Date of Award

Summer 2026

Language

English

Embargo Period

4-21-2026

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College/School/Department

Department of Educational and Counseling Psychology

Program

Counseling Psychology

First Advisor

M. Dolores Cimini

Committee Members

Jessica L Martin, Kimberly F Colvin, Janine Jurkowski

Keywords

Social determinants of health, alcohol use, self-efficacy, health disparities, recovery

Subject Categories

Counseling Psychology

Abstract

Heavy alcohol consumption is associated with a range of psychosocial problems and chronic conditions, resulting in approximately 140,000 preventable deaths each year. With these potential consequences in mind, it is understandable that 46% of individuals who consume alcohol report attempting to reduce the quantity of alcohol they drink; however, very few enter formal treatment. Despite this, many people will decrease their heavy drinking over time, presumably due to individual and environmental factors, particularly self-efficacy and protective social determinants of health (SDoH). This study aimed to answer the research question “How is SDoH adversity related to the likelihood of reporting reduced alcohol use and to what extent does self-efficacy moderate this relationship?” Results of a moderated logistic regression model were statistically significant; however, the interaction term was nonsignificant, indicating that self-efficacy did not moderate the relationship between SDoH adversity and the likelihood of participants reporting reduce alcohol use. A follow-up logistic regression, testing main effects only, indicated a significant main effect for SDoH adversity, indicating that as SDoH adversity increased, the odds of reporting reduced alcohol consumption decreased. In other words, individuals who experience greater SDoH adversity were less likely to report reduced alcohol use. There was no significant main effect for self-efficacy, suggesting self-efficacy does not significantly impact the odds of reporting reduced alcohol consumption. Future research should continue to explore differences in self-efficacy and experiences of SDoH adversity across the spectrum of recovery and harm reduction. In addition, future research should continue to explore the interaction between SDoH adversity and other individual factors hypothesized to impact reducing alcohol use.

License

This work is licensed under the University at Albany Standard Author Agreement.

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