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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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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
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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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
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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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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Example: Overestimation of alcohol consumption among
peers
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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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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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