Normative re-education: Electronic/mailed personalized normative feedback (PNF)—Event-specific prevention (21st birthday cards)
Under this event-specific prevention PNF strategy, students receive a birthday card on their 21st birthday, warning them against excessive celebratory drinking.
Effectiveness: = Lower effectiveness
Cost: $ = Lower
Barriers: # = Lower
Research Amount: *** = 7 to 10 studies
Public Health Reach: Broad
Primary Modality: Online/offsite
Staffing Expertise Needed: Coordinator
Target Population: Individuals, underage, or specific groups
Duration of Effects: Mixed short-term (< 6 months) effects; long-term (≥ 6 months) effects not assessed
Effectiveness ratings are based on the percentage of studies reporting any positive outcomes. Strategies with three or fewer studies did not receive an effectiveness rating due to the limited data on which to base a conclusion. Cost ratings are based on the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number of randomized controlled trials (RCT) that evaluated the strategy. Duration of effects refers to the timeframe within which the intervention demonstrated effects on alcohol-related behavioral outcomes; follow-up periods for short-term effects were <6 months; follow-up periods for long-term effects were ≥6 months.
Larimer, M.E.; and Cronce, J.M. Identification, prevention, and treatment revisited: Individual-focused college drinking prevention strategies 1999–2006. Addictive Behaviors 32:2439–68, 2007.
- Smith, B.H.; Bogle, K.E.; Talbott, L.; Gant, R.; and Castillo, H. A randomized study of four cards designed to prevent problems during college students’ 21st birthday celebrations. Journal of Studies on Alcohol 67(4):607−15, 2006.
Cronce, J.M.; and Larimer, M.E. Individual-focused approaches to the prevention of college student drinking. Alcohol Research and Health 34(2):210–21, 2011.
- Lewis, M.A.; Neighbors, C.; Lee, C.M.; & Oster-Aaland L. 21st birthday celebratory drinking: Evaluation of a personalized normative feedback card intervention. Psychology of Addictive Behaviors 22(2):176–85, 2008.
- Neighbors, C.; Lee, C.M.; Lewis, M.A.; Fossos, N.; and Walter, T. Internet-based personalized feedback to reduce 21st birthday drinking: A randomized controlled trial of an event-specific prevention intervention. Journal of Consulting and Clinical Psychology 77(1):51–63, 2009.
Additional studies not identified in prior reviews
- LaBrie, J.W.; Migliuri, S.; and Cail, J. A night to remember: A harm-reduction birthday card intervention reduces high-risk drinking during 21st birthday celebrations. Journal of American College Health 57(6):659-63, 2009.
References from 2019 update
No studies identified
Examples of cards used by universities:
- Northern Arizona University: https://in.nau.edu/campus-health-services/health-promotion/
- Cal Poly Pomona: https://www.cpp.edu/~healthcounseling/what-we-do/wellness-services/21st-birthday-card.shtml
For more information about intervention designs and implementation, check the articles in the References tab.