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.     

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.     

The Alcohol Policy Information System (APIS) and Policy Research At NIAAA

Public policies have the potential to prevent the adverse consequences of alcohol consumption on a larger scale than any other category of interventions. However, measuring the effects of specific policies on alcohol-related behaviors and health outcomes is difficult and presents a variety of daunting challenges. One important challenge stems from the nonexperimental nature of most policy research, which makes it difficult to distinguish between causal relationships and noncausal associations. Another key challenge arises from the complexity of alcohol-related behaviors and outcomes and the wide range of potential effects that specific policy interventions may have on different groups and actors in various contexts. A third important challenge involves the difficulty in accurately characterizing the policies to be studied, which can be attributed largely to the arcane legal framework of statutes and regulations in which policies are created. This challenge is magnified by the enormous variety of alcohol-related public policies that have been adopted at all levels of government and the myriad variations in specific provisions that are embedded in the laws and regulations. Valid analysis of policy effects depends on surmounting all of these challenges and accurately characterizing policies and discerning the true causal effects of those policies on well-specified outcomes of interest.     

The extent and nature of alcohol-related problems in public senior housing

To examine both the extent and nature of alcohol-related problems in senior housing and how management responds to these problems, 100 local housing authorities (LHAs) in Connecticut with responsibility for senior housing were surveyed. The response rate was 90%. Results indicated variability among LHAs regarding their experiences with alcohol misuse among residents. It was evident in the numbers of residents abusing alcohol, the procedures for addressing problems when they occur, and LHAs' assessment of the extent and seriousness of problems. Few LHAs had either staff training regarding alcohol abuse or policies to address alcohol-related problems. Conclusions concerning whether alcohol-related problems were widespread in public senior housing were related to the size of the LHA. Housing specialists, public policymakers, and educators should assist management personnel in developing policies and procedures regarding misuse of alcohol. In addition, resources should be directed to educate housing authority staff about detection of the problem and strategies for intervention.     

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.     

Personalized boosters for a computerized intervention targeting college drinking: The influence of protective behavioral strategies

ABSTRACT

Objective: Computerized interventions are cost-effective and can quickly deliver individual feedback to many students. However, in-person interventions are more efficacious. The current study sought to improve the efficacy of a popular online intervention via e-mailed boosters with personalized feedback. Participants: Participants were 213 student drinkers at a southeastern public university, ages 18–24. Methods: Students were randomized into (1) intervention only, or (2) intervention plus booster. Alcohol consumption and related problems were assessed at baseline, 2 weeks post, and 4 weeks post. Results: Boosters yielded reductions in drinking, but not alcohol-related problems. Boosters were associated with significant reductions for drinking frequency, heavy drinking days, peak drinks, and associated blood alcohol concentration (BAC). Protective behavioral strategies (PBS) moderated this effect, with significant reductions for students low in PBS, but not students already highly engaged in PBS use. Conclusions: Easy dissemination and low cost make e-mailed boosters a very efficient way to promote student health.     

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.     

A Campus-community Coalition to Control Alcohol-related Problems Off Campus: An Environmental Management Case Study

Abstract

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.     

A review of environmental-based community interventions

Alcohol use and related problems can be influenced by a wide variety of prevention interventions, including efforts that focus on changing the community alcohol environment-for example, by reducing underage access to alcohol, decreasing alcohol availability among adults, and increasing awareness of alcohol-related issues. Examples of environmental-based community interventions that focus on reducing alcohol use and related problems are Communities Mobilizing for Change on Alcohol, the Community Prevention Trial, the Sacramento Neighborhood Alcohol Prevention Project, Saving Lives, Operation Safe Crossing, and Fighting Back. Evaluations of these programs found that programs that change the community environment can reduce alcohol use and related problems among both youth and adults, even in communities with relatively low readiness to address alcohol issues. Research also has identified particular settings and situations where alcohol environmental changes are particularly needed as well as factors influencing the effectiveness of certain strategies. Despite the progress made, additional questions still need to be addressed in future research to maximize the benefits associated with environmental-based community interventions.     

Effects of a web-based pre-enrollment alcohol brief motivational intervention on college student retention and alcohol-related violations

Objective: To determine whether completing a pre-enrollment Web-based alcohol brief motivational intervention (BMI) increased student retention and reduced student alcohol-related violations. Participants: Fall 2011 (3,364) and Fall 2012 (3,111) entering cohorts of all first-year students at a midwestern state university. Method: Students completing the brief intervention (BI) were compared to students not completing the BI. Retention was tracked for four years for the 2011 cohort and three years for the 2012 cohort. Campus and community alcohol violations were tracked for two academic years following enrollment. Kaplan–Meier survival analysis and Cox regression were used to test retention survival. Logistic regression was used to test campus and community violations. Results: Students in both cohorts who completed the BI had significantly higher retention and significantly fewer alcohol-related violations than noncompleters. Conclusions: Population-level Web-based BIs help prevent student dropout and decrease alcohol-related violations, with impacts extending multiple years. Web-based BI is an efficacious population-level prevention tool.     

