1. USING FACEBOOK TO DELIVER A
SOCIAL NORM INTERVENTION TO REDUCE
PROBLEM DRINKING AT UNIVERSITY
BRAD RIDOUT, PhD CANDIDATE
Dr ANDREW CAMPBELL, SENIOR LECTURER
ABSTRACT
INTRODUCTION. University students usually overestimate peer alcohol use,
resulting in them ‘drinking up’ to perceived norms. Social norms theory suggests
that correcting these inflated perceptions can reduce alcohol consumption.
Recent findings by the current authors show portraying oneself as ‘a drinker’
is considered by many students to be a socially desirable component of their
Facebook identity, perpetuating an online culture that normalises binge-drinking
(Ridout et al., 2012). However, social networking sites have yet to be utilised in
social norms interventions.
METHOD. Actual and perceived drinking norms were collected from 244
university students. Ninety-five students who screened positive for hazardous
drinking were randomly allocated to a control or intervention group that received
social norms feedback via personalised Facebook messages over three sessions.
RESULTS. At one month post-intervention, the quantity and frequency of alcohol
consumed by the intervention group during the previous month had significantly
reduced compared to baseline and controls. Reductions were maintained three
months post-intervention. Perceived drinking norms of the intervention group
were significantly more accurate post-intervention.
DISCUSSION. This is the first study to show Facebook can successfully correct
misperceptions of peer drinking norms, resulting in clinically significant reductions
in alcohol use. Facebook has many advantages over traditional social norms
delivery and provides an innovative method for tackling university drinking. These
results have implications for the use of positive messages about safe alcohol use
in Facebook newsfeeds, which may counter the negative messages regarding
alcohol normally seen on Facebook.
INTRODUCTION
An increasing body of research has shown that the social norms approach can be
effective in reducing problematic alcohol use in university populations (Moriera
et al., 2009). University students tend to overestimate how much the average
student drinks, increasing the likelihood they will ‘drink up’ to these misperceived
norms. As normative beliefs are one of the strongest determinants of alcohol
consumption among university students (Lewis & Clemens, 2008), social norms
theory suggests correcting inflated perceptions of drinking norms can lead to
reductions in alcohol consumption.
Previous research has found that media exposure has an impact on normative
beliefs regarding alcohol use among adolescents (Anderson et al., 2009). In
addition to exaggerated portrayals of alcohol use in marketing and traditional
media, today’s youth are confronted with an abundance of alcohol-related
content on social media, such as photos and comments from friends, as well as
advertisements and alcohol-related games. Recent findings by the current authors
show portraying oneself as ‘a drinker’ is considered by many students to be a
socially desirable component of their Facebook identity, perpetuating an online
culture that over-represents and normalises binge-drinking (Ridout et al., 2012).
Social norms interventions focus on gauging perceived quantity or frequency
of alcohol use by others, accurately measuring the actual normative quantity or
frequency of alcohol consumed, then dispersing this normative data back to the
sampled group. Social norms theory proposes that if true normative feedback is
delivered effectively and is well received by the targeted sample, they will be less
likely to conform to the false norm, mediating decreases in actual alcohol use.
Despite a Cochrane review finding that delivering social norms feedback online is
as effective as face-to-face (Moriera et al., 2009), social networking sites have yet
to be utilised in social norms interventions. The current study aims to address this
gap in the literature by conducting a social norms intervention using Facebook. It is
proposed that utilising a social networking site, such as Facebook, to deliver social
norms information has a number of advantages over using an external website or
regular email. Firstly, it allows feedback to be provided to participants in the form
of an ‘inbox’ message that is identical to a message that would be received from
a ‘Facebook friend’, and in the environment most often used to digest textual
information regarding their peers’ drinking behaviour. It also has the additional
benefit of remaining visible whenever the participant uses their Facebook inbox,
so that they may refer back to it. Finally, the exponential uptake of smartphone
technology means that many students now have access to Facebook on their
mobile phones. Given that many young people use Facebook while out socialising,
there may be potential for students to be reminded of their personalised social
norms feedback while actually in a situation where they are drinking.
