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 (19-24)
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.
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.
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 Dependence , 190 , 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. Developer San Diego State University 5500 Campanile Drive San Diego, CA 92182-4730 619-594-0710 rmoyer@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 (19-24)
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
Notes
As an upstream preventive intervention, this program targets and reduces problem behaviors that are associated with increased risk of developing substance use disorder or opioid use disorder later in life.
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 Dependence , 190 , 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 use 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.