Preventing Alcohol Use Among Urban American Indian Youth: The Seventh Generation Program

SUMMARY

In comparing alcohol use between American Indian and non-Indian youth, the age at first involvement with alcohol is younger, the frequency and amount of drinking are greater, and negative consequences are more common for Indians. This article presents the results from the first phase of an innovative alcohol prevention program targeting urban Indian youth. Urban Indian youth were chosen as the participants since the majority of the roughly two million American Indians now live in urban areas. The Seventh Generation Program described in this article is unique in that it blends mainstream prevention approaches with American Indian culture to produce a program that is culturally sensitive to and appropriate for the urban Indian community in which it was developed. A quasi-experimental research design was used to evaluate the Generation Program.     

Unplanned Sexual Activity as a Consequence of Alcohol Use: A Prospective Study of Risk Perceptions and Alcohol Use Among College Freshmen

Objective: The authors' goal was to show how risk perceptions regarding unplanned sexual activity following alcohol use are prospectively related to subsequent alcohol consumption.

Participants: Undergraduate students (N = 380) completed questionnaires at 2 time points during their freshman year. Methods: In the middle of the academic year (T1), students estimated their risk of engaging in unplanned sex and reported their alcohol use during the previous term. Four months later (T2), they again reported alcohol use and indicated whether they had engaged in unplanned sex since T1. Results: Students who consumed more alcohol at T1 rated their risk of unplanned sex more highly, suggesting relative accuracy. Those with higher risk perceptions consumed more alcohol at T2 (controlling for T1 use), suggesting that they maintained the high-risk behavior. Last, those who were unrealistically optimistic (ie, estimated low risk at T1 yet had unplanned sex by T2) reported greater alcohol use at T2. Conclusions: These findings highlight the role that risk perceptions regarding sexual activity may play in college students' alcohol use.     

The Culture of High-Risk Alcohol Use Among Club and Intramural Athletes

Abstract

Objective: The purpose of this study was to examine the drinking patterns of club and intramural college athletes and compare their alcohol consumption, perceived norms around the excessive use of alcohol, experience of negative consequences, and employment of protective strategies with those of campus varsity athletes. Participants: A total of 442 undergraduate students attending a private, suburban institution in the Northeast participated in the American College Health Association National College Health Assessment-II Web survey in spring 2011. Thirty-five students identified themselves as varsity athletes, 76 identified as club sport athletes, and 196 students identified themselves as intramural athletes. Methods: Survey responses were analyzed using Statistical Package for the Social Sciences. The Pearson's correlation coefficient and test for independence were applied to identify significant relationships between athlete status and identified variables related to alcohol use. Results: Results indicated that there were significant correlations between athlete status and all variables, to varying degrees. Conclusions: These findings have implications for campus health promotion professionals and athletics program coordinators seeking to address high-risk alcohol use among college athletes.     

Effectiveness of a Web-based Alcohol-Misuse and Harm-Prevention Course Among High- and Low-Risk Students

Objective: In the current study, the authors assessed whether a new online alcohol-misuse prevention course (College Alc) is more effective at reducing alcohol use and related consequences among drinkers and nondrinkers. Participants: The authors compared incoming college freshmen who reported any past 30-day alcohol use before the beginning of the semester with those who did not. Method Summary: The authors randomly assigned students who completed a precollege baseline survey to either complete a 3-hour noncredit version of College Alc or serve as members of a control group. The authors conducted a follow-up survey 3 months later. Results: Findings indicated that among freshmen who were regular drinkers before college, College Alc appeared to reduce the frequency of heavy drinking, drunkenness, and negative alcohol-related consequences. Among freshmen who did not report any past-30-day alcohol use before college, College Alc did not appear to have any beneficial effects. Conclusions: Results suggest that College Alc may be an effective program for students with a history of alcohol use.     

