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.     

The Role of Monthly Spending Money in College Student Drinking Behaviors and Their Consequences

Objective: Alcohol use among college students is pervasive and affected by economic factors such as personal income and alcohol price. The authors examined the relationship among students' spending money, drinking rate, and alcohol-related consequences.

Participants: In 2005, the authors conducted a Web-based survey among a random sample of 3,634 undergraduate students from 2 large universities.

Methods: The authors used multiple logistic regression to model drinking behaviors and multiple linear regression to model alcohol-related consequences.

Results: The lowest reported levels of average monthly spending money were associated with reduced levels of drinking and getting drunk. Spending money was independently associated with experiencing alcohol-related consequences caused by a student's own drinking, even after the authors controlled for personal drinking behaviors. The effects for consequences caused by others' drinking were significant for students who had gotten drunk.

Conclusions: These findings have implications for alcohol price and marketing, particularly around colleges, and suggest actions for parents to consider.     

How College Students Conceptualize and Practice Responsible Drinking

Abstract

Objective: This study sought to employ a mixed-methods approach to (a) qualitatively explore responsible drinking beliefs and behaviors among a sample of college students, and (b) quantitatively assess the prevalence of those behaviors. Participants: Convenience samples, drawn from currently enrolled students attending a large public university in Texas, comprised 13 participants in the qualitative phase and a random sample of 729 students for the quantitative phase. Methods: A partially mixed sequential dominant status design (qual → QUAN) was employed. Results: Participants associated 7 distinct themes with drinking responsibly; however, embedded inside these themes were numerous potentially harmful elements. Quantitative findings supported the qualitative themes, also highlighting gender and ethnic differences. Males believed responsible drinking behaviors should occur with significantly less frequency than females, whereas Whites attached less relative necessity to certain responsible drinking behaviors. Conclusion: This study represents an initial attempt to determine specific, evidence-based characteristics of responsible drinking.     

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.     

Heavy Episodic Drinking in College Students: Associations With Features of Psychopathy and Antisocial Personality Disorder

Abstract

Objective: This study extends the college heavy episodic drinking literature by examining the associations between features of psychopathy and antisocial personality disorder (ASPD), on the one hand, and heavy episodic drinking and associated problem behaviors, on the other. Participants: Participants were 159 (85 male, 74 female) undergraduates from a private university. Methods: Participants completed self-report measures assessing alcohol use, frequency, and consequences of heavy episodic drinking, and personality pathology. Results: It was found that psychopathy, independent of ASPD, was related to the prediction of heavy episodic drinking frequency and problems associated with alcohol use. It was also found that the relation between traits of psychopathy and heavy episodic drinking are limited largely to the impulsive and antisocial aspects of this condition. Conclusion: These findings point to the need for further investigation of the association between psychopathy and ASPD traits and heavy episodic drinking behaviors in college students.     

Gender Differences in the Associations Among Body Mass Index,Weight Loss,Exercise, and Drinking Among College Students

Abstract

Objective: To explore gender differences regarding weight management behaviors of college drinkers. Participants: Nationally representative sample of college students from the fall 2008 American College Health Association's National College Health Assessment II (N = 26,062 students). Methods: Structural equation modeling was used to examine potential gender differences in associations among exercise, weight loss behaviors, and alcohol use. Results: Critical ratio tests revealed that associations between exercise and weight loss behaviors were more strongly correlated among females as compared with males. For females, there was a small negative association between exercise and drinking behaviors; in contrast, for males, there was a positive relationship between exercise and alcohol use. Weight loss behaviors were positively associated with drinking for both female and male students; however, the association was significantly stronger for females. Conclusions: This investigation furthers previous research on drunkorexia and also sheds additional light on the gender-based differences in weight management behaviors of drinkers.     

Condom Use in Heavy Drinking College Students: The Importance of Always Using Condoms

Abstract

Objective: The authors examined whether alcohol use decreased condom use. Participants: The subjects were heavy-drinking students on 5 different college campuses. Methods: A face-to-face interview, administered between November of 2004 and February of 2007, gathered information about condom use, alcohol use, and other behaviors. Multivariate logistic regression was used to assess predictors of condom use. Results: Of the 1715 participants, 64% reported that they did not always use condoms. Male students who drank heavily were less likely to always use condoms (adjusted odds ratio [AOR] 0.61). Participants with more sexual partners used condoms less when drinking (AOR 1.93 for men, 1.45 for women). Conclusions: Many students do not use condoms consistently, especially those who drink heavily or have multiple sexual partners. Clinicians at student health need to encourage all students to use condoms every time they have intercourse.     

