A campus-community coalition to control alcohol-related problems off campus: an environmental management case study

The authors report on the effects of a university and community coalition in preventing problems related to college students' off-campus drinking. The Albany, New York, Committee on University and Community Relations used strategies based on an environmental-management approach that focuses on changing the environment in which individuals make decisions about alcohol consumption and related behaviors. Committee initiatives included improving enforcement of local laws and ordinances, creating a safety-awareness campaign for off-campus students, and developing a comprehensive advertising and beverage-service agreement with local tavern owners. The initiatives were associated with a decline in the number of alcohol-related problems in the community, as indicated by decreases in the number of off-campus noise ordinance reports filed by police and the number of calls to a university-maintained hotline for reporting off-campus problems. An environmental management approach, the authors suggest, has promise as an effective means of preventing alcohol-related problems among college students.     

Alcohol policies on college campuses

State and local alcohol policies can minimize opportunities for people to use alcohol, thereby reducing consumption and alcohol-related problems. Little is known, however, about the prevalence of campus policies aimed at reducing college students' alcohol use and related problems. The authors surveyed school administrators in Minnesota and Wisconsin to assess the frequency of alcohol policies and whether institutional characteristics were likely to predict campus policies. They also compared administrators' responses to policies posted on college Web sites. Most schools prohibited beer kegs and provided alcohol-free housing for students. A minority of schools prohibited all alcohol use on campus or at Greek organizations or banned advertisements in school newspapers for alcohol or off-campus bars. The prevalence of policies varied with school characteristics, and agreement was poor between Web-site policy information and that provided by administrators. Further research on the prevalence of college alcohol policies might be useful for assessing trends and future prevention needs on campuses.     

Exploring the Relationship Between Experiential Avoidance,Alcohol Use Disorders,and Alcohol-Related Problems Among First-Year College Students

Abstract

Objective: This study explored the relationship of experiential avoidance (eg, the tendency to avoid, suppress, or otherwise control internal experiences even when doing so causes behavioral harm) to alcohol use disorders and alcohol-related problems. Participants: Cross-sectional data were collected from 240 undergraduate college students in their first year in college between December 2009 and April 2010. Methods: Participants completed a diagnostic interview and online self-report survey. Results: Students with a history of alcohol abuse or dependence had significantly higher levels of experiential avoidance relative to students with no alcohol use disorder diagnosis. A hierarchical linear regression analysis found that experiential avoidance significantly predicted alcohol-related problems, even after controlling for gender and psychological distress. Furthermore, experiential avoidance mediated the relationship of psychological distress to alcohol-related problems. Conclusions: These findings suggest that experiential avoidance may play a role in problematic alcohol use among college students.     

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.     

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.     

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.     

Alcohol-Related Emergency Department Visits Associated With Collegiate Football Games

Abstract

Objective: In 2003, after several post–college football game riots, multiple strategies including strict enforcement of open container laws were instituted by the authors’ city and university. The authors compared alcohol-related visits to the on-campus emergency department (ED) associated with home football games in 2002 and 2006, hypothesizing that alcohol-related visits should decline. Participants: ED patients during home game weekends. Methods: Retrospective cohort study comparing the 2002 and 2006 home games—similar seasons wherein the team went undefeated. Logistic regression assessed the impact of environmental and patient characteristics on the likelihood of an ED visit being alcohol related. Results: In total 2,220 visits in 2002 and 2,146 visits in 2006 were reviewed. Alcohol-related visits increased from 2002 (7.9%) to 2006 (9.5%, p = .06). Despite community interventions, the odds of an ED visit being alcohol related increased (odds ratio [OR] 1.3, 95% confidence interval [CI₉₅] 1.06–1.64). Conclusions: Community measures did not reduce alcohol-related visits to the ED.     

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.     

