Engaging communities to prevent underage drinking

Community-based efforts offer broad potential for achieving population-level reductions in alcohol misuse among youth and young adults. A common feature of successful community strategies is reliance on local coalitions to select and fully implement preventive interventions that have been shown to be effective in changing factors that influence risk of youth engaging in alcohol use, including both proximal influences and structural and/or environmental factors related to alcohol use. Inclusion of a universal, school-based prevention curriculum in the larger community-based effort is associated with the reduction of alcohol use by youth younger than 18 years of age and can help reach large numbers of youth with effective alcohol misuse prevention.     

Environmental Approaches to Prevention in College Settings

Because of concerns regarding drinking among college students and its harmful consequences, numerous prevention efforts have been targeted to this population. These include individual-level and community-level interventions, as well as other measures (e.g., online approaches). Community-level interventions whose effects have been evaluated in college populations include programs that were developed for the community at large as well as programs aimed specifically at college students, such as A Matter of Degree, the Southwest DUI Enforcement Project, Neighborhoods Engaging With Students, the Study to Prevent Alcohol-Related Consequences, and Safer California Universities. Evaluations of these programs have found evidence of their effectiveness in reducing college drinking and related consequences. The most effective approaches to reducing alcohol consumption among college students likely will blend individual-, group-, campus-, and community-level prevention components.     

Using the NIAAA brief alcohol screener in social work practice for selected prevention targeting youth

ABSTRACT

This article discusses the use of brief screeners in social work practice to identity adolescents in need of selected interventions for alcohol and other drug use problems. Brief screeners can increase access to alcohol or other drug intervention services and promote the diffusion of evidence-based interventions to underserved communities when integrated in Screening, Brief Intervention, and Referral to Treatment (SBIRT) initiatives. The two-item NIAAA Brief Alcohol Use Screener is discussed as a developmentally tailored assessment tool that can be integrated into SBIRT in social work practice to improve detection of early-stage alcohol problems among adolescents who lack routine access to preventative health care. The use of brief, empirically supported alcohol screeners in trainings for social work students and new professionals can enhance their preparation and competence to offer child and adolescent clients appropriate selected intervention options to reduce harms associated with underage alcohol use.     

Building,Engaging, and Sustaining a Continuum of Care From Harm Reduction to Recovery Support: The Rutgers Alcohol and Other Drug Assistance Program

Since 1983, the focus of the Rutgers Alcohol and Other Drug Assistance Program (ADAP) has been developing policies, training staff to identify students at risk, developing and implementing evidence-based screening and brief interventions, providing short-term counseling by professionals trained in alcohol and other drug abuse to assist students beyond brief interventions, identifying effective treatment for college students, developing a campus recovery program, on-campus recovery housing, and other supports for students in recovery. This article presents a case study of the Rutgers ADAP program, of building and sustaining a program committed to engaging students in both evidence-based risk reduction interventions and an on-campus recovery community given their stage of change and motivation to make changes. Historical milestones are described as part of a creative model for intervention. We identify the challenges of integrating substance abuse recovery into campus mental health programs, and of integrating recovery into other university communities.     

Social Service Research and Religion

Abstract

Development of accountability standards to demonstrate cause and effect relationships are gaining rapid advancement in the field of social sciences. Many governmental agencies, foundations, and other funders have developed approaches that require organizations to utilize science-based programs and incorporate evaluative methods to show improved outcomes and cost benefits to society. This article will examine the need for increased accountability in developing effective interventions by faith-based organizations in the delivery of social service interventions. Recently, there has been a strong movement toward governmental funding for faith-based institutions to provide social services, although there has been inadequate scientific data to demonstrate that approaches implemented are effective in meeting needs or yielding favorable outcomes. Similarly, many faith-based organizations provide innovative and effective programs that could serve as model programs if there was appropriate empirical evidence. This article will discuss how rigorous evaluative approaches such as randomized clinical control trials can produce scientific data on program effectiveness. We will use a case example in the field of drug and alcohol treatment to illustrate these points.     

