A high-tech approach to curb heavy drinking

Merrill explains that traditional feedback interventions often ask people to consider their drinking behavior at 30 days or similar static points. A-FRAME builds on these earlier studies by focusing on participants' most recent drinking events and providing feedback directly after those experiences.

Merrill calls this the “morning-after effect,” as people often feel the worst about their drinking the morning after a night out, tending to regret their behavior and its consequences. “It’s an opportunity to introduce feedback when they’re more likely to change,” she said. “The idea is to give them timely input like, ‘Here’s what you said about last night’s drinking, and here’s what that might mean for you.’”

The first open trial of A-FRAME was launched just before the arrival of COVID-19 and had to be quickly moved to an online platform. Since that first trial involved only Brown University students during a pandemic lockdown, drinking behaviors were atypical.

During the second and most recent trial, which focused on the feasibility and acceptability of A-FRAME, researchers expanded the participant pool to include a broader age range, including young adults not currently in college. In total, 18 young adults took part, 44% of which were women. The average age was 22.6 years old; 66.7% were white, 27.8% Black, 16.7% Asian, 5.6% Native American/Alaskan Indian and 22% Hispanic/Latino.

Participants were asked to set their drinking-related goals and complete daily surveys for 28 days. If they reported drinking the previous night or day, they received feedback on their progress, their blood alcohol concentration and perceived peer drinking norms. 

Participants set goals based on what they want to change, such as deciding to drink no more than three days per week. “If it’s their third drinking day of the week, we might prompt them to think about ways to avoid drinking again and stay on track with their goals,” Merrill said. “We also offer personalized feedback options. So, if participants are uninterested in certain topics, like drinking-related consequences, they don’t have to select those. They get to decide what feedback is most relevant and motivating for them.”

Merrill suggests that a key goal of the study is to help participants connect the dots between their drinking choices and outcomes, and whether those outcomes are positive or negative. “It’s about getting them to recognize those event-level links,” she said.

Now that the second open trial is complete, the team of researchers from Brown's Center for Alcohol and Addiction Studies, along with a colleague from Old Dominion University, is launching a full randomized trial and recruiting participants until the end of February 2025.

“In the randomized trial, we’re not just testing A-FRAME; we’re also randomizing participants who get paid for completing surveys,” Merrill said. “This will help us figure out whether financial incentives drive engagement or if the program itself is engaging enough. That will provide important insights into whether A-FRAME can be effective outside of a paid research setting.”