College Student Smokers' Cognitive Appraisal of High-Risk Activities

Abstract

Objective: Students who smoke are more likely to engage in risky behaviors such as binge drinking and unprotected sex (Schnieder and Morris, Environ Behav. 1999; 23:575–591). The goals of the present study were to determine whether smokers assess these behaviors as lower risk than nonsmokers, and if smoking rate influences risk perceptions. Methods: Participants were 303 college students. Cognitive Appraisal of Risky Activities (Fromme et al., Cognit Ther Res. 1997; 21:421–442) and smoking were assessed August–November, 2006. Results: Smokers reported significantly less risk, more benefit, and more involvement in risky behaviors than nonsmokers (p < .01). In hierarchical linear regression, risk perceptions moderated the association between smoking and (a) expected benefit from risky sexual behaviors (β = ?1.121, p < .05); and (b) expected involvement with illicit drugs (β = ?.313, p < .01). Conclusions: College smokers’ assessment of high-risk behaviors influenced their intended involvement. Risk perception change may therefore alter their involvement in high-risk behaviors.     

An Examination of Risky Drinking Behaviors and Motivations for Alcohol Use in a College Sample

Abstract

Objective: The current study examined (1) drinking motives as a mediator of risky drinking behaviors (ie, pregaming and drinking games) and alcohol-related problems and (2) whether gender moderates the association between risky drinking behaviors and negative consequences. Participants: Participants (N = 368; 68% female) were drinkers aged 18 to 25. Data were collected from September to November 2010 and January to May 2011. Methods: Participants completed measures regarding typical pregaming and drinking game alcohol consumption, drinking motives, and alcohol-related consequences. Results: Social, coping, and enhancement motives partially explained relationships, with enhancement motives explaining the most variance for pregaming (31%) and drinking games (44%). Relationships between risky drinking and consequences were not moderated by gender. Conclusions: Drinking to enhance positive affect may be the most salient motivation for drinking related to pregaming and drinking games for college drinkers. Findings have implications for interventions tailored to students engaging in various heavy drinking practices.     

The Inability of Self-affirmations to Decrease Defensive Bias Toward an Alcohol-Related Risk Message Among High-Risk College Students

Abstract

Objective: To examine the efficacy of a self-affirmation task in deterring college alcohol misuse and the importance of preexisting beliefs in predicting subsequent behavior change. Participants: Heavy-drinking undergraduates (N = 110) participated during the 2011–2012 academic year. Methods: Participants were randomized to complete an affirmation or control task before reading an alcohol risk message. Alcohol-related beliefs and behaviors were assessed. Participants completed a 2-week online follow-up assessing alcohol-related behaviors. Results: Both groups reported increased perceived problem importance, but neither group displayed changes in personal risk. Follow-up assessment revealed similar, significant declines in peak consumption in both groups, with no significant between-group differences. Preexisting beliefs accounted for 5% to 10% of variance in drinking outcomes. Conclusions: An affirmation task does not seem to decrease defensive processing or alter high-risk drinking behaviors among college students and should not be utilized in lieu of more effective strategies.     

Drinking Game Participation Among Undergraduate Students Attending National Alcohol Screening Day

Abstract

Objectives, Participants, Methods: Drinking game participation has increased in popularity among college students and is associated with increased alcohol consumption and alcohol-related problems. The current study investigated drinking game participation among 133 undergraduates attending National Alcohol Screening Day (NASD) in April of 2007. Results: A large percentage of the sample reported lifetime (77%) and recent (52%) drinking game participation. Males were more likely to report recent participation and reported higher levels of consumption while playing drinking games. Drinking game participants were more likely to experience a range of alcohol-related problems, and the relationship between drinking game participation and alcohol-related problems was mediated by weekly alcohol consumption. Conclusions: These results suggest that drinking game participation is a risk factor for elevated levels of alcohol consumption and alcohol-related problems. Programs should be developed to educate students about the risks of drinking game participation, and prevention programs like NASD should address drinking games.     

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.     

Electronic Cigarette Use Among College Students: Links to Gender,Race/Ethnicity,Smoking, and Heavy Drinking

Abstract

Objective: Electronic cigarette (e-cigarette) use continues to rise, and current data regarding use of e-cigarettes among college students are needed. The purpose of this study was to examine e-cigarette use and the relation of such use with gender, race/ethnicity, traditional tobacco use, and heavy drinking. Participants and Methods: A sample of 599 college students enrolled in General Psychology at a state university completed a self-report questionnaire. Results: Twenty-nine percent of students reported prior use of e-cigarettes, with 14% reporting use in the past 30 days. E-cigarette use was linked to male gender but not to race/ethnicity. Dual use (ie, concurrent use of both traditional and e-cigarettes) was related to heavier use of traditional and e-cigarettes, and nicotine use was linked to pronounced rates of heavy drinking. Conclusions: E-cigarette use among college students is exponentially on the rise, and its co-use with alcohol may contribute to negative outcomes in this population.     