A multi-level analysis of school racial composition and ecological correlates of academic success

Current policy and practice interventions have failed to address disparities in academic success by race/ethnicity or socio-economic status. In addition, as policy interventions to prevent racially segregated schools have stalled, progress toward reducing these achievement gaps has also slowed. This exploratory study employs multi-level modeling to examine how risk and protective factors in students' schools, homes, peer groups, and neighborhoods relate to behavior and academic performance. We examine whether these relationships depend on the racial composition of the school and, in particular, the concentration of African American students in schools. The findings indicate that protective school, home, peer group, and neighborhood environments characterized by social support and safety are associated with positive academic outcomes and behavior. Students attending more segregated schools in which the majority of students are African American report worse behavioral and academic outcomes than students in other schools, even when controlling for other important dimensions of the school environment, school climate, school safety, and poverty. In addition, school racial composition shapes how key protective factors relate to grades.     

The Efficacy of the Social Norms Approach to Substance Abuse Prevention Applied to Fraternity Men

Abstract

Students tend to overestimate the amount of alcohol consumed among their peers and often drink to that imaginary level. The social norms strategy, designed to correct norm misperceptions, has been correlated with a decrease in reported consumption in the general college population. However, it has had little or no impact among Greek students, the group that consumes the most alcohol. The authors investigated and subsequently found three possible flaws in the application of the social norms strategy that may account for the failure to decrease binge drinking among fraternity men: there is no predominant, healthy drinking norm in this population; students are influenced more by people within their network(s) than by others; and binge drinking is the norm in this group and may serve to perpetuate the problem. The findings, though preliminary, provide the first step in developing interventions beyond the social norms approach to address binge drinking among fraternity men.     

The efficacy of the social norms approach to substance abuse prevention applied to fraternity men

Students tend to overestimate the amount of alcohol consumed among their peers and often drink to that imaginary level. The social norms strategy, designed to correct norm misperceptions, has been correlated with a decrease in reported consumption in the general college population. However, it has had little or no impact among Greek students, the group that consumes the most alcohol. The authors investigated and subsequently found three possible flaws in the application of the social norms strategy that may account for the failure to decrease binge drinking among fraternity men: there is no predominant, healthy drinking norm in this population; students are influenced more by people within their network(s) than by others; and binge drinking is the norm in this group and may serve to perpetuate the problem. The findings, though preliminary, provide the first step in developing interventions beyond the social norms approach to address binge drinking among fraternity men.     

Social norms approaches using descriptive drinking norms education: a review of the research on personalized normative feedback

College students have been shown to consistently overestimate the drinking of their peers. As a result, social norms approaches are effective in correcting these misperceived norms to reduce alcohol consumption and alcohol-related problems. In this review of literature, the authors critically evaluated the effectiveness of personalized normative feedback. In addition, the authors reviewed personalized normative feedback interventions and provided suggestions for increasing the efficacy of these interventions by making better use of salient referent group data.     

A systematic review of evidence-based interventions for students with challenging behaviors in school settings

The author's systematic review of 2,294 articles from 10 journals in the fields of education, special education, school social work, school psychology, and school counseling identified 42 articles meeting search criteria of addressing evidence-based interventions for students with challenging behaviors in school settings. Interventions were considered evidence-based if they were (a) manualized or structured to facilitate replication; (b) evaluated with an experimental design; and (c) demonstrated to be effective. Current practices available to address students who require evidence-based interventions for challenging behaviors are summarized. Suggestions for intervention development to address the needs of students with difficult behaviors are offered.     

Sexual violence victimization among female secondary school students in eastern Ethiopia

Behavioral, lifestyle, and relationship factors have all been identified as risk factors that increase a woman's vulnerability to sexual violence victimization. However, it remains unclear which risk factors most strongly increase young women's vulnerability to sexual violence victimization because most studies only examine a few factors simultaneously. Using a cross-sectional sample of 764 female secondary school students from eastern Ethiopia, multivariate analyses revealed that high-rejection sensitivity, having multiple sexual partners, the frequent watching of pornography, and use of alcohol or other soft drugs (Khat or shisha) are factors associated with higher levels of sexual violence victimization. The overall rates of victimization is high in this group, with 68% of the young women studied having experienced at least one instance of sexual violence victimization. Based on type of sexual perpetration, 52% of the young women were victimized by at least one instance of sexual offence, 56% by sexual assault, 25% by sexual coercion, and 15% by sexual aggression. Qualitative data gathered from interviews of extracurricular club members and school officials and focus group discussion with students were used to further augment and illustrate results from the quantitative data. Several suggestions for intervention are presented in light of these results.     

