Because prevention isn’t just NCAAW...
One of the most important suggestions we want to give you is that prevention programming, and alcohol abuse prevention specifically, should not be limited to only one week. It takes a multi-level concerted campus commitment to these issues to truly make a difference. You spend so much time, energy and money on NCAAW, why not take that momentum and build a year full of activities and educational programming?
National Collegiate Health and Wellness Week
NCHWW is always held the first Sunday in March through the following Saturday. In 2004, that will be March 7-13. This is a great week to sponsor programs that emphasize topics such as nutrition, exercise, mental health, sexual health, and others.
World AIDS Day
World AIDS Day is always observed on December 1. Perhaps you could sponsor a speaker, or a workshop on “how to help a friend who is HIV-positive.” How about a candlelight remembrance program; passing out red ribbons; a display of the AIDS Memorial Quilt? Maybe you could have “A Day Without Art” where you memorialize the impact of the AIDS crisis on the world of art and entertainment by covering up anything on your campus that is artistic. Many campuses choose to observe AIDS awareness weeks or month during February to coincide with Valentine’s Day and the obvious event tie-ins available that month.
Women’s History Month
March is Women’s History Month. Perhaps you could hold a women’s health fair. Work with a campus sorority to promote breast self-exams to prevent breast cancer. Maybe you could do a program on preventing sexual assault. The possibilities are limitless, and the Women’s Center on your campus would probably love to co-sponsor activities with you. Note that Men’s Health Week is in June and you could provide a week of events focusing on men’s health issues.
Great American Smokeout, Sexual Responsibility Week, Safe Spring Break
The BACCHUS and GAMMA Peer Education Network sponsors these three additional campaigns in November, February, and March. You can build a whole week of activities around the themes, doing programs on topics such as impaired driving prevention, smoking cessation, safer sex, alcohol poisoning, safe travel skills, sun/skin care, and others. For more information on campaigns, see www.bacchusgamma.org or call 303-871-0901.
Finals Stress Busters!
Everyone gets nuts around finals time. So, what can you do to help students manage the stress? Maybe you could pitch a tent in the middle of campus with “stress buster” activities. How about a midnight breakfast where students can get some free nourishment and relieve some stress? Maybe you could put together care packages with healthy food samples from local stores. Maybe host a free massage hour in the union.
Safe Senior Week/Graduation
Why not get out there and talk to those seniors? Remind them to party smart during the celebration. You may want to provide some fun events during their week or pass out promotional items or serve mocktails at an event. Focus on issues such as impaired driving prevention, peer pressure, alcohol poisoning, and more!
Don’t Cancel That Class!
Offer to fill in for professors who need to be away from class. Present an interactive health education program to the class. Word will spread fast to other faculty and soon you will have a new avenue for your health messages. Send faculty a list of programs that you can do that apply to their disciplines of study.
NEWS FROM THE FIELD
Encouraging Practices and Reports
To better prepare the individuals on your campus responsible for year-round prevention efforts, we thought it would be important to highlight just a few of the recent findings and creative strategies that have surfaced in the prevention area. These are but a few of the guideposts that can help us frame our goals to reach students in a meaningful way on alcohol abuse issues, and develop a comprehensive prevention program on our campuses.
The Social Norms Approach:
An Effective Method to Increase Protection and Reduce Risk
(Michael P. Haines, Director; Rich Rice, Coordinator of Information and Education)
The National Social Norms Resource Center is an independent center that supports, promotes and provides technical assistance in the application of the social norms approach to a broad range of health, safety and social justice issues, including alcohol-related risk-reduction and the prevention of tobacco abuse.
At most colleges and universities across the country the fall semester has begun. Nowadays, one sure sign that college students have returned to campus is that print, television, and radio media are filled with stories about the problems they will face, especially with alcohol. Last year at this time, one widely reported survey claimed to show that “a large majority of parents are worried about how high-risk drinking will affect their children” who are college bound. Shortly thereafter, much press attention was given to the latest report from the College Alcohol Survey, whose findings were very similar to those in its first report issued nearly eight years ago. The headlines, familiar by now, were largely unchanged from those that appeared in 1994 when the Wall Street Journal titled its coverage of this story: “Binge Drinking at Nation’s Colleges is Widespread, Harvard Study Finds.”
