A review of social host policies focused on underage drinking parties: suggestions for future research

Underage drinking continues to be a public health concern, partially due to the ease in which adolescents obtain alcohol and consume it in private locations. States and municipalities have implemented strategies to counteract this, including adopting public policies called social host policies, despite limited evidence of effectiveness. Traditionally, these laws have held adults accountable for furnishing alcohol to underage drinkers. However, states and communities are using another policy, also called social host, to deter underage drinking parties where easy access to alcohol and high-risk use occurs. These innovative laws hold individuals who control the property accountable for underage drinking that occurs there, regardless of alcohol source. We conducted a critical analysis of social host policies focused on hosting underage drinking parties and constructed a conceptual model to understand their targeted factors. Future research recommendations are discussed.     

A randomized test of a small-group interactive social norms intervention

Social norms interventions are a common approach to addressing the problem of college student drinking. An increasingly popular but not yet well-validated social-norms-based intervention consists of providing normative feedback to students in small groups. OBJECTIVE, PARTICIPANTS, AND METHODS: In this study, the authors used a randomized design to test an interactive form of small-group social norms correction with 502 first-year students during September and October 2001. Because the unit of random assignment was at the level of the classroom, the authors used hierarchical linear modeling to estimate variability. They investigated whether small-group interactive social norms correction could influence alcohol perceptions and behaviors above and beyond a noninteractive social norms education approach. RESULTS: Results indicate that the approach has a fairly substantial influence on student perceptions; however, the findings do not support an influence of interactive small-group social norms correction on measures of alcohol use behaviors. CONCLUSIONS: Given these findings, the use of interactive small-group social norms approach to influence student misperceptions may be considered as a primer for population-level preventive interventions.     

Social norms theory-based interventions: testing the feasibility of a purported mechanism of action

Social norms-based interventions targeting college student drinking behaviors have become increasingly popular. Such interventions purportedly modify student misperceptions of fellow student drinking behaviors, which leads to changes in individual drinking behavior. Despite claims of successful interventions, research demonstrating that social norms-based interventions modify student perceptions is lacking. OBJECTIVE: The authors conducted a laboratory experiment examining the feasibility of this mechanism of action and aimed to determine the validity of the campus-specific drinking norms hypothesis. PARTICIPANTS AND METHODS: The authors randomly assigned 60 students to 1 of 3 research conditions: Alcohol 101 (national drinking norms), a didactic presentation of campus specific drinking norms, or a control condition. RESULTS: Both intervention groups modified student misperceptions regarding peer alcohol use, and these changes were sustained 1 week later. CONCLUSIONS: Social norms-based interventions can contribute to more accurate drinking perceptions among college students.     

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.     

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.     

Sleep Quality and Alcohol Risk in College Students: Examining the Moderating Effects of Drinking Motives

Abstract

Objective: Sleep problems and alcohol misuse are common issues experienced by college students that can have detrimental effects on overall health. Previous work indicates a strong relationship between poor sleep quality and alcohol risk in this population. This study explored the moderating effect of drinking motives in the relationship between global sleep quality and experience of alcohol-related negative consequences. Participants: College students (N = 1,878) who reported past-month drinking. Methods: Participants completed online surveys assessing sleep and alcohol-related behaviors. Results: Poorer sleep quality and higher drinking motives (coping, conformity, and enhancement) predicted greater alcohol-related consequences, controlling for drinking. Further, coping motives moderated the relationship between sleep quality and consequences such that participants reporting poor sleep and high coping motives experienced heightened levels of consequences. Conclusions: These findings advance the understanding of the relationship between sleep problems and alcohol-related risk and provide implications for targeted campus-based health promotion interventions.     

Alcohol-related fan behavior on college football game day

High-risk drinking on game day represents a unique public health challenge. OBJECTIVE: The authors examined the drinking behavior of college football fans and assessed the support for related interventions. PARTICIPANTS: The authors randomly selected 762 football fans, including college students, alumni, and other college football fans, to complete an anonymous online game-day survey. METHODS: The authors collected data on participants' drinking behaviors and support for specific game-day interventions. RESULTS: Analysis revealed that, overall, fans drank significantly more on game day than they did the last time they partied or socialized. Nondrinkers were the most supportive of game-day interventions, followed by moderate drinkers, whereas heavy drinkers offered the least support. CONCLUSIONS: With the exception of limiting tailgating hours on game day, fans support game-day interventions, including alcohol-free alternatives, designating tailgating areas where open containers are permitted, and increasing law enforcement efforts.     