Results of a social norm intervention to prevent binge drinking among first-year residential college students

The effects of a primary prevention social norm intervention on binge drinking among 1st-year residential college students were examined. Six hundred thirty-four students attending a medium-sized public university in the South were randomly assigned to receive a two-phase social norm intervention or the standard campus psychoeducational prevention program. At posttest, no differences were found between intervention and control group students on any of the alcohol use and alcohol-use risk factor measures. Significant subgroup differences were found by stage of initiating binge drinking behaviors, for frequency of alcohol use, F(3, 507) = 3.69, p = .01; quantity of alcohol use, F(3, 507) = 2.51, p = .05; and social norms, F(3, 505) = 2.53, p = .05. These findings suggest the need for tailoring social norm binge drinking interventions to students' stage of initiating heavy drinking and carefully monitoring for potential negative, as well as positive, effects of norm-based prevention messages.     

Efficacy of interventions targeting alcohol,drug and smoking behaviors in university and college students: A review of randomized controlled trials

Objective: To evaluate the effectiveness of interventions targeting alcohol consumption, drug use and smoking for college/university students.Participants: College/University students.Methods: Studies were eligible if: (1)included students attending universities/colleges; (2)implemented in a university/college setting; (3)aimed to improve at least one of the following behaviors: alcohol and/or drug use and/or smoking; (4)were RCTs. The effect of the interventions on behaviors was determined by the percentage of studies that reported an effect. Due to the heterogeneity of outcomes meta-analysis was not conducted.Results: 88 studies met criteria. University-based interventions were effective for reducing alcohol-related outcomes (drinking patterns, BAC, consequences, problem drinking). Inconsistent findings for drug and smoking were observed.Conclusions: University-based interventions have the potential to improve health for students. While there is a breadth of research examining the efficacy of interventions to reduce alcohol consumption, further research is needed to determine the best approach for addressing smoking and drug use among students.     

Social skills, competence, and drug refusal efficacy as predictors of adolescent alcohol use

Numerous alcohol and drug abuse prevention trials have included social resistance training as a strategy for reducing early-stage adolescent alcohol use. Evaluations of these trials has shown them to be moderately effective, although the precise impact of the resistance training in comparison to other programmatic features has not been clearly identified. The current study examined the extent to which assertiveness and related social skills, personal competence (perceived cognitive mastery), and refusal efficacy predict alcohol involvement. Males were at greater risk for poor refusal skills and reported higher alcohol involvement. Cross-sectionally, youth characterized by poor social skill development reported lower refusal efficacy, lower grades, poor competence, and more alcohol use. Poor refusal efficacy was associated with more risk-taking, lower grades, less competence, and more alcohol use. Longitudinally, both poor refusal skills and risk-taking were associated with higher alcohol use. High personal competence was associated with lower alcohol use in both the eighth and tenth grades, but had no long-term effects on alcohol use. Findings highlight the close interplay between perceived competence and refusal skill efficacy, both of which should be included as essential components of school-based prevention strategies.     

Predictors of Alcohol Use among College Students in New York State

Abstract

The prevalence and correlates of alcohol and other drug use were determined for students attending colleges in New York State. The New York State Division of Substance Abuse Services selected a representative sample of approximately 7,700 undergraduate students randomly selected from 22 colleges. Students were given a 10-page questionnaire dealing with patterns of alcohol and other drug use. The vast majority of both males and females reported alcohol use in the past 30 days; however, males (28%) were twice as likely as females (15%) to be classified in the heavier drinking category. White college students (25%) are far more likely to be heavier drinkers than are black students (5%) even after other factors are taken into account. Students attending colleges in Upstate New York areas (24%) have higher rates of heavier drinking than do those in New York City (15%). Multivariate statistical analyses were done to determine the relative importance of various social factors in determining drinking behavior.     