One thing that has changed, however, is a growing awareness that this kind of coverage unfortunately masks the fact that most students drink moderately, if at all. Once the best kept secret on college campuses, this norm of moderation has begun to play an increasingly important role in the ongoing public dialogue about the place of alcohol in college life. Even a recent NIAAA press release, acknowledged that heavy drinkers are a minority and that “alcohol abuse does not run rampant among all college and university students.”1 How has this once neglected fact come to be perhaps the greatest open secret of college life? The answer is Social Norms.
In the recent past, the predominant approach in the field of health promotion has sought to motivate behavior change by focusing on risk. Sometimes called “the scare tactic approach” or “health terrorism,” this method essentially hopes to frighten individuals into change by insisting on the negative consequences of certain behaviors. Think of the image of a crumpled automobile, flashing red lights, and the tag line “Speed kills! ” and you will have a sense of the tenor of this sort of public health campaign. Unfortunately, the public tends to disregard this kind of message. Why? Just ask any of the vast majority of motorists exceeding 55 mph on the highway and they will tell you: because it exaggerates both the risk and the prevalence of harm.
“Traditional strategies,” the sociologist Wes Perkins has pointed out, “have not changed behavior one percent.”2 In 1986, he and Alan Berkowitz published the findings from their research revealing that most students on their campus overestimated their peers’ support of permissive drinking practices and that this overestimation correlated with drinking behavior. 3 Correcting this misperceived social norm, they suggested, might reduce heavy drinking and related harm. Over the next decade a number of practitioners began to investigate the implications of this work, and the results of their efforts spearheaded the approach to health promotion now widely known as social norms.
By now, a number of colleges and universities using this approach have seen dramatic reductions in heavy episodic alcohol consumption and related harm. The University of Arizona—a large, public institution—reported a 28% reduction over four years, whereas Hobart and William Smith Colleges—a small, private institution in the northeast—achieved a 40% reduction after the same length of time. These are just two examples. Of course, the social norms approach can be used to address other than alcohol-related issues. Only recently, the University of Wisconsin-Oshkosh reported a 29% reduction in smoking rates after the implementation of a campaign, and there are similar projects currently underway at Virginia Commonwealth University and at five schools in a demonstration project directed by BACCHUS & GAMMA and the Centers for Disease Control, to name but a few. Some of the other areas in which the social norms approach is now being applied include academic performance and sexual assault prevention.
One of the major themes of the recent national conference on the social norms model was the need for practitioners to constantly bear in mind that this is a data-driven, integrated process. This means that both the quantitative and qualitative data that is gathered informs how a campaign evolves from stage to stage, and that the stages are dependent upon one another. Furthermore, evidence has begun to accumulate that the most effective social norm campaigns share the following characteristics:
- There is a clear, positive norm underlying the campaign. Nevertheless, successful campaigns often provide a variety of messages that give a fuller picture of the actual norms.
- Competing, scare tactic messages are absent.
- Message dosage is high, ongoing and intense, and both message recall and acceptance by the target audience are frequently evaluated.
- Synergistic strategies are used so that normative messages are delivered in various contexts.
- Normative messages are delivered to the general population, not just targeted sub-groups. This counters both the personal and the contextual misperception effects.
1 See http://www.niaaa.nih.gov/press/2002/college.htm
2 See http://www.yalealumnimagazine.com/issues/01_05/alcohol.html
3 H. Wesley Perkins and Alan Berkowitz. (1986). “Perceiving the community norms of alcohol use among students: Some research implications for campus alcohol education programming.” International Journal of the Addictions, 21, 961-976.
Promising Practices: Programs of Excellence for America’s College and Universities
(a project authored by David Anderson, Ph.D. and Gail G. Milgram, Ed.D. and funded by the Century Council).
This Source Book highlights some of the “Promising Practices” taking place in higher education that address alcohol abuse prevention and other health and wellness issues.
These recommendations will not seem unfamiliar. Some are quite global; others are specific. There was no attempt to establish an order of importance or priority; after all, every local situation may differ in immediate needs and historical progress.