(Unintended) Consequences of initiating an alcohol sales policy at college football stadiums: A case study

University officials are increasingly considering selling alcoholic beverages at campus football stadiums. To inform this decision, we report on offenses occurring at a campus football stadium and surrounding community on game day weekends between 2009 and 2013. Campus police log data for 35 home football weekends were examined, accounting for 1,940 distinct incidents. There was a general upward trend in crime incidents. On average, 330 total crime incidents occurred when alcohol was not sold (2009–2011) compared to 475 annually when alcohol was sold (2012–2013). Liquor law violations and alcohol consumption by a minor were the two most frequently cited offenses. Liquor law violations (317) was highest after alcohol sales initiated. Police incidents were markedly higher when playing a traditional football rival at home. College administrators, health officials, athletic departments, and local law enforcement must work together to weigh the potential benefit of enhanced financial profit against the risk of increased alcohol-related crime.     

Syrian Refugees Living on the Edge: Policy and Practice Implications for Mental Health and Psychosocial Wellbeing

This qualitative study aims to explore the difficulties experienced by Syrian refugees living in the camps of Turkey in the pre‐migration and post‐migration environment and the impacts thereof on their mental wellbeing. Semi‐structured interviews were conducted with Syrian refugees living in three different camps on the Syrian border of Turkey. Syrian refugees were highly exposed to traumatic events in the pre‐migration period, including armed conflicts, human rights violations, and social and economic devastation. Participants reported a wide range of difficulties in the post‐migration environment, including separation from and loss of close ones, camp difficulties, gender‐based, adaptational and economic adversities. They reported a number of psychological and social effects of these pre‐migration and post‐migration difficulties. The implications of the findings are discussed and recommendations are made concerning the necessity of a rights‐based approach to policies and interventions for mental health and psychosocial wellbeing of Syrian refugees.     

The Effect of Graduate School on Identity Issues

Abstract

Objectives: To provide a critical review of the efficacy of brief interventions for alcohol use in college health centers. Methods: Studies were included if (a) they examined brief intervention trials that were conducted in college- or university-based student health centers or emergency departments, and (b) they provided pre–post data to estimate change. Results: Twelve studies suggested that screening and brief interventions in these settings are acceptable, feasible, and promote risk reduction. Conclusions: Findings support continued use of time-limited, single-session interventions with motivational interviewing and feedback components.     

Non-traditional Student Retention: Exploring Perceptions of Support in a Social Work Graduate Program

This study examines non-traditional student perceptions of social support in the context of a group intervention offered by a graduate program at a predominantly white university in the southern United States of America. The goal of the group intervention was to enhance perceptions of social support, as measured by a standardized instrument administered pre and post the group intervention. Data analysis showed no significant differences in pre–post changes in perceptions of social support between intervention and comparison groups. A follow-up survey questionnaire administered to group intervention participants provided feedback that shed light on these unanticipated results: it is recommended that future interventions for improving non-traditional student retention focus on supporting the development of social support networks among incoming and first-year graduate students.     

SBIRT Training in Social Work Education: Evaluating Change Using Standardized Patient Simulation

A grand challenge for social work is addressing widespread public health problems of alcohol misuse. MSW students (n = 83) received Screening, Brief Intervention, and Referral to Treatment (SBIRT) training through didactic sessions, role plays, and pre–post videotaped standardized patient (SP) interactions. SBIRT knowledge, self-reported practice behaviors, and confidence were assessed at pretest, 30 days, and 6 months posttest. Videos were coded to assess intervention-adherent behaviors. General linear mixed models analyzed changes. Participants demonstrated increased adherence to SBIRT behaviors, and knowledge, skills, and confidence increased posttraining. Findings suggest SBIRT training increases students’ capacity to implement evidence-based interventions designed to reduce alcohol misuse.     

Enforcing alcohol policies on college campuses: reports from college enforcement officials

We assessed alcohol enforcement practices at 343 U.S. colleges via surveys of directors of campus law enforcement. We measured types and frequency of enforcement and barriers to enforcement. We found that 61% of colleges indicated nearly always proactively enforcing alcohol policies, with most frequent enforcement at intercollegiate sporting events and least frequent enforcement at fraternity/sorority events. Approximately half of the enforcement departments work closely with their local law enforcement agency but respondents indicated a greater need for cooperation with local law enforcement. Half of the respondents reported no barriers to alcohol enforcement on campus. Large colleges and public colleges tended to report greater enforcement levels. While many campuses report proactive alcohol enforcement, several areas of improvement in alcohol enforcement at colleges are indicated.     

Putting Words to the Experience: An Italian Group Intervention for Children of Separated Parents

This article presents an Italian group intervention for children of separated parents and describes preliminary findings about its efficacy. After briefly discussing the state of art for interventions of children of separated parents, the core characteristics of the group intervention are explained and each meeting is described. Then, pre–post research is presented to provide empirical support for this approach. Results reported that participation in the group strengthens the social and interpersonal self-concept dimension in the majority of children. Results are discussed considering both empirical and clinical implications.     

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

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

Challenges and Recommendations to Enforcement of Alcohol Policies on College Campuses: An Administrator's Perspective

Abstract

Objective: The purpose of this study was to examine challenges and recommendations (identified by college administrators) to enforcing alcohol policies implemented at colleges in the southeastern United States. Methods: Telephone interviews were conducted with 71 individuals at 21 institutions. Results: Common challenges included inconsistent enforcement, mixed messages received by students, and students’ attitudes toward alcohol use. The most common recommendations were ensuring a comprehensive approach, collaboration with members of the community, and enhanced alcohol education.