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.     

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.     

The use of protective behavioral strategies is related to reduced risk in heavy drinking college students with poorer mental and physical health

The present study examined the moderating role of health status (physical, mental, and social health) and the relationships between protective behavioral strategies utilized to reduce high-risk drinking (e.g., avoiding drinking games, setting consumption limits, or having a designated driver) and alcohol use and negative consequences in a sample of heavy drinking college students (N = 1,820). In this high risk sample, multiple regression analyses showed that stronger social health was related to increased drinking, while poorer physical, mental, and social health were related to increased alcohol negative consequences. Further, moderation effects revealed that increasing the use of protective behaviors was associated with significantly less drinking in those with stronger social health, as well as significantly lower numbers of negative consequences among participants with poorer physical and mental health. Implications for college counselors and medical personnel are discussed.     

Attitudinal and normative predictors of alcohol use by older adolescents and young adults

A model of alcohol use based on the theory of planned behavior, expectancy theory, and the developmental literature on the influence of parents and peers was examined with 87 eleventh grade students, 105 college freshmen, and 107 college juniors. Specifically, the influence of attitudes about the positive and negative consequences of drinking, perceived parental and peer norms about alcohol consumption, and perceived control over drinking predicted self-reported alcohol use. The results suggest that, during adolescence, decisions to consume alcohol are rational, based on the consideration of the positive consequences of alcohol use and perceptions of control over drinking; however, the negative consequences of alcohol use are discounted. While perceived peer norms predicted alcohol consumption in all three age groups, the influence of perceived parental norms varied such that they predicted alcohol use only among the college juniors. Implications and avenues for future research are discussed.     

Assessing University Students’ Self-efficacy to Employ Alcohol-Related Harm Reduction Strategies

Abstract

Objective: Develop and evaluate key psychometric properties of a self-report questionnaire specifically designed to assess student drinkers’ self-confidence to employ a variety of strategies intended to reduce unhealthy consequences of high-risk drinking. Methods: Four hundred ninety-eight participants rated their confidence (from “not at all confident” to “completely confident”) to employ 17 harm reduction strategies when drinking. Results: Factor analysis and internal consistency reliability analyses indicated that the 17 items constitute a single scale with good test–retest reliability. Consistent with other research examining previous use of such strategies, women in our sample reported significantly higher harm reduction self-efficacy than did men. Harm reduction self-efficacy was also associated with reported number of high-risk drinking episodes in the previous 2 weeks. Conclusion: This brief and easily administered questionnaire holds promise as a clinical tool to identify individuals with low harm reduction self-efficacy and as an outcome measure for health promotion and educational interventions.     

Protective Effects of Parent–College Student Communication During the First Semester of College

Abstract

Objective: Recent studies suggest that parents maintain influence as their adolescents transition into college. Advances in communication technology make frequent communication between parents and college students easy and affordable. This study examines the protective effect of parent–college student communication on student drinking behaviors, estimated peak blood alcohol concentration (eBAC), and serious negative consequences of drinking. Participants: Participants were 746 first-year, first-time, full-time students at a large university in the United States Methods: Participants completed a baseline and 14 daily Web-based surveys. Results: The amount of time spent communicating with parents on weekend days predicted the number of drinks consumed, heavy drinking, and peak eBAC, consistent with a protective within-person effect. No association between communication and serious negative consequences was observed. Conclusions: Encouraging parents to communicate with their college students, particularly on weekend days, could be a relatively simple, easily implemented protective process to reduce dangerous drinking behaviors.     

Differences in African American and White college students' drinking behaviors: consequences, harm reduction strategies, and health information sources

The authors explored the differences between African American and White college students' drinking behaviors and their attitudes toward consequences, harm-reduction strategies, and health information sources. They collected data from a randomly selected sample of 1,110 students in a large public university to examine the effects of a high-risk drinking prevention intervention. In the current analysis, they compared African American and White students on indicators of high-risk drinking, drinking consequences, harm-reduction strategies, the sources that students typically used for health information, and the believability of those sources. The African American students scored lower on drinking measures than the White students did, reported fewer negative consequences, and more regularly employed drinking-reduction strategies, with one exception--choosing a designated driver. Both African and White respondents reported that their parents were their most frequent and usual sources of health-related information and said that parents and health professionals were the most credible sources.     