Main Hypothesis: Participants who receive personalised social norms feedback
will report less monthly alcohol consumption (quantity and frequency) at followup, compared to baseline and a control group.
METHOD
A randomised controlled trial was conducted at an Australian university in 2012. Social norms
data regarding perceived alcohol use of their classmates’ and own actual alcohol consumption,
as measured by the Graduated-Frequency Measure (GF; Midanik, 1994), was collected via an
online survey of a class of 244 undergraduate students (M = 19.05 years, range 17–36, 78%
female), 98 of whom were identified by the Alcohol Use Disorders Identification Test (AUDIT,
Babor et al., 2001) as reporting potentially hazardous alcohol use and randomly allocated to
either the intervention or control group. Participants in the intervention group received social
norms feedback one week after completing the initial screening questionnaire, in the form of
a Facebook ‘inbox’ message, including statements comparing the participants’ perceptions of
classmates’ alcohol use with actual descriptive and injunctive social norms calculated from
their classmates’ responses. Figures comparing the participant’s average episodic and weekly
alcohol consumption with the median consumption of their classmates who drink were
also included. As per World Health Organization recommendations (Babor et al., 2001), the
message stated the participant’s AUDIT score, an explanation of associated health risks and
information on reducing these risks (see Figure 1).
To confirm feedback was read and understood, the message concluded with a hyperlink
to a brief online form asking participants to type in the figures regarding their own and
their classmates’ alcohol use and approval of heavy drinking. Follow-up assessments were
conducted at one and three months, with all participants completing the GF on each occasion.
The intervention group received an updated Facebook social norms feedback message one
week after completing the one month follow-up and were again asked to confirm they had
read and understood via a brief online form. The social norms questions and AUDIT were
completed again by all participants at the three month follow-up.
RESULTS
Prior to any social norms feedback being sent out, checks were carried out to
ensure that the intervention and control groups did not differ on any reported
demographic or alcohol variables of interest. Three participants failed to complete
all surveys and were therefore excluded from analysis. The 95 remaining
participants were 80% female and ranged in age from 17-24 years (M = 18.93,
SD = 1.223). Data collected on the key outcome variable (GF) was heavily
skewed in the positive direction. In order to allow for parametric analysis, a log10
transformation was carried out. Descriptive statistics are based on original values.
A repeated measures ANOVA revealed a significant interaction between
intervention group and follow-up time on alcohol consumption quantity,
F(2,186) = 5.818, p < .01. A Helmert contrast comparing baseline quantity to an
average of follow-ups confirmed that, as predicted, the intervention group reduced
their monthly drinking quantity at the follow-ups significantly more in comparison
to the control group, F(1,93) = 10.446, p < .01 (see Figure 2). A second repeated
measures ANOVA revealed there was also a significant interaction between
the intervention group and follow-up time on alcohol consumption frequency,
F(2,186) = 6.281, p < .01. A Helmert contrast comparing baseline frequency to
an average of follow-ups confirmed that, as predicted, the intervention group
reduced their monthly drinking frequency at the follow-ups significantly more
when compared to the control group, F(1,93) = 10.569, p < .01 (see Figure 3).
Figure 4 shows significant changes in accuracy of perceived drinking norms by
the intervention group post-intervention, compared to the control group whose
perceptions remained largely unchanged.

2. USING FACEBOOK TO DELIVER A SOCIAL NORM INTERVENTION TO REDUCE PROBLEM DRINKING AT UNIVERSITY
BRAD RIDOUT, PhD CANDIDATE; Dr ANDREW CAMPBELL, SENIOR LECTURER; THE UNIVERSITY OF SYDNEY
Hi Student
Thank you for completing the alcohol survey for HSBH1005 recently.
