The Alcohol Prevention Compass

Transcription

1 1 August 3, 2016 The Alcohol Prevention Compass Kimberley Timpf, Senior Director of Partner Education

2 Considering the Full Spectrum of Evidence Detailed Literature Review and Analysis +33 alcohol prevention strategies investigated +6,000 journals and magazines +400 articles reviewed, summarized and analyzed Data Collection from Credible Web Sources Sites include the Higher Education Center, Social Norms Institute, Promising Practices Sourcebook, NIAAA, SAMHSA, Institute of Medicine Discussions with Key Informants in the Field Practitioners with demonstrated success Notable researchers More than 200 people interviewed at over 150 institutions and organizations

3 3 Success Is Measured Along Multiple Dimensions Changed Minds Changed Actions Changed Outcomes Attitudes toward drunk driving Frequency of alcohol use ER visits Knowledge of hard alcohol use risk Drinking to get drunk Blackouts Awareness of campus policies Pregaming behavior Nausea, vomiting Willingness to participate in alcohol-free options Knowledge of genetic factors in alcohol use Fake ID use Doing shots DUI s Alcohol violations Understanding of BAC Typical BAC Recidivism Ability to set limits on alcohol use Heavy episodic drinking occurrences Academic performance Belief that drinking is the cool thing to do Drinking the night before an exam Neighborhood complaints

4 4 Quantifying the Impact: Step 1 Step 1: Core Outcomes External Determinants of Behavior Personal Determinants of Behavior 1 point each, 3 points max Behavioral Intentions Behavior (Alcohol Use) 2 points each, 6 points max Negative Consequences of Behavior 1 point each, 3 points max

5 5 Quantifying the Impact: Steps 2-4 Step 2: Effect Size Step 3: Sustained Effects Step 4: Methodology 0 - <10% change = 0 pts 10 - <20% change = 1pt 20+ % change = 2 pts < 1 week = 0 pts 8 30 days = 1 pt 31 days 6 months = 2 pts 6 months 1 year = 3 pts 1 year + = 4 pts Anecdotal Evidence Published Case Study Quasi-Experimental Randomized Control Trial = X1 = X2 = X4 = X6 = TOTAL Impact Score per Article Calculating Average Impact Score Across Articles Total Impact Scores # of articles = Final Impact Score

6 6 Coding the Research: How it Works Kypri et al. (2004) Step 1: Core Outcome Step 2: Effect Size Step 3: Sustained Effects Step 4: Methodology Behavior (Alcohol Use) 26% reduction in total consumption = 37% decrease in heavy episodic drinking = < 6 months = +2 RCT = 6 Consequences of Alcohol Use 30% reduction in personal problems = 28% reduction in academic consequences = Subtotal = x TOTAL = 120

7 Social Norms Marketing is Put to the Test

8 Determining the Cost of Each Strategy Sample Strategy Cost Analysis: Social Marketing Public Sources of Information Anecdotal Data from Campuses Social Marketing Strategies (HEC) Institution Prorated Cost Evaluation (Core Survey) Advertisements: $239 University of Florida $83,235 Newspaper Ads $4,200 University of Virginia $6,569 Flyers & posters $5,210 Purdue University $4,630 Graphic designer $1,375 McCartney University $32,000 TOTAL $11,024 Cost estimates prorated for institution of 10,000 undergraduates Cost Considerations Activities Employees Materials/Media Total Cost: Institution Size Average Cost of Social Marketing Across Sources: $27,491

9 Caveats, Assumptions and Interpretive Guidance 1 Optimal Implementation 2 Context Matters 3 No Silver Bullets 4 Values Not Static Cases and studies were discounted where They lacked fidelity Lack of efficacy was attributed to mediating factors Clearly some approaches work best on certain kinds of campuses Literature and cases provide and average impact across campuses Individual approaches not as effective as complementary ones The goals was more clarity around approaches, not necessarily their combined synergy The literature and field continues to evolve Partner input is encouraged

10 The Raw Data of the Analysis STRATEGY Score $ Reach Breathalyzer Feedback $500 10% Invited Speakers 0.0 $3,000 5% BAC Cards 3.0 $1,000 10% Fatal Vision Goggles 3.3 $700 8% Medical Amnesty 8.0 $7,000 70% Curriculum Infusion 8.3 $4,500 5% TIPS for the University 11.0 $33,950 30% RA Training 11.1 $1,348 49% 21st Birthday Cards 11.1 $5,045 22% Fake ID Policies 12.0 $0 30% Parent-Based Interventions 12.8 $2,000 25% Parental Notification 13.3 $2,000 37% RBS Training 13.5 $1,225 45% Safe Rides 14.0 $89,899 21% Peer Engagement 14.5 $9,473 25% Substance-Free Housing 15.8 $0 2% Friday Classes 16.0 $0 60% STRATEGY Score $ Reach Limiting Drink Specials 16.5 $0 15% Social Marketing 17.3 $12,927 60% Prime For Life 18.5 $3,915 6% Small Group Social Norms 19.5 $2,340 30% Policies 21.2 $8,520 40% Alcohol-Free Options 22.0 $27,570 9% Bystander Intervention 22.0 $19,746 12% Social Norms Marketing 27.8 $14,400 60% Alcohol Price and Taxation 29.6 $0 45% Alcohol Skills Training Program 35.0 $9,090 6% Comprehensive Environmental Efforts 36.9 $29,000 50% Parent-Based Intervention + BASICS 48.0 $17,334 19% BASICS 51.1 $19,535 3% Online Education 52.6 $8,690 16% SBI in Healthcare Setting 56.7 $14,771 35% Group Motivational Enhancement 72.7 $11,872 28%