Binge drinking in and out of college: An examination of social control and differential association on binge drinking behaviors between college students and their non-college peers

ABSTRACT

Excessive drinking behavior is a common problem on college campuses but it also affects the same age group that does not attend college. This is a sociological concern because of the multitude of negative consequences associated with binge drinking. The role of peers and social control factors, including the revised routine activities approach to involvement was used to examine what factors influence alcohol consumption. Although there are differences between the drinking behavior of both groups, peer behavior was consistently the strongest predictor of individual drinking behavior for both college and non-college students. Both groups are at risk for experiencing the negative consequences of alcohol use and reduction efforts need to target peer groups.     

Efficacy of a web-based, tailored, alcohol prevention/intervention program for college students: 3-month follow-up

This study presents the results of an efficacy evaluation of a web-based brief motivational alcohol prevention/intervention program called Michigan Prevention and Alcohol Safety for Students (M-PASS). Four on-line sessions providing individually-tailored feedback were delivered to first-year college students over 9 weeks. Non- and low-risk drinking participants received risk prevention, while high-risk drinking participants received a risk-reduction intervention. Both intervention and control groups were surveyed at baseline and at a 3-month follow-up. Analysis showed positive effects for both men and women on stage of change, drinking behavior, drinking motivation and attitudes, and use of risk-reduction strategies. These results provided evidence of efficacy and found that M-PASS had both intervention and prevention effects, making it unique among currently developed brief alcohol interventions for college students.     

Effectiveness of the Brief Alcohol and Screening Intervention for College Students (BASICS) Program With a Mandated Population

Abstract

Objective: This study evaluated the effectiveness of a large-scale intervention designed to reduce alcohol abuse among adjudicated college students. Participants: Participants were college students mandated to attend a Brief Alcohol Screening and Intervention for College Students (BASICS) program and a randomly selected comparison group of high-risk drinkers. Methods: Data were collected from January 2006 through December 2008. A total of 1,390 (67%) students in the intervention group and 508 (61%) students in the comparison group completed baseline and 6-month follow-up surveys. Results: Male students in the intervention group significantly decreased their drinking at follow-up, whereas those in the comparison group increased their drinking. Women in both the intervention and comparison groups decreased their drinking at 6 months. Conclusions: When implemented with fidelity, BASICS is a generally effective intervention, especially for male adjudicated college students. The intervention was most effective for moderate- and high-risk drinkers.     

Calorie Restriction on Drinking Days: An Examination of Drinking Consequences Among College Students

Objective: This study examined the association between restricting calories on intended drinking days and drunkenness frequency and alcohol-related consequences among college students.

Participants: Participants included a random sample of 4,271 undergraduate college students from 10 universities.

Methods: Students completed a Web-based survey regarding their high-risk drinking behaviors and calorie restriction on intended drinking days.

Results: Thirty-nine percent of past 30-day drinkers reported restricting calories on days they planned to drink alcohol, of which 67% restricted because of weight concerns. Restricting calories on drinking days was associated with greater odds of getting drunk in a typical week. Women who restricted were more likely to report memory loss, being injured, being taken advantage of sexually, and having unprotected sex while drinking. Men were more likely to get into a physical fight.

Conclusions: These results highlight the importance of considering weight control behaviors in the examination of high-risk college drinking.     

An Examination of Drinkers’ Consequences by Sexual Orientation

Abstract

Objective: This study examined college student drinkers by sexual orientation (SO), alcohol use, and negative consequences in a national sample that self-identified gender and SO. Participants: Students completing the Spring 2005 National College Health Assessment (N = 54,111). Methods: A secondary analysis was conducted examining student responses by SO to items regarding negative consequences associated with alcohol. Results: Bisexual students had the highest mean scores on an index of alcohol-related harm. Significant differences were found by SO among male high-risk drinkers for alcohol-related consequences of “fighting” and “injuring another,” and females for “injuring another” and “unprotected sex.” Bisexual students had significantly greater than expected cell counts for significant results, including a significant finding for bisexual low-risk female students for alcohol-related “regret.” Conclusion: These findings suggest that more research is necessary to discern real differences in alcohol-related risk among college students by sexual orientation.     

