ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Digital Mental Health
This article is part of the Research TopicAdolescent Smoking, Alcohol Consumption and Psychoactive Substance Misuse in Low-Middle Income CountriesView all 12 articles
Patterns of Alcohol Use and Response to Digital Brief Interventions in College Students: A Secondary Analysis of a Cluster Randomized Trial
Provisionally accepted
Abhishek Ghosh1*
Blessy B George1Narayanan C Krishnan2Renjith R Pillai1
Soundappan Kathirvel1Mamta Sharma3Anil Kumar4Debasish Basu1
Michael Patrick Schaub5*- 1Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
- 2Indian Institute of Technology Palakkad, Kanjikode, India
- 3Punjabi University, Patiala, India
- 4Indian Institute of Technology Ropar, Rupnagar, India
- 5Universitat Zurich, Zürich, Switzerland
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Background Drinking among college students in India is rising, influenced by social and cultural shifts. This study aimed to classify drinking behaviors among underage students using Latent Class Analysis (LCA) and assess the effectiveness of digital screening and brief intervention (DSBI) and brief advice (DSBA) across identified classes. Methods This was a secondary analysis of a two-stage cluster randomized trial that screened 693 college students (age 18-22 yrs) with the Alcohol Use Disorders Identification Test (AUDIT). LCA was employed to identify latent classes in a main sample (N=693, AUDIT scores 1-40) and a subsample of enrolled participants (N=548, AUDIT scores 8-19). Model fit was assessed using AIC, BIC, and log-likelihood values, with a 3-class solution preferred for its interpretability and fit. A General Linear Model (GLM) analyzed the effectiveness of digital interventions over 3 and 6 months. Results Three latent classes emerged from the main sample: “recreational drinkers” (minimal issues), “hidden problem drinkers (limited family concerns),” and “problem drinkers” (higher family concerns). In addition to the “hidden problem drinkers”, the subsample comprised “emerging” and “observable” problem drinkers. Significant reductions in AUDIT scores were observed across all classes from baseline to 3 months, which stabilized by 6 months. A significant interaction effect was found between time and latent class [F(4)=14.60,p<.0001], “observable problem drinkers” outperforming the two other classes. Conclusions Underage drinking represents three latent classes. Digital interventions can effectively reduce alcohol use across all classes of underage college problem drinkers.
Keywords: alcohol use, audit, brief advice, brief intervention, Digital, screening
Received: 26 Oct 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Ghosh, George, Krishnan, Pillai, Kathirvel, Sharma, Kumar, Basu and Schaub. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Abhishek Ghosh
Michael Patrick Schaub
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