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Cannabis eCHECKUP TO GO

A brief, web-based personalized feedback program that aims to reduce the harms associated with cannabis use in college students by increasing protective behavioral strategies and correcting misperceived norms for cannabis use.

Program Outcomes

  • Marijuana/Cannabis

Program Type

  • Drug Prevention/Treatment

Program Setting

  • School
  • Online

Continuum of Intervention

  • Indicated Prevention

Age

  • Early Adulthood (19-22)

Gender

  • Both

Race/Ethnicity

  • All

Endorsements

Blueprints: Promising

Program Information Contact

Counseling & Psychological Services
San Diego State University
5500 Campanile Drive
San Diego, CA  92182-4730
Phone: (619) 594-0710
Email: echug@sdsu.edu
Website: www.echeckuptogo.com

Program Developer/Owner

Richard J. Moyer, III, Psy.D.
San Diego State University


Brief Description of the Program

Cannabis eCHECKUP TO GO is a commercially available, online, personalized feedback intervention designed to motivate college students to reduce cannabis (marijuana) use by correcting misperceived social norms and providing education on cannabis use. After completing a web-based baseline assessment on demographic measures, cannabis consumption, cannabis consequences and perceived social norms, intervention participants receive standard personalized feedback on their cannabis use, information on their perceptions of cannabis use norms versus actual use prevalence at their university and nationally, and a list of change strategies related to cannabis use (i.e., protective behavioral strategies), all delivered in a manner consistent with Motivational Interviewing. Participants are then asked to consider using these change strategies to help reduce their cannabis use.

Outcomes

Riggs et al. (2018) found that, compared to control group participants, intervention group participants reported significantly greater reductions in:

  • cannabis use

Brief Evaluation Methodology

Riggs et al. (2018) used a randomized controlled trial of college students from one large public university in Colorado. Undergraduate students screened for heavy cannabis use were eligible to participate in the study. A total of 301 participants were randomly assigned to the intervention condition (n=146) or healthy stress management control condition (n=155). Primary outcomes measured at a six-week posttest were cannabis use and consequences of cannabis use.

Study 1

Riggs, N. R., Conner, B. T., Parnes, J. E., Prince, M. A., Shillington, A. M., & George, M. W. (2018). Marijuana eCHECKUPTO GO: Effects of a personalized feedback plus protective behavioral strategies intervention for heavy marijuana-using college students. Drug and Alcohol Dependence190, 13-19. https://doi.org/10.1016/j.drugalcdep.2018.05.020


No training is necessary as the program is fully self-contained online and may be purchased directly by colleges and universities.

Prior to subscribing, prospective subscribers are provided with a fully function demo of the program. As a self-guided software-as-a-service, there are no formal training materials, but eCHECKUP TO GO staff are available to support subscribers by phone, email, and/or online meetings through the subscription term.

Source: Washington State Institute for Public Policy
All benefit-cost ratios are the most recent estimates published by The Washington State Institute for Public Policy for Blueprint programs implemented in Washington State. These ratios are based on a) meta-analysis estimates of effect size and b) monetized benefits and calculated costs for programs as delivered in the State of Washington. Caution is recommended in applying these estimates of the benefit-cost ratio to any other state or local area. They are provided as an illustration of the benefit-cost ratio found in one specific state. When feasible, local costs and monetized benefits should be used to calculate expected local benefit-cost ratios. The formula for this calculation can be found on the WSIPP website.

Start-Up Costs

Initial Training and Technical Assistance

No training is necessary as the program is fully self-contained online and may be purchased directly by colleges and universities.

Prior to subscribing, prospective subscribers are provided with a fully function demo of the program.  As a self-guided software-as-a-service, there are no formal training materials, but eCHECKUP TO GO staff are available to support subscribers by phone, email, and/or online meetings through the subscription term.

Curriculum and Materials

Online program expense covered with purchase of license.

Licensing

The annual subscription fee of $1075 USD (per campus, per year) provides subscribers with unlimited use of the Cannabis eCHECKUP TO GO.

The Electronic Verification of Completion (EVC) program can be added to the Cannabis eCHECKUP TO GO at no extra cost.