HEADS UP! A nested intervention with freshmen male college students and the broader campus community to promote responsible drinking

The National Institute on Alcohol Abuse and Alcoholism developed several guidelines for effective interventions in dealing with problematic college student drinking, including targeted individual interventions paired with broader campus community involvement. The project Heads UP! combines these suggestions in an effort to intervene with high-risk first-year male college students. The objective of the program is to reduce campus alcohol-related negative events and prevent these high-risk students from developing dangerous drinking patterns throughout college. The project provides an environment that supports students in actively following the goals outlined by the intervention, and it actively impacts the overall campus by helping students make responsible drinking decisions. Promising results are forthcoming, and the authors encourage other universities to design and adopt similar campus-supported programs nested within the broader campus community that target high-risk populations on campus.     

Selected health behaviors that influence college freshman weight change

OBJECTIVE AND PARTICIPANTS: The authors investigated the effect of physical activity (PA), fruit and vegetable intake, and alcohol use on 6-month weight change in 193 college freshmen (78.8% white, 88.2% women, 94.5% on a meal plan). METHODS: The authors administered a Web-based survey in fall 2002 (baseline) and spring 2003 (follow-up). RESULTS: There was an overall average weight gain of 2.5 lbs (p < .05), although only 57% reported weight gain (M = 7.1 lbs). Fruit and vegetable intake decreased (p = .034), alcohol use increased (p > .05), and PA was unchanged. Weight gain for students with body mass indexes (BMI) > or =25 kg/m2 was nearly twice that of students with BMIs < 25 (p < .05). Students with low-frequency baseline PA were twice as likely to be overweight. Follow-up data showed that students reporting > or = 4 sessions per week (ie, high frequency) of low-intensity PA were twice as likely to have healthy BMIs as students engaging in low- and moderate-frequency PA. CONCLUSIONS: PA interventions should target freshmen with BMIs > or = 25.     

Gender differences in predicting high-risk drinking among undergraduate students

The purpose of this study was to examine gender differences in college students' high-risk drinking as measured by an estimated blood alcohol concentration (eBAC) based on gender, height, weight, self-reported number of drinks, and hours spent drinking. Using a developmental/contextual framework, high-risk drinking is conceptualized as a function of relevant individual characteristics, interpersonal factors, and contextual factors regularly mentioned in the college drinking literature. Individual characteristics include race, gender, and age; interpersonal characteristics include number of sexual partners and having experienced forced sexual contact. Finally, contextual factors include Greek membership, living off-campus, and perception of peer drinking behavior. This study is a secondary data analysis of 1,422 students at a large university in the Southeast. Data were gathered from a probability sample of students through a mail survey. A three-step hierarchical logistic regression analysis showed gender differences in the pathway for high-risk drinking. For men, high-risk drinking was predicted by a combination of individual characteristics and contextual factors. For women, interpersonal factors, along with individual characteristics and contextual factors, predicted high-risk drinking, highlighting the importance of understanding female sexual relationships and raising questions about women's risk-taking behavior. Implications for prevention and assessment are discussed.     

Impact of perceived second-hand consequences related to alcohol use on college students' drinking behavior intent: a test of feasibility

This article presents the results of an experiment designed to determine the impact of a group discussion about second-hand consequences of alcohol use on college students' intentions to consume alcohol. Participants were students enrolled in two large Community Health courses at a large Midwestern university (n = 184). After randomization of class sections into an intervention or a control group, intervention group students participated in a class discussion on the negative consequences college students experience as a result of other students' drinking behavior, prior to answering survey questions regarding their drinking behavior intent. Compared to controls who completed the questionnaire only, intervention group participants reported intent to limit themselves to fewer drinks per drinking occasion (p = .003) and fewer drinks per week (p = .004). The effects of the brief educational intervention were analyzed using structural equation modeling, to test the feasibility of a hypothesized intervention mechanism.     