Screening for Alcohol Problems Among 4-Year Colleges and Universities

Abstract

Objective: To assess the use of alcohol screening tools across US colleges. Participants: Directors of health services at 333 four-year colleges. Methods: An online survey was conducted regarding the use of alcohol screening tools. Schools reporting use of formal tools were further described in terms of 4 tools (AUDIT, CUGE, CAPS, and RAPS) that the authors judged to be the most favorable based on prior empirical comparative studies. Results: Forty-four percent of colleges reported use of at least 1 formal alcohol screening tool and nearly all of these used a tool appropriate for college students. However, less than half of the 44% of colleges that used a screening tool used 1 of the 4 most favorable tools. Conclusions: Continued efforts are needed to encourage colleges to use the most effective available screening tools to identify alcohol-related problems that require intervention among students.     

Evidence-Based Social Work Practice with Mentally Ill Persons who Abuse Alcohol and Other Drugs

Abstract

The current article outlines a comprehensive approach to evidence-based social work practice, and applies it to persons with severe and persistent mental illness who also abuse alcohol and other drugs. Representative empirical literature is summarized within a framework that delineates the three major functions of evidence-based social work practice: assessment, intervention and evaluation. Assessment protocol, which incorporates the use of valid scales to complement the qualitative interview, is based on domain-specific research that outlines relevant psychosocial risk factors, and highlights those that are amenable to change. Intervention strategies are derived from the growing body of controlled research findings, but flexibility in implementation is recommended to accommodate clients' individual needs and the vagaries of daily practice. Naturalistic evaluation methods are used to capitalize on the use of brief, valid process and outcome measures to augment individual qualitative evaluation and to aggregate data for program evaluation. The implications of this integrated evidence-based strategy for social work practice are discussed.     

What Colleges Are Doing About Student Binge Drinking A Survey of College Administrators

Abstract

In 1999, the Harvard School of Public Health College Alcohol Study surveyed 734 US college administrators to learn what colleges were doing to prevent binge drinking. Respondents rated the severity of student alcohol-abuse problems and described prevention efforts and institutional investments in prevention infrastructure. Prevention practices were widespread in the areas of general education about alcohol, use of policy controls to limit access to alcohol, restricting advertising at home-game sporting events, and allocation of living space to alcohol-free dormitories. Programming was less prevalent for more targeted alcohol education, outreach, and restrictions on alcohol advertising in campus media. Nationally, most of the surveyed colleges reported having a campus alcohol specialist, many had task forces, and about half were performing in-house data collection. Less common were program evaluations, community agreements, or neighborhood exchanges. Prevention practices varied with institutional characteristics and the surveyed administrators' perceptions of the severity of alcohol problems.     

Pilot of a Computer-Based Brief Multiple–Health Behavior Intervention for College Students

Abstract

Objective: Given the documented multiple health risks college students engage in, and the dearth of effective programs addressing them, the authors developed a computer-based brief multiple–health behavior intervention. This study reports immediate outcomes and feasibility of a pilot of this program. Participants: Two hundred students attending a midsized university participated. Methods: Participants were randomly assigned to the intervention or control program, both delivered via computer. Immediate feedback was collected with the computer program. Results: Results indicate that the intervention had an early positive impact on alcohol and cigarette use intentions, as well as related constructs underlying the Behavior-Image Model specific to each of the 3 substances measured. Based on the implementation process, the program proved to be feasible to use and acceptable to the population. Conclusion: Results support the potential efficacy of the intervention to positively impact behavioral intentions and linkages between health promoting and damaging behaviors among college students.     

Risk Factors for Alcohol Use in the United States, 1947–2005

ABSTRACT

National public opinion polls that were conducted from 1947 to 2005 found that Americans' reported alcohol consumption remained fairly constant. Although alcohol use has remained consistent, the findings reveal that consumption levels vary by age, gender, race, ethnicity, and socioeconomic status. The results also show an increase in the number of reported problems within families that are due to excessive alcohol consumption. This article examines the differences in alcohol consumption levels related to these various demographic factors and explores the impact of alcohol use among families and implications for social work practice.     

