Introduction
How Do We Choose Our Alcohol Prevention Programs? Fun for the students, sneak in education! Sobering displays. Information booklets.
Drinking Games with Non-Alcoholic Beverages
Infamous Beer Goggle Challenges
Sobering Visuals
My Dissertation Journey 178 sources read, scanned, or a randomly pulled quote. Most important things I learned: Alcohol prevention efforts that offer individual educational components, as opposed to comprehensive programs, show little to no evidence of effectiveness. (DeJong, Larimer, Wood, & Hartman, 2009; Rooke, Thorsteinsson, Karpin, Copeland, & Allsop, 2010; Schuckit, Kalmijn, Smith, Saunders, & Fromme, 2012; Walters & Neighbors, 2005) Most institutions are still offering general alcohol educational information as their primary prevention program, the scientifically proven least effective method of influencing and changing student behavior. (Kolbe et al., 2004; Nelson et al., 2010)
The Work Has Been Done For Us! Social Ecological Model Higher Education Center For Alcohol Abuse and Alcoholism Typology for Alcohol Prevention on College Campuses National Institute on Alcohol Abuse and Alcoholism (NIAAA) 3-In-1 Framework
Social Ecological Model Prevention work in public health is typically guided by this model. Recognizes that any health-related behavior is affected through multiple levels of influence:
Social Ecological Model Individual Interpersonal Institutional Factors Community Factors Public Policy
Higher Education Center For Alcohol Abuse and Alcoholism Typology for Alcohol Prevention on College Campuses Based on the Social Ecological Model, William DeJong and Linda Langford developed a typology of programs and policies for preventing and treating campus-based alcohol-related problems. Two dimensions of the typology include: Social Ecological Framework Key areas of strategic intervention
Social Ecological Framework: Individual Level Individual Prevention efforts focused on individual factors are intended to increase awareness of alcohol-related problems, change attitudes and beliefs, foster each student s determination to avoid high-risk drinking and to intervene to protect other students endangered by alcohol. Typical efforts include: Freshman Orientation skits and programs Alcohol Awareness Week events Goal is to give students facts that will convince them to make better-informed choices. Unfortunately, evidence suggests information alone is not sufficient in producing behavior change.
Social Ecological Framework: Individual Level Individual Individual level practices that are showing promise include: Brief motivational interventions or feedback interviews Alcohol skills training
Social Ecological Framework: Institutional Level Interpersonal Prevention efforts focused on interpersonal (or group) factors are intended to change perceived student social norms about alcohol. Typical efforts include: Peer-to-Peer programs (Peer Health Educators) Winning example: Dartmouth College trains students to engage in dialogue with peers! Social Norms Campaigns Students greatly overestimate the number of their peers who drink heavily.
Social Ecological Framework: Community Level Community Factors Institutional factors are those relating to the community surrounding the campus. This factor can vary greatly depending on campus location. SMU versus UT Dallas Typical efforts include: Campus and community coalition Goal should be to curb youth access to alcohol and ensure responsible alcohol sales and marketing by local bars, restaurants and liquor outlets.
Social Ecological Framework: Community Level Public Policy College officials must work for policy change at state and federal levels. Some examples of past efforts include: Minimum drinking age 21 Increased penalties for illegal services to minors Reduced density of retail outlets serving alcohol Increased excise tax rates on alcohol
Key Areas of Strategic Intervention Second Dimension of Typology Four Areas of Strategic Intervention: 1. Modification of students attitudes, behaviors and intentions in respect to alcohol use. 2. Expelling or changing factors in the environment that influence the problem of alcohol use. 3. Administering harm reduction strategies to safeguard against shortterm consequences that alcohol can have on student. 4. Offering interventions and treatment to students suffering from alcohol addiction.
