Overview. Rationale. Rationale. Celebratory Drinking. Solutions. Research is emerging 6/9/2011. Barriers

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Developed by: Tavis Glassman PhD, MPH, MCHES & Alia Kadri Overview Scope of the problem - Qualitative Data - Quantitative Data Solutions - Intervention Options Tens-of-thousands of people attend game day events! - Drink heavily - Public health issue - Liability Rationale Barriers - Policy Research is emerging - However few tailored Rationale interventions have been implemented, and even fewer have been evaluated. Celebratory Drinking Most students report drinking at some point during their college experience 43% engage in high-risk drinking 22% engage frequently in high-risk drinking College students who consume alcohol with motive to celebrate reach higher levels of intoxication Holidays Special events Special occasions Glindemann, Wiegand, & Geller. (27). Celebratory drinking and intoxication: A contextual influence on alcohol consumption. Environment and Behavior, 39, 32-66. 1

Why Game Day? Occurs multiple times over fall semester More social events associated with high-risk drinking Celebration lasts all weekend Game Day Certain football games result in more alcohol consumption than others Homecoming Rivalry games High profile games i.e., championships or bowl games COMPARED TO Events occur once a year Holidays Spring Break Events occur once in a lifetime 21 st Birthday Graduation Champion, Blocker, Buettner, Martin, Parries, McCoy, Mitra, Andrews, & Rhodes. (29). High-risk versus low-risk football game weekends: Differences in problem drinking and alcohol-related consequences on college campuses in the United States. International Journal of Adolescent Medicine and Health. 21(2). 249-62. (Neighbors, Oster-Aaland, & Bergstrom, 26; Neal & Fromme, 27) Drinking on Game Day Is there anything different about drinking on Game Day vs. a typical social occasion? Females AND Males Glassman, T. & Dodd, V. Alcohol-related Fan Behavior on College Football Game Day. U.S. Department of Education s 21 st Annual National Meeting on Alcohol and Other Drug Abuse and Violence Prevention in Higher Education, 27, Omaha, NE. Tailgate tradition on campus Start drinking earlier Extreme drinking for prolonged hours To enjoy the game more Police are more lenient on Game Day Prolonged hours of drinking On game day, I start drinking at like 1: in the morning, which is not like me. Female You are drinking all day from like 9 a.m. to like 9 p.m. Male Tailgate Tradition You always hear that you can t go to a game unless you drink before. Nobody goessober to the game. Female Game day is on Saturday. No one has classes the next day and everyone is drinking. Male 2

Enjoy the Game More If you are not drunk and drunk people are falling on you in the stands, you get agitated. If you are drunk, you participate with them and go yah and cheer. Female You want to stay drunk throughout the whole game; you don t want it to wear off. Male Extreme Drinking on Game Days Everyone s going to find an excuse to drink anyways, like oh it s a state rival or it s the first game of the season or it s just a really big game. Female Drinking a six pack is not high-risk drinking, it is just a warm up before you go out. Male Other Notable Quotes (males) Campus police are more lenient. Everyone on the side of the road has cups in their hands. Beam Team is a tradition to a lot of people. A liter of Jim Beam before you go to the game. Do you typically drink alcohol on game day? Where do you spend a majority of your time drinking before the game? 1.4% 1%.1% Don't Drink 49.2%.8% Yes No 11.3% 27.6% 9.7% 48.9% Tailgate Area Friend's Home Home Other Bar Restaurant Glassman, T., Dodd, V., Sheu, J. J., Rienzo, B. A., & Wagenaar, A. C.(21). Extreme ritualistic alcohol consumption among college students on game day. Journal of American College Health, 8,413-423. (Glassman et al., 21) 3