A supplemental fee of $375 USD (per campus, per year) adds the Personal Reflections & Verification of Completion Program (PRP) to a new or existing eCHECKUP TO GO subscription.

Other Start-Up Costs

eCHECKUP TO GO provides the on-line program only.  It is incumbent on the institution/subscriber to have the staff to support the dissemination of the program.  Additionally, while the eCHECKUP TO GO program can be delivered independently, without in-person feedback, if a site wishes to deliver feedback in-person, then that site must have a facility and the staff to support that level of intervention.  Those services are not provided by eCHECKUP TO GO.

Intervention Implementation Costs

Ongoing Curriculum and Materials

None.

Staffing

No information is available

Other Implementation Costs

No information is available

Implementation Support and Fidelity Monitoring Costs

Ongoing Training and Technical Assistance

Staff is available to support subscribers by phone, email, and/or online meetings through the subscription term.

Fidelity Monitoring and Evaluation

The program can be administered in a variety of ways: in-person, online, with in-person feedback, without in-person feedback, as part of a population-level prevention campaign, as part of a judicial/sanction protocol, in health centers, and in psychological services center.  There is not a single protocol, and thus there is not a fidelity protocol.  Subscribers can always discuss their implementation strategies with eCHECKUP TO GO staff, comprised of psychologists and other mental health support staff.

Ongoing License Fees

The subscription fee is per campus site, per year, so the renewal fee of $1075 would occur yearly.

Other Implementation Support and Fidelity Monitoring Costs

No information is available

Other Cost Considerations

No information is available

Year One Cost Example

A flat annual license fee is assessed for a college or university to purchase and receive implementation support for Cannabis eCHECKUP TO GO.

Annual Subscription $1,075.00
Total One Year Cost $1,075.00

The Year 1 cost for an institution to implement Cannabis eCHECKUP TO GO is $1075. The per student expense depends on the number of students receiving the program.


No information is available

Program Developer/Owner

Richard J. Moyer, III, Psy.D.DeveloperSan Diego State University5500 Campanile DriveSan Diego, CA 92182-4730619-594-0710rmoyer@echeckuptogo.com www.echeckuptogo.com

Program Outcomes

  • Marijuana/Cannabis

Program Specifics

Program Type

  • Drug Prevention/Treatment

Program Setting

  • School
  • Online

Continuum of Intervention

  • Indicated Prevention

Program Goals

A brief, web-based personalized feedback program that aims to reduce the harms associated with cannabis use in college students by increasing protective behavioral strategies and correcting misperceived norms for cannabis use.

Population Demographics

College students who are users of cannabis. Riggs et al. (2018) evaluated college students aged 18 and older who reporting using cannabis at least twice per week.

Target Population

Age

  • Early Adulthood (19-22)

Gender

  • Both

Race/Ethnicity

  • All

Other Risk and Protective Factors

Peer descriptive norms (perceived used prevalence), positive expectations of cannabis use, negative consequences of cannabis use.

Risk/Protective Factor Domain

  • Individual
  • Peer

Risk/Protective Factors

Risk Factors

Protective Factors


*Risk/Protective Factor was significantly impacted by the program

Brief Description of the Program

Cannabis eCHECKUP TO GO is a commercially available, online, personalized feedback intervention designed to motivate college students to reduce cannabis (marijuana) use by correcting misperceived social norms and providing education on cannabis use. After completing a web-based baseline assessment on demographic measures, cannabis consumption, cannabis consequences and perceived social norms, intervention participants receive standard personalized feedback on their cannabis use, information on their perceptions of cannabis use norms versus actual use prevalence at their university and nationally, and a list of change strategies related to cannabis use (i.e., protective behavioral strategies), all delivered in a manner consistent with Motivational Interviewing. Participants are then asked to consider using these change strategies to help reduce their cannabis use.

