Behavioral Economics and College Student Alcohol Misuse: A Systematic Review of Current Interventions

Background: American colleges and universities are experiencing epidemic levels of alcohol misuse among students. Approximately 40% of college students reported an episode of binge drinking within the past month, and these drinking rates have remained high for two decades. Alcohol misuse poses a serious public health concern because this pattern of drinking is associated with severe physical, social, psychological, and economic consequences. Traditional prevention and intervention efforts have not succeeded in significantly reducing alcohol misuse among college students. However, behavioral economics-based interventions show promise in further decreasing rates of alcohol misuse among college students. As such, this systematic review examined behavioral economic-based interventions targeting college student alcohol misuse. The review aims were to: (a) identify the application of behavioral economics concepts in interventions, and (b) determine if social work researchers are implementing behavioral economics-based interventions.

Methods: We conducted a rigorous search using three electronic databases. Studies were required to be published in English within the past 30 years, analyze quantitative data, and evaluate a behavioral economics-labeled intervention aimed at decreasing alcohol misuse among college students in the United States. Searches yielded 121 articles potentially relevant for review. After title, abstract, full text review, a total of eight studies fully met inclusion criteria. For each study, we extracted data on sample size, behavioral economics-based concepts applied in the intervention, outcomes studied, research design, and social work status of researchers.

Results: Studies were published from 1993-2016, and samples focused exclusively on college students. Sample sizes ranged from 66-164 students. The majority of studies concurrently examined the behavioral economics concepts of delay discounting, alcohol reinforcement, and alternative rewards (n = 6). All identified studies found that behavioral economics-based interventions led to significant reductions in college student drinking. Studies relied on student self report of alcohol consumption. Seven studies used an experimental design. Four studies used a follow-up period of six-months. No study determined a hierarchy of rewards alternative to alcohol to maximize students’ motivation to change. No social work researchers were identified in the reviewed studies.

Implications: In this review, behavioral economics-based interventions aimed at deterring college student alcohol misuse primarily focused on delay discounting, alternative rewards, and alcohol reinforcement. Hence, many heuristics and biases foundational to behavioral economics decision-making frameworks were unexplored. Thus, the impact of many behavioral economic concepts on college students’ decisions to misuse alcohol remain unknown. Furthermore, none of the included studies determined a hierarchy of rewards alternative to alcohol to motivate students’ decision making. To extend current prevention and intervention efforts, we present currently implement strategies and highlight areas for growth. In addition, we discuss the relevance of behavioral economics-based interventions within social work research.