- Integrate alcohol abuse prevention efforts into the fabric of the institution. Alcohol abuse prevention will be best served when it is an integral part of the institution. Since academics are the core of institutions of higher education, it is critical that alcohol abuse prevention efforts be melded into the existing curriculum of each university and college. This is a particularly important concept for those campuses where many or all of the population are commuter students. Integrating alcohol abuse prevention into academic courses ensures that the messages reach their target populations. Beyond academics, incorporation of alcohol abuse prevention into the overall mission of the institution also suggests that financial grounding for these efforts should be institutionalized. Such programs should be incorporated in the regular, ongoing budget of the institution. This step is important, as current alcohol abuse prevention initiatives typically operate with limited funds, resources, and personnel.
- Ensure that efforts are clearly defined and well grounded. The professional literature on college-based alcohol abuse prevention is still evolving; however, it is important that those charged with campus alcohol abuse prevention initiatives clarify their assumptions and define the theories that underlie their prevention efforts. Individuals in the prevention area need to work with others on their campus to decide what they believe is important for the students in their unique setting at a specific point in time. Needs assessment and clear articulation of goals are critical to an appropriate campus initiative. The design, implementation, and evaluation of the program are enhanced when the outcomes are clearly defined.
- Create a comprehensive and long-term perspective. Although the incentive to address specific alcohol abuse consequences promptly is strong, it is the belief of this review committee that the ultimate solution to campus alcohol abuse problems lies in a long-term comprehensive approach. This view was supported by members of the Advisory Panel, as well as from the professional literature from other disciplines. Certainly, short-term initiatives may be immediately helpful; however they typically do not address the underlying issues and thus, the problems will more than likely reoccur. Changing the culture on campus and modifying campus norms and behaviors takes time. To expect change quickly is simply not realistic; patience and sustained effort will generate results ultimately.
- Design campus initiatives to be multi-targeted and broad-based. Campuses typically have a diverse student population; therefore, it is important to target approaches specifically to various groups. For example, messages for athletes may clearly diverge from messages for fraternity and sorority members; and some approaches for first-year students may be much different from those used with graduating seniors. There are numerous potential target groups based on a variety of issues, e.g. gender, sexual orientation, age, year in college, fraternity/sorority affiliation, place of residence, family background, and patterns of alcohol use.
- Allocate appropriate resources and staff commensurate with the task. In order to implement a comprehensive and long-term approach to solving campus alcohol abuse problems, it is necessary to have appropriate staffing and resources and adequate training for these employees. As initiatives were reviewed in the creation of this sourcebook, it was often found that a half-time professional was handling the alcohol abuse prevention activities for a campus of 20,000 students. Similarly, it was discovered professionals and offices did not have the time to share the work that they were doing because of all their other responsibilities. Extending the implications of cost-benefit and cost-offset studies of prevention to campuses, it is likely that investments will be recovered in dollars as well as student health. But that investment should be made on a continuous basis, with or without external help.
- Build program connections on and off the campus. Although the prior recommendation cites the need for resources, this is not to suggest that one individual or a single office should be charged with “doing it all alone.” In fact, in order to fully integrate the substance abuse initiatives into the institutional fabric, it is vital that those charged with the responsibility of implementing alcohol abuse prevention efforts build connections with individuals and organizations on the campus. Infusion of alcohol abuse prevention concepts into the classroom setting, collaboration with the institutional research office, linkage with student organizations, support of resident hall personnel and other outreach illustrate the importance of having a variety of individuals and offices share responsibility. However, this type of local ownership requires consistency and a long-term perspective. Similarly, it is very helpful to build connections off campus with local services, enforcement personnel, or those who serve or provide alcohol. Progressive campuses view this issue as a shared concern of both the internal and external community.
- Collaborate with other professionals. Just as this Sourcebook serves as a testimony to the willingness of individuals to share their work with others, campus personnel are best served when they collaborate with one another by sharing their insights, frustrations, concerns, and successes. This may be accomplished through a local consortium, a statewide initiative, or a national forum. This collaboration may be at a fixed time, as at a conference, or over time through electronic or print communication. Collaboration and dissemination help professionals realize that they are not alone; since others are addressing similar issues, each benefits from shared insight and expertise. In this way campus personnel will be more sustained by the support of others, rather than experience a sense of isolation. Collaboration is not limited to other professionals with an alcohol abuse prevention specialty. It is often helpful to extend collaboration to professionals in various academic disciplines as well as with community, regional, and state leaders.
