Frequently Asked Questions


About monitoring campus alcohol problems

How do you recommend monitoring the extent of campus alcohol problems and the effects of our intervention efforts?

Monitoring problems and progress on your campus doesn’t have to be complicated, and at least some of the information you need may already be available. First, you’ll need to determine what types of information will be helpful in assessing the nature of alcohol problems at your school and the effects of your efforts. Then, you have several choices: collecting new data, using data already collected on your campus, viewing data from existing surveys or other sources, or combining these options.

Consider collecting three types of information: data on students’ drinking itself, plus its consequences at both the individual and campus levels. To follow are some options for measures and tools.

Possible measures of student drinking itself:

  • Frequency of alcohol use (e.g., number of days per week)
  • Quantity of alcohol consumed in a typical drinking day (e.g., number of standard drinks per day)
  • Peak quantity of alcohol use (e.g., maximum number of drinks consumed in a single day)
  • Frequency of binge drinking (e.g., number of binge drinking occasions in a 2-week period). NIAAA defines binge drinking as 5 or more standard drinks for men, or 4 or more standard drinks for women, in a 2-hour period.

Possible assessments for individual-level consequences of alcohol use that have been validated for use with college students follow:

  • Consequences of alcohol use can be assessed using the Rutgers Alcohol Problem Index (RAPI) or the Young Adult Alcohol Consequences Questionnaire (YAACQ).
  • The severity of alcohol-related psychopathology can be assessed using the Alcohol Use Disorders Identification Test‒Concise (AUDIT-C) or the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST).

Possible measures of campus-level consequences of alcohol use (many campuses may already be monitoring and tracking at least some of this information):

  • Emergency room transports (if possible, record blood alcohol concentration)*
  • Sexual assaults
  • Alcohol-involved deaths (intentional and unintentional, by both injuries and poisoning)
  • Costs for repairs of vandalized property
  • Police services: calls, citations, or arrests for alcohol-related offenses
  • Incident reports from judicial affairs, student life, or public safety
  • Documented problems at sporting events
  • Neighborhood complaints
  • Mapped locations of problem areas using police/emergency call and response data (heavy drinking areas can also be identified in student surveys)

*Note: An increase in emergency room transports may be a positive consequence, depending on the focus of your intervention.

College alcohol intervention experts strongly advise conducting an annual survey of a random sample of students to assess self-reported alcohol use and alcohol-related problems. Several commercial surveys are available to monitor student alcohol use, including but not limited to the Core Institute’s Alcohol and Other Drug Use Survey and the American College Health Association’s National College Health Assessment. Using one of these surveys may increase your ability to compare your institution with other colleges. You also have the option of developing an instrument that you tailor to your own needs, which can incorporate validated measures of alcohol use and its consequences.

A word about gathering broad vs. more specific data: Although gathering broad data on alcohol consumption and subsequent problems is important, by itself it may not help you select or evaluate your strategies. You’ll likely need to supplement broad, generic measures with more specific data on student subgroups or specific times and places where problems arise. If, for instance, you choose to focus on football games, a global measure of “binge drinking” is unlikely to demonstrate success. Instead, be sure you either already have a measure of alcohol consumption at those events or start to gather data at those events directly.

Likewise, if you want to see if an individual-level approach is working, it is important to track who has received the intervention and examine changes in their data before and after. A broad survey cannot capture individual-level changes if it mixes data for those who did and did not receive the intervention.

About selecting and implementing strategies

General questions about selecting strategies

Why does CollegeAIM recommend both individual-level and environmental-level strategies?

Your greatest chance for making a safer campus will likely come from a combination of individual- and environmental-level interventions that work together to maximize positive effects. Individual-level strategies, which generally aim to reduce drinking levels in students who drink heavily, may seem a logical place to start. For two reasons, however, it’s best not to stop there:

(1) Students don’t live in a vacuum. Ready availability of alcohol in the broader campus and community environment has the potential to undercut the impact of a carefully chosen and well-implemented individual-level intervention. Addressing the environment includes enforcement strategies and policies that help to curb access and act as a deterrent, as well as providing consequences to reduce recidivism.