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.     

Social Networks,Substance Use,and Mental Health in College Students

Abstract

Objectives: The relationship between social network risk (alcohol-using close friends), perceived peer closeness, substance use, and psychiatric symptoms was examined to identify risk and protective features of college students’ social context. Participants: Six hundred and seventy undergraduate students enrolled in a large southeastern university. Methods: An online survey was administered to consenting students. Results: Students with risky networks were at a 10-fold increase of hazardous drinking, 6-fold increase for weekly marijuana use, and 3-fold increase for weekly tobacco use. College students’ who feel very close to their peers were protected against psychiatric symptoms yet were at increased risk for marijuana use. Perceived closeness of peers was highly protective against psychiatric symptoms, adding a natural preventive effect for a population at great risk for mental illness. Conclusions: Results support targeting college students through network-oriented preventive interventions to address substance use as well as mental health.     

Alcohol Education Project: Preliminary Answers

Abstract

The goal of the five year University of Massachusetts (UMass) Demonstration Alcohol Education Project has been to promote responsible decision making about alcohol use. The UMass/Amherst campus has 25,000 students, of which there is an approximate one third turnover every academic year. Educational methods used to achieve the goal have included community development, mass media, and such intensive approaches as workshops, courses, and guest lectures. Mass media reaches up to 70% of the student body, while intensive interventions reach about 5%.

Data has been gathered from a large number of sources in order to evaluate the following objectives: 1) University students will demonstrate decreased inappropriate alcohol consumption patterns. 2) University students will demonstrate an increased level of planning, conducting, and participation in responsible social activities. 3) University students will demonstrate an increased number of interventions with peers around alcohol issues. 4) University students will demonstrate a decrease in peer pressures which contribute to inappropriate alcohol use among their peers. 5) Key people within the university community will demonstrate an increase in behavior which encourages responsible decisions about alcohol.

Analysis of the program model indicates the initial assumptions were generally valid. For example, predisposing factors such as attitudes toward drinking, and certain demographics are in fact predictors of contexts and quantity and frequency of drinking, which are in turn predictors of negative consequences. Preliminary results from the data collected indicate significant changes in knowledge, but no significant change in individual behavior for the parameters measured. There are indications of trends toward changes in party giving behaviors and heightened alcohol awareness in certain dormitories. Additionally, the university community designed and adopted a set of guidelines for interpretation of the trustees' policy on consumption of alcoholic beverages on campus. The guidelines were designed to be social and educational in nature; their impact was confounded when the minimum drinking age for the state was raised to 20.     

Social Capital and Adolescent Substance Use: The Role of Family,School, and Neighborhood Contexts

This study assesses the link between social capital factors of norm‐setting social arenas including family, school, and neighborhood and adolescent substance use measured by cigarette smoking, alcohol consumption, and illicit drug use among a sample of adolescents in California. The key messages of this study are that socialization processes at different life domains, in varying degrees, are associated with adolescent substance use behavior. Compared with school and neighborhood contexts, family is the most influential setting that should be primarily targeted for youth substance use prevention. Among different aspects of within‐family social resources, parental monitoring seems to be the most protective of adolescent substance use. Study implications on family‐based interventions are discussed.     

Heavy alcohol use compared to alcohol and marijuana use: do college students experience a difference in substance use problems?

This study examines the risk for alcohol and other drug (AOD) problems resulting from alcohol plus marijuana use compared to alcohol-only use. Data are from telephone interviews with 1113 randomly selected college students attending two large urban universities in the southwestern United States. Alcohol and marijuana users (dual users) were more likely to be younger and report a higher mean number of drinks per occasion and experiencing all AOD problems studied compared to alcohol-only users. Multivariate logistic regression analysis findings reveal the relationship between dual-substance use and increased risk for AOD problems remained after controlling for demographics and alcohol use behaviors. Such problems include greater odds of legal problems and riding with or being an intoxicated driver. College students using alcohol and marijuana are at much higher risk for AOD problems than are students who use alcohol only, even when heavy drinking is taken into account.