e., other students at their school), consequences of alcohol use, personal risk factors, as well as information on protective behavioral strategies that students could use to mitigate alcohol-related consequences.
Primary outcomes included drinking game participation frequency, number of drinks consumed while playing drinking games, and total number of drinks consumed on occasions when playing drinking games (i.e., including before, during, and after playing drinking games) and were assessed via online surveys at baseline, 1-month, and 6-month follow ups. To assess drinking game participation, students were presented with a definition of drinking games (“Playing games where drinking is part of the known rules, or where chugging is involved. The object of the game is either to avoid drinking or to show that you can drink a lot. A secondary aim is to get others to drink a lot”) and asked to report how frequently they participated in drinking games over the past month, how many drinks they typically consumed while playing drinking games, and how many total drinks they typically consumed on occasion when they participated in drinking games. The Daily Drinking Questionnaire was used to measured how many alcoholic drinks students consumed in a typical week. The Quantity/Frequency/Peak Questionnaire was used to assess the frequency with which students consumed alcohol and was measured on a 0 to 7 scale ranging from “Do not drink alcohol” to “Every day.” The researchers employed longitudinal analyses to account for whether changes in outcomes differed across conditions at 1-month and 6-month follow-ups, controlling for covariates such as baseline alcohol consumption levels.
The intervention did not reduce how frequently students played drinking games
The online intervention did not result in decreased frequency of participating in drinking games among high school seniors. See Figure below.
The intervention did, however, improve alcohol use during drinking games
Participants assigned to the intervention condition experienced significant reductions in the number of drinks consumed while playing drinking games from baseline to the 30-day follow-up. There were no differences between groups from the 30-day follow-up to 6 months or from baseline to 6 months. See Figure below.
Similarly, on number of drinks consumed on drinking game occasions (not during only the drinking game itself), the intervention group had a greater decrease than control from baseline to 30-day follow-up. But no significant differences between groups were observed from the 30-day follow-up to 6 months or baseline to 6 months. Of note, however, when examining only the change within group, the intervention significantly decreased drinks on drinking game occasions from baseline to 6-month follow-up, while the control stayed the same over time. See Figure below.
WHAT ARE THE IMPLICATIONS OF THE STUDY FINDINGS?
This study evaluated the efficacy of an online alcohol intervention providing personalized feedback to high school seniors for reducing their frequency of playing drinking games, quantity of alcohol consumed while playing drinking games, and total amount of alcohol consumed on occasions involving drinking games. Results indicate that while the intervention did not reduce the frequency with which students participated in drinking games, it did result in decreases in quantity of alcohol consumed while playing drinking games and on occasions when drinking games took place.
Findings from this study align with prior research on eCHECKUP TO GO, which has demonstrated that the online intervention is an effective, low-cost tool for reducing quantity of alcohol use among adolescent and young adults – at least for a while. While prior studies have primarily focused on the program’s efficacy in addressing alcohol use among college students, this study extends that to hazardous alcohol use during drinking games among high school students. Prior research on eCHECKUP TO GO has shown mixed results regarding its effectiveness for reducing frequency of alcohol consumption among youth and young adults. Similarly, this study found that the online intervention did not reduce how often high school seniors participated in drinking games. This suggests that eCHECKUP TO GO might benefit from incorporating additional components aimed at reducing the frequency of alcohol consumption, alongside its existing focus on minimizing the quantity of alcohol consumed and harms associated with hazardous drinking. At the same time, it is possible that personalized normative feedback-based interventions like these – that also offer tips on ways to reduce harms when drinking, called protective behavioral strategies – are best suited to help manage the intensity of alcohol use when it occurs, but are not as helpful when it comes to days of alcohol use.
Also consistent with prior evidence on eCHECKUP TO GO, this intervention’s effectiveness in reducing the quantity of alcohol consumed relative to the control group was most pronounced at the short-term 30-day follow-up. However, this study also demonstrated that reductions in the total quantity of alcohol consumed on occasions involving drinking games were sustained for up to 6 months in the intervention group. It is worth noting that high school seniors participated in the online program at the start of the school year, with the 6-month follow-up occurring while they were still in high school. Future research should investigate whether these reductions persist post-graduation, both for students who transition to college and those who do not. For instance, many students transitioning to college face newfound independence from parental oversight and exposure to an environment characterized by heightened alcohol-related behaviors and associated risks. Developing interventions that successfully reduce alcohol use and harms among high school seniors – and maintain their effects through the college years and beyond – could yield significant public health benefits.
