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.
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
SNIPE Social Norms Intervention for
PolysubstancE usE in university
Funded by the European
Prevention and Information
Feasibility study of a web-
feedback intervention on
social norms for
A multi-national study
involving 26 institutions of
higher education across
seven European countries2
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.
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
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
Correction of misperceptions through mass media
campaigns or through the use of web-based
Do European students overestimate the AOD use of
peers? Are there differences between
How can students be reached and which are the
challenges in implementing a web-based social norms
intervention using personalised feedback?
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
Difficulties to get some universities/student unions on
Country specific restrictions to student recruitment -
restrictions to directly contact students
Through student email
(Germany, Slovakia, Turkey,
Through personal contact in
lectures and informed consents
Through campus advertisement
Several weeks between recruitment at some sites
and possibility to register
Two months between registrations and accessibility of
the baseline questionnaire
Development of scales and items
Adaptation and translation
IT capacity problems
Example: Overestimation of alcohol
consumption among peers
Perceived versus actual rates of
think that the
think that the
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
73.4 12.6 57.1 3.4
Turkey 22.9 4.6 13.4 3.0
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
Finding common ground regarding presentation and
Pre-testing in seven countries
Language complexity (seven languages)
IT capacity problems
Summary of results
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
Difficulties in access to student
Big time delays in the process of approaching
Big loss to follow-up
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
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.