Where do you spend the majority of your time drinking during the game? Where do you spend the majority of your time drinking after the game?.9% 3.% 2.8% 2.8% 2% 3.7% Don't Drink Friend's Home Home Bar 16.3% 2.8% 1.7% 1.3% Don't Drink 1.3% Friend's Home 46.4% Bar 84.3% Other Tailgate Area Restaurant 21.2% Home Other Restaurant Tailgate Area (Glassman et al., 21) (Glassman et al., 21) Number of hours spent drinking alcohol on Game Day 14.2% hours 7.2% 19.9% 43.4% 1-2 hours 3-4 hours -6 hours 1.2% > 6 hours Alcohol Consumption Measures The standard high-risk drinking measure (+/4+) does not adequately capture how heavily people actually drink. The standard definition does not include a time parameter - in a row or in a sitting. Is the two-hour NIAAA definition practical? Other measures are needed. (Glassman et al., 21) Alcohol Consumption Measure: ERAC A customized measure and term were developed to describe excessive alcohol consumption associated with tailgating. Extreme Ritualistic Alcohol Consumption (ERAC) vs. Celebratory Drinking ERAC Defined 1 drinks for males 8 drinks for females High-Risk Drinking & ERAC Rates % 4% 4% 3% 3% 2% 2% 1% 1% % % High-Risk Drinking & ERAC Rates for Game Days 36.% 34.3% 1.7% 16.2% Typical 26 Game Day High-Risk Drinking Rates 32.1% 11.1% 43.8% 26.8% UT VU FSU ERAC Drinking Rates 4

Drinking Rates on Game Day ERAC Rates by Gender Percentage 6 4 3 2 1.8 Drink on Game Day 36 Drinking Rates 1.7 Binge ERAC Percentage 3 2 2 1 1 23.4 1.7 Male Female Gender Findings were significant at p <.1. The OR for gender (male/female) was 2.6, 9% C.I.= 1.712, 3.843. ERAC Rates by Classification ERAC Rates by Ethnicity Percentage 3 2 2 1 1 6 1.7 1.7 24.9 18.7 Percentage 2 1 1 2 2.2 1.1 18 Freshmen Sophomores Juniors Seniors Graduates Classification Asian Black Latino White Ethnicity Findings were significant at p <.1. Findings were significant at p <.1. ERAC Rates by Greek Status ERAC Rates by Legal Drinking Age Percentage 3 2 2 1 1 24. 13.6 Non-Greek Greek Greek Status Percentage 3 2 2 1 1 23. 9.7 Under 21 21 and Over Age Findings were significant at p <.1. The OR for Greek status (yes/no) was 2.6; 9% C.I.= 1.317, 3.223. Findings were significant at p <.2. The odds ratio for Greek status (yes/no) was 2.86 (1.892-4.34).

Game-Day Survey Results Results show that males consume more alcohol but females suffer more consequences These consequences include: Hangover Vomiting Driving under the influence Blackouts Injuries Fighting Sexual assault Trouble with police Game Day Drinking Consequences Percent 4 3 3 2 2 1 1 32 Game Day Drinking Consequences 16 Had a hangover Drove af t er drinking 13 11 Blacked out Vomited Got into a fight Consequences 8 or argument Drove af t er or more drinks Haun, J., Glassman, T., Dodd, V., & Young, G. (27). Game-day survey results: Looking at football fan alcohol-related behaviors. American Journal of Health Education. 38 (2): 91-96. Alcohol Related Consequences Association Between Alcohol-Related Arrests and College Football Game Days 7.3 12.3 11.8 Game Day Saturdays Holidays Average Number of Arrests per Day Merlo, L., Hong, J., & Cottler, L.B. (29). The association between alcohol-related arrests and college football game days. Drug and Alcohol Dependence, 16, 69-71. College Football Games and Crime Game Day BrAC Research Data shows an increase in arrests for Assaults Vandalism Disorderly conduct Alcohol-related offenses Game upsets are associated with the largest increase in offenses Rees, D. & Schnepel, K. T. (28). College football games and crimes. Working Paper Series. 8-1, 1-42. 6