(2) Students who drink heavily are not the only ones in need of prevention attention. Those who drink moderately have, on average, a lower individual risk of harmful consequences, but they outnumber students who drink heavily. Studies estimate that students who drink at non-extreme levels―four or fewer drinks on occasion―experience one-third to one-half of all college drinking-related problems (Gruenewald, Johnson, Ponicki, & Lascala, 2010; Weitzman & Nelson, 2004). Moreover, students who typically drink moderately, but occasionally engage in heavier drinking, may be at greater risk for negative consequences than students who regularly drink heavily (Toomey & Wagenaar, 2002). This underscores the need to curb student drinking at all levels by reducing alcohol availability, while providing targeted approaches for those who drink most heavily and therefore have the greatest individual risk for harm.

The challenge for campus staff and administrators is to put together a manageable number and combination of strategies that fits the priorities and meets the needs of their campus.

References
Gruenewald PJ, Johnson FW, Ponicki WR, & Lascala EA. A dose-response perspective on college drinking and related problems. Addiction, 105(2):257–69, 2010.

Toomey TL, & Wagenaar AC. Environmental policies to reduce college drinking: Options and research findings. Journal of Studies on Alcohol Supplement, Mar(14):193–205, 2002.

Weitzman ER, & Nelson TF. College student binge drinking and the “prevention paradox”: Implications for prevention and harm reduction. Journal of Drug Education, 34(3):247‒66, 2004.

At times we hear about campuses trying out interesting strategies that CollegeAIM doesn’t identify, or that have too few studies to rate effectiveness. Should we follow suit?

Campus officials sometimes implement new, untested strategies that appear to offer quick, low-cost solutions to the complex problem of student alcohol use, or they try novel interventions because they are popular at other schools. CollegeAIM was created to give campuses a more systematic and effective way to choose strategies, allowing you to see which ones have a strong evidence base and which do not.

It’s best to implement strategies with evidence of effectiveness first, and only then consider exploring other, less well-evaluated strategies. At times, though, it may be appropriate to experiment with less well-studied approaches. If you choose to do so, then:

  • Check CollegeAIM and make sure the strategy is not among those that have been shown to be ineffective, as these are not worth pursuing in any case.
  • Check the latest literature for any evidence of effectiveness. If you find supporting research, consider consulting with evaluation experts on campus to discuss the study’s rigor and the implications of its findings.
  • Incorporate a strong evaluation component in your planning process. It’s important to conduct a more comprehensive evaluation for untested strategies than for those already rated as effective in CollegeAIM. For this step, consider partnering with faculty with expertise in prevention or program evaluation.
  • Publish the results of the evaluation to aid your own college as well to inform and guide other schools.
  • Campuses may also benefit from implementing a new strategy on a small scale, utilizing a plan-study-do-act cycle as used in the National College Health Improvement Program. Starting small allows campuses to test and refine strategies before rolling them out on a larger scale.

The following question, submitted by a campus reviewer of CollegeAIM, regards a serious problem for which staff members are considering a strategy that lacks evidence for effectiveness:

Q:   Our campus had an alcohol overdose death and we are working diligently to prevent this from ever happening again. We had been considering implementing a bystander intervention strategy, but CollegeAIM lists this as not having sufficient research to support an effectiveness rating. Many campuses are looking to utilize this strategy, which is often used to prevent sexual assault. Should we give it a try?

A:   After the tragedy of losing a student to an alcohol overdose death, it’s understandable to direct efforts to prevent that specific outcome. In general, though, it is best to focus on interventions that currently have proven effectiveness for reducing alcohol-related problems. Although some research has examined the use of bystander interventions to prevent college sexual assault, we don’t yet have evidence regarding their use to prevent alcohol overdose, and it’s not likely that you can generalize results from one research area to the other. Still, with a very specific intended outcome such as preventing overdoses, a campus might think through whether situations that give rise to alcohol overdose present opportunities for bystander interventions analogous to situations that give rise to sexual assault. If they see similarities and can find a bystander intervention that has been proven to be effective, then they might adapt that program. It would be important to evaluate it fully to see if it works for their outcome in their setting, and to publish the findings to share with the field.

About specific individual-level strategies

How do we choose strategies to target specific subgroups such as first-year students, student athletes, members of Greek organizations, and mandated students?

The chart below lists strategies from the full CollegeAIM that (1) focused on specific subgroups and (2) were shown to be effective in the majority of at least four studies. Five strategies for freshmen and two for mandated students met these criteria. Although a handful of strategies focused on student-athletes and members of the Greek system, there were too few studies for each strategy to draw strong conclusions about effectiveness.

