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College age remains a significant risk period for hazardous/extreme drinking among males and females. Recent data suggests that while drinking patterns are converging across sexes, college-age females are engaging in greater levels of binge drinking. Although brief interventions (BI) designed to reduce alcohol consumption and related harms in college and young adult populations have shown positive effects, the rigor of research on this topic has been impaired by limited outcome measurement, measurement inconsistencies, variability in methodologies, and modest effect sizes. There is a paucity of studies that use comparative designs of efficacious interventions that examine mediators and moderators (e.g., gender, sub-population differences, developmental considerations, behavioral and neurocognitive phenotypes, and environmental factors that contribute to change) and how these relate to behavior change and maintenance of effects. Adapting existing evidence-based intervention designs and tailoring approaches to meet specific individual and contextual characteristics may contribute to greater intervention efficacy, longer term reductions in high risk/extreme drinking and related consequences, and cost savings where resources are limited. The overall goal of this conference is to build upon the existing base of evidence-based alcohol BI for college and young adult populations (e.g., CollegeAIM, recent meta-analyses) and address key areas that will advance the field: 1) methods and challenges to optimizing intervention design, and 2) implementation and scale up of BI approaches. While BIs show modest effects, understanding the active ingredients that contribute to behavior change and refinement of intervention methods is needed to achieve greater magnitudes of intervention effects that will inform implementation practices and personalized approaches. Just as there are different pathways to the transition to alcohol dependence, pathways leading to intervention efficacy and successful outcomes are heterogeneous. Positive effects may be obtained dependent upon intervention components that are unique to the individual; for example, gender, associated comorbidities, reward/incentive-salience, self-regulation. Disentangling mechanisms of action is critical to yielding evidence-based interventions that will translate into efficacious personalized prevention interventions for dissemination and implementation across settings. This conference brings together key researchers from varied perspectives who conduct seminal research in intervention design and methodology, translation of neuroscience to prevention and intervention research, and implementation science in young adult populations.