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9/28/2017 Our Presenter Why Care About College Student Drinking? Environmental Strategies to Over 1,800 deaths among 18-24 year old college students Reduce Alcohol-Related Harm 2.8 million students between the ages of 18 and 24 Among

  1. 9/28/2017 Our Presenter Why Care About College Student Drinking? Environmental Strategies to  Over 1,800 deaths among 18-24 year old college students Reduce Alcohol-Related Harm  2.8 million students between the ages of 18 and 24 Among College Students drove under the influence of alcohol last year  590,000 unintentionally injured under the influence of alcohol Bob Saltz, Ph.D.,  More than 690,000 assaulted by another student Prevention Research Center who has been drinking Pacific Institute for Research and Evaluation  More than 97,000 are victims of alcohol-related sexual assault or date rape Dr. Bob Saltz  About 25 percent of college students report Prevention Research Center academic consequences of their drinking including missing class, falling behind, doing poorly on exams Powered by: The Ohio State University or papers, and receiving lower grades overall 1

  2. 9/28/2017 M ean Score for 5+ Drinks in a Row in Past 2 Weeks by 4-year College Student Status Twice "the scope of the problem makes immediate results of Once any interventions highly College unlikely" Non-College Wechsler, et al., 1994 None Wave 1 Wave 2 Wave 3 Wave 4 (18) (19-20) (21-22) (23-24) Measurement Wave 2

  3. 9/28/2017 Public Health Model Public Health Model Individual Individual Alcohol Environment Vehicle Traffic Laws, Roads/Intersections Alcohol-Related Problems Traffic Safety 3

  4. 9/28/2017 Task Force Recommendations Recommendations – Tier 2 …finally  Increased enforcement of minimum  Tier 1: Evidence of Effectiveness Among College Students drinking age laws  The formation of a campus and community coalition may be critical  Implementation, increased publicity, and  Tier 2: Evidence of Success With General to implement these strategies Populations That Could Be Applied enforcement of other laws to reduce to College Environments alcohol-impaired driving effectively  Restrictions on alcohol retail outlet density  Tier 3: Evidence of Logical and Theoretical Promise, But Require  Increased price and excise taxes on More Comprehensive Evaluation alcoholic beverages  Tier 4: Evidence of Ineffectiveness  Responsible beverage service policies in social and commercial settings 4

  5. 9/28/2017 RELATIVE PRODUCTION OF PROBLEMS BY FREQUENT BINGE VS. NON-BINGE DRINKERS (CAMPUS SAMPLE, '98 - '99 SCHOOL YEAR) 1600 So Why Not Just Go With Tier 1 Strategies? 1400 FREQUENT BINGE DRINKERS NON-BINGE DRINKERS NUMBERS OF PROBLEMS FIFTY-PERCENT CONTROL LINE  Problems not limited to high-risk drinkers 1200 Sounds like a lot of work… 1000 800 600 400 …why bother? 200 0 CRIME VICTIM 2 CRIME VICTIM 1 OVERDOSE SCHOOL TROUBLE POLICE TROUBLE SEX PERP 2 SEX VICTIM 2 PHYSICAL FIGHTS SEX PERP 1 UNPROTECT SEX SEX VICTIM 1 PERFORM POORLY DAMAGE THINGS INJURED UNPLANNED SEX ARGUE WORK HIGH DUI DRINK DRIVING RUDE FORGET CRITICIZED RIDE WITH DUI REGRETS MISS CLASS BEHIND WORK DRINK CONTEST VOMIT HANGOVER PROBLEM CATEGORY 5

  6. 9/28/2017 Typical Hurdles for Comprehensive So Why Not Just Go With Tier 1 Strategies? Prevention Strategy  Problems not limited to high-risk drinkers  Implicit assumption that the only “target”  Some difficult to implement with fidelity is high-risk drinkers  Can be labor intensive & costly for large …but there are challenges  Ambivalence about youth drinking populations  Low perceived efficacy of preventive  Some individual-level strategies might be interventions compromised in "hostile" environments  Challenges of coordination and resource  Opportunity to create synergy across allocation levels of intervention  Possible fears of “backlash” 6