Heavy episodic drinking and college entrance

The college environment appears to encourage heavy drinking. Consequently, correlates of student drinking were assessed at college entrance. First-semester freshmen (N = 520, 54 percent women) completed self-report measures of social affiliation and self/peer drinking for high school and college. Analyses indicated that: 1) increased drinking at college entrance mirrored perceived increases by peers, 2) perceptions of peer drinking were robustly overestimated with women displaying the larger overestimation bias; and 3) social affiliation was associated with men's drinking and moderated its relation to perceived peer drinking at college entrance. These results advance understanding of the manner in which heavy drinking patterns emerge as men and women enter college, and campus programs that consider these factors may better promote health and reduce the harms associated with heavy drinking among college students.     

Preenrollment Immunization Policies of American Colleges: An Assessment of the Need for Policy Implementation

Abstract

Alcohol abuse among college students is prevalent, yet few instruments with sound reliability and validity are available to assess these problems in this population. As part of a large, baseline assessment battery for a prospective study of offspring of alcoholics, the 27-item Young Adult Alcohol Problems Screening Test (YAAPST) was given to 490 freshmen at a large mid western university; approximately 9 months later, 482 subjects completed the scale again. In addition to asking about such traditional problems as experiencing blackouts and driving while intoxicated, the YAAPST included specific items relating to college experiences (eg, getting into sexual situations that were later regretted, missing classes, and receiving lower grades than usual). The YAAPST was designed to assess these drinking consequences over two different time frames, lifetime and past year, and also to indicate the frequency of occurrence during the past year. Results indicated that the YAAPST is a unidimensional scale with good psychometric properties (good internal consistency and test-retest reliability). Three different approaches were used to demonstrate the validity of the YAAPST. Findings supported criterion validity (with interview-based alcohol abuse/dependence diagnoses as the criterion), concurrent validity (comparing the YAAPST with other drinking measures), and construct validity (correlating the YAAPST with etiologically relevant personality, motivational, and peer influence variables). The YAAPST is a promising screening instrument for alcohol problems in college students. It has excellent psychometric properties and the potential to provide a range of useful information to the clinician or researcher.     

My student body: a high-risk drinking prevention web site for college students

The authors investigated the efficacy of an interactive Web site, MyStudentBody.com: Alcohol (MSB:Alcohol) that offers a brief, tailored intervention to help heavy drinking college students reduce their alcohol use. They conducted a randomized, controlled clinical trial to compare the intervention with an alcohol education Web site at baseline, postintervention, and 3-month follow-up. Students were assessed on various drinking measures and their readiness to change their drinking habits. The intervention was especially effective for women and persistent binge drinkers. Compared with women who used the control Web site, women who used the intervention significantly reduced their peak and total consumption during special occasions and also reported significantly fewer negative consequences related to drinking. In addition, persistent heavy binge drinkers in the experimental group experienced a more rapid decrease in average consumption and peak consumption compared with those in the control group. The authors judged MSB:Alcohol a useful intervention for reaching important subgroups of college binge drinkers.     

Validation of a measure of college students' intoxicated behaviors: associations with alcohol outcome expectancies, drinking motives, and personality

OBJECTIVE: The authors aimed to develop a measure of college students' intoxicated behaviors and to validate the measure using scales assessing alcohol outcome expectancies, motives for drinking, and personality traits. PARTICIPANTS AND METHOD SUMMARY: The authors administered these measures and an inventory describing 50 intoxicated behaviors to 198 college students and conducted factor analysis on intoxicated behaviors. Logistic regression models examined relationships between intoxicated behavior dimensions and expectances, motives, and personality traits. RESULTS: Self-reported behaviors during intoxication episodes were reducible to 3 basic dimensions that formed reliable and valid scales: social, antisocial, and emotionally labile intoxication. CONCLUSIONS: Researchers can use the Intoxicated Behaviors Inventory to evaluate the effectiveness of interventions targeting drinking or to identify college students at risk for problematic consequences of alcohol use. In addition, results point to the need for community efforts to encourage more moderate drinking among college students.