Abstract

Abstract Background Alcohol misuse is prevalent among college students globally, including in India. Digital screening and brief interventions (DSBI) promise to address this issue. This study assesses DSBI's effectiveness in a state‐wide cluster randomized trial among college students in India. Methods We recruited 548 participants (274 in each DSBI and digital screening and brief advice‐DSBA) from 40 colleges across 10 districts of Punjab, India. Colleges were selected via two‐stage cluster random sampling and were allocated to groups using permuted block randomization. Participants with Alcohol Use Disorder Identification Test (AUDIT) scores between 8 and 19 were included. The digital platform directed eligible participants to their respective groups. DSBI participants received information on alcohol harms, normative and personalized feedback, a decisional balance checklist, and a menu of options. DSBA participants received screening and alcohol harm information. Follow‐ups were conducted at 3‐ and 6‐month post‐intervention. Primary outcome: reduction in AUDIT scores; secondary outcomes: frequency of drinking, drinks per drinking day, and frequency of heavy episodic drinking (HED). Results Baseline demographics and clinical variables did not significantly differ between groups, except for participants' age. 37.6% were women. Follow‐up rates were 513/548 at 3 months and 483/548 at 6 months, with no group differences in attrition. AUDIT scores significantly decreased in both groups at 3 and 6 months (Time F = 1870.11, p < 0.001, partial η 2 = 0.77), with no Group × Time effects ( F = 0.160, p = 0.85). Drinking frequency, HED frequency, and drinks per drinking day decreased significantly in both groups without between‐group differences. Conclusion The study highlights the potential policy implications of integrating brief digital interventions for alcohol misuse into educational health initiatives.