Kuerbis Alexis, Muench Frederick J, Lee Rufina, Pena Juan, Hail Lisa
Silberman School of Social Work, City University of New York, Hunter College , New York , NY , United States.
Department of Psychiatry, Northwell Health , Great Neck , NY , United States.
PeerJ. 2016 Jun 21;4:e2114. doi: 10.7717/peerj.2114. eCollection 2016.
Background. Normative feedback (NF), or receiving information about one's drinking compared to peer drinking norms, is one of the most widely used brief interventions for prevention and intervention for hazardous alcohol use. NF has demonstrated predominantly small but significant effect sizes for intention to change and other drinking related outcomes. Identifying mechanisms of action may improve the effectiveness of NF; however, few studies have examined NF's mechanisms of action, particularly among adults. Objective. This study is an exploratory analysis of two theorized mechanisms of NF: discrepancy (specifically personal dissonance-the affective response to feedback) and belief in the accuracy of feedback. Method. Using Amazon's Mechanical Turk, 87 men (n = 56) and women (n = 31) completed an online survey during which they were asked about their perceptions about their drinking and actual drinking behaviors. Then participants were provided tailored NF and evaluated for their reactions. Severity of discrepancy was measured by the difference between one's estimated percentile ranking of drinking compared to peers and actual percentile ranking. Surprise and worry reported due to the discrepancy were proxies for personal dissonance. Participants were also asked if they believed the feedback and if they had any plans to change their drinking. Mediation analyses were implemented, exploring whether surprise, worry, or belief in the accuracy of feedback mediated severity of discrepancy's impact on plan for change. Results. Among this sample of adult drinkers, severity of discrepancy did not predict plan for change, and personal dissonance did not mediate severity of discrepancy. Severity of discrepancy was mediated by belief in the accuracy of feedback. In addition, viewing one's drinking as a problem prior to feedback and post-NF worry both predicted plan for change independently. Conclusions. Results revealed that NF may not work to create personal dissonance through discrepancy, but belief in the accuracy of feedback may be important. It appears the more one believes the feedback, the more one makes a plan for change, suggesting practitioners should be mindful of how information within feedback is presented. Findings also indicate NF may work by validating a preexisting perception that drinking is a problem instead of creating concern related to discrepancy where none existed. Limitations regarding generalizability are discussed.
背景。规范反馈（NF），即与同龄人饮酒规范相比，获取关于个人饮酒情况的信息，是预防和干预有害饮酒行为应用最为广泛的简短干预措施之一。NF已被证明对改变意图及其他与饮酒相关的结果主要产生虽小但显著的效应量。确定其作用机制可能会提高NF的有效性；然而，很少有研究探讨NF的作用机制，尤其是在成年人中。目的。本研究对NF的两种理论机制进行探索性分析：差异（具体为个人失调——对反馈的情感反应）以及对反馈准确性的信念。方法。利用亚马逊的土耳其机器人平台，87名男性（n = 56）和女性（n = 31）完成了一项在线调查，期间他们被问及对自身饮酒情况的认知以及实际饮酒行为。然后为参与者提供量身定制的NF，并评估他们的反应。差异的严重程度通过个人估计的饮酒百分位排名与同龄人相比以及实际百分位排名之间的差异来衡量。因差异而报告的惊讶和担忧是个人失调的替代指标。参与者还被问及是否相信反馈以及是否有改变饮酒行为的计划。进行中介分析，探讨惊讶、担忧或对反馈准确性的信念是否中介差异严重程度对改变计划的影响。结果。在这个成年饮酒者样本中，差异严重程度并未预测改变计划，且个人失调并未介导差异严重程度。差异严重程度由对反馈准确性的信念介导。此外，在反馈前将自己的饮酒视为问题以及反馈后担忧均独立预测改变计划。结论。结果表明，NF可能无法通过差异产生个人失调，但对反馈准确性的信念可能很重要。似乎一个人越相信反馈，就越会制定改变计划，这表明从业者应留意反馈中的信息呈现方式。研究结果还表明，NF可能是通过验证饮酒是问题这一预先存在的认知来发挥作用，而不是在不存在差异的情况下引发与差异相关的担忧。讨论了关于可推广性的局限性。