Social Norms Theory-Based Interventions: Testing the Feasibility of a Purported Mechanism of Action

Social norms-based interventions targeting college student drinking behaviors have become increasingly popular. Such interventions purportedly modify student misperceptions of fellow student drinking behaviors, which leads to changes in individual drinking behavior. Despite claims of successful interventions, research demonstrating that social norms-based interventions modify student perceptions is lacking. Objective: The authors conducted a laboratory experiment examining the feasibility of this mechanism of action and aimed to determine the validity of the campus-specific drinking norms hypothesis. Participants and Methods: The authors randomly assigned 60 students to 1 of 3 research conditions: Alcohol 101 (national drinking norms), a didactic presentation of campus specific drinking norms, or a control condition. Results: Both intervention groups modified student misperceptions regarding peer alcohol use, and these changes were sustained 1 week later. Conclusions: Social norms-based interventions can contribute to more accurate drinking perceptions among college students.     

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.     

Binge drinking in female college students: the association of physical activity, weight concern, and depressive symptoms

As an initial step in building gender-specific binge drinking intervention programs, the authors investigated the relation of potentially modifiable factors (physical activity level, weight concern, and depressive symptoms) to binge drinking while controlling for the effects of previously established correlates of binge drinking (tobacco and marijuana use, GPA, and perception of peer alcohol use). Four-hundred-twelve college women completed an in-class survey. Multivariate analyses revealed that tobacco and marijuana use, GPA, and physical activity were significantly associated with binge drinking, whereas tobacco use and perception of peers' alcohol use were associated with more frequent binge drinking. The findings suggested that the variables associated with any binge drinking and frequency of binge drinking may differ and that binge drinking can be associated with positive health behaviors (ie, greater physical activity) as well as risky health behaviors (eg, tobacco use).     

Drinking locations prior to impaired driving among college students: implications for prevention

Drinking and driving is perhaps the most serious problem associated with heavy drinking among college students in the United States. In this study, the authors examined drinking locations prior to impaired driving in a college student sample. They administered the Impaired Driving Assessment to 91 college students identified as high risk for drinking and driving. Participants reported an average of 7.98 (SD = 7.67) impaired driving episodes during the past 5 weeks. Using a random effects model, the authors found that location was a significant predictor of blood alcohol content (BAC), F(6,89.6) = 3.62, p = 0.0029. After drinking alcohol at a party, students' average estimated BAC prior to driving (geometric M = 0.089) was significantly greater than all other drinking locations (geometric M = 0.033). The findings of this study provide insight into drinking locations prior to impaired driving and can be used by college health practitioners to develop appropriate interventions to reduce the magnitude of this problem.     

Underage college students' drinking behavior, access to alcohol, and the influence of deterrence policies. Findings from the Harvard School of Public Health College Alcohol Study

Underage drinking is a major problem at American colleges, but little is known about the extent of alcohol use in different student groups, in different colleges, and in states with different control policies. We used data from the 2001 and 3 previous Harvard School of Public Health College Alcohol Studies that compared responses of underage students with those of their 21-23-year-old peers. Underage students drank alcohol less frequently but were more likely to drink to excess when they drank. College educational efforts and deterrent policies were limited in their outreach, and half of underage students obtained alcohol very easily. Underage students in states with extensive laws restricting underage and high-volume drinking were less likely to drink and to binge drink. A majority of underage students supported increasing efforts to control underage drinking. The results suggest that additional policy efforts to control underage drinking may be effective and feasible.     

Addressing Sexually Transmitted Infections (STIs), including HIV/AIDS,in the Context of Sexual Health

ABSTRACT

Sexually transmitted infections (STIs) have occupied a central place in public health agendas for at least the past 500 years, but have been the subject of opinions, decrees and “moral positions” for much longer. Societies have long tried to control the sexual behaviors of their populations, not only for reasons of social control, but also with the objective of controlling the spread of disease—HIV is the latest example of how societies respond to infections spread through the most private of individual behaviors. The article outlines the burden of disease associated with sexually transmitted infections including HIV, and explores their impact on efforts to achieve the Millennium Development Goals (MDGs). A large number of options for prevention and care of the sexually transmitted infections and HIV are currently available in both resource-rich and resource-constrained settings. In this article I move beyond the narrow focus of biomedical interventions concentrated on the individual and explore the evidence for public health measures aimed at controlling these infections. Using a public health framework I outline the various measures that can be implemented for STI/HIV control, and in addition to exploring the evidence for their public health effectiveness, I also look at how each of these interventions can be delivered within a paradigm of sexual health more generally. Finally, the article proposes recommendations for which effective strategies should be incorporated into a broader framework for promoting sexual health.     

Results of a Social Norm Intervention to Prevent Binge Drinking Among First-year Residential College Students

Abstract

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.     

