College Drinking Outcomes: A Role for the Alcohol Environment

Transcription

1 College Drinking Outcomes: A Role for the Alcohol Environment Richard Scribner MD, MPH LSU Health Sciences Center NEW ORLEANS School of Public Health

2 Acknowledgements Funding NIAAA R01 AA Research Team Katherine Theall Karen Mason Neal Simonsen William DeJong Shari Kessel- Schneider

3 Problem Alcohol related outcomes represent the leading health and social problem among American college students including high rates of assaultive violence Hingson (2002) estimates 600,000 students are assaulted annually by another student who had been drinking and 70,000 students are victims of alcohol related sexual assault Hingson documented 1444 deaths among

4 Understanding College Drinking Developmental Perspective College students drink more than their non college attending counterparts (Shulenburg & Maage 2001) Campus environment represents a developmental mismatch no controls, permissive environment Social Norms Perspective Greater the normative misperception the greater the risk Two steps 1) Student generalize observations of heavy drinking patterns among target groups 2) Students adapt their drinking to their perception of the norm (Borsari & ; Perkins )

5 Current Prevention Efforts Individual Brief interventions Social norms marketing Environmental Policy Enforcement

6 Three Studies To determine whether individual drinking rates are associated with campus alcohol environment To determine whether the campus alcohol environment modifies the effect of a social norms marketing campaign

7 Conceptual Model Campus Community Level Individual Level Perceived Behavior Study 2 College Alcohol Environment Drinking Patterns Study 1 Alcohol Related Outcomes Individual Risk

8 Social Norms Marketing Research Project (SNMRP) Campuses

9 Study 1 Background Community alcohol environment associated with drinking levels in community based studies Conduct a multilevel analysis to determine if individual drinking patterns associated with campus alcohol environment

10 Study 1 Method Individual level data SCANB survey used in the Social Norms Marketing Research Program (SNMRP) at 32 campuses between Campus level data Alcohol outlet information from states Alcohol Beverage Control Boards Alcohol policy environment assessed using key informants surveys Drink specials data obtained from phone survey of a random sample of on-sale alcohol outlets surrounding the campus

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12 Table 1. Sociodemographic Characteristics of Students (N=17,051) % n Sex Male Race/ethnicity African American/Black Asian Hispanic/Latino White Age Under or older Greek membership Greek member or pledge Not a Greek member Alcohol use in high school Drinker Abstainer Alcohol Consumption Drinks when partying (± s.d.) Average drinking occasions (± s.d.) Binge drinker (yes) a Students allowed to enter more than one race or ethnicity (3.6) 5.8 (7.9)

13 Table 2. Coefficients from selected variable in multilevel analysis of SNMRP data Mean # drinks when partying (intercept) Campus-level variables Empty Model Campus Level Model Complete Model Model 1 Model 2 Model On-sale alcohol density per enrolled a Student-level variables Male Age < 20 years Level of high school drinking Time (year 1 4) Cross-level interactions Treatment x time Random Effects ICC 8.4% 5.2% 3.4% AIC

14 Table 5. Multi-level Analyses of Mean Number of Drinks When Partying Role of Alcohol Advertisement and Drink Specials, N=17,051 Students and 32 Universities Number of Drink Specials Pro-Alcohol Advertisement Model 1 Model 2 Mean number of drinks (intercept) Fixed Effects (Regression coefficient, β) Campus-level variables Number of drink specials Pro-alcohol advertisements On-sale alcohol density per 1000 enrolled a ICC 3.9% 3.3% AIC

15 Conclusions Strong grouping of students with similar drinking patterns by campus i.e., ICC = 8.4% Much of that grouping (i.e., >30%) is explained by the density of off campus bars even when individual risk is controlled Campus alcohol outlet density strong predictor of individual drinking patterns

16 Limitations Unmeasured confounds Endogenous effects i.e., students picking party schools

17 Study 2 Background Results documenting the effectiveness of Social Norms Marketing campaigns have been equivocal Determine if the intervention effect of a successful social norms marketing campaign is moderated by the campus alcohol environment Consistent with Social Norms theory in terms of target salience

18 Study 2 Method Individual level data SCANB survey used in the Social Norms Marketing Research Program (SNMRP) at 32 campuses between Campus level data Alcohol outlet information from states Alcohol Beverage Control Boards On-sale outlet density only

19 Table 1. Effect Modification by On-Sale Alcohol Outlet Density (3-mile radius) Number of Drinks When Partying Full Model High Density Schools Low Density Schools Intercept Cross-level interactions Treatment x Time Time x On-sale density Treatment x Time x On-sale density Goodness of Fit AIC

20 Table 2. Effect Modification by On-Sale Alcohol Outlet Density (3-mile radius) Composite Drinking Scale Full Model High Density Schools Low Density Schools Intercept Cross-level interactions Treatment x Time * Time x On-sale density Treatment x Time x On-sale density * Goodness of Fit AIC

21 Conclusions The intervention effect of a successful social norms was moderated by the campus alcohol environment The intervention effect was only observed in low outlet density campuses Students may better perceive the actual drinking levels of peers when they have a salient target like bars to drink and have more opportunities to observe drinking behavior

22 Questions