Description of the Program

Cannabis eCHECKUP TO GO is a commercially available, online, personalized feedback intervention designed to motivate college students to reduce cannabis (marijuana) use by correcting misperceived social norms and providing education on cannabis use. After completing a web-based baseline assessment on demographic measures, cannabis consumption, cannabis consequences and perceived social norms, intervention participants receive standard personalized feedback on their cannabis use, information on their perceptions of cannabis use norms versus actual use prevalence at their university and nationally, and a list of change strategies related to cannabis use (i.e., protective behavioral strategies), all delivered in a manner consistent with Motivational Interviewing. Participants are then asked to consider using these change strategies to help reduce their cannabis use.

Adapted from the eCHECKUP TO GO for alcohol misuse, the Cannabis eCHECKUP TO GO further assesses protective behavioral strategies for cannabis and injunctive norms items (e.g., friends' approval of using cannabis). The program uses personalized feedback to encourage participants to use protective behavioral strategies. The goal of the personalized feedback is to highlight discrepancies between student perceptions and the actual prevalence of use among peers to increase cognitive dissonance related to participants' use. Intervention participants also receive suggestions on what they could purchase (i.e., cell phone bills, streaming services) if they save the money they would spend on cannabis.

Theoretical Rationale

Perceptions of social norms favoring cannabis use have been identified as risk factors for one's own cannabis use and misuse. Normative reeducation (i.e., correcting misperceptions of social norms) related to cannabis use and acceptability represents a sensible target for addressing cannabis misuse among college students. Additionally, research studies have found support for positive behavioral strategies as a protective factor for alcohol misuse, and such strategies may protect against cannabis use.

Theoretical Orientation

  • Normative Education

Brief Evaluation Methodology

Riggs et al. (2018) used a randomized controlled trial of college students from one large public university in Colorado. Undergraduate students screened for heavy cannabis use were eligible to participate in the study. A total of 301 participants were randomly assigned to the intervention condition (n=146) or healthy stress management control condition (n=155). Primary outcomes measured at a six-week posttest were cannabis use and consequences of cannabis use.

Outcomes (Brief, over all studies)

Riggs et al. (2018) found that intervention group participants showed significantly greater reductions in cannabis use outcomes of hours high per week, days high per week, weeks high per month, and periods high per week compared to control group participants.

Outcomes

Riggs et al. (2018) found that, compared to control group participants, intervention group participants reported significantly greater reductions in:

  • cannabis use

Effect Size

Riggs et al. (2018) reported partial eta-squared effect sizes ranging from small to medium effects (.02-.07).

Generalizability

Riggs et al. (2018) limited the sample to undergraduates from one large public university in Colorado.

Potential Limitations

Riggs et al. (2018)

  • High attrition and evidence of differential attrition; however, analyses used inverse probability of follow-up weights to account for disproportionate loss
  • No details on reliability or validity of cannabis use and consequences outcome measures

Endorsements

Blueprints: Promising

Program Information Contact

Counseling & Psychological Services
San Diego State University
5500 Campanile Drive
San Diego, CA  92182-4730
Phone: (619) 594-0710
Email: echug@sdsu.edu
Website: www.echeckuptogo.com

References

Study 1

Certified

Riggs, N. R., Conner, B. T., Parnes, J. E., Prince, M. A., Shillington, A. M., & George, M. W. (2018). Marijuana eCHECKUPTO GO: Effects of a personalized feedback plus protective behavioral strategies intervention for heavy marijuana-using college students. Drug and Alcohol Dependence190, 13-19. https://doi.org/10.1016/j.drugalcdep.2018.05.020

Study 1

Study 1 (Riggs et al., 2018) referred to the program as called Marijuana ECHECKUP TO GO. Since the time of the publication, the program has been rebranded as Cannabis ECHECKUP TO GO with this terminology now used on the intervention website. Thus, this study review uses the term "cannabis."

Evaluation Methodology

Design:

Recruitment: Undergraduate college students from one large public university in Colorado were recruited online in the fall of 2016 to participate in the study. Eligibility criteria were that participants were 18 years of age or older, a university student, a recreational cannabis user (i.e., non-medicinal), and reported typical cannabis use of at least twice per week. Of the 918 completed screeners, 527 (57%) met eligibility requirements. A total of 301 students agreed to participate in the study and completed a baseline assessment.