Roles of Organizers and Champions in Building Campus—Community Prevention Partnerships

Objective: A campus—community partnership can be an effective vehicle for launching environmental strategies to prevent college alcohol-related problems. In this study, the authors' primary aim was identifying key factors that facilitate or impede colleges' efforts to build campus—community partnerships. Participants and Methods: From fall 2004 to summer 2006, administrators at five 4-year colleges participated in a multisite case study. Level of partnership development was the primary outcome. Results: Three interrelated factors facilitated higher-developed partnerships: college staff assigned to facilitate the partnerships who worked as community organizers, higherlevel college administrators who served as aggressive champions, and community initiation of the partnership. The authors did not observe this trio of factors among the less-developed partnerships. A lack of administrative support made it more difficult for a champion to emerge, a college administrator who staunchly advocated for a campus—community partnership, and for those assigned to facilitate the partnership to carry out their work. Conclusions: Colleges should appoint higher-level administrators to serve as champions, while also ensuring that those assigned to facilitate a partnership can apply community organizing skills.     

Support for Alcohol-Control Policies and Enforcement Strategies Among US College Students at 4-Year Institutions

Objective: The authors examined college student support for policies and enforcement strategies to reduce alcohol problems on campus. Participants: A random sample of students from each of 32 four-year colleges and universities participated. Methods: Students completed an anonymous mail survey. Results: A majority of students supported 5 of the 12 policy proposals. Whatever percentage of students indicated support for a policy, a far smaller percentage reported that other students supported it. The majority at all 32 schools supported using stricter disciplinary sanctions for students who engage in alcohol-related violence and repeatedly violate campus alcohol policy. The majority at more than half of the schools supported applying stricter penalties for the use of false IDs to purchase alcohol illegally and prohibiting kegs on campus. Conclusions: Higher-education administrators should survey students to learn which policies a majority of their students will endorse.     

Understanding the Relationship Between Alcohol and Sex: Latino and White College Students and Problematic Sexual Experiences While Drinking

Objectives: The authors examined whether the relationship between alcohol expectancies and sexual experiences while drinking differed between Latino and white college students. Participants: The authors considered students if they were white or Latino, unmarried, aged 18-25 years, reported any drinking, and had at least 1 sexual partner in the present school year. Methods: The investigators collected surveys from a random sample of 13,868 undergraduate students from the 14 California public university campuses. They used tests of group differences and hierarchical multiple regressions. Results: Social-facilitation alcohol expectancies were associated with the total number of different alcohol-related sexual experiences among Latino students. Neither social facilitation nor sexual-enhancement alcohol expectancies were differentially predictive of white or Latino students' frequency of sexual experiences. Conclusions: Additional research is necessary to determine whether concepts targeted by alcohol prevention programs operate in a differential manner for Latino students.     

The reliability of environmental measures of the college alcohol environment

Much of what we know about students' drinking patterns and problems related to alcohol use is based on survey research. Although local and national survey data are important to alcohol-prevention projects, they do not sufficiently capture the complexity of the alcohol environment. Environmental prevention approaches to alcohol-related problems have been shown to be effective in community settings and researchers have begun to study and adapt such approaches for use on college campuses. Many environmental approaches require systematic scanning of the campus alcohol environment. This study assessed the inter-rater reliability of two environmental scanning tools (a newspaper content analysis form and a bulletin analysis form) designed to identify alcohol-related advertisements targeting college students. Inter-rater reliability for these forms varied across different rating categories and ranged from poor to excellent. Suggestions for future research are addressed.     

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.     

Demographic and Predeparture Factors Associated with Drinking and Alcohol-Related Consequences for College Students Completing Study Abroad Experiences

Abstract

Objective: Study abroad students are at risk for increased and problematic drinking behavior. As few efforts have been made to examine this at-risk population, the authors predicted drinking and alcohol-related consequences abroad from predeparture and site-specific factors. Participants: The sample consisted of 339 students completing study abroad programs. Methods: Participants filled out online measures at predeparture, abroad, and at postreturn. Results: The authors found that drinking and consequences abroad were predicted by a number of factors, including demographics (eg, younger age, male sex, Greek affiliation, white ethnicity), student factors (eg, low GPA, major area of study), study abroad site factors (eg, apartment living abroad, study in Europe), predeparture levels of drinking and consequences, sensation seeking, and goals related to social gathering. Conclusions: Findings can be used to inform campus policies for admission to study abroad programs as well as assist in the development of interventions targeted toward preventing risk for students during abroad experiences.     

