Whose Opinion Matters? The Relationship Between Injunctive Norms and Alcohol Consequences in College Students

Harm reduction approaches may benefit from research extending the exploration of predictors of alcohol use per se to those components most directly related to alcohol-related harm. This investigation evaluated the relationship between perceived injunctive norms of alcohol use (level of approval of drinking behaviors in specific situations) and the experience of alcohol-related consequences as a function of typical student reference groups at increasing levels of similarity to the respondent: based on race, gender, Greek status, and combinations of these dimensions, as well as parents, close friends, and the students\u27 own attitudes. Participants were 3753 students (61% female) from two campuses who completed an online survey. Preliminary analyses determined that there were no differences in the relationship between perceived injunctive norms and consequences across the eight student groups of varying specificity, thus all eight levels were combined into one variable of perceived student injunctive norms. However, the relationship between this variable and consequences was weaker than the perceived attitudes of more proximal referents (parents, close friends, as well as their own personal attitudes). Subsequent analyses predicting consequences while controlling for demographic variables and drinking level, revealed that perceived injunctive norms for students, parents, and close friends as well as personal attitudes each significantly predicted consequences. Results suggest an important role for perceived injunctive norms in the experiencing of consequences over and above the amount of consumption and point to types of injunctive norms feedback that might form effective interventions (i.e., incorporating close friend and parent feedback as well as general student feedback)

Cross-Cultural Pedagogy: Practical Strategies for a Successful Interprofessional Study Abroad Course

This article discusses some practical strategies for designing and implementing a cross-cultural interprofessional study abroad course, including pre-departure preparation, facilitating small groups with local students, establishing a weekly theme, utilizing role-play and reflective assignments, and implementing meaningful evaluation strategies. These strategies were based on three years of experience and were found to effectively increase students’ cultural competence and self-confidence, as evidenced by student evaluations and results from a focus group conducted one year after the course. Short term study abroad courses with appropriate pedagogical design are significant strategies for health profession programs in the face of growing diversity and globalization

Ethnicity Specific Norms and Alcohol Consumption Among Hispanic/Latino/a and Caucasian Students

Previous research has shown that social norms are among the strongest predictors of college student drinking and that normative misperceptions of more similar groups’ drinking behavior may be more influential on individual drinking than those groups perceived to be more different. However, limited research has explored the moderating role of ethnicity in this context. The current study examined the differential impact that Hispanic/Latino/a and Caucasian students’ normative perceptions of both typical and same-ethnicity college students’ drinking behavior had on their own drinking. Participants (N = 5,369 students; 60.4% female; 81.4% Caucasian; mean age 19.9 years) from two colleges completed web-based surveys assessing their alcohol consumption, and their perceptions of the drinking behaviors of both the typical college student and the typical same-ethnicity college student at their campus. Results demonstrated that perceived norms were significantly associated with likelihood of drinking regardless of race or ethnicity specificity, but that Hispanics/Latinos/as typically had weaker relationships between ethnicity-specific norms and drinking than general student norms and drinking. The opposite was true for Caucasians such that the relationship between same-ethnicity norms and drinking was stronger than the relationship between general student norms and drinking. Further, Hispanic/Latino/a students with high perceived norms were less likely to have consumed any alcohol than Caucasians with similar normative beliefs. Further, a campus site interaction suggests that the size of the minority population on campus relative to other students may influence the relationship between norms and drinking. Implications and targets for future investigation are discussed

Heavier drinking American college students may self-select into study abroad programs: An examination of sex and ethnic differences within a high-risk group

As with other heavier drinking groups, heavier drinking American college students may self-select into study abroad programs with specific intentions to use alcohol in the foreign environment. This cross-sectional study used a sample of 2144 students (mean age = 20.00, SD = 1.47) to explore differences in alcohol use and related negative consequences among (1) students intending to study abroad while in college, (2) students not intending to study abroad, and (3) students reporting prior study abroad participation. Results revealed that participants with no intention to study abroad drank less and experienced fewer alcohol-related consequences than participants intending to study abroad. In addition, students reporting prior completion of study abroad programs drank more and reported more hazardous alcohol use than those not intending to study abroad. Ethnic and sex differences existed; with White students, males, and females intending to study abroad and non-White students who previously completed study abroad programs demonstrating the most risk. These findings provide empirical support that study abroad students may be a heavier drinking subgroup necessitating intervention prior to beginning programs abroad

Randomized Controlled Trial of BASICS for Heavy Drinking Mandated and Volunteer Undergraduates: 12-Month Outcomes

This is the first randomized trial testing whether heavy drinking undergraduates mandated to the Brief Alcohol Screening and Intervention for College Students (BASICS) program following a campus alcohol violation would benefit as much as heavy drinking volunteers up to one year post-intervention using high-risk control groups to model disciplinary-related and naturalistic changes in drinking. Participants (61% male; 51% mandated; 84% Caucasian; Mage = 20.14 years) were screened for heavy drinking and randomized to BASICS (n = 115) or control (n = 110). Outcome measures collected at baseline, 4 weeks, 3, 6, and 12 months post-intervention included the Daily Drinking Questionnaire and Rutgers Alcohol Problem Inventory. At 4 weeks post-intervention, intent-to-treat multilevel longitudinal models showed that regardless of referral group (mandated or volunteer) BASICS significantly decreased weekly drinking, typical drinks, and peak drinks relative to controls (ds = .41-.92). Decreases in alcohol problems were of large effect size (d = .87). At 12 months post-intervention, BASICS participants (regardless of referral group) reported significantly fewer alcohol problems (d = .56) compared to controls. Significant intervention gains for peak drinks and typical drinks were sustained in both referral groups relative to controls (ds = .42; .11). Referral group had no significant main effect and did not interact with intervention condition to predict outcomes. BASICS was associated with less drinking and fewer alcohol problems, even among heavier drinking mandated students up to one year post-intervention. Provision of BASICS-style programs within disciplinary settings may help reduce heavy drinking and alcohol problems among at-risk students