Assignment: The 301 students were randomly assigned to the adapted Cannabis eCHECKUP TO GO intervention condition (n=146) or healthy stress management (HSM) control condition (n=155). However, because three participants were ineligible after random assignment, the CONSORT diagram and text stated that 144 students received the intervention and 154 students received the HSM comparison program.

Attrition: Assessments occurred at baseline and six weeks post-intervention. A total of 227 students out of 301 randomized (75%) completed the six-week follow-up assessment.

Sample:

The sample of undergraduate college students was 51% male and had a mean age of 19.97 years. Most were white (82-89%) and non-Hispanic/Latino (87-90%), with similar percentages of men and women.

Measures:

All measures came from computer-based self-reports. At baseline and posttest, participants completed a 203-item survey asking about their personal substance use, use consequences, perceived cannabis use norms, and protective behavioral strategies. Three categories of dependent variables were measured: cannabis use and cannabis use consequences as the main outcomes, and program targets/risk and protective factors (descriptive norms, injunctive norms, and protective behavioral strategies).

The five indicators of the cannabis use were: hours high per week, hours high per using day, days high per week, weeks high per month, and periods high per week. The number of endorsed time periods was summed across days of the week. Cannabis  use consequences were assessed by summing the total number of consequences experienced in the last month and the average severity of the endorsed consequences, measured on a 5-point scale from "never" to "always" experienced. Other than citing an established measure for protective behavioral strategies (a protective factor), the authors did not report any reliability or validity information for the outcome measures, despite noting some concerns about social desirability.

Analysis:

General linear models were used to examine posttest intervention effects on cannabis use and consequences outcome variables with controls for baseline outcomes and participant biological sex. Additionally, because of differential attrition on two participant characteristics (males and heavier cannabis users), the authors used standard inverse probability weights to create an estimated probabilities of dropout variable, which was also included as a covariate in analyses.

Exploratory moderation analyses examining whether there were program differences by participant sex were conducted by adding a sex by intervention interaction term to general linear models.

Intent-to-Treat: All students who completed the posttest assessment were included in analyses, and the weighting helped adjust the estimates for missing data by better representing the randomized sample.

Outcomes

Implementation Fidelity:

There was no information on implementation fidelity, although the intervention delivery is a computer-based standardized program. The authors also mentioned that a manipulation check was performed to confirm all participants received the intended information.

Baseline Equivalence:

The authors stated that there were no significant differences between the two conditions on sex, racial/ethnic background, or age (Table 1), and Table 3 presents tests showing no significant differences across conditions on the baseline outcomes.

Differential Attrition:

Participants who completed the study reported significantly fewer hours high per week, hours high per use day, days high per week, time periods per week, and were less likely to be male than female than those participants who dropped out of the study.

The authors reported that there were no statistically significant differences in the number of completers vs. non-completers or heavy or male users across conditions. It is unclear whether the authors tested for differential attrition by condition for race/ethnicity and all cannabis outcomes.

Posttest:

There were significant intervention effects on four of seven cannabis use and cannabis use consequences outcomes, with the intervention group showing significantly greater reductions in hours high per week, days high per week, weeks high per month, and periods high per week compared to the control group. Effect sizes (partial eta-squared) for intervention effects ranged from small to medium effects (.02-.07).

There was also a significant intervention condition effect for one of three risk and protective factors, such that students in the intervention condition reported reduced descriptive norms (perceived used prevalence), compared to students in the control condition.

Moderation analyses showed that participant biological sex did not moderate intervention effects on outcomes.  For moderation analyses examining risk and protective factors as outcomes, females in the intervention condition used significantly more protective behavioral strategies at posttest than males in the intervention condition.

Long-Term: Not examined.

Contact

Blueprints for Healthy Youth Development
University of Colorado Boulder
Institute of Behavioral Science
UCB 483, Boulder, CO 80309

Email: blueprints@colorado.edu

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Blueprints for Healthy Youth Development is
currently funded by Arnold Ventures (formerly the Laura and John Arnold Foundation) and historically has received funding from the Annie E. Casey Foundation and the Office of Juvenile Justice and Delinquency Prevention.