Some of the questions you answered come from the Alcohol Use Disorders Identification Test (AUDIT), a questionnaire developed by
the World Health Organisation to determine whether a person’s drinking might be becoming problematic.
Your AUDIT score was 14. This puts you in the HAZARDOUS range.
A person scoring in this range has a high risk of experiencing short-term harm such as blackouts, personal injury, trouble with the
law, social embarrassment, and poor academic performance.
A person scoring in this range is also at risk of experiencing long-term harms such as road trauma, unplanned pregnancy and
sexually transmitted infections, liver disease, certain cancers, and damage to the prefrontal area of the brain responsible for cognitive
reasoning and emotional and behavioural regulation.
THE BEST WAY TO REDUCE YOUR RISK LEVEL IS TO REDUCE THE NUMBER OF DRINKS YOU CONSUME PER OCCASION.
You said that you drink alcohol 2-3 times a week and that you think a typical student in this unit of study drinks 4 or more times a
week.
Actually, of the students in this unit who drink alcohol, most (84%) do so only 2-4 TIMES A MONTH OR LESS.
You said that you have 7 to 9 standard drinks when drinking and that you think a typical student in this unit of study has 7 to 9
standard drinks when drinking.
Actually, of the students in this unit who drink alcohol, just over half (51%) have NO MORE THAN 4 standard drinks on a typical day
when drinking.
You said that you have six or more standard drinks weekly and that you think a typical student in this unit of study has six or more
standard drinks weekly.
Actually, of the students in this unit who drink alcohol, most (84%) have 6 or more standard drinks ONCE A MONTH OR LESS.
Only 2% of students drank as much as you did in the past month.
You said that you are neutral regarding other students drinking heavily in public, and that you think most students in your unit of
study are neutral regarding other students drinking heavily.
Results revealed that only 3% of students in your unit of study approve of other students drinking heavily in public, while more than
half (52%) DISAPPROVE.
Please confirm that you have read and understood these results by taking a minute to complete the form at the following link:
https://www.surveymonkey.com/s/XXXXXXX.
You must complete this brief form in order to continue your participation in this study.
Many thanks,
The Research Team
Figure 1. Sample social norms feedback via Facebook message
Brad Ridout
PhD Candidate
Faculty of Health Sciences
The University of Sydney
PO Box 170, Lidcombe NSW 1825
AUSTRALIA
T: +61 2 9036 7129
F: +61 2 9351 4331
brad.ridout@sydney.edu.au
Dr Andrew Campbell
Senior Lecturer
Faculty of Health Sciences
The University of Sydney
PO Box 170, Lidcombe NSW 1825
AUSTRALIA
T: +61 2 9351 9762
F: +61 2 9351 9540
andrew.campbell@sydney.edu.au

3. Perceived norms (1-5 Likert scale)
Mean difference from actual norm
USING FACEBOOK TO DELIVER A SOCIAL NORM INTERVENTION TO REDUCE PROBLEM DRINKING AT UNIVERSITY
BRAD RIDOUT, PhD CANDIDATE; Dr ANDREW CAMPBELL, SENIOR LECTURER; THE UNIVERSITY OF SYDNEY
2
2
2
2
1.8
1.8
1.8
1.8
1.6
1.6
1.6
1.6
1.4
1.4
1.4
1.4
1.2
1.2
1.2
1.2
1
1
1
1
0.8
0.8
0.8
0.8
0.6
0.6
0.6
0.6
0.4
0.4
0.4
0.4
0.2
0.2
0.2
0.2
0
0
0
Baseline
3 month
follow-up
Baseline
3 month
follow-up
How often do you think a
typical student drinks?
How many standard drinks
when drinking?
Non-significant Interaction:
F(1,93) = .45, p > .05
F(1,93) = 9.34, p < .01
Significant Interaction:
Intervention
Control
0
Baseline
3 month
follow-up
How often has 6 or more
drinks on one occasion?