- Conduct and use ongoing evaluation. The importance of evaluation could fill an entire subset of recommendations. If campus approaches are to be thoughtful, they must be needs-based and vary according to different groups and audiences on the campus. Thus, a needs assessment process should be a primary foundation of the campus efforts. It is important that the evaluation design be part of early discussions on campus strategies so that monitoring can occur. Ongoing feedback and review are helpful to campus personnel to determine whether their approaches are accomplishing what was intended. It is particularly important to maintain this type of monitoring so that the expenditure of limited resources is properly directed. It is also important not to rely on single evaluation approaches. Although it does take a significant amount of effort, campus evaluation should be theorydriven and build upon derived hypotheses and desired outcomes for the campus. Global protocols and measures, while helpful from the perspective of providing comparison with other institutions from specific regions of the country, may not fully address the desired outcomes for a particular campus at a specific point in time. In addition, evaluation should not be only at the global level for the campus (such as an annual survey), but should also be able to measure individual initiatives, such as an assessment of the effectiveness of peer educator classroom interventions, a follow-up on the helpfulness of strategies used with students involved in judicial sanctioning, and reactions to media approaches. Ongoing quantitative and qualitative evaluation approaches with a longitudinal perspective will be very helpful to the alcohol abuse prevention effort. Also, the shared results would enhance the sparse professional literature in the field.
- Clearly define the message and market the initiative. Campus programs are beginning to emphasize strategies that address overall environment on campus, with emphasis on the clear communication of specific messages. Not only are desired student behaviors specified, but misperceptions are also addressed. A clear focus helps to shape the message on the campus regarding alcohol abuse, serving as a prime example of how an initiative can be built upon strong theoretical grounding. Hand-in-hand with message clarity is the need to market both the project elements and their messages in sophisticated ways. Students are bombarded daily with a multitude of media messages on many issues, making it all the more critical that alcohol abuse prevention strategies compete powerfully for attention, understanding, and adoption.
- Solicit support from the top and bottom of the campus hierarchy. Often we hear the call that support from the top (i.e., the president, chancellor, provost or even the governing board) is needed for the alcohol abuse prevention program to be integrated and supported on a campus. Such support is extremely helpful, especially for our featured comprehensive programs. However, lack of support from the top does not mean that nothing can be accomplished. In addition, support from the “bottom” is critical. The “grassroots” initiative is an integral part of the fabric of the institution. Working together, individuals on and off the campus, having shared interests and desires, can accomplish significant impact and change. Further, just as it is essential to have appropriate needs-based and targeted approaches, it is important for the long-term sustenance of the alcohol abuse prevention effort that the voice of those who benefit from that effort — students, peer educators, faculty members, staff members, parents, alumni, and others — is sought and heeded.
Highlights from the NIAAA Call to Action
In 2002, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) released a report titled A Call T Action: Changing the Culture of Drinking at U.S. Colleges. This report was developed by a task force of college presidents, alcohol researchers and students who looked at the current state of alcohol use and abuse in higher education, and the current resources employed to fight abuse on college and university campuses. Their report focused on three things:
1.Summarizing the scope of the problem
2.A look at the effectiveness of programs being used by schools and communities
3.A summary of recommendations designed to improve prevention efforts
One of the outcomes of the Call to Action was the creation of a website www.collegedrinkingprevention.gov which not only includes the entire report, but is separated into action plans for the following constituents:
College Presidents Community Leaders
Campus Health Administrators High School Counselors
RAs/Peer Educators Students
We encourage you to visit their website to learn more. The NIAAA Task Force singles out peer educators as a proactive force in fighting alcohol abuse .In their publication that accompanies the report titled, “What Peer Educators and Resident Advisors (RAs) Need to Know About College Drinking,” they list the following reasons why they are reaching out to peer educators as follows:
• Peer Educators are trusted by classmates to provide reliable answers and accurate information, regardless of health topic.
• Peer Educators have hands-on knowledge that enables you to interpret the NIAAA report from a different perspective.
• Peer Educators are a very important link between the administration and student body.
• Peer Educators can assist college presidents in reducing underage/excessive drinking.