Young adults and casual sex: the relevance of college drinking settings

This study investigated the relevance of college drinking settings on the likelihood of students having sexual intercourse with a stranger. A random sample of 7,414 undergraduates at 14 public California universities responded to questions regarding frequency of attendance at six different setting types since the beginning of the semester (e.g., Greek, residence-hall parties, and bars or restaurants), drinking behavior, and sexual activity. Multi-level modeling examined the association between each setting type and the occurrence of alcohol-related sexual intercourse with a stranger. Findings indicated strong, positive associations between frequency of attendance at Greek parties, residence-hall parties, off-campus parties, and the occurrence of alcohol-related sex with a stranger. Frequency of attending the six settings and proportion of times drunk at the settings were also positively associated with alcohol-related sex with a stranger. Efforts aimed at preventing outcomes associated with casual sex (e.g., pregnancy, sexually transmitted infections, or mental health) should target specific drinking settings where students might be at high risk for risky alcohol use and unsafe sex behaviors.     

A study of the relationship between protective behaviors and drinking consequences among undergraduate college students

The authors identified the number, type, and frequency of protective behaviors that undergraduate college students who consume alcohol use to prevent alcohol-related consequences. Their hypothesis was that students who engage in more types of protective behaviors with greater frequency would be less likely to experience alcohol-related consequences. Participants consisted of a randomly selected sample of 1,355 undergraduates aged 18 years and older at a large public university. Students completed a mailed questionnaire on alcohol and health behaviors in spring 2002. The findings (after adjustment for covariates) indicated that self-protective behaviors are inversely associated with alcohol-related problems for women but not for men. The influences of gender and racial and ethnic differences are considered in relation to prevention and intervention programs aimed at reducing alcohol-related consequences on college campuses.     

Characteristics of precollege sexual violence victimization and associations with sexual violence revictimization during college

Abstract

Objective: To examine the prevalence and characteristics of precollege sexual victimization (SV) experiences and associations with revictimization and recent substance use behaviors among a sample of college students who reported precollege SV. Participants: A sub-sample of 931 college students who reported precollege SV at baseline data collection for an ongoing multi-site clinical trial. Methods: Data were collected via electronic surveys between September 2015 and March 2017. Measures included precollege and during college SV, recent substance use, and alcohol-related harm reduction behaviors. Results: Precollege SV characteristics associated with revictimization included: Nonpenile penetration (aOR: 1.51, 95%CI: 1.04–2.19); pressured sex (aOR: 1.46, 95%CI: 1.06–2.01); and stranger assault (aOR: 2.03, 95%CI: 1.22–3.40). Past 30-day binge drinking was also associated with revictimization (aOR: 1.86, 95%CI: 1.36–2.54). Conclusions: The relationship between precollege SV and alcohol, especially binge drinking, may require a more integrated approach to preventing subsequent revictimization.     

Alcohol-Related Problems Seen at the Student Health Services

Abstract

The number and types of alcohol-related problems seen by medical, nursing, and mental health professionals at the University of Massachusetts Health Services has been assessed since 1975 as part of a Demonstration Alcohol Education Project.

Medical outpatient clinic alcohol-related contacts using encounter forms completed on every outpatient visit during 1975 and 1976 revealed that 0.08% of approximately 92,500 visits annually were alcohol related, including 0.03% for chronic problems and 0.05% for acute problems (mainly contusions, lacerations, and fractures). Week-long contact surveys conducted in November 1976, and April 1977 recorded a much higher proportion of alcohol-related problems for over 60% of about 2,200 contacts each week. In November 1976, 1.4% of 1,346 reported visits were alcohol related, including 8.0% of contacts which occurred on weekends. In April 1977 2.7% of 1,582 reported visits were alcohol related, including 17.0% of weekend visits. No chronic alcohol problems were reported either week, and most of the acute problems involved traumatic injuries, such as contusions, lacerations, and sprains.

Mental health outpatient clinic alcohol-related contacts self-reported by students at the initial visit revealed that 5.8% of 1,179 initial visits between January 1976, and June 1977 were alcohol related, most involving their own alcohol use. Week-long contact surveys involving all 256 contacts during November 1976 and 192 contacts during April 1977 showed that 13.7% of contacts were for alcohol-related problems, over half due to alcohol abuse by someone else, such as a parent or boy/girlfriend.

The findings suggest that a significant proportion of students seen by student health services have acute rather than chronic alcohol-related problems, especially acute traumatic injuries and relationship problems.     

An Examination of Drinkers’ Consequences by Sexual Orientation

Abstract

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