This study recruited a small, predominantly white female sample from two high schools in a single US region, limiting generalizability of the findings. Future iterations with larger, more diverse samples are warranted.
This study relied on self-reports of alcohol use from adolescents and may be subject to a number of reporting biases (e.g., social desirability bias), despite efforts to ensure confidentiality and reduce bias. It is unlikely, however, that such bias would have been different between the groups.
The intervention was compared to an assessment-only control and future efforts are needed to compare eCHECK UP TO GO to active comparison conditions among high school seniors.
BOTTOM LINE
The eCHECK UP TO GO intervention did not result in reductions in frequency of participation in drinking games, but it did result in significant reductions in quantity of alcohol consumed while playing drinking games from baseline to 30 days and in total number of drinks consumed on occasions in which drinking games were played from baseline to 30 days and baseline to 6 months. Reductions for the intervention group in quantity of alcohol consumed while playing drinking games and on occasions when drinking games were played were significantly greater than those observed in the control condition from baseline to 30 days. Findings suggest the brief online alcohol intervention may be able to help reduce harms associated with hazardous drinking among high school students participating in drinking games at least in the short-term.
For individuals and families seeking recovery: For parents of teenagers using alcohol, online programs like eCHECKUP TO GO may help to reduce hazardous drinking associated with playing drinking games. Advocacy efforts to encourage the adoption of alcohol prevention programming in high schools across the nation could help to expand the reach of these interventions, potentially reducing alcohol-related harms experienced by adolescents and their families.
For treatment professionals and treatment systems: This study highlights the potential for school-based alcohol prevention programming to reduce hazardous alcohol use among high school students. Treatment systems should seek to build collaborative relationships with schools to integrate empirically supported interventions like eCHECKUP TO GO into their prevention efforts and to help expand innovative, scalable prevention program offerings.
For scientists: Findings from this study indicate that a school-delivered online adolescent alcohol use intervention may be helpful in reducing quantity of alcohol consumed while playing drinking games and total number of drinks consumed on occasions when drinking games are played. Alcohol reductions were primarily observed from baseline to 30 days, with some effects lasting for total number of drinks consumed on occasions when drinking games were played up to 6 months. However, it is not known whether such reductions in quantity of alcohol consumed will last. Additionally, this study relied on a small sample of predominantly White females from two high schools in a single US region. Future randomized controlled trials with larger, more diverse samples and longer-term follow-ups lasting beyond high school graduation are needed to understand if the online alcohol intervention is helpful for reducing alcohol-related harms beyond high school and into young adulthood, a period marked by substantial increases in alcohol consumption and associated consequences.
For policy makers: Supporting the implementation of low-cost, scalable interventions like eCHECKUP TO GO in high schools may significantly reduce hazardous drinking associated with drinking game participation among high school seniors, contributing broad public health and societal benefits. Increased funding to understand whether these online programs promote sustained drinking reductions beyond high school graduation and to bolster these interventions for assisting high school graduates in making the transition out of high school and into young adulthood are warranted.
Although interventions targeting college students’ drinking game participation have shown mixed results, some have demonstrated benefits such as reduced drinking game participation and decreased alcohol use. For example, eCHECKUP TO GO, an online brief alcohol intervention that provides personalized normative feedback, has proven efficacious for reducing alcohol use and problems among college students. Alcohol Wise, an online intervention that includes eCHECKUP TO GO, resulted in significant reductions in drinking game participation and high-risk drinking behaviors among college students. However, few interventions have been specifically tailored for high school students. This study tested an adapted version of eCHECKUP TO GO designed to address drinking game participation in high school seniors, a group with markedly higher alcohol use levels relative to their younger high school counterparts. The researchers hypothesized that students receiving the intervention would report decreased frequency of participation in drinking games, decreased number of drinks consumed while playing drinking games, and decreased total number of drinks consumed on occasions when playing drinking games at the 30-day follow up relative to students in the control group, and that these drinking reductions would be sustained within intervention participants at 6 months.
HOW WAS THIS STUDY CONDUCTED?
