Is the social norms approach feasible to reduce drug use among university students in Europe? Results from the SNIPE study

1. Is the social norms approach
feasible to reduce drug use among
university students in Europe?
Results from the SNIPE study
Stock C.*, Helmer S., Vriesacker B,.
Dempsey R., Kalina O., Dohrmann S. * and
the SNIPE project group
*Unit for Health Promotion Research, Institute
of Public Health, University of Southern
Denmark

2. SNIPE Social Norms Intervention for
PolysubstancE usE in university
students
 Funded by the European
Commisssion Drug
Prevention and Information
Programme
 Feasibility study of a web-
based, personalised
feedback intervention on
social norms for
polysubstance use
 A multi-national study
involving 26 institutions of
higher education across
seven European countries2

3. Background
 University students experience social pressures to
engage in alcohol and other drug (AOD) use, at a time
that often coincides with the transition to adulthood.
 Evidence suggests that overestimating the AOD
consumption of peers may lead to use substances more
heavily and frequently than they would otherwise do.
 Interventions providing students with accurate
information on normative behaviour have been identified
as a useful prevention instruments in previous research.
 Comparative studies in Europe are lacking.
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4. The Social Norms Approach
 Differing from existing health education strategies:
 Promoting the healthy behaviour of the majority –
rather than focussing on the unhealthy actions of the
minority
 Does not use fear arousal or moral tactics
 Aims at engaging the target group and stresses that
messages are based on the information that they
themselves provided
 Correction of misperceptions through mass media
campaigns or through the use of web-based
personalised feedback
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5. Examples
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6. Research questions
 Do European students overestimate the AOD use of
peers? Are there differences between
institutions/countries?
 How can students be reached and which are the
challenges in implementing a web-based social norms
intervention using personalised feedback?
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7. Design
 Intervention group: Access to a website portal providing individualised
social norms feedback
 Delayed Intervention Control Group: Access to the intervention
website after study completion
 Baseline and 5 months Follow-up: Personal and perceived peer AOD
use
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8. Challenges 1
 Recruitment
 Difficulties to get some universities/student unions on
board
 Country specific restrictions to student recruitment -
restrictions to directly contact students
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9. Student recruitment
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 Through student email
(Germany, Slovakia, Turkey,
Belgium)
 Through personal contact in
lectures and informed consents
(Denmark)
 Through campus advertisement
(UK, Spain)

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11. Challenges II
 Time delays
 Several weeks between recruitment at some sites
and possibility to register
 Two months between registrations and accessibility of
the baseline questionnaire
 Baseline questionnaire
 Development of scales and items
 Adaptation and translation
 Pre-testing
 IT capacity problems
 log-in
 Web-based questionnaire
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12. Student samples (only intervention group)
Registration
Baseline
survey
completion
Intervention
views Loss
Belgium 439 167 130 - 40 %
Germany 546 306 221 - 59 %
Slovak
Republic
1633 838 769 - 53 %
Turkey 600 93 81 - 83 %
Denmark 469 132 99 - 78 %
Spain 120 29 11 - 91 %
UK 143 51 69 - 64 %
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13. Example: Overestimation of alcohol
consumption among peers
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14. Perceived versus actual rates of
cannabis use
Males Females
Student who
think that the
majority has
used
cannabis
(%)
Students who
have used
cannabis
(%)
Student who
think that the
majority has
used
cannabis
(%)
Students who
have used
cannabis
(%)
Belgium 67.9 9.3 60.6 6.1
UK 68.0 28.0 60.6 7.0
Germany 70.0 38.8 70.0 20.6
Spain 45.0 6.2 72.0 4.4
Denmark 33.3 6.2 27.6 3.7
Slovac
Republic
73.4 12.6 57.1 3.4
Turkey 22.9 4.6 13.4 3.0
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15. Challenges III
 Before launching the intervention ethical approval had to
be optained in seven different countries which
contributed to the time delay between baseline survey
and access to the intervention website
 Development of the intervention website was more
complicated than foreseen
 Complexity of the intervention (smoking, alcohol, illicit
drugs)
 Finding common ground regarding presentation and
message content
 Pre-testing in seven countries
 Language complexity (seven languages)
 IT capacity problems
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18. Summary of results
 Baseline data
 The baseline data confirmed our hypothesis of an
overestimation of the consumption of peers
 Such misperception was not specific to countries,
however the amount differs
 Thus more realistic perception of normative behaviour
would be beneficial
 Feasibility
 Difficulties in access to student
 Big time delays in the process of approaching
students
 Big loss to follow-up
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19. Lessons learned
 Development and testing of such a complex intervention
tool cannot be done in 2 years
 Proper time needs to be planned for consensus
procedures and translation if more sites/countries are
involved
 Sufficient IT capacity is crucial!!
 The intervention tool needs to be established before the
baseline data collection is done including formulation
and presentation of messages.
 When data on perceived and actual behaviour are
collected they should be quickly entered into a ready
made website – This would make the intervention
available when students are keen to visit the website.
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