Key Areas of Strategic Intervention DeJong and Langford (2002) offer the following matrix for mapping campus and community prevention efforts. Areas of Strategic Intervention Knowledge, attitudes, and behavioral intentions Environmental change Alcohol-free options Normative environment Alcohol availability Alcohol promotion Policy/law enforcement Program and Policy levels (Social Ecological Framework) Individual Group Institution Community Public Policy Health protection Intervention and treatment *Note the Environmental Change category includes five subcategories!
Key Areas of Strategic Intervention Example of how the Typology Matrix works: Policy: Minimum Drinking Age Law State Level: TABC could increase the number of sting operations at local bars and restaurants. Community Level: Local police could engage in a pact with campus police to deliver notifications of alcohol-related incidents involving college students. Institutional Level: On campus pub serving alcohol should require responsible beverage service training course. Group Level: Adequate controls are required of special event planners to ensure no underage students are served alcohol. Individual Level: Media campaign to publicize the law, campus policy, increased enforcement efforts, and consequences of violating the law.
NIAAA 3-in-1 Framework Much like the Department of Educations Typology, the NIAAA 3-in-1 Framework follows the Social Ecological Model, however targets 3 groups: 1. Individuals, Including At-Risk or Alcohol-Dependent Drinkers 2. Student Body as a Whole Address factors that encourage high-risk drinking: Widespread availability of alcoholic beverages to underage and intoxicated students Aggressive social and commercial promotion of alcohol Large amounts of unstructured student time Inconsistent publicity and enforcement of laws and campus policies Student perceptions of heavy alcohol use as the norm 3. College Campus and the Surrounding Community
NIAAA 3-in-1 Framework Along with the 3-in-1 Framework, the NIAAA ranked prevention efforts, in a tiered system, according to effectiveness. Tier 1: Evidence of Effectiveness Among College Students Prevention recommendations for this strategy include: cognitive-behavioral skills training to alter students alcohol expectancies Deglamorfy alcohol expected norms clarification motivational interventions designed to change behavior
NIAAA 3-in-1 Framework Tier 2: Evidence of Success With General Populations That Could Be Applied to College Environments Proven to work in non-college environments, not yet evaluated for college campuses. Strategies include: stricter minimum drinking age enforcement stricter enforcement and broad marketing of alcohol-impaired driving laws control of the number of establishments offering alcohol for sale around the campus increased alcoholic beverage taxes appropriate policies regarding beverage service in settings that are both social and commercial the establishment of an alcohol coalition involving both campus and community major stakeholders
NIAAA 3-in-1 Framework Tier 3: Evidence of Logical and Theoretical Promise, But Require More Comprehensive Evaluation - The committee recommends campuses involve researchers in the evaluation of the strategies recommended in this tier which include: Friday classes to reduce Thursday night alcohol consumption late night, campus supported, alcohol-free student activities elimination of keg parties where attendees are in large part underage alcohol-free residence halls employment of responsible resident assistants greater control or total elimination of alcoholic beverages at sporting events and tailgate parties refusal of gift money from alcoholic beverage manufacturers; complete ban of alcohol on campus stronger law enforcement at campus events that traditionally promote heavy drinking underage drinking law marketing on campus; disciplinary action for code of conduct violations development of a safe rides program to provide free or low cost transportation to students who have consumed alcohol regulation of reduced cost drinks (happy hour); and using orientation to inform students and their parents of alcohol policies and associated sanctions
NIAAA 3-in-1 Framework Tier 4: Evidence of Ineffectiveness - The committee cautions against funding the following components in isolation of other proven strategies (however, they point out possible ineffectiveness even when used in conjunction with other strategies): Education relating to health risks associated with alcohol use. Use of breath analysis tests to offer immediate blood alcohol level information to students.
How are we doing?? In 2010, a study of 351 U.S. colleges and universities, 98% of those institutions offered basic awareness and education programs to address student drinking. Despite all of the attention from the research community, laws created by federal and state governments, and prevention efforts put forth by higher education institutions, the degree of alcohol consumption, binge drinking, and significance of alcohol-related problems on U.S. college and university campuses has remained a serious and unchanged problem for 30 years (White & Hingson, 2014).
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