• Peer Educators input can make college alcohol prevention programs more successful.
Recommendations for Colleges and Universities
To change the culture of drinking on campus, the NIAAA Task Force recommends that all colleges and universities adopt the following overarching approach to program development and then select appropriate strategies from among those presented in the report to tailor programs to the special needs of their schools.
The research strongly supports the use of comprehensive, integrated programs with multiple complementary components that target:
• Individuals, Including at-risk or alcohol-dependent drinkers,
• The student population as a whole, and
• The college and the surrounding community (Hingson and Howland, 2002; DeJong et al.,1998;Institute of Medicine,1989).
The 3-in-1 Framework presented here focuses simultaneously on each of the three primary audiences. The NIAAA Task Force members agreed that the 3-in-1 Framework is a useful introduction to encourage presidents, administrators, college prevention specialists, students, and community members to think in a broad and comprehensive fashion about college drinking. It is designed to encourage consideration simultaneously of multiple audiences on and off campus. The Task Force offers the 3-in-1 Framework as a starting point to develop effective and science-based prevention efforts. The brief descriptions that follow provide the rationale for emphasizing these three targets in prevention programs aimed at high-risk student drinking and identify alternative prevention strategies that address each group.
What does a multivariate perspective mean? Alcohol research clearly indicates that multiple factors interact to produce various drinking patterns. Factors include students’ genetic/biological characteristics, family and cultural backgrounds and environments, previous drinking experiences in high school, and the particular environment of the college in which they are enrolled. Even within one college, patterns may be influenced by students ’participation in fraternities/sororities, sports teams, or other social groups. Research has the capacity to bring this enlarged perspective to the problem of college drinking and to test models that take into account many of these factors.
(1) Individuals, Including At-Risk or Alcohol-Dependent Drinkers:
The risk for alcohol problems exists along a continuum. Targeting only those with identified problems misses students who drink heavily or misuse alcohol occasionally (e.g., drink and drive from time to time). In fact, nondependent, high-risk drinkers account for the majority of alcohol-related problems (Lemmens,1995; Kreitman,1986).It is crucial to support strategies that assist individual students identified as problem, at-risk, or alcohol-dependent drinkers. Strategies are clearly needed to engage these students as early as possible in appropriate screening and intervention services -whether provided on campus or through referral to specialized community-based services. One important effort to increase on-campus screening is National Alcohol Screening Day, an event that takes place in April each year. This program, supported by NIAAA and the Substance Abuse and Mental Health Services Administration, provides free, anonymous testing and health information at a growing number of colleges and universities.
(2) Student Body as a Whole:
The key to affecting the behavior of the general student population is to address the factors that encourage high-risk drinking (DeJong and Langenbahn, 1996; DeJong and Linkenbach,1999; DeJong and Langford, 2002; Perkins, 2002; Toomey and Wagenaar,2002; Toomey et al.,1993).They include the:
• 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; and
• Student perceptions of heavy alcohol use as the norm.
Specific strategies useful in addressing these problem areas tend to vary by school. Examples of some of the most promising strategies appear in the “Recommended Strategies ”section of the report.
(3) College and the Surrounding Community:
Mutually reinforcing interventions between the college and surrounding community can change the broader environment and help reduce alcohol abuse and alcohol-related problems over the long term. When college drinking is reframed as a community as well as a college problem, campus and community leaders are more likely to come together to address it comprehensively. The joint activities that typically result help produce policy and enforcement reforms that, in turn, affect the total drinking environment. Campus and community alliances also improve relationships overall and enable key groups such as student affairs offices, residence life directors, local police, retail alcohol outlets, and the court system to work cooperatively in resolving issues involving students (Hingson and Howland, 2002; Holder et al.,1997a, 2000; Perry and Kelder,1992).
To address alcohol abuse, colleges and universities should:
Define high-risk drinking precisely.
Determine the causes and results of alcohol abuse.
Develop policies about alcohol use and enforce them consistently.
Hold policy violators accountable for their behavior.
Include in those policies prevention and other appropriate responses.
Pay particular attention to all new students, first-year and transfer.
Enlist the direct support of the chief executive and members of the governing board.
Commit funds to address alcohol abuse through education, enforcement, treatment and related activities.
