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.     

Brief Screening and Intervention for Alcohol and Drug Use in a College Student Health Clinic: Feasibility,Implementation, and Outcomes

Abstract

Objective: Evaluation of the Brief Alcohol Screen and Intervention in College Students (BASICS) in a university primary care setting. Participants/Methods: Undergraduates (N = 449) participated in BASICS and electronic surveys assessing frequency/quantity of alcohol and drug use, psychosocial and mental health outcomes, and demographic information. Data were collected at baseline and 6-month follow-up between August 2006 and August 2008. Results: Drinking and drug use decreased between baseline and 6 months. Participants reported an increase in protective factors and in readiness to change alcohol-related behaviors, and a decrease in alcohol-related consequences and in distress symptoms. Heavy episodic drinking at baseline significantly moderated the changes in number of drinks in a typical week and in a typical weekend, and number of drinks on the occasion drank most on a weekend. Conclusions: BASICS can be implemented in a primary health care setting and university students may reduce their alcohol and/or drug use.     

In Praise of Feedback: An Effective Intervention for College Students Who Are Heavy Drinkers

Abstract

The efficacy of brief motivational feedback to reduce drinking among college students has been reported by several researchers. As an extension of this theoretical and applied framework, the author tested the use of mailed feedback to influence the drinking behavior of students self-identified as moderate-to-heavy drinkers in two randomized trials. A 6-week follow-up of the efforts suggested the efficacy of the feedback intervention at reducing alcohol consumption. The feedback mechanism used in the studies is described in detail and possible reasons for its efficacy are explored. In light of the cost-effective nature of this intervention, it may warrant a place in larger campus prevention programs.     

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.     

Partying Before the Party: Examining Prepartying Behavior Among College Students

Objective: The authors examined the phenomenon known to college students as prepartying, which is the consumption of alcohol prior to attending an event or activity (eg, party, bar, concert) at which more alcohol may be consumed. Participants: To explore the extent of this behavior, the authors surveyed 227 college students about each drinking event over a 1-month period. Results: Principal results revealed that 64% of participants engaged in prepartying (75% of drinkers) and that prepartying is involved in approximately 45% of all drinking events. Prepartying was predictive of more drinking throughout the day of the drinking event and alcohol-related negative consequences. Men and women engaged in this behavior at similar rates, and prepartying was most related to social reasons for drinking. Conclusion: Because prepartying is well-known among students, the authors suggest that clinicians and researchers target it to better understand college drinking and to help students understand the associated dangers.     

College Students Define Binge Drinking and Estimate Its Prevalence: Results of a National Survey

Abstract

Data from the 1999 College Alcohol Study were used to examine how students define the term binge drinking, to determine how much binge drinking the students think exists on their campuses, and to analyze how students' estimates compare with aggregated self-reports of student drinking. The findings indicate that the median of the students' definitions of binge drinking is 6 drinks in a row for men and 5 for women, 1 drink higher than the definition used by researchers. Students' definitions of binge drinking vary with their own drinking levels, suggesting that dissenting views of the research definition may represent voices of the heaviest drinkers. At the median, students estimated that 35% of all students were binge drinkers. Half (47%) of the students underestimated the binge drinking rate at their school, 29% over-estimated it, and 13% were accurate. Although programs designed to reduce the frequency or prevalence of binge drinking by emphasizing healthier norms would be most useful in addressing binge drinkers who overestimate drinking norms, this group includes only 13% of college students.     

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.     

The moderating effect of alcohol use on protective and risky sex behaviors among college students in the Southeast United States

ABSTRACT

Objective: College students are a high-risk population for new human immunodeficiency viruses (HIV) diagnoses. Although condom use self-efficacy and HIV knowledge can protect against risky sexual behavior (RSB), these same protective factors have been shown to exacerbate RSB. The influence of alcohol use can further complicate these protective factors to influence RSB. Participants: 689 African American/Black and non-Hispanic White college students attending a public university in the Southeast United States. Method: This study sought to examine the relations between condom use self-efficacy and HIV knowledge with RSB and the moderating effect of alcohol use. Results: Findings showed positive associations between RSB and HIV knowledge and alcohol use. Unexpectedly, low frequency drinkers with high condom use self-efficacy were at increased risk for RSB compared to high frequency drinking counterparts. Conclusions: Findings point to the need to target prevention services for low-risk drinkers in college settings.     

Reducing High-Risk Drinking Among Student-Athletes: The Effects of a Targeted Athlete-Specific Brief Intervention

Abstract

Objective: This study examined the effects of a single-session motivational interviewing–based in-person brief alcohol intervention that contained student-athlete–specific personalized drinking feedback. Participants: Participants were 170 National Collegiate Athletic Association Division I student-athletes meeting screening criteria for heavy episodic drinking. Methods: Baseline assessments of alcohol use frequency and quantity, norm perceptions of peers' alcohol use, experiences of negative consequences, and use of protective behaviors were administered to student-athletes prior to a 1-session brief intervention containing personalized feedback highlighting the relationship between alcohol use and athletic performance. Follow-up assessment was conducted 3 months post intervention. Results: Student-athletes participating in the athlete-specific brief intervention showed significant reductions in their alcohol use and alcohol-related negative consequences, increases in use of protective behavioral strategies, and corrections in norm misperceptions at 3 months post intervention relative to a no-treatment comparison group. Conclusions: Student-athlete–specific brief alcohol interventions show promise in addressing high-risk drinking, reducing associated harms, and supporting health.     