This study was a randomized control trial testing the efficacy of a brief online alcohol intervention on drinking game participation at 1-month and 6-month follow-ups in 109 high school seniors recruited from two urban high schools in the Northwest as part of a larger trial, where classes made up the units randomized rather than individual participants – a common design in school-based interventions. Parents were mailed letters from the schools with study details and consent forms. Students whose parents consented were then recruited from core classes during the first month of the fall semester, whereby they could provide assent prior to completing the online baseline survey. To be eligible, students had to have reported at least 1 binge drinking episode in the 2 weeks prior to the baseline assessment. Students were randomized at the classroom level to either the 30-minute online intervention module (i.e., eCHECKUP TO GO; n = 72) or an assessment only control (n = 37).
The eCHECKUP TO GO intervention consisted of an online assessment to capture basic demographic information, alcohol-related behaviors, and knowledge and beliefs about alcohol to inform personalized feedback delivered back to the participant via text, graphs, and video recordings. Feedback provided includes elements related to the students drinking and how this compares to their peers (i.e., other students at their school), consequences of alcohol use, personal risk factors, as well as information on protective behavioral strategies that students could use to mitigate alcohol-related consequences.
Primary outcomes included drinking game participation frequency, number of drinks consumed while playing drinking games, and total number of drinks consumed on occasions when playing drinking games (i.e., including before, during, and after playing drinking games) and were assessed via online surveys at baseline, 1-month, and 6-month follow ups. To assess drinking game participation, students were presented with a definition of drinking games (“Playing games where drinking is part of the known rules, or where chugging is involved. The object of the game is either to avoid drinking or to show that you can drink a lot. A secondary aim is to get others to drink a lot”) and asked to report how frequently they participated in drinking games over the past month, how many drinks they typically consumed while playing drinking games, and how many total drinks they typically consumed on occasion when they participated in drinking games. The Daily Drinking Questionnaire was used to measured how many alcoholic drinks students consumed in a typical week. The Quantity/Frequency/Peak Questionnaire was used to assess the frequency with which students consumed alcohol and was measured on a 0 to 7 scale ranging from “Do not drink alcohol” to “Every day.” The researchers employed longitudinal analyses to account for whether changes in outcomes differed across conditions at 1-month and 6-month follow-ups, controlling for covariates such as baseline alcohol consumption levels.
The intervention did not reduce how frequently students played drinking games
The online intervention did not result in decreased frequency of participating in drinking games among high school seniors. See Figure below.
The intervention did, however, improve alcohol use during drinking games
Participants assigned to the intervention condition experienced significant reductions in the number of drinks consumed while playing drinking games from baseline to the 30-day follow-up. There were no differences between groups from the 30-day follow-up to 6 months or from baseline to 6 months. See Figure below.
Similarly, on number of drinks consumed on drinking game occasions (not during only the drinking game itself), the intervention group had a greater decrease than control from baseline to 30-day follow-up. But no significant differences between groups were observed from the 30-day follow-up to 6 months or baseline to 6 months. Of note, however, when examining only the change within group, the intervention significantly decreased drinks on drinking game occasions from baseline to 6-month follow-up, while the control stayed the same over time. See Figure below.
WHAT ARE THE IMPLICATIONS OF THE STUDY FINDINGS?
This study evaluated the efficacy of an online alcohol intervention providing personalized feedback to high school seniors for reducing their frequency of playing drinking games, quantity of alcohol consumed while playing drinking games, and total amount of alcohol consumed on occasions involving drinking games. Results indicate that while the intervention did not reduce the frequency with which students participated in drinking games, it did result in decreases in quantity of alcohol consumed while playing drinking games and on occasions when drinking games took place.
Findings from this study align with prior research on eCHECKUP TO GO, which has demonstrated that the online intervention is an effective, low-cost tool for reducing quantity of alcohol use among adolescent and young adults – at least for a while. While prior studies have primarily focused on the program’s efficacy in addressing alcohol use among college students, this study extends that to hazardous alcohol use during drinking games among high school students. Prior research on eCHECKUP TO GO has shown mixed results regarding its effectiveness for reducing frequency of alcohol consumption among youth and young adults. Similarly, this study found that the online intervention did not reduce how often high school seniors participated in drinking games. This suggests that eCHECKUP TO GO might benefit from incorporating additional components aimed at reducing the frequency of alcohol consumption, alongside its existing focus on minimizing the quantity of alcohol consumed and harms associated with hazardous drinking. At the same time, it is possible that personalized normative feedback-based interventions like these – that also offer tips on ways to reduce harms when drinking, called protective behavioral strategies – are best suited to help manage the intensity of alcohol use when it occurs, but are not as helpful when it comes to days of alcohol use.