Exploring the Relationship Between Experiential Avoidance,Alcohol Use Disorders,and Alcohol-Related Problems Among First-Year College Students

Abstract

Objective: This study explored the relationship of experiential avoidance (eg, the tendency to avoid, suppress, or otherwise control internal experiences even when doing so causes behavioral harm) to alcohol use disorders and alcohol-related problems. Participants: Cross-sectional data were collected from 240 undergraduate college students in their first year in college between December 2009 and April 2010. Methods: Participants completed a diagnostic interview and online self-report survey. Results: Students with a history of alcohol abuse or dependence had significantly higher levels of experiential avoidance relative to students with no alcohol use disorder diagnosis. A hierarchical linear regression analysis found that experiential avoidance significantly predicted alcohol-related problems, even after controlling for gender and psychological distress. Furthermore, experiential avoidance mediated the relationship of psychological distress to alcohol-related problems. Conclusions: These findings suggest that experiential avoidance may play a role in problematic alcohol use among college students.     

An analysis of the sexual health and safety information study abroad directors present their students prior to departure

Abstract

Objective: Study abroad students engage in problematic alcohol use, risky sexual activity, and maintain high risk for sexual assault; however, there is a lack of information about relevant prevention practices in study abroad programs. The purpose of this project was to understand the health and safety behaviors (HSBs) discussed with students prior to departure. Method: A total of 143 study abroad program directors from the U.S. completed an online survey, including demographics of the program director and institution, and questions about the HSBs discussed with students. Results: Chi-square analyses revealed that discussions of HSBs rarely differed by institution size or location; however, all HSBs were more likely to be discussed by directors administering programs with higher enrollment. Conclusion: Study abroad directors provide some basic information on sexual health to their students; however, more work is needed to ensure students are informed and attending to information about potential health risks prior to traveling abroad.     

A content analysis of sexual health and substance use information presented on study abroad websites: Findings and recommendations

Abstract

Objective: Despite study abroad students frequently engaging in risky behaviors, there is a dearth of research exploring prevention efforts taken by study abroad programs. The goal of this project was to examine information presented on study abroad program websites regarding sexual assault, alcohol use, drug use, and risky sexual behavior. Participants: A total of 753 universities in the US were selected from the Carnegie Classification of Institutes database. Method: Coders evaluated the website of each institution’s study abroad program for the presence of information about the four factors of interest. Results: Sixty-seven percent of the websites provided no information on any of these risk behaviors. Chi-square analyses revealed institutional demographic differences in the presentation of prevention information. We also identified three emerging themes about avenues for modifying website content. Conclusion: Study abroad programs can provide more detail and action oriented information on their websites for students.     

Substance Abuse in Lesbian,Gay, Bisexual,and Transgender Communities

Abstract

This article calls attention to the lack of knowledge concerning alcohol and other drug (AOD) use in lesbian, gay, bisexual, and transgender populations. Twenty-five Internet Web sites related to the LGBT substance use are reviewed.     

Rates of Asymptomatic Nonurethral Gonorrhea and Chlamydia in a Population of University Men Who Have Sex With Men

ABSTRACT

Objective: To evaluate a text message (SMS) program as a booster to an in-person alcohol intervention with mandated college students. Participants: Undergraduates (N = 224; 46% female) who violated an on-campus alcohol policy over a 2-semester period in 2014. Methods: The SMS program sent drinking-related queries each Thursday and Sunday and provided tailored feedback for 6 weeks. Response rates to SMS drinking-related queries and the associations between weekend drinking plans, drinking-limit goal commitment, and alcohol consumption were examined. Gender differences were explored. Results: Ninety percent of SMS queries were completed. Weekend binge drinking decreased over 6 weeks, and drinking-limit goal commitment was associated with less alcohol consumption. Compared with women, men had greater reductions in alcohol consumption when they committed to a drinking-limit goal. Conclusions: Preliminary evidence suggests that an SMS program could be useful as a booster for helping mandated students reduce weekend binge drinking.     

A Preliminary Exploration of Immigrant Substance Abusers from the Former Soviet Union Living in Israel,Germany and the United States: A Multi-National Perspective

SUMMARY

The Former Soviet Union (FSU) has historically been seen as having an unusually large population of individuals with alcohol problems. Since the fall of the communist regime, a growing drug abusing population has become visible. With the large migration of its residents to western countries and to Israel, the rates of alcohol and drug problems among these immigrants appear to be disproportionally high, although reliable data are lacking. The purpose of this article is to summarize exploratory data regarding alcohol and other drug use among immigrants from the Former Soviet Union living in Israel, Germany and the United States, and to identify further research needs and implications for treatment and policy.     