The Association of Multiple Risk Factors With Fruit and Vegetable Intake Among a Nationwide Sample of College Students

Few college students meet fruit and vegetable intake recommended requirements, and most receive no information from their institutions about this issue. The avoidable disease burden among students is large, the necessary information infrastructure exists, and Healthy People 2010 objectives indicate efforts should be taken to increase intake. Objective: The authors examined the association of high-risk behaviors and fruit and vegetable intake to inform design of multiple risk factor interventions. Participants and Methods: The authors obtained data from a sample of 40,209 18- to 25-year-old college students who completed the American College Health Association-National College Health Assessment during the spring 2002 and 2003 semesters. Results: Predictors of high fruit and vegetable intake for men and women included better: seatbelt and helmet use, physical activity, perceived health, sleep, self-care behaviors, and grades. Other notable predictors of high intake were reduced likelihood of cigarette smoking, alcohol use, drinking and driving, and feeling hopeless in both sexes; reduced likelihood of drinking and driving among men; and a greater likelihood of anorexia among women. Conclusions: The authors discuss implications of these findings.     

Do “Clicker” Educational Sessions Enhance the Effectiveness of a Social Norms Marketing Campaign?

Abstract

Objective: Social norms campaigns are a cost-effective way to reduce high-risk drinking on college campuses. This study compares effectiveness of a “standard” social norms media (SNM) campaign for those with and without exposure to additional educational sessions using audience response technology (“clickers”). Methods: American College Health Association's National College Health Assessment questions are used to evaluate actual and perceived use. Additional survey questions assess individual exposure to the interventions. Results: The authors find “clicker” technology to be more effective than social norms poster media alone in reducing misperceptions of normative alcohol use for those students who attended clicker sessions. Conclusion: Poster SNM campaigns may be most effective when supported by group “clicker” heath-related sessions.     

Trends in College Binge Drinking During a Period of Increased Prevention Efforts: Findings from 4 Harvard School of Public Health College Alcohol Study Surveys: 1993–2001

Abstract

The 2001 Harvard School of Public Health College Alcohol Study surveyed students at 119 4-year colleges that participated in the 1993, 1997, and 1999 studies. Responses in the 4 survey years were compared to determine trends in heavy alcohol use, alcohol-related problems, and encounters with college and community prevention efforts. In 2001, approximately 2 in 5 (44.4%) college students reported binge drinking, a rate almost identical to rates in the previous 3 surveys. Very little change in overall binge drinking occurred at the individual college level. The percentages of abstainers and frequent binge drinkers increased, a polarization of drinking behavior first noted in 1997. A sharp rise in frequent binge drinking was noted among students attending all-women's colleges. Other significant changes included increases in immoderate drinking and harm among drinkers. More students lived in substance-free housing and encountered college educational efforts and sanctions resulting from their alcohol use.     

Alcohol Use in Students Seeking Primary Care Treatment at University Health Services

Abstract

Objective: Given the high rate of at-risk drinking in college students, the authors examined drinking behaviors and associated factors in students being seen in student health services for primary care visits from October 30, 2004, to February 15, 2007. Methods: Analyses were based on a Health Screening Survey completed by 10,234 college students seeking general medical treatment. Results: Alcohol use was similar to other studies with 57% (n = 5,840) meeting the National Institute on Alcohol Abuse and Alcoholism criteria for at-risk drinking. Twenty-six percent of the students reported smoking at least once in the last 3 months. Risk factors for at-risk drinking included young age, white males, drinking at a fraternity/sorority house, and use of tobacco. Conclusions: These findings support the widespread implementation of alcohol screening and intervention in university health services.     

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.     

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.     

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.     

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

ABSTRACT

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

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.     

Reducing alcohol use in college students: a controlled trial of two brief interventions

This study tested two forms of alcohol reduction programming for college students. Thirty-seven moderate to heavy drinkers completed measures of quantity/frequency, drinking consequences, and attitude questionnaires. Participants were randomly assigned to one of three groups: 1) a two-hour information and motivation session plus mailed personal feedback on their drinking; 2) mailed feedback only; or 3) no treatment. At a 6-week follow-up session, the feedback-only group decreased drinks per month as compared to control. No other differences were statistically significant, though decreases favored the treatment conditions about equally over control. Implications for research and treatment are discussed.     

Mobile MyPlate: A Pilot Study Using Text Messaging to Provide Nutrition Education and Promote Better Dietary Choices in College Students

Abstract

Objective: To evaluate the acceptance and effectiveness of repetitive nutrition-related text messages on college students’ nutrition knowledge and fruit and vegetable consumption. Participants: One hundred fifty undergraduate (18–24 years old) non–health major students with a texting mobile phone. Methods: The intervention group received biweekly text messages of the MyPlate icon and the United States Department of Agriculture's Dietary Guidelines (DGs) for 7 weeks. The control group received the same information in a mailed brochure. A pre and post online survey assessed the students’ knowledge and behavior. Results: The intervention resulted in greater MyPlate food group recognition (p <.05) compared with control and a trend toward improved knowledge of the DGs. In the intervention group, fruit consumption was elevated (p <.05) and a trend toward elevated vegetable consumption was determined. No gender differences in intervention effectiveness exist. Conclusion: Texting repeated messages appears to be an acceptable and effective way to increase nutrition knowledge and promote positive diet-related behaviors in college students.