Also consistent with prior evidence on eCHECKUP TO GO, this intervention’s effectiveness in reducing the quantity of alcohol consumed relative to the control group was most pronounced at the short-term 30-day follow-up. However, this study also demonstrated that reductions in the total quantity of alcohol consumed on occasions involving drinking games were sustained for up to 6 months in the intervention group. It is worth noting that high school seniors participated in the online program at the start of the school year, with the 6-month follow-up occurring while they were still in high school. Future research should investigate whether these reductions persist post-graduation, both for students who transition to college and those who do not. For instance, many students transitioning to college face newfound independence from parental oversight and exposure to an environment characterized by heightened alcohol-related behaviors and associated risks. Developing interventions that successfully reduce alcohol use and harms among high school seniors – and maintain their effects through the college years and beyond – could yield significant public health benefits.
This study recruited a small, predominantly white female sample from two high schools in a single US region, limiting generalizability of the findings. Future iterations with larger, more diverse samples are warranted.
This study relied on self-reports of alcohol use from adolescents and may be subject to a number of reporting biases (e.g., social desirability bias), despite efforts to ensure confidentiality and reduce bias. It is unlikely, however, that such bias would have been different between the groups.
The intervention was compared to an assessment-only control and future efforts are needed to compare eCHECK UP TO GO to active comparison conditions among high school seniors.
BOTTOM LINE
The eCHECK UP TO GO intervention did not result in reductions in frequency of participation in drinking games, but it did result in significant reductions in quantity of alcohol consumed while playing drinking games from baseline to 30 days and in total number of drinks consumed on occasions in which drinking games were played from baseline to 30 days and baseline to 6 months. Reductions for the intervention group in quantity of alcohol consumed while playing drinking games and on occasions when drinking games were played were significantly greater than those observed in the control condition from baseline to 30 days. Findings suggest the brief online alcohol intervention may be able to help reduce harms associated with hazardous drinking among high school students participating in drinking games at least in the short-term.
For individuals and families seeking recovery: For parents of teenagers using alcohol, online programs like eCHECKUP TO GO may help to reduce hazardous drinking associated with playing drinking games. Advocacy efforts to encourage the adoption of alcohol prevention programming in high schools across the nation could help to expand the reach of these interventions, potentially reducing alcohol-related harms experienced by adolescents and their families.
For treatment professionals and treatment systems: This study highlights the potential for school-based alcohol prevention programming to reduce hazardous alcohol use among high school students. Treatment systems should seek to build collaborative relationships with schools to integrate empirically supported interventions like eCHECKUP TO GO into their prevention efforts and to help expand innovative, scalable prevention program offerings.
For scientists: Findings from this study indicate that a school-delivered online adolescent alcohol use intervention may be helpful in reducing quantity of alcohol consumed while playing drinking games and total number of drinks consumed on occasions when drinking games are played. Alcohol reductions were primarily observed from baseline to 30 days, with some effects lasting for total number of drinks consumed on occasions when drinking games were played up to 6 months. However, it is not known whether such reductions in quantity of alcohol consumed will last. Additionally, this study relied on a small sample of predominantly White females from two high schools in a single US region. Future randomized controlled trials with larger, more diverse samples and longer-term follow-ups lasting beyond high school graduation are needed to understand if the online alcohol intervention is helpful for reducing alcohol-related harms beyond high school and into young adulthood, a period marked by substantial increases in alcohol consumption and associated consequences.
For policy makers: Supporting the implementation of low-cost, scalable interventions like eCHECKUP TO GO in high schools may significantly reduce hazardous drinking associated with drinking game participation among high school seniors, contributing broad public health and societal benefits. Increased funding to understand whether these online programs promote sustained drinking reductions beyond high school graduation and to bolster these interventions for assisting high school graduates in making the transition out of high school and into young adulthood are warranted.