Research Forms Basis of RWJF Program to Tackle College Binge Drinking
In early 1995, the Boston University School of Public Health conducted a study of college-drinking-reduction programs to inform an evolving Robert Wood Johnson Foundation (RWJF) program to reduce college-age binge drinking.
The study, Review of Research on Interventions to Reduce College Student Drinking and Related Health and Social Problems, found that environmental interventions (changing the surrounding conditions or influences) appear to have the potential to reduce college binge drinking at relatively low cost.
The researchers recommended that RWJF support the development of a carefully evaluated, multitarget, multistrategy community/university program to reduce college-age drinking. Each university/community involved should:
- develop a community/university task force;
- assess college drinking on the campus and in the community;
- develop strategies to reduce alcohol use and related problems within the community and on campus;
- review clinician procedures to diagnose alcohol problems on campus and in the community and offer brief intervention referral, treatment, and after-care services;
- develop a plan to evaluate the proposed intervention;
- develop plans to institutionalize the program.
RWJF used the findings to develop its $10 million national program, A Matter of Degree: Reducing High-Risk Drinking among College Students, which develops model approaches to reduce student binge drinking on campuses at 10 colleges and universities, as well as in their surrounding communities, by establishing a college/community partnership at each site.
RWJF provided $36,410 in funding from January to April 1995 to support the study.
Despite more than two decades of efforts to reduce alcohol use on college campuses, there was no accessible summary of knowledge about college-drinking-reduction programs and policy responses to what works (or might work) to reduce college-age drinking and related problems.
This project was intended to help staff from RWJF answer two questions as they contemplated developing a program to reduce college-age binge drinking: (1) What programs currently exist, and what previous efforts have been attempted to reduce college student drinking and related problems? And (2) What are useful future directions for program development, research, and evaluation?
The objectives of the project were to:
- evaluate existing published and non-peer-reviewed literature on the effects of various interventions,
- identify and classify types of initiatives that campuses are pursuing,
- offer recommendations about which types of interventions hold the most promise.
Researchers at Boston University's School of Public Health examined medical and psychological indexes to find all relevant articles and data produced over a 10-year period. They identified more than 230 studies on college-age drinking, 43 of which used experimental or quasi-experimental designs to study the effects of interventions that reduce college-age drinking and related problems.
Researchers presented the study results in a report to RWJF entitled Review of Research on Interventions to Reduce College Student Drinking and Related Health and Social Problems.
Overall, the report indicated that environmental interventions (measures to improve health by changing the surrounding conditions or influences) appear to have the potential to reduce college binge drinking at relatively low cost.
The literature indicates that interventions to reduce college-age drinking that were aimed at changing individual beliefs, knowledge, attitudes, and behaviors in conjunction with environmental interventions can reduce drinking. However, no intervention that was the subject of more than one study produced reductions in college student drinking in each study.
Limitations of these studies included reliance on self-reported data and convenience samples that are unlikely to be representative of the college population; in some studies, a lack of random assignment of students to different interventions; and lack of process measures to assess implementation of interventions, comparison areas in environmental interventions, exploration of how college students get alcohol, and data on drinking among minority populations.
The types of programs studied included:
- Individually oriented prevention education: Twenty-four programs attempted to change individual knowledge, attitudes, drinking, or drinking-related problems. Ten studies of those 24 programs identified specific interventions that produced significant reduction in drinking or drinking problems. Fourteen interventions resulted in drinking declines.
- Treatment: Three studies explored treatment programs for college problem drinkers. Two studies reported reductions in drinking, but both had serious methodological weaknesses.
- Environmental interventions: Ten studies examined the effects of laws raising the legal alcohol purchase age on college populations; five of them identified reductions in drinking or related problems, and two reported increases in violence. Other environmental interventions fund to reduce drinking among college-age persons and adults included increasing the taxes on alcohol, conducting server-intervention training programs, reducing the number of outlets that sell alcohol (per geographic area or population density), enacting laws that hold liquor outlets liable for serving minors or intoxicated patrons, having state monopoly (state liquor stores) versus privatized alcohol sales outlets, setting curfews for young drivers, lowering the legal blood alcohol limit for drivers 21 years of age and younger, and establishing comprehensive community intervention programs.