The Impact of Living in Co-ed Resident Halls on Risk-taking Among College Students

Abstract

Objective: Although previous research has suggested that college housing impacts student behavior and outcomes, recent research linking college housing to risk-taking has been limited. In this study, we investigate if patterns of risk behavior differ based on the type of college housing environment students reside in. Participants: This study utilizes 510 college students living in on-campus college housing. Methods: Students were recruited from 5 college sites across the United States. Participants responded to survey items online that measured current risk-taking behaviors such as binge drinking and sexual activity. Results: After controlling for an assortment of demographic and psychological variables, results indicated that students living in co-ed housing were more likely than students living in gender-specific housing to binge drink and consume alcohol, have more permissive sexual attitudes, and have more recent sexual partners. Conclusions: On-campus housing environments impact college student risk behaviors. Implications are discussed in light of the decline of in loco parentis on most college campuses.     

Short-Term Prospective Effects of Impulsivity on Binge Drinking: Mediation by Positive and Negative Drinking Consequences

Abstract. Objective: Although the association of impulsivity with diverse alcohol outcomes has been documented, the mechanisms by which impulsivity predicts drinking over time remain to be fully characterized. The authors examined whether positive drinking consequences, but not negative drinking consequences, mediated the association between impulsivity and subsequent binge drinking, over and above prior binge drinking. Participants: Participants were 171 college students. Methods: Participants completed 2 online surveys with an average interval of 68 days between assessments at Time 1 (September to October 2012) and Time 2 (November to December 2012). Results: Path analysis showed that, among 5 facets of impulsivity, the effect of sensation seeking on subsequent binge drinking was completely mediated by prior positive consequences. No mediating effects of negative consequences were found. Conclusions: Prior experience of positive drinking consequences may serve as one of the risk pathways by which sensation seeking shapes binge drinking over time. Personalized intervention strategies may utilize information about students’ impulsivity facets to address their binge drinking and alcohol-related consequences.     

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.     

The Co-Occurrence of Alcohol Use and Gambling Activities in First-Year College Students

Objective: Both alcohol use and gambling are behaviors that can be problematic for many college students; however, it is not clear whether the relationship between the 2 exists for students who have recently entered college.

Participants: The sample included 908 first-year college students who were surveyed in fall 2005, approximately 1 month after entering college.

Methods: Participants completed Web-based surveys on alcohol use and gambling behaviors.

Results: Alcohol use and alcohol-related risks were significantly related to both gambling frequency and peak gambling loss.

Conclusions: These findings have implications for researchers and clinicians working in the area of addictive behaviors among college students, suggesting that those presenting with problems in 1 domain may also be at risk for problems in the other.     

The Role of Positive Alcohol Expectancies in Underage Binge Drinking Among College Students

Abstract

Objective: This study explored associations between positive alcohol expectancies, and demographics, as well as academic status and binge drinking among underage college students. Participants: A sample of 1,553 underage college students at 3 public universities and 1 college in the Southeast who completed the Core Alcohol and Drug Survey in the Spring 2013 semester. Methods: A series of bivariate analyses and logistic regression models were used to examine associations between demographic and academic status variables as well as positive alcohol expectancies with self-reported binge drinking. Positive alcohol expectancies were examined in multivariable models via 2 factors derived from principal component analyses. Results: Students who endorsed higher agreement of these 2 emergent factors (sociability, sexuality) were more likely to report an occurrence of binge drinking in the past 2 weeks. Conclusions: Study results document associations between positive alcohol expectancies and binge drinking among underage students; implications for prevention and treatment are discussed.     

Examination of the relationships between dietary restraint,alcohol, and adverse problems among women

Objective: Women who report greater chronic dieting consume more alcohol, drink more frequently, and experience greater problems than women who report less chronic dieting. Alcohol may also temporarily disrupt a woman's dietary rules, leading to increased caloric intake and subsequent restriction. This study examined whether alcohol use mediated the relationship between dietary restraint and alcohol problems in a woman's daily life. Participants: Women (N = 59) completed the study by the fall of 2013. Methods: Participants completed up to six assessments for 10 days, including intended dietary restraint, alcohol use, and problems. Results: Drinking quantity partially mediated the relationship between dietary restraint and alcohol problems. For each drink consumed, there was a 1.4 times greater likelihood of eating after drinking, which was associated with greater intention to subsequently restrict calories. Conclusions: The types of drinks consumed and reasons for restricting one's caloric intake may inform the relationship between these behaviors.