BrAC Rates Self-Estimated vs Actual Percent of Fans Intoxicated (.8mL/L) BrAC Rates.8.7.6..4.3.2.1.66 Self-Estimated.49 Actual P ercen t 6 4 3 2 1 3 Perceived 2 Actual Participants Participants Glassman, T., Braun, R., Whewell, A., & Reindl, D. Blood (breath) Alcohol Concentration Rates of College Football Fans on Game Day. Journal of Alcohol and Drug Education(in press). Glassman, T., Braun, R., Whewell, A., & Reindl, D. Blood (breath) Alcohol Concentration Rates of College Football Fans on Game Day. Journal of Alcohol and Drug Education(in press). Game Day BrACAverage.8.7 Blood Alcohol Level.6..4.3 Average BAC All Participants n= 466.2.1 All Games Colorado Western Northern Temple Eastern (Fri, Sept 11; Michigan Illinios (Sat, Oct 24; Michigan 9:pm) (Sat, Oct 1; (Sat, Oct 17; 7:pm) (Fri, Nov 2; 7:pm) 7:pm) 7:pm) Game Day Opponent THEORY OF PLANNED BEHAVIOR Behavioral Beliefs Path Analysis Evaluations of Behavioral Outcomes Attitude Toward Behavior.1* Attitude Toward the Behavior.39* Normative Beliefs Motivation to Comply Subjective Norm Behavioral Intention Behavior.8 Subjective Norm.46* Behavioral Intention R 2 =.4*.72* R 2 =.2* Number of Drinks Consumed on Game Day Control Beliefs Perceived Power Perceived Behavioral Control.4 Perceived Behavioral Control. -.7 7

Utilize TPB to Develop Messages ATB: males; drinking expectancies e.g., Social, having fun, enjoying the game PBC: females; external influences e.g., Availability, price, enforcement SN: underage; perceived norms e.g., Peer pressure [Behavioral Intention] [Attitude Toward the Behavior] [Attitude Toward the Behavior] [Attitude Toward the Behavior] 8

[Attitude Toward the Behavior] [Subjective Norm] [Perceived Behavioral Control] [Subjective Norm] Intervention Options Intervention Options Education Meet/greet with former players Public Service Announcements Use: Emails, Websites, Newspapers, and Social Networks Influential people -Coach -SG President -University President Message: Positive fan behavior Social Marketing Use: Social norm messages highlighting positive normative behavior Promote laws specific to the campus and community -open container law Freshman Orientation Classes Discuss positive fan behavior Game Day Wellness Promotion Hydration Sun protection Hypothermia Calorie monitoring Alcohol consumption -legal issues -risk reduction strategies Bystander behavior Safe transportation Recycling Designate Alcohol Free Areas Non-alcoholic games/activities Show pre-game shows charge for concessions Income generating 9

Game Day non-alcoholic Alternatives Intervention Options Permit alcohol consumption only where alcohol is sold by third party venders trained in Responsible Beverage Services Check IDs Refuse service to intoxicated individuals Ban alcohol sales in stadium Policy Restrict tailgating times and locations No reentry back into stadium Restrict alcohol related ads during NCAA events http://www.cspinet. org/booze/cafst/ Policy 96% of universities indicated their athletic department has a policy regarding alcohol at athletic events 71% of universities designate tailgating areas on campus on game day 1% reported keeping the designated zones alcohol free One university restricted the time of tailgating prior to the games The NCAA (28) reported that 92% of its members ban the sale of alcoholic beverages at sporting events (Alcohol Prevention Coalition, 21) Policy Proposal Approx. 8% (n=47) would support designated tailgating areas that allow alcohol consumption Chi-square analyses indicate no significant difference among demographic groups regarding their support Study published in USA Today (2) Glassman, T., Braun, R., Whewell, A., & Reindl, D. Blood (breath) Alcohol Concentration Rates of College Football Fans on Game Day. Journal of Alcohol and Drug Education(in press). Regulate Tailgating: Case Study An university in the Midwest changed it s tailgating policy to allow alcohol consumption to one specific area Security, clear borders, ID checks, etc. Intervention Options Enforcement Results showed no change in alcohol consumption or related problems No change in tailgating or game attendance However, students perception of peers alcohol consumption increased Coordinate university, city, and state enforcement resources Fan text messaging system - Fans can anonymously text authorities if disruptive fan behavior occurs before, during, and after the game Oster-Aaland, L. K., & Neighors, C. (27). The impact of a tailgating policy on students drinking behavior and perceptions. Journal of American College Health, 6, 281-284. 1

