The Effects of Personalized Feedback about ALDH2*2, Alcohol Use, and Associated Health Risks on Drinking Intention and Consumption: the Role of Self-Efficacy and Perceived Threat

BACKGROUND:The genetic variant ALDH2*2, associated with alcohol-related flushing, is a risk factor for alcohol-related health problems. The public has been largely unaware of these risks, suggesting potential for educational interventions to reduce harms among at-risk individuals. Self-efficacy and threat perception are mechanisms of health behavior change that may explain discrepancies in how people respond to health risk information. In the current pilot study, we examined the effects of a brief feedback intervention about the health risks related to flushing, ALDH2*2, and alcohol use on participants' intention to change their drinking and their past-month heaviest week drinking quantity. We also evaluated whether self-efficacy and threat perception related to intention to change drinking. METHODS:We enrolled 360 Asian American undergraduates (58% female; age 17-25). Participants were randomized to view (1) phenotype feedback about the alcohol-related cancer risk associated with flushing and ALDH2*2 (PHEN), (2) PHEN plus their own ALDH2 genotype (PHEN+GENE), or (3) an attention control session (CONTROL). Participants who completed the feedback (n = 324) reported their intention to change their drinking post-feedback and their recent alcohol consumption, self-efficacy, and threat perception at baseline and 1-, 4-, 7-, and 10-month post-feedback. RESULTS:Those in PHEN+GENE had significantly higher intention to change drinking compared with those in CONTROL regardless of ALDH2*2 status. A significant interaction was found between self-efficacy and threat perception in predicting intention to change drinking. Higher intention to change drinking did not relate to decreased heaviest week drinking quantity. CONCLUSIONS:Receiving risk feedback was associated with greater intention to change drinking among both ALDH2*2(+) and ALDH2*2(-) participants, but intention to change was not found to be associated with a decrease in heaviest week drinking quantity. Future work in larger samples will further examine self-efficacy and threat perception as potential mechanisms underlying participants' intention to change their drinking behavior. TRIAL REGISTRATION:ClinicalTrials.gov: NCT04967599.