  7. 9/28/2017 Unique Hurdles for College Prevention What are we trying to prevent? Safer California Universities Project Goal:  Emphasis often on “process” over  Intoxication “outcome”  Preference for persuasion over control To evaluate the efficacy of a “Risk Management” approach  Harm related to intoxication  Universities are complex, diffuse to alcohol problem prevention organizations  Prevention staff trained in education, awareness strategies NIAAA grant #R01 AA12516  Prevention staff usually lacks authority to with support from CSAP/SAMHSA . launch initiatives 7

  8. 9/28/2017 Random Assignment Integrated Intervention Strategies for Strategies for Implementation Off-Campus Parties  Focused on one (at most two) settings Intervention Sites Comparison Sites  Compliance Checks  Focused on beginning of academic year  CSU Chico  Cal Poly SLO  DUI Check Points  Highly-specified planning and  Sacramento State  San Jose State implementation process  CSU Long Beach  CSU Fullerton  Party Patrols  UC Berkeley  UC Irvine  Maximum attention to tasks and  UC Davis  UC Los Angeles  Pass Social Host “Response Cost” implementation per se (rather than  UC Riverside  UC San Diego Ordinance  UC Santa Cruz  UC Santa Barbara process)  A Social Host Safe Party Campaign  Planned mid-course correction 8

  9. 9/28/2017 Outcomes  Likelihood of getting drunk at a given generic setting (e.g., Greek parties; residence halls) plus additional aggregate measure across all settings  Two baseline years combined vs. two years post-intervention combined  Controlling for individual-level variables and campus/community variables 9

  10. 9/28/2017 Practical Significance A Matter of Degree (AMOD) Weitzman et al. American Journal of Preventive Medicine. 2004 In addition…  At each campus, 900 fewer students drinking to intoxication at off-campus parties  AMOD achieved reductions among college and 600 fewer getting drunk at students in: No Displacement bars/restaurants during the fall semester at • Binge Drinking intervention schools relative to controls. • Driving after drinking • Alcohol related injuries  Equivalent to 6,000 fewer incidents of • Being assaulted by other drinking college intoxication at off-campus parties and 4,000 students fewer incidents at bars & restaurants during the fall semester at Safer intervention schools relative to controls 10

  11. 9/28/2017 Campus Community Strategy to Project Components Change the Drinking Culture  Neighborhoods Engaging with Students (NEST) Comparison  Enforcement  LateNight@WWU  Western Washington University  Campus Community Coalition work groups were  Bellingham, Washington involved in planning, implementation, and process evaluation. Saltz, et.al., 2009 11

  12. 9/28/2017 SPARC Environmental Strategies SPARC Results 1. Reduce Alcohol Availability  Strong evidence that a comprehensive environmental approach that includes a focus Study to Prevent Alcohol Related 2. Address Price/Marketing on off-campus parties can be effective Consequences: 3. Improve Social Norms  Level of Impact Public health significance: Using a Community Organizing Approach to 4. Minimize Harm • 228 fewer students per school experiencing 1 or more Implement Environmental Strategies in and severe consequences due to their own drinking in the Expectations of each Intervention School: around the College Campus past 30 days • 107 fewer students per school causing alcohol-related  Include 3 of the 4 areas in strategic plan injuries to others in past 12 months Mark Wolfson, et al  But: Impact on marginal rates: not a panacea  Most strategies should be comprehensive – i.e., Wake Forrest University include Policy, Awareness, and Enforcement elements Wolfson, et.al., 2012 12

  13. 9/28/2017 www.collegedrinkingprevention.gov Future Research: Where are we heading? Environmental Strategies to Reduce Alcohol-Related Harm  Replications Including Alternative Mix of Strategies Among College Students  Full-Spectrum Comprehensive Interventions Bob Saltz, Ph.D., Prevention Research Center  Translational Research: Pacific Institute for Research and Evaluation Implementation research lags far behind efficacy studies  Improved Prevention Management Powered by: The Ohio State University 13

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