Referent Group Proximity,Social Norms,and Context: Alcohol Use in a Low-Use Environment

Abstract

Objective: The purpose of this study was to investigate the relationship between perceived normative use of alcohol and reported consumption in an environment where relatively little alcohol use occurs. Participants: A total of 585 undergraduate students completed an online survey on alcohol use in March 2006. Methods: Participants reported personal alcohol use and perceptions of use by “friends,” “the average student,” and “the average student who drinks.” Results: Due to the large number of students reporting zero alcohol use, zero-inflated negative binomial regression was used to analyze the data. Results showed that perceptions of use and beliefs about the acceptability of use by proximal groups were strongly and positively correlated with personal alcohol use. Perceptions of distal groups were either not correlated or were correlated negatively with personal use. Conclusion: These findings suggest that the use of distal referent groups for a social norms campaign in a low-use environment may have paradoxical effects.     

Oral Cancer Risk Behaviors Among Indiana College Students: A Formative Research Study

Objectives: In fall 2004, the authors used a survey to assess the knowledge, attitudes, motivations, and behaviors of college students relative to oral cancer prevention to inform development of targeted prevention programming. Participants: A convenience sample of 1,003 undergraduate students at one public university in Indiana participated. Methods: Discriminant function analysis was employed to analyze participants' motivations; perceived risks; individuals who influence participants' alcohol, tobacco, and marijuana use; and factors that facilitate and discourage use. The study sample was divided into users and nonusers to differentiate between groups and predictor (discriminating) variables. Multiple regression analysis was used to determine the extent to which participants' knowledge, attitudes, peer perceptions, sex, age, and ethnicity contributed to participants' combined alcohol, tobacco, and marijuana use behaviors. Results: With 2 exceptions, discriminant function analysis (p < .01) correctly categorized user status (ie, nonusers vs combined users of alcohol and cigarettes; nonusers vs combined users of alcohol, cigarettes, and marijuana) by the predictor variables. Multiple regression analysis to determine whether independent variables predicted combined drug use generated significant (p < .01) results across all combined use behaviors. Conclusions: Multiple oral cancer prevention program options along with additional formative research efforts were suggested by study results.     

Longitudinal Evaluation of Peer Health Education on a College Campus: Impact on Health Behaviors

Objective: The authors investigated the longitudinal impact of peer health education on the health behaviors of undergraduate students pertaining to alcohol and drug use, eating and nutrition, and sexual health. Participants: From fall 2003 to spring 2006, the authors annually administered a Web-based survey to a cohort of 2,000 randomly selected undergraduate students. Results: Students who had contact with peer health educators were significantly more likely over time than other students to report less alcohol consumption and fewer related negative consequences. Results also show that students who had contact with peer health educators initially endorsed engaging in unhealthy weight management and fat talk behaviors during their first year but decreased these unhealthy behaviors by their third year. No significant differences in sexual health behaviors were found. Conclusions: Results indicate that peer health educators play an important role in promoting healthy behaviors in the areas of alcohol and drug use and in eating and nutrition.     

Patients' Evaluations of Gynecologic Services Provided by Nurse Practitioners

Abstract

The development, operating principles, and users' evaluations of a broad-based gynecologic program emphasizing effective birth control on a university campus are discussed. A major feature that is explored is the use of nurse practitioners as the primary service providers. The forces that resulted in the formation of the program and the methods used to enhance its effectiveness are described. The evaluations of 3,527 users over a three-year period are indicated by summarizing responses to a questionnaire covering the following topics; whether providing such a service was helpful, likelihood of arranging for the service elsewhere if unavailable at the health center, attitudes of staff, medical procedures used, availability of services, and the opportunity to thoroughly discuss concerns. The evaluations were seen as extremely supportive of both the program and the use of nurse practitioners in this setting.