Significant Interaction:
F(1,93) = 21.19, p < .001
Baseline
3 month
follow-up
How do students feel about
others drinking in public?
Significant Interaction:
F(1,93) = 12.03, p < .01
Figure 4. Changes in perceived drinking norms compared to actual drinking norms before and after intervention.
and has successfully addressed the limitations of many previous social norms
interventions by:
- Including a control group
- Confirming participants read and understood feedback (first study to do so)
- Not conflating the social norms effect by including other intervention
strategies (such as alcohol education and further resources).
While previous studies have focused on how online social networking content
can perpetuate a binge drinking culture (Ridout et al., 2012), these results have
implications for the use of Facebook to promote positive messages about safe
alcohol use, which may counter the negative messages regarding alcohol normally
seen on Facebook.
Given the power of peer influence among adolescents, and that heavy drinking
at university can escalate into a long-term struggle with alcohol, correcting
misperceptions regarding the prevalence and social approval of binge drinking
behaviour is an inexpensive and effective strategy that could potentially bring
widespread benefit to university populations. Future studies are now needed to
validate the current findings with larger and more diverse samples.
CONCLUSIONS
This is the first study to show Facebook can successfully correct misperceptions
of peer drinking norms, resulting in clinically significant reductions in alcohol use.
These findings suggest that informing above average drinkers of the actual
drinking norms among their proximal peers (those in the same unit of study) and
how their perceived norms and own drinking behaviour and compares to these
norms, influences a change in drinking behaviour, both in terms of how often they
drink alcohol and how many standard drinks they consume on each occasion. This
lends support to the increasing body of literature that has found brief online social
norms interventions effective in reducing problematic drinking behaviour.
Results also suggest that corrections to misperceived norms are lasting, as
evidenced by the significant increase in accuracy of norm perceptions at the three
month follow-up.
Facebook has many advantages over traditional social norms delivery, as discussed
above, and given its ubiquitous nature, provides an engaging and innovative
method for tackling the challenge of university drinking. Furthermore, this study
provides support for the effectiveness of online social norms interventions
REFERENCES
Anderson, P., de Bruijn, A., Angus, K., Gordon, R., & Hastings, G. (2009). Impact of alcohol advertising
and media exposure on adolescent alcohol use: A systematic review of longitudinal studies. Alcohol
and Alcoholism, 44, 229–243.
Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. (2001). The Alcohol Use Disorders
Identification Test, Guidelines for use in primary care (2nd ed.). Geneva, Switzerland: World Health
Organization.
Lewis, T. F. & Clemens, E. (2008). The influence of social norms on college student alcohol and
marijuana use. Journal of College Counselling, 11, 19–31.
Midanik, L. T. (1994). Comparing usual quantity/frequency and graduated frequency scales to assess
yearly alcohol consumption: Results from the 1990 United States National Alcohol Survey. Addiction,
89, 407–412.
Moreira, M. T., Smith, L. A., & Foxcroft, D. (2009). Social norms interventions to reduce alcohol
misuse in university or college students (Review). Cochrane Database of Systematic Reviews, 3,
CD006748.
Ridout, B., Campbell, A., & Ellis, L. (2012). ‘Off your Face(book)’: Alcohol in online social identity
construction and its relation to problem drinking in university students. Drug and Alcohol Review,
31, 20–26.
Brad Ridout
PhD Candidate
Faculty of Health Sciences
The University of Sydney
PO Box 170, Lidcombe NSW 1825
AUSTRALIA
T: +61 2 9036 7129
F: +61 2 9351 4331
brad.ridout@sydney.edu.au
Dr Andrew Campbell
Senior Lecturer
Faculty of Health Sciences
The University of Sydney
PO Box 170, Lidcombe NSW 1825
AUSTRALIA
T: +61 2 9351 9762
F: +61 2 9351 9540
andrew.campbell@sydney.edu.au