Use available resources and technologies to increase the campus community’s understanding of the institution’s “duty to care.”
Develop mechanisms to communicate with parents and guardians about their children’s involvement in situations of alcohol abuse.
- What Can You Do?
Report from the National Symposium on Alcohol Practices sponsored by the Inter-Association Task Force on Alcohol and Other Substance Abuse Issues High-Risk College Student Drinking
High-risk college student drinking includes the following:
Drinking and driving or other activities where the use of alcohol is dangerous
Drinking when health conditions or medications make use dangerous
The 2002 Student Monitor Report
(edited from article appearing in The Peer Educator™, May/June 2002, Vol. 24, No. 10)
Early in the Fall of 2001, The BACCHUS and GAMMA Peer Education Network was invited to develop some polling questions by the president of Student Monitor, a nationally respected research firm that specializes is surveying college and university students to better understand their wide range of activities and interests on behalf of their corporate clients. This company develops its data through in-person, intercept based interviewing and included a total of 1,200 student interviews representative of location (North, South, East and West), type of school (Public or Private), and enrollment size. All of these interviews were conducted the week of October 8, 2001.
What Students Think Are Biggest Campus Issues
Students were given a list of 21 issues that exist on college campuses and were asked to identify their choices of what they considered to be the top three. Here were their responses.
It will come as little surprise for most students to find that four of the top five were concerning financial issues. But when it comes to campus issues that pertain to health topics, alcohol and drug issues were number one and two.
Students Think Most of Their Peers Are Healthy, And Would Confront Them if They Weren’t
When it comes to how students perceive their choices about alcohol, it is clear they believe a majority of their peers are making healthy decisions. When given the statement “Students drink on this campus, but most balance their drinking and other responsibilities pretty well,” two thirds (66%) agree. Students at private schools agreed at a rate of 78% while public schools were at 61%. Also, more men agreed with the statement (69%) than women (63%).
When given the statement “Generally students on this campus are pretty responsible when it comes to balancing their academic and social lives,” again a clear majority (61%) agreed. Once again, there was a higher sense of agreement among private school students and men.
At the same time, students made it very clear that they would not hesitate to speak up to friends who they thought might be hurting themselves. When given the statement “I am comfortable confronting my friends about their drinking if I think their health or safety is at risk,” 81% of students said yes.
Students Aware of and Happy With Peer Education
Several survey questions asked students about their knowledge and perception of peer educators. For those of you involved with peer education, you will be happy with the findings. Students were asked if they were aware of any student organizations on their campus that address health and safety issues. More than 70% of students said they were aware of a group. It is also positive to know that the number of seniors who said they were aware had grown from the number of freshmen who had answered yes to the question.
The next question revealed some extremely interesting data. Here was the question that was posed: “If you were faced with a personal health problem or had been involved in a traumatic experience, whom would you most likely first seek out to talk about it?”
Conventional wisdom might say that the number one answer would be that students chose their friends to talk to as a first option. However, as you can see from the chart, friends were a distant fourth choice on the list – coming in at less than 10%.
Interestingly enough, almost half of students would still turn to their parents first if they needed to talk, even though they now are in college. What is noteworthy here is perhaps parents are not aware of what a great support they still are to their sons and daughters and it may be in our best interest to try to inform them of their role. When it comes to peer educators, it is clear the potential impact they can have as a resource for other students on campus. The survey shows that 14%, or approximately one in seven students name peer educators or student leaders as the place they would go when they needed to talk. This is amazing. And although one could make the case that 14% is not an extremely high number, the chart also reveals that just 17% (only a 3% increase from peer educators) of students choose the health service or professional counselors as their first choice. This validates the role of peer educators as referral agents on our campus. If many students are choosing to “tell their story” to other students first, it is a great way to get these peer educators to link the students wanting or needing help with the professional services on campus.
What Students Think About Alcohol Policies
Everyone knows that college students hate the alcohol policies on their campus and that the vast majority of students think they are far too strict, right? WRONG. Slightly more than two-thirds of students (67%) believe the alcohol policy was “about right.” About the same number of students thought the policies were too lenient (15%) as did those who thought the policies were too strict (17%).
It is interesting to note from the chart that there is a difference in opinion between male students and female students.