11 11 A Visual Depiction of the Findings 1. Invited Speakers 2. Safe Rides 3. Breathalyzer Feedback 4. Prime for Life 5. Fake ID Policies 6. Substance-Free Housing 7. Curriculum Infusion 8. BASICS 9. Limiting Drink Specials 10. Parental Notification 11. Comprehensive Environmental Efforts 12. RA Training 13. Parent-Based Intervention + BASICS 14. Bystander Intervention 15. Small Group Social Norms 16. BAC Cards 17. Group Motivational Enhancement 19. Alcohol Skills Training Program st Birthday Cards 21. Online Education 22. Parent-Based Intervention 23. RBS Training 24. Friday Classes 25. Medical Amnesty 26. Social Marketing 27. Peer Engagement 28. Social Norms Marketing 29. SBI in Healthcare Setting 30. Alcohol-Free Options 31. Alcohol Price and Taxation 32. Fatal Vision Goggles 33. Policies 18. TIPS for the University

12 12 Interpreting Placement Justify and Evaluate Consider and Execute with Care Do No Harm Make a case The Prevention Sweet Spot

13 13 Interpreting Placement Justify and Evaluate Consider and Execute with Care Do No Harm Make a case The Prevention Sweet Spot

14 14 Two Tools to Inform Effective Prevention EverFi Compass College AIM 33 strategies 60 interventions Universal, Selective, Indicated Impact Score/Average Cost Points assigned according to behavioral impact, effect size, effect length, and type of study. Individual and Environmental Effectiveness Rating/Cost Range Rating codes assigned based on literature reviews and direct knowledge of strategies

15 Examining the Intersections 15

16 16 Examining the Intersections: Some Direct Comparisons Score/Rating $ # Articles Breathalyzer Feedback $500 3 (1) Skills training, alcohol focus: Blood alcohol concentration (BAC) feedback alone Too few studies Mid-range costs 2 Medical Amnesty 8.0 $7,000 1 (1) Establish amnesty policies Too few studies Lower costs 1 21 st Birthday Cards 11.1 $5,045 8 (1) Normative Re-education: Electronic/mailed personalized normative feedback (PNF) Eventspecific prevention (21st birthday cards) Lower Lower Cost 2 Effectiveness Limiting Drink Specials 16.5 $0 6 Restrict happy hour/price promotions Higher effectiveness Lower costs Alcohol-Free Options 22 $27, (1) Required alcohol-free programming Too few studies/ mixed results Higher Cost Social Norms Marketing 27.8 $14, Conduct campus-wide social norms campaign Lower effectiveness Mid-range costs BASICS 51.1 $19, (2) Brief motivational intervention (BMI) In-person Individual (e.g., BASICS) Higher effectiveness (#)= articles in common Mid-range cost 20+

17 17 Examining the Intersections: Requires a Closer Look Score/Rating $ # Articles Comprehensive Environmental Efforts 36.9 $29, e.g., Prohibit alcohol use/sales at campus sporting events Moderate effectiveness Mid-range costs Online Education 52.6 $8, (10) Multi-component education-focused program: AlcoholEdu for College Higher effectiveness Higher costs 5 Personalized feedback intervention, echeckup TO GO (formerly echug) Higher Effectiveness Lower costs 11 Alcohol 101 Plus Too few studies Lower costs 3 Screening and Brief Intervention in Healthcare Setting 56.7 $14,771 7 Brief motivational intervention (BMI) In-person Individual (e.g., BASICS) Higher effectiveness Mid-range cost Individual-level strategies delivered by health professionals not rated by CollegeAIM NS NS NS Curriculum Infusion 8.3 $4,500 7 Unable to identify equivalent or similar NA NA NA Peer Engagement (peers administering MI s, lifestyle management courses, etc.) 14.5 $9, (2) Brief motivational intervention (BMI) In-person Individual (e.g., BASICS) Higher effectiveness Mid-range cost (#)= articles in common

18 18 Universal Recommendations Apply to Both Tools Programming with a Purpose Be intentional with efforts and gather data on whether they succeed The Comprehensive Trap Don t try to do it all a few targeted interventions can be very effective An Emerging Picture Stay attuned to new research to inform your efforts Knowing How to Spend Implement programs strategically to mitigate costs Beyond the Research Test your messages and strategies against the research base, behavior theory, and your instincts The Value of Synergy 6 Prevention efforts must complement each other Data-driven Success 7 The best strategy is grounded in data Campus Fit 8 Make decisions based up on your culture, allies, and resources