Alcohol use is a major cause of both morbidity and mortality among college students.1
Almost half (44%) of college students report binge drinking, and almost one fifth of students report frequent binge drinking. Frequent binge drinkers are more likely to experience serious health and other consequences of their drinking behavior compared to other students. As many as 1700 college student deaths each year are alcohol-related and approximately half of students who use alcohol report direct alcohol-related harms.2-6
Among undergraduates, college freshmen are at highest risk for alcohol problems, likely related to their newfound independence and decreased experience with alcohol compared to upperclassmen.7
Preventing the negative consequences associated with alcohol use requires both screening to identify those at risk and intervention directed towards those who suspected of being at risk. Screening tools are available to identify college students at risk for problem drinking.8-10
However, a large scale approach to screening among college students remains challenging as many students do not seek routine or preventive health care at student health centers.11, 12
The social networking site (SNS) Facebook may provide an innovative approach towards the initial identification of college students at risk for problem alcohol use. SNSs such as Facebook are popular among and consistently used by college students; current data suggests between 94 and 98% of students maintain a Facebook profile and most report daily use.13-15
Facebook allows students to create a personal web profile, communicate with friends and build an online social network.16, 17
Increasingly, SNSs are being used for research to investigate adolescent and young adult attitudes and characteristics.18
The nature of SNSs allow large amounts of identifiable information to be revealed and disseminated and thus collected as data.19
References to alcohol use are common on SNSs; up to 83% of college students’ Facebook profiles reference alcohol.20, 21
These references may be displayed on status updates, which are personally written text displayed on a public “wall” on the profile. One example may be, “Tom got really drunk last weekend!” References may also be displayed in personal pictures, such as a photograph of the profile owner holding a bottle of beer. References may also be displayed through downloaded icons, often called “bumper stickers” which show humorous quotes or images. One example is, “Let’s get embarrassingly drunk and end the evening with a variety of bad choices.” Previous work has illustrated that display of references to intoxication or problem drinking on Facebook are associated with being identified as at increased risk for problem drinking using a validated clinical screening tool.22
Thus, displayed references to problem drinking on Facebook profiles may be a means of early identification of students who are at risk for negative health consequences associated with alcohol use.
If references to problem drinking on Facebook profiles can provide an accurate means of identifying those within a population who are at risk, there are several ways in which universities could incorporate Facebook into screening efforts. A first option is to systematically assess displayed information on publicly available Facebook profiles in order to identify students at risk, then approach these students and recommend that they undergo further screening or counseling. This Facebook assessment could be undertaken by a campus health care provider such as a counselor or nurse. A second option is to provide training to peer leaders on campus, such as dormitory resident advisors. These peer leaders would then be able to recognize displayed references to problem alcohol use on Facebook, approach the student regarding this concern, and recommend clinical screening.
Among potential barriers towards these screening approaches, one is how students would perceive being approached regarding displayed Facebook content. It is possible that they may perceive being screened for health behaviors via Facebook as an invasion of privacy. A previous study evaluated college students’ views regarding privacy and information sharing and found that students perceived they disclosed more information about themselves on Facebook than in general, but that information control and privacy were important to them.23
Thus, many SNS users state that privacy issues regarding displayed profile content are important to them, yet many users still choose to display large amounts of personal information online.23
In order to determine if Facebook has a place as an innovative complement to current screening approaches, several gaps in our understanding must be addressed. It remains unclear whether older adolescents believe there is an association between displayed Facebook references to alcohol and offline alcohol use. If college students perceive displayed alcohol references as indicative of alcohol use, they may better understand potential benefits of addressing alcohol references displayed on Facebook. It is possible that students and peer leaders could be future partners in screening and intervention efforts. It is also unclear if students have communication preferences for potential screening or intervention efforts using Facebook, and in what ways they are willing to communicate regarding their Facebook displays of alcohol use. Before next steps towards screening or intervention based on SNS content can take place, views of this population must be understood.
The purpose of this study was to explore freshmen college students’ perceptions of displayed references to Facebook alcohol use and their communication preferences if they were to be contacted regarding their displays of Facebook alcohol use.