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Christiane Stock  NHPRC 2013
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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

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

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  • In my talk I willfocus on the feasibility of developing and testing a web-based intervention for univeristy students in Europe thatuses the social norms approach in order to reduce smoking, alcohol and other drug use. I did thisstudytogether with the SNIPE studygroupconsisting of researchers from seven European countries-
  • The SNIPE projectwasfunded by the European commission. It ran from 2011-2013.
  • University students are in an age wheretheyexperience social pressure… at the same time theyare in a period of transition from adolecsence to adulthood, moveaway from home and experiencemany new stressors. This makesthemprone to increase drug use and some studies show thattheyconsumption is higherthanthat of their peer outsideuniversity.Evidence suggest that students areoftenoveresimating the consumption of theirfellow students and thismaylead to…Therfore it is suggestedthataccuate information about the actualconsumption of peers maylead to a reducedspocial pressure to use drugs. Intervention studies usingthis social norms approach has identifiedthis as a usefulprevention instrument.However, most of the reseaerch has been done in the US or in Australian and studies in Europe aresparse. Comparative studies involving more thanone country in Europe areactuallylacking at all.Therfore the SNIPE studywasundertaken as such a feasibilitytrial.
  • Therearesomecharacterisics of the social norms approach that I wouldlike to highlight whcihmakes the approach promising in the light of thelimitedeffects of traditional drug preventionstrategies.
  • Inthispresentation I will present the veryfirstresults of the SNIPE study. Due to the factthat the data collection and analysis is still ungoing I willonly present data of the baseline study and willfocus on the feasibility of our intervention design ratherthangoingonto the effectiveness of the approach.Therfore the reseaerchquestionsare:
  • Whensetting up the design for the studywefaced the firstchallenges in recruiting students to the study at the intervention and control sites in the differentcountries. First of all barriers had to beovercome to get the universities on board. In somecountriesuniversityleaderships or student unions where not supporting the study. In addition some country had certainrestrictions to approach students with invitations to participate in the study. Email invitations have not beenpossible in Denmark due to a law to protectpersonal data of students. Therforeuniversityemailaddressescould not beused to approach students ifthey have not given permission to do so.
  • Due to thisfact student recrueitmentdifferedbetweencountries.
  • Transcript

    • 1. 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
    • 2. 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 countries2
    • 3. 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
    • 4. 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 4
    • 5. Examples 5
    • 6. 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? 6
    • 7. 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 7
    • 8. Challenges 1  Recruitment  Difficulties to get some universities/student unions on board  Country specific restrictions to student recruitment - restrictions to directly contact students 8
    • 9. Student recruitment 9  Through student email (Germany, Slovakia, Turkey, Belgium)  Through personal contact in lectures and informed consents (Denmark)  Through campus advertisement (UK, Spain)
    • 10. 10
    • 11. 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 11
    • 12. 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 % 12
    • 13. Example: Overestimation of alcohol consumption among peers 13
    • 14. 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 14
    • 15. 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 problems 15
    • 16. 16
    • 17. 17
    • 18. 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 18
    • 19. 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. 19