Does intervention dose affect the effectiveness of the social norms alcohol prevention programme The GOOD Life?

Background & Aim: It is well established that effective prevention programmes are essential to reduce alcohol consumption among adolescents and in turn prevent harmful consequences related to alcohol. However less is known about how specific intervention components and delivery mode influence the effectiveness of such preventive interventions. The aim of this study was to examine whether the level of exposure to, satisfaction with and recall of social norms messages had an impact on the preventive effect of the school-based social norms intervention The GOOD Life. Methods: Data from a cluster-randomised controlled trial including 38 schools (n=1355 pupils aged 13-17 years) were analysed using multilevel logistic regression models. Intervention and control group completed an online survey, at baseline and 3-months follow-up. The GOOD Life intervention provided normative feedback through three different components. At follow-up, the intervention group (n=641) was asked about their satisfaction with and recall of the intervention. The effects were examined on three outcomes: overestimation of peer drinking, binge drinking (5 or more drinks on one occasion) and alcohol-related harms. Results: Increased exposure to, satisfaction with and recall of the social norms messages enhanced the intervention effects on norm perceptions. For alcohol related harms, enhanced effects were observed for higher intervention exposure and satisfaction. For binge drinking we found enhanced, but insignificant intervention effects for those who received higher intervention dose. Conclusion: Our findings suggest that it was possible to enhance the preventive effect of the social norms intervention when it was delivered through more than one component, the satisfaction with the intervention components was high and when pupils could recall the social norms messages delivered. Main message: Factors related to both level of exposure to and pupils’ retention of intervention content had an impact on the effectiveness of The GOOD Life intervention. Implication for practice: Implementers should assure high exposure through different components and high recall seems to be more important for the effectiveness of the programme than the overall appeal and pupil satisfaction.