To evaluate and optimize brief alcohol interventions (BAIs), it is critical to have a credible overall effect size estimate as a benchmark. Estimating such an effect size has been challenging because alcohol outcomes often represent responses from a mixture of individuals: those at high risk for alcohol misuse, occasional nondrinkers, and abstainers. Moreover, some BAIs exclusively focus on heavy drinkers, whereas others take a universal prevention approach. Depending on sample characteristics, the outcome distribution might have many zeros or very few zeros and overdispersion; consequently, the most appropriate statistical model may differ across studies. We synthesized individual participant data (IPD) from 19 studies in Project INTEGRATE (Mun et al., 2015b) that randomly allocated participants to intervention and control groups (N = 7,704 participants, 38.4% men, 74.7% White, 58.5% first-year students). We sequentially estimated marginalized zero-inflated Poisson (Long et al., 2014) or negative binomial regression models to obtain covariate-adjusted, study-specific intervention effect estimates in the first step, which were subsequently combined in a random-effects meta-analysis model in the second step. BAIs produced a statistically significant 8% advantage in the mean number of drinks at both 1–3 months (RR = 0.92, 95% CI = [0.85, 0.98]) and 6 months (RR = 0.92, 95% CI = [0.85, 0.99]) compared to controls. At 9–12 months, there was no statistically significant difference in the mean number of drinks between BAIs and controls. In conclusion, BAIs are effective at reducing the mean number of drinks through at least 6 months post intervention. IPD can play a critical role in deriving findings that could not be obtained in original individual studies or standard aggregate data meta-analyses.
Research on maternal socialization of child emotion regulation often involves measures of general parenting, yet little research has considered how maternal emotion regulation and emotion expressivity relate to children's ability to regulate their emotions. Because emotion regulation can be viewed as intergenerational, mothers who display higher levels of positive emotions and lower levels of negative emotions may create a more optimal emotional climate for children to learn and practice emotion regulation, aiding in the intergenerational transmission of optimal emotion regulation. We tested a mediation model where maternal positive expressivity was hypothesized to mediate the relation of maternal emotion regulation to child emotion regulation. We also examined maternal negative expressivity as a moderator of the association of maternal positive expressivity to child emotion regulation. Maternal emotion regulation, measured as the use of reappraisal, and maternal expressivity were self-reported when children were 4 -5 years old (T1). Child emotion regulation, measured as effortful control, was observed at T1. When children were 8 -9 years old (T2), a summary score of child emotion regulation was computed from observed and teacher-reported effortful control. Higher levels of maternal reappraisal were related to more maternal positive expressivity, which in turn was associated with better child emotion regulation (T2), controlling for prior levels of child regulation (T1), only when maternal negative expressivity was low. This longitudinal moderated mediation pathway suggests that adaptive emotion regulation strategies used by mothers can be transmitted to children through maternal emotional expressions, specifically the interplay of positive and negative emotions.
BackgroundBrief motivational interventions (BMIs) are one of the most effective individually focused alcohol intervention strategies for college students. Despite the central theoretical role of motivation for change in BMIs, it is unclear whether BMIs increase motivation to change drinking behavior. We conducted a two‐step meta‐analysis of individual participant data (IPD) to examine whether BMIs increase motivation for change. N = 5903;59% women, 72% White) from Project INTEGRATE. The BMIs included individually delivered motivational interviewing with personalized feedback (MI + PF), stand‐alone personalized feedback (PF), and group‐based motivational interviewing (GMI).MethodsWe included 15 trials of BMI (N = 5903;59% women, 72% White) from Project INTEGRATE. The BMIs included individually‐delivered motivational interviewing with personalized feedback (MI + PF), stand‐alone personalized feedback (PF), and group‐based motivational interviewing (GMI). Different measures and responses used in the original trials were harmonized. Effect size estimates were derived from a model that adjusted for baseline motivation and demographic variables for each trial (step 1) and subsequently combined in a random‐effects meta‐analysis (step 2).ResultsThe overall intervention effect of BMIs on motivation for change was not statistically significant (standard mean difference [SMD]: 0.026, 95% CI: [−0.001, 0.053], p = 0.06, k = 19 comparisons). Of the three subtypes of BMIs, GMI, which tended to provide motivation‐targeted content, had a statistically significant intervention effect on motivation, compared with controls (SMD: 0.055, 95% CI: [0.007, 0.103], p = 0.025, k = 5). By contrast, there was no evidence that MI + PF (SMD = 0.04, 95% CI: [−0.02, 0.10], k = 6, p = 0.20) nor PF increased motivation (SMD = 0.005, 95% CI: [−0.028, 0.039], k = 8, p = 0.75), compared with controls. Post hoc meta‐regression analysis suggested that motivation sharply decreased each month within the first 3 months postintervention (b = −0.050, z = −2.80, p = 0.005 for k = 14).ConclusionsAlthough BMIs provide motivational content and normative feedback and are assumed to motivate behavior change, the results do not wholly support the hypothesis that BMIs improve motivation for change. Changing motivation is difficult to assess during and following interventions, but it is still a theoretically important clinical endpoint. Further, the evidence cautiously suggests that changing motivation may be achievable, especially if motivation‐targeted content components are provided.
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