Educa'onal Interven'on to Prevent Alcohol Abuse Among Students. 10 years of declining nega1ve consequences

Transcription

1 Educa'onal Interven'on to Prevent Alcohol Abuse Among Students 10 years of declining nega1ve consequences James C. Turner, MD Execu've Director Department of Student Health Na'onal Social Norms Ins'tute Professor of Internal Medicine University of Virginia 1

2 University of Virginia (UVa) 2

3 University of Virginia Public university in CharloMesville, Virginia Founded in 1819 by Thomas Jefferson Total enrollment ~20,000 13,500 undergraduates 6,500 graduate and professional students 65% undergrads from Virginia Strong academic and research tradi'ons Fraternity + Sorority ( Greek ) community, intercollegiate sports, loyal alumni Work hard/play hard culture 3

4 UVa Medical Consequences of Alcohol Abuse 2011/ Emergency Department Visits (14%) 95% undergrad 57% male, 43% female 77% White, 6% Asian, 7% African- Am, 11% Other 32% 21yo, 22% 18, 19, 20 yo, 1% 17 yo Intoxica'on 49%, Injury 35%, Med/psych 16% 9 Admissions (2 GI bleed, 3 psych, 1 pneum, 2 head injury, 1 alcohol poisoning) 127 Student Health Visits by 98 pa'ents (0.2%) 4

5 U.S. College Drinking All major surveys or studies of college drinking demonstrate no significant trend regarding high risk drinking and consequences since

6 Unique Living and Learning Environment 21 year old drinking law is a social experiment on college campuses that has failed: to limit access to lower drinking to decrease health consequences. No drinking age, just a buying age. Sources include legal aged friends, family, roommates Lack of mentoring or modeling for responsible alcohol consump'on. Effort expended in teaching responsible and safe use for those who chose to consume. 6

7 Complementary Strategies and Methodologies Environmental management (EM) Policies and laws Enforcement Referrals for educa'on and medical evalua'on Community coali'ons Server training Health Educa'on Social Norms Marke'ng (SNM) Marke'ng healthy and safe norms (reinforces safer consump'on and use of more protec've behaviors). Correc'ng mispercep'ons about norma've behaviors and aktudes Social Marke'ng Promo'ng behaviors, aktudes, or cultural change 7

8 Mispercep'ons Drive Behavior Overes'ma'on of the degree to which peers actually drink. Underes'ma'on of the degree to which students use protec've behaviors (e.g. keeping a drunk friend from driving). News and media coverage, popular culture of movies and music, legendary stories, health terrorism ads and research. Mythical peer pressure enables unhealthy behaviors, BUT correc'ng mispercep'ons results in decreased unhealthy behavior. 8

9 Mispercep'ons among UVa students from surveys and focus groups Quan'ty (e.g. fraternity members think the median number of drinks consumed per week by upper- class students is 10, but actual consump'on is 5). University policies (e.g. anecdotal reports from focus groups reveals suspicion of using the ER because of concern about gekng in trouble; but these are unfounded myths.). Underes'ma'on of the degree to which students use protec've behaviors (e.g. keeping a drunk friend from driving). 9

10 Correc'ng Mispercep'ons Accurate informa'on about frequency and quan'ty of alcohol Accurate informa'on about prac'cing protec've behaviors: Seeking appropriate medical care for self and others Designated drivers Not leaving an intoxicated friend alone Staying in groups Self monitoring blood alcohol concentra'on Media/informa'on campaign Student developed and tested High target popula'on frequency and penetra'on Recogni'on and branding 10

11 Signs of alcohol poisoning or injury Caring for an intoxicated friend Using the ER 11

12 Quan'ty and Frequency 12

13 Hoo Knew? 13

14 Smart Phone Apps Florida State University: ebac 14

15 Outcomes Assessment Student Surveys Nega've consequences Protec've behaviors Binge drinking and es'mated BAC Emergency Department sta's'cs Case mix and level of severity 15

16 Binge Drinking UVa vs. All College Students Binge Drinking All US College Students Binge Drinking at UVa Percent Responding 2012 Social norms campaign begins BLUE: Monitoring the Future - Survey ; Volume II. College Students and Adults Ages University of Michigan and Department of Health and Human Services. RED: UVa Health Behavior Survey.

17 NegaIve Consequences from Alcohol All UVa Undergraduates % 45% 40% 35% 30% 25% 20% 15% 10% 5% 0%.24*.38*.19*.51*.55** Odds RaIos *p<.001 **p<.01 Year 2001 Year 2002 Year 2003 Year 2004 Year 2005 Year 2006 Year 2007 Year 2008 Year 2009 Year

18 NegaIve Consequences from Alcohol All UVa Undergraduates % 45% 40% 35% 30% 25% 20% 15% 10% 5% 0%.40*.47*.37*.68**.72** Odds RaIos *p<.001 **p<.01 Year 2001 Year 2002 Year 2003 Year 2004 Year 2005 Year 2006 Year 2007 Year 2008 Year 2009 Year

19 Emergency Room Visits at UVa SNM project has encouraged friends caring for friends and using the ER ER visits are up > 100% Hospital admissions are decreased (closed head trauma, alcohol poisoning) Actual incident rate of injury has declined mirroring declines in self- reported injury (ref: Keller A, Turner JC, and Bauerle J. Longitudinal comparison of ED admissions for alcohol- related trauma and self- reported alcohol- related injury in a college popula'on. The American Journal of Drug and Alcohol Abuse : ) More students are seeking appropriate care for themselves and friends. 19

20 2001 to 2010: Outbreak of Health? Ø Decrease: binge drinking 33%, drinking/driving 81%, injury 76%, unwanted sex 53% Ø Students with recall of campaign lower BAC and fewer consequences Ø 23,300 more students over 10 years had NO nega've consequences related to alcohol. Ø Significant increases in use of protec've behaviors. Ø Increased use of emergency services, less frequent injuries and less severe cases 20

21 Community of Caring Hi, my name is S.., I'm a first year here at UVa and I really wanted to thank you for all of the alcohol awareness outreach that is made mandatory for incoming first years. I was at a party (off grounds) over the weekend where I discovered a friend experiencing alcohol poisoning. Her friends wanted to put her to bed because they all thought she was just extremely tired, but from the online course that was required before move-in, all the talks from the Health Promotion department, and even the Stall Seat Journal, I knew this girl was in need of serious medical attention. She is now recovering in the hospital, and it's become clear that if I hadn't called an ambulance, she may not have made it through the night. So thank you so much again, because the knowledge I gained from your department truly saved my friend's life. I cannot thank you enough. 21

22 Thank you More informa'on: Na'onal Social Norms Ins'tute Department of Student Health University of Virginia PO Box Brandon Ave. CharloMesville, VA hmp:// 22