christiane stock nhprc 2013

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Is the social norms approach feasible to reduce drug use among university students in Europe? Results from the SNIPE study Stock C.*, Helmer S., Vriesacker B,. Dempsey R., Kalina O., Dohrmann S. * and the SNIPE project group *Unit for Health Promotion Research, Institute of Public Health, University of Southern

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Is the social norms approach feasible to reduce drug use among university students in Europe? Results from the SNIPE study

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Page 1: Christiane Stock  NHPRC 2013

Is the social norms approach feasible to reduce drug use

among university students in Europe? Results from the

SNIPE study

Stock C.*, Helmer S., Vriesacker B,. Dempsey R., Kalina O., Dohrmann S. *

and the SNIPE project group

*Unit for Health Promotion Research, Institute of Public Health, University of

Southern Denmark

Page 2: Christiane Stock  NHPRC 2013

SNIPE Social Norms Intervention for PolysubstancE

usE in university students Funded by the

European Commisssion Drug Prevention and Information Programme

Feasibility study of a web-based, personalised feedback intervention on social norms for polysubstance use

A multi-national study involving 26 institutions of higher education across seven European countries

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Page 3: Christiane Stock  NHPRC 2013

Background

University students experience social pressures to engage in alcohol and other drug (AOD) use, at a time that often coincides with the transition to adulthood.

Evidence suggests that overestimating the AOD consumption of peers may lead to use substances more heavily and frequently than they would otherwise do.

Interventions providing students with accurate information on normative behaviour have been identified as a useful prevention instruments in previous research.

Comparative studies in Europe are lacking.3

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The Social Norms Approach

Differing from existing health education strategies: Promoting the healthy behaviour of the

majority – rather than focussing on the unhealthy actions of the minority

Does not use fear arousal or moral tactics Aims at engaging the target group and stresses

that messages are based on the information that they themselves provided

Correction of misperceptions through mass media campaigns or through the use of web-based personalised feedback

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Examples

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Research questions

Do European students overestimate the AOD use of peers? Are there differences between institutions/countries?

How can students be reached and which are the challenges in implementing a web-based social norms intervention using personalised feedback?

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Design Intervention group: Access to a website portal providing

individualised social norms feedback Delayed Intervention Control Group: Access to the

intervention website after study completion Baseline and 5 months Follow-up: Personal and perceived

peer AOD use

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Challenges 1 Recruitment

Difficulties to get some universities/student unions on board

Country specific restrictions to student recruitment - restrictions to directly contact students

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Student recruitment

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Through student email (Germany, Slovakia, Turkey, Belgium)

Through personal contact in lectures and informed consents (Denmark)

Through campus advertisement (UK, Spain)

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Challenges II Time delays

Several weeks between recruitment at some sites and possibility to register

Two months between registrations and accessibility of the baseline questionnaire

Baseline questionnaire Development of scales and items Adaptation and translation Pre-testing

IT capacity problems log-in Web-based questionnaire

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Page 12: Christiane Stock  NHPRC 2013

Student samples (only intervention group)

Registration

Baseline survey

completion

Intervention views Loss

Belgium 439 167 130 - 40 %

Germany 546 306 221 - 59 %

Slovak Republic

1633 838 769 - 53 %

Turkey 600 93 81 - 83 %

Denmark 469 132 99 - 78 %

Spain 120 29 11 - 91 %

UK 143 51 69 - 64 %

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Page 13: Christiane Stock  NHPRC 2013

Example: Overestimation of alcohol consumption among

peers

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Page 14: Christiane Stock  NHPRC 2013

Perceived versus actual rates of cannabis use

Males Females

Student who think that

the majority has used cannabis

(%)

Students who have

used cannabis

(%)

Student who think that

the majority has used cannabis

(%)

Students who have

used cannabis

(%)

Belgium 67.9 9.3 60.6 6.1

UK 68.0 28.0 60.6 7.0

Germany 70.0 38.8 70.0 20.6

Spain 45.0 6.2 72.0 4.4

Denmark 33.3 6.2 27.6 3.7

Slovac Republic

73.4 12.6 57.1 3.4

Turkey 22.9 4.6 13.4 3.0

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Page 15: Christiane Stock  NHPRC 2013

Challenges III

Before launching the intervention ethical approval had to be optained in seven different countries which contributed to the time delay between baseline survey and access to the intervention website

Development of the intervention website was more complicated than foreseen Complexity of the intervention (smoking,

alcohol, illicit drugs) Finding common ground regarding presentation

and message content Pre-testing in seven countries Language complexity (seven languages) IT capacity problems15

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Summary of results

Baseline data The baseline data confirmed our hypothesis of

an overestimation of the consumption of peers Such misperception was not specific to

countries, however the amount differs Thus more realistic perception of normative

behaviour would be beneficial Feasibility

Difficulties in access to student Big time delays in the process of approaching

students Big loss to follow-up

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Lessons learned Development and testing of such a complex

intervention tool cannot be done in 2 years Proper time needs to be planned for consensus

procedures and translation if more sites/countries are involved

Sufficient IT capacity is crucial!! The intervention tool needs to be established

before the baseline data collection is done including formulation and presentation of messages.

When data on perceived and actual behaviour are collected they should be quickly entered into a ready made website – This would make the intervention available when students are keen to visit the website.

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