Check BAC Program Pronounced: Check Back Student Affairs created the program to deter high-risk drinking Allows student season-ticket holders who were ejected from a game for intoxication offenses to attend future games by submitting to blood alcohol testing http://www.nytimes.com/29/11/19/sports/ncaafo otball/19drunk.html Theory of Community Readiness Different communities are at different stages of readiness for dealing with a specific problem. The stage of readiness can be accurately assessed. Communities can be moved through a series of stages to develop, implement, and improve effective programs. To maintain momentum, it is critical to use appropriate interventions at each stage of readiness Nine Stages of Readiness for Community Change 1. No Awareness Goal: To raise awareness of the issue. 2. Denial Goal: To raise awareness that the issue is a problem that can be successfully addressed. 3. Vague Awareness Goal: To increase motivation to take action to combat the problem. 4. Preplanning Goal: To detail possible efforts or actions to combat the problem..preparation Goal: To create an action plan and commit to moving forward. Developed by the Tri-Ethnic Center for Prevention Research, Colorado State University Nine Stages of Readiness for Change 6. Initiation Goal: To implement an action plan item. 7. Stabilization Goal: To make the program an expected and accepted part of the community s activities. 8. Confirmation/Expansion Goal: To expand and enhance the prevention program. 9. Professionalization Goal: To use community resources to improve prevention efforts, maintain momentum, and ensure growth. ACHA Developing a position statement / call to action on game day prevention Prevention Norm Keeping up with the Jones 11

Q & A Summary Recommendations to increase safety 1. Educate 2. Provide alcohol-free game day alternatives 3. Increase enforcement of underage drinking and open container laws 4. Designate tailgating areas on campus which clearly delineate where alcohol consumption is legal. Limit the number of tailgating hours 6. Use theory (TPB & TCR) Acknowledgements University of Toledo GatorWellHealth Promotion Services at the University of Florida Special thanks for assisting with data collection and related photos. References Allen, G. (29, November 28). Reining in tailgate parties a challenge for colleges. NPR. Retrieved from http://www.npr.org/templates/story/story.php?storyid=121372 Champion, H., Blocker, J.N., Buettner, C.K., Martin, B.A., Parries, M., McCoy, T.P., Mitra, A., Andrews, D.W., & Rhodes, S.D. (29). High-risk versus low-risk football game weekends: Differences in problem drinking and alcohol-related consequences on college campuses in the United States. International Journal of Adolescent Medicine and Health. 21(2): 249-262. Glassman T, Braun R, Whewell A, Reindl DB. Blood (breath) Alcohol Concentration Rates of College Football Fans on Game Day. Journal of Alcohol and Drug Education. 211; in press. Glindemann, K. E., Wiegand, D. M., and Geller, E. S. (27). Celebratory drinking and intoxication: a contextual influence on alcohol consumption. Environment and Behavior, 39, 32-366. References Haun, J., Glassman, T., Dodd, V., & Young, G. (27). Game-day survey results: Looking at football fan alcohol-related behaviors. American Journal of Health Education. 38 (2): 91-96. Merlo, L., Hong, J., & Cottler, L.B. (29). The association between alcohol-related arrests and college football game days. Drug and Alcohol Dependence, 16, 69-71. Neighbors, Oster-Aaland, & Bergstrom, 26; Neal & Fromme, 27 Rees, D. & Schnepel, K. T. (28). College football games and crimes. Working Paper Series. 8-1, 1-42. The association between alcohol-related arrests and college football game days. Drug and Alcohol Dependence. 16 (21): 69-71. The U.S. Department of Education s Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention. (21, July).Pregaming: A high-risk behavior. Retrieved from http://www.higheredcenter.org/files/prevention_updates/july21.pdf 12