Cross-Cultural Patterns in College Student Drinking and its Consequences—A Comparison between the USA and Sweden

Aims: The aim of the study was to compare alcohol use, consequences and common risk factors between American and Swedish college students. Methods: A secondary comparative analysis from one American and two Swedish studies in college settings. Results: Swedish freshmen report higher alcohol use than US freshmen students. Swedish residence hall students report higher alcohol use than US residence hall students, but lower than American fraternity/sorority members. US students were less likely to be drinkers. Controlling for age, country moderated the relationship between family history and harmful drinking scores for women (stronger in the USA), and between expectancies and harmful drinking scores for men (stronger in Sweden), though in both cases this represented a small effect and patterns were similar overall. Conclusions: Swedish students are at higher risk for alcohol use than US students, but similar patterns between aetiological predictors and outcomes in both countries suggest that research from the USA is generalizable to Swedish students and vice versa. More research is needed to better understand unique relationships associated with age and family history

Group Identification as a Moderator of the Relationship Between Perceived Social Norms and Alcohol Consumption

Previous research has shown that social norms are among the strongest predictors of college student drinking. Among college students, perceiving that “others” drink heavier relative to themselves has been strongly and consistently associated with heavier drinking. Research has also shown that the more specifically “others” are defined, the stronger the association with one’s own drinking. The present research evaluated whether group identification as defined by feeling closer to specific groups moderates the associations between perceived drinking norms in the group and one’s own drinking. Participants included 3752 (61% Female) students who completed online assessments of their perceived drinking norms for four groups of students on their campus as well as identification with each group and participants’ own drinking behavior. Results indicated that greater identification with same-sex students, same-race students, and same-Greek-status students were associated with stronger relationships between perceived drinking norms in the specific groups and own drinking

Brief motivational interventions for college student drinking may not be as powerful as we think: An individual participant-level data meta-analysis

Background For over two decades, brief motivational interventions (BMIs) have been implemented on college campuses to reduce heavy drinking and related negative consequences. Such interventions include in-person motivational interviews (MIs), often incorporating personalized feedback (PF), and stand-alone PF interventions delivered via mail, computer, or the Web. Both narrative and meta-analytic reviews using aggregate data from published studies suggest at least short-term efficacy of BMIs, although overall effect sizes have been small. Method The present study was an individual participant-level data (IPD) meta-analysis of 17 randomized clinical trials evaluating BMIs. Unlike typical meta-analysis based on summary data, IPD meta-analysis allows for an analysis that correctly accommodates the sampling, sample characteristics, and distributions of the pooled data. In particular, highly skewed distributions with many zeroes are typical for drinking outcomes, but have not been adequately accounted for in existing studies. Data are from Project INTEGRATE, one of the largest IPD meta-analysis projects to date in alcohol intervention research, representing 6,713 individuals each with two to five repeated measures up to 12 months post-baseline. Results We used Bayesian multilevel over-dispersed Poisson hurdle models to estimate intervention effects on drinks per week and peak drinking, and Gaussian models for alcohol problems. Estimates of overall intervention effects were very small and not statistically significant for any of the outcomes. We further conducted post hoc comparisons of three intervention types (Individual MI with PF, PF only, and Group MI) vs. control. There was a small, statistically significant reduction in alcohol problems among participants who received an individual MI with PF. Short-term and long-term results were similar. Conclusions The present study questions the efficacy and magnitude of effects of BMIs for college drinking prevention and intervention and suggests a need for the development of more effective intervention strategies

Project INTEGRATE: An Integrative Study of Brief Alcohol Interventions for College Students

This paper provides an overview of a study that synthesizes multiple, independently collected alcohol intervention studies for college students into a single, multisite longitudinal data set. This research embraced innovative analytic strategies (i.e., integrative data analysis or meta-analysis using individual participant-level data), with the overall goal of answering research questions that are difficult to address in individual studies such as moderation analysis, while providing a built-in replication for the reported efficacy of brief motivational interventions for college students. Data were pooled across 24 intervention studies, of which 21 included a comparison or control condition and all included one or more treatment conditions. This yielded a sample of 12,630 participants (42% men; 58% first-year or incoming students). The majority of the sample identified as White (74%), with 12% Asian, 7% Hispanic, 2% Black, and 5% other/mixed ethnic groups. Participants were assessed two or more times from baseline up to 12 months, with varying assessment schedules across studies. This paper describes how we combined individual participant-level data from multiple studies, and discusses the steps taken to develop commensurate measures across studies via harmonization and newly developed Markov chain Monte Carlo algorithms for two-parameter logistic item response theory models and a generalized partial credit model. This innovative approach has intriguing promises, but significant barriers exist. To lower the barriers, there is a need to increase overlap in measures and timing of follow-up assessments across studies, better define treatment and control groups, and improve transparency and documentation in future single, intervention studies