Refusal self-efficacy and alcohol-related behaviours in community samples: a systematic review and meta-analysis

This meta-analysis summarizes the association between Refusal Self-efficacy (RSE) (or resistance self-efficacy or self-regulatory efficacy) and alcohol consumption, binge-drinking, and alcohol-related problems in community samples. A total of 67 studies (74 samples) met the inclusion criteria and were synthesized. Pearson’s correlation coefficients (r) were extracted as a measure of effect size. A random-effects model was used to estimate the mean effect size. Heterogeneity between studies was calculated, and the possibility of publication bias and the influence of each study on the overall effect size. The main results show a negative association between RSE and frequency of alcohol consumption (r = -.35), quantity of alcohol consumption(r = -.29), and frequency-quantity alcohol index(r = -.22); binge-drinking (r = -.32); and alcohol-related problems(r = -.35). Age moderated the relationship between RSE and quantity alcohol consumption. No significant moderation effects were found due to self-efficacy scale length, year of publication, publication status and geographic location. The moderating effect of the research design (longitudinal vs transversal) was not analysed due to the insufficient number of longitudinal correlations available. The findings of this meta-analysis contribute to systematizing our knowledge about the role of cognitive mechanisms in regulating alcohol-related behaviours.