drinking behavior and its consequences), feedback about expectancies and motives for drinking, and decision-making procedures that prompt the individual to weigh the benefits and negative aspects of drinking. Skills training approaches were less effective, as were interventions for men and for those who were already drinking heavily.

An intervention reported by Carey, Carey, and colleagues (2006) did produce significant benefit. They evaluated MI as a means of reducing problematic drinking among 509 heavy-drinking undergraduates who were randomly assigned to one of six conditions. The students received one of two versions of MI or no interviews. The standard version of MI stressed the students’ autonomy in deciding what they wanted to do, discussed norms about drinking, provided tips for reducing drinking, and reinforced talk about change. The second, “enhanced” version included a worksheet containing a decisional grid to help students clarify the pros and cons of changing their behavior. Students were also assigned to receive or not receive a Timeline Follow Back (TLFB) interview that took the students back through the previous 90 days, starting with the most recent period, and helped them reconstruct their drinking behavior during this time. Assessment of the students’ drinking behavior and alcohol-related problems occurred at baseline and 1, 6, and 12 months postintervention. They found that the TLFB by itself reduced alcohol consumption compared with the no-intervention control. The standard MI produced significantly greater reductions in alcohol use and alcohol problems than did the TLFB; those who received the enhanced MI did not improve as much. On the basis of this evidence, motivational interviewing coupled with the TLFB appears to have the greatest potential to reduce drinking significantly among undergraduates.

Other Approaches

In addition to school-based and college interventions, efforts to prevent substance use and abuse among young people often include other community, media, regulatory, or policy approaches. These more broadly based strategies tend to target norms and policies rather than trying to reach individuals with behavior change strategies, although in many cases they are combined with components that target individuals more directly through schools and families. Many of these interventions, particularly those targeting alcohol, also focus on reducing the consequences of substance use as much as use itself.

The Centers for Disease Control and Prevention’s Guide to Community Preventive Services (n.d.) recommends restrictions on outlet density and zoning to reduce excessive alcohol consumption and enhanced enforcement of laws prohibiting the sale of alcohol to minors. Nationally oriented recommendations related to reducing and preventing underage drinking call for these and other approaches, such as limiting the marketing of alcohol

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