Brief consultations may affect students' health-risk behavior

November 3, 2008

GAINESVILLE, Fla. — College students cut down on drinking alcohol, using marijuana and drunken driving after receiving a new form of health consultation that addresses multiple risk behaviors and focuses on positive self-image, a University of Florida study has found.

The study, conducted by Chad Werch, director of the Addictive & Health Behaviors Research Institute at UF’s College of Health and Human Performance, provided college students with brief interventions and one-on-one consultations to address a range of health behavior, from drinking and drug use, to nutrition and getting enough sleep.

The study also found that in addition to reducing potentially harmful habits, students increased certain behavior beneficial to their health, such as amount of sleep.

Addressing multiple negative health habits is important because people seldom have only one bad habit, Werch said.

“It’s not only that a population might not exercise,” Werch said. “If they are not exercising, they also are most likely not eating very healthy. They are probably having trouble sleeping, and there might be some stress issues.”

The study, to be published in the journal Annals of Behavioral Medicine, involved 303 college students from a Southeastern university. Roughly half the students, a control group, were provided with standard health promotion materials, such as pamphlets warning about the dangers of smoking. The other experimental group received a brief, one-on-one consultation with a health professional that addressed multiple risk behaviors. The study found that the brief, multiple behavior intervention was more effective.

“There were significant outcomes for those students who had the brief multiple behavior interventions,” Werch said. “It goes beyond these particular behaviors; they are actually saying the quality of their lives has improved.”

Addressing behavior is important because the vast majority of illnesses and premature deaths in the United States come from behavioral factors, ranging from poor diet and lack of exercise to substance use and abuse, Werch said.

Use of potentially harmful substances is common among college students: 84.5 percent of college undergraduates drank alcohol in 2007, 41 percent used tobacco products and 30.1 percent reported using marijuana, according to the Core Alcohol and Drug survey, a survey originally developed by the Department of Education in the 1980s to gauge alcohol and drug use on university campuses.

Brief interventions that may affect health-related behavior stand in contrast to traditional, media-based public health campaigns in that they are person-to-person, may occur only once or twice and focus on positive benefits of healthy habits rather than the potential harm of negative ones. The brevity of the multiple behavior interventions also makes them cost-effective.

“The whole idea is that these interventions are time-limited — they are not intensive or extensive,” Werch said. “The emphasis is on motivation.”

In the feedback section of the intervention, trained fitness specialists offered students positive images of a healthy person at a college age.

By emphasizing the positive and avoiding negative images, the fitness specialist could avoid students tuning out, a common problem among young people exposed to traditional health warnings, Werch said.

“We don’t get into saying, ‘Smokers look like this’ — that’s a typical public health message,” Werch said.

Highlighting positive self-image in interventions could play a main role in decreasing addictive behavior, according to Carlo DiClemente, professor at the Department of Psychology, University of Maryland, Baltimore County and a co-author of the study.

“The idea that there are some central mechanisms like image that might contribute to reducing risk across multiple areas of functioning is intriguing to public health and seems critical for targeting risk reductions in addiction,” DiClemente said.

Another unique aspect of the research done by Werch is its focus on social bonds to try to stimulate changes in behavior, according to Rick Gibbons, research professor at Dartmouth College Department of Psychological and Brain Sciences, who was not involved in the study.

“College students (like the rest of us) are very aware of the kind of image they portray to others,” Gibbons said. “And they realize that behaviors like drinking and using drugs affect those images. Dr. Werch has taken advantage of this concern in a very creative way, and used it to develop an intervention that uses social motivation to change what are very social behaviors.”

The study builds on previous work by Werch and his colleagues that found brief interventions could have a positive effect on exercise among adolescents.