Preventing Juvenile Delinquency Through Early Family Intervention

ABSTRACT

Any professional working in the field of juvenile corrections can attest to the impact of family dynamics in contributing to and maintaining delinquent behavior, and studies have for years linked family dysfunction with the problem of juvenile delinquency. While most research has been done by professionals in other fields, social workers frequently provide intervention with these families. This article offers an overview of the aspects of family dysfunction which increase the risk of juvenile delinquency and offers suggestions for social work intervention in four areas: identification of families at risk, early intervention, service delivery, and preventive education. All may be considered preventive methods if used effectively.     

Heavy drinking on college campuses: no reason to change minimum legal drinking age of 21

The recent Amethyst Initiative argues that a minimum legal drinking age (MLDA) of 21 has created a culture of heavy alcohol use on college campuses by making drinking clandestine and extreme. This group and others argue that lowering the MLDA will reduce the problem of "binge drinking" on college campuses. However, such a policy change would remove one of the most researched and supported policies in the nation's alcohol control arsenal. There is little evidence that other interventions or policies are capable of working on the same broad level as MLDA 21, and there could also be a deleterious ripple effect in related legislation because MLDA 21 works in conjunction with other drinking laws. In addition, historic and international experiences with a lowered MLDA indicate there are serious social and public health consequences. Instead of removing efficacious interventions, we must remain committed to implementing and enforcing evidence-based practices and legislation.     

Alcohol consumption among undergraduate social work students at a South African university

ABSTRACT

Alcohol consumption among tertiary level students is a public health problem that can adversely affect students’ performance at university. This study therefore investigated the drinking patterns; reasons for drinking; and the perceived impact of drinking on academic performance of undergraduate social work students at a South African university. Of the 145 students who completed a group administered survey questionnaire, 88% reported using alcohol mainly for social purposes and enjoyment, with two-fifths admitting to participating in binge drinking. Despite these findings, a high proportion (78%) reported not performing poorly on a test or exam due to alcohol consumption in the preceding 12 months. Recommendations are provided for the education and support of social work students as future healthcare professionals.     

Relative Contributions of Treatment-Related Changes in Communication Skills and Dyadic Coping Skills to the Longitudinal Course of Marriage in the Framework of Marital Distress Prevention

Most prior studies of skill-based preventive interventions for couples compare changes in problem-solving behaviors made by treated couples with those made by control couples. Unexpected findings in these studies highlight the need to examine within-group variability in behavior change among treated couples, alternative behavioral domains, including dyadic support and coping, and partners' intended and actual use of strategies taught in the interventions. A 24-month longitudinal study of 109 couples participating in an 18-hour intervention designed to enhance communication and dyadic coping revealed that marital outcomes are enhanced to the extent that (a) wives increase their positive problem-solving behavior and husbands decrease their negative problem-solving behavior over the course of the intervention, and (b) wives and husbands increase their positive dyadic coping behaviors, and husbands decrease their negative dyadic coping behaviors. Moreover, greater postintervention use of strategies taught in the intervention program produced better outcomes, and wives' improvements in positive and negative dyadic coping strengthened associations between strategy use and relationship satisfaction. Discussion emphasizes the importance of devising interventions that target key interpersonal processes and that motivate participants to display newly acquired behaviors.     

Change IS Possible: Reducing High-Risk Drinking Using a Collaborative Improvement Model

Abstract

Objective: To describe the adoption of public health and improvement methodologies to address college students’ high-risk drinking behaviors and to aid in prevention efforts. Participants: Members of 32 colleges and universities, content experts, and staff members of the National College Health Improvement Program (NCHIP). Methods: A 2-year learning collaborative developed by NCHIP trained individuals from 32 different college and universities in using the Plan–Do–Study–Act cycle as a method to create and implement initiatives aimed at reducing students’ high-risk drinking behaviors and related harms. Results: Participants experienced success ranging from noteworthy increases in type and amount of interventions directed at reducing high-risk drinking, to creating collaboratives across campus, the local community, and stakeholders. Challenges related to data collection and creating lasting cultural change remain. Conclusions: The use of quality improvement methodologies and creation of a national collaborative successfully effected meaningful change in high-risk drinking behaviors on college campuses.     

Heavy Drinking on College Campuses: No Reason to Change Minimum Legal Drinking Age of 21

Abstract

The recent Amethyst Initiative argues that a minimum legal drinking age (MLDA) of 21 has created a culture of heavy alcohol use on college campuses by making drinking clandestine and extreme. This group and others argue that lowering the MLDA will reduce the problem of “binge drinking” on college campuses. However, such a policy change would remove one of the most researched and supported policies in the nation's alcohol control arsenal. There is little evidence that other interventions or policies are capable of working on the same broad level as MLDA 21, and there could also be a deleterious ripple effect in related legislation because MLDA 21 works in conjunction with other drinking laws. In addition, historic and international experiences with a lowered MLDA indicate there are serious social and public health consequences. Instead of removing efficacious interventions, we must remain committed to implementing and enforcing evidence-based practices and legislation.