A review of decisional balance research and directions for brief alcohol intervention among college students.

This paper provides a review of decisional balance (DB) and proposes strategies for improving DB measurement with respect to alcohol interventions for college students. Although existing alcohol interventions for college drinking are widely available, many undergraduates do not perceive any need to change their drinking. Intervention strategies that encourage students to consciously consider reasons for changing problem behaviors and resolve ambivalence may provide unique benefit. The DB and alcohol literature suggest; 1) a relationship exists between DB and motivation to change (MTC); 2) the decisional balance proportion (DBP) represents a promising new way to conceptualize MTC; and 3) while the DBP is a step forward in DB measurement, it can be improved. Alternative strategies proposed for improving the DBP include; 1) a weighted DBP, which may increase predictive ability and provide a closer approximation of an individual's MTC compared to the original DBP; 2) a coded DBP, which may allow for identification of common reasons why college students choose to drink or not drink; and 3) personalized DBP feedback, which may increase intervention efficacy by further highlighting the discrepancy between behaviors and goals. These strategies can be applied separately or in conjunction, and represent a potentially promising new avenue for DB research.