- There are few rigorous studies that specifically examined effects on college students, particularly on environmental interventions. Thus, strong conclusions about how well most of the interventions worked specifically on college students cannot be reached.
- Although some of the individual interventions have been studied rigorously and have been found to reduce drinking and related problems, their feasibility on a broad scale is not clear and the expense of widespread application, which has not been calculated, may be prohibitive.
The report recommended that RWJF support the development of a carefully evaluated, multitarget, multistrategy community/university program to reduce college-age drinking. Although this has not been tested, data suggest that such an approach could work. Each university/community involved should:
- Develop a community/university task force comprising university students, staff, and faculty; member of fraternities, sororities, and student groups; community officials; representatives of concerned private organizations, citizens, and local media.
- Assess college drinking on the campus and in the community. The assessment should include a student survey about drinking, smoking, drug use, and related problems; a collection of community and university alcohol use and problem indicators; a review of policies and programs to address substance use and key state laws; and a review of recreational resources.
- Develop strategies to reduce alcohol use and related problems within the community and on campus. These strategies can include education about the adverse health and social consequences of alcohol; resistance skills training and promising, individually oriented behavioral techniques; education about relevant city ordinances, campus regulations, and state laws; counseling or treatment programs; a review of university admission and disciplinary policies as well as changes as needed; or review of other city or university policies.
- Review clinical procedures to diagnose alcohol problems on campus and in the community and offer brief intervention referral, treatment, and after-care services.
- Develop a plan to evaluate the proposed intervention, including process and impact evaluations and outcome monitoring of trends in community indicators.
- At the start of the program, develop plans to institutionalize it. Activities could include annual task force reports to the university/community, a permanent line of funding from the university or from city hall; plans to transfer program initiatives to city departments and university departments and raise resources for postprogram operations, and development of a college interest group program to further control college student drinking over time.
The study report, entitled Review of Research on Interventions to Reduce College Student Drinking and Related Health and Social Problems, was presented to RWJF. The grantee also published a chapter in a book based primarily on the study results. (See the Bibliography for details.)
AFTER THE GRANT
RWJF used the results of the report to develop its national program entitled A Matter of Degree: Reducing High-Risk Drinking among College Students. This $10-million program is administered by the American Medical Association (AMA) and is developing model approaches to reduce student binge drinking on campus and in the surrounding community by developing college/community partnerships.
The programs started initiatives at 10 colleges: the University of Colorado at Boulder, the University of Delaware, Louisiana State University, Lehigh University, the University of Nebraska-Lincoln, the University of Vermont, the University of Wisconsin-Madison, the University of Iowa, Florida State University, and Georgia Institute of Technology.
The program follows all recommendations of this grant but one: review of clinical procedures to diagnose alcohol problems and offer brief intervention referral, treatment, and after-care services. Program assessment and evaluation are being conducted under separate RWJF grants (ID#s 028190 and 034746) to the Harvard School of Public Health. Under a separate RWJF grant (ID# 039380), the AMA will conduct a communications campaign aimed at deglamorizing student binge drinking on highest-risk campuses.
The principal investigator, Ralph Hingson, Sc.D., is currently chairing the Panel on Prevention and Treatment of the National Institute of Alcohol Abuse and Alcoholism National Advisory Council Sub-Committee on College Drinking, which is updating the literature review done under this grant and publication of the results.
GRANT DETAILS & CONTACT INFORMATION
Review and Analysis of Programs to Reduce College Drinking
Boston University School of Public Health (Boston, MA)
Dates: January 1995 to April 1995
Ralph Hingson, Sc.D.
(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)
Hingson R, Berson J, Dowley K. Review of Research on Interventions to Reduce College Student Drinking and Related Health and Social Problems. Boston, Mass.: Boston University School of Public Health, January 3, 1995. Presented to The Robert Wood Johnson Foundation.
Hingson R, Berson J, Dowley K. "Interventions to Reduce College Student Drinking and Related Health and Social Problems." In Alcohol: Minimising the Harm: What Works, Plant M, Single E, Stockwell T (eds.). London, England, and New York, N.Y.: Free Association Books, 1997.
Report prepared by: Lori De Milto
Reviewed by: Robert Crum
Reviewed by: Patricia Patrizi
Program Officer: Janet Heroux