Subgroup Strategies (# studies showing effectiveness/total # studies evaluated)
Freshmen
  • IND-3Generic personalized normative feedback (PNF) (5/5)
  • IND-21e-CHECKUP TO GO (4/4)
  • IND-13Parent-based alcohol communication training (4/6)
  • IND-15Brief motivational intervention—in-person, individual based (7/7)
  • IND-17AlcoholEdu for College (contains personalized feedback intervention, or PFI) (3/4)
Mandated Students
  • IND-22Personalized feedback intervention (PFI): Generic/other (4/4)
  • IND-15Brief motivational intervention—in-person, individual based (11/13)

Of course, students can be members of more than one high-risk group, such as freshmen who are student athletes or pledges or both. You may wish to consider how these groups overlap on your campus when deciding on a program.

Among the choices listed above, the size and duration of effects on drinking differ, so be sure to check details in the individual-level or environmental-level summaries before making a selection. And keep in mind that an effective means of reducing alcohol use among all students, including those in these subgroups, is to use multiple strategies and include both individual- and environmental-level approaches.  

Many of our incoming freshmen students arrive on campus with established drinking habits. How can we address this issue?

Freshmen drinking and expectations generally tend toward over-consumption. The question is whether the school facilitates those tendencies or moderates them. Keep in mind that in most cases, the college environment produces a significant increase in alcohol consumption whatever the students’ previous drinking history.

Be proactive in addressing freshman alcohol use before and soon after they arrive on campus. Anecdotal evidence suggests that the first 6 weeks of enrollment are critical to first-year student success. If students initiate or increase alcohol use during this phase, they may adapt less successfully to campus life.

During the summer prior to matriculation, you might offer a parent-based intervention (see IND-13), which helps facilitate conversations between parents and students about alcohol use and have been shown to reduce drinking during freshmen year (Ichiyama et al., 2009; Turrisi et al., 2001). Online pre-matriculation programs that include personalized feedback also have proven effective over the short term.

Once students are on campus, assess the extent of the problem. If your campus is not assessing the drinking habits of incoming students, set up a system to do so (see the FAQ on monitoring campus alcohol problems). If your campus is assessing incoming freshmen, develop rapid ways to process data, identify risk levels, and tailor prevention strategies accordingly.

Early in the fall semester, plan to distribute campus alcohol policies with information about services for students who are struggling with alcohol use, including specific resources for those who identify as being in recovery.

See also the FAQ on specific subgroups for a list of individual-level interventions shown effective with freshmen. Keep in mind, however, that the campus environment has a powerful influence on students’ drinking behavior, and that environmental-level strategies have proven effectiveness in reducing the availability and appeal of alcohol for all students.

References
Ichiyama MA, Fairlie AM, Wood MD, Turrisi R, Francis DP, Ray AE, et al. A randomized trial of a parent-based intervention on drinking behavior among incoming college freshmen. Journal of Studies on Alcohol and Drugs Supplement, Jul(16):67–76, 2009.

Turrisi R, Jaccard J, Taki R, Dunnam H, & Grimes J. Examination of the short-term efficacy of a parent intervention to reduce college student drinking tendencies. Psychology of Addictive Behaviors, 15(4):366–72, 2001.

How can we assess the potential effectiveness of commercial products before we invest our limited resources in them?

Be aware, first, that many commercial products have been modified over time. Before investing in any commercial product, clarify which version of the product you are considering, then request or look for empirical support for that specific version. Research on a previous version may not apply to later ones. Beyond studies conducted by the commercial firm, see if you can find evaluations by independent researchers.

Study quality varies significantly, so you might want to consult with an evaluation expert on your campus, perhaps in the behavioral or social sciences departments, to help assess the scientific rigor and neutrality of the studies. If you are still uncertain about the product, request a free trial period from the product developer and conduct your own evaluation to make sure it addresses your campus goals.

Personalized feedback interventions (PFIs) and personalized normative feedback (PNF) are among the more effective individual-level strategies in CollegeAIM. What are PFI and PNF? Some of these are listed as “generic” strategies—what does “generic” mean? Where can we learn to implement a generic strategy?

Personalized feedback interventions (PFIs) for alcohol provide individual students with tailored feedback on their alcohol use, their risk of potential consequences, their expectations about alcohol’s effects, and their perceptions of campus drinking norms as compared with actual levels. Personalized normative feedback (PNF) focuses solely on the norms perception component, which seeks to reduce alcohol use by correcting the common misperception that most students drink to excess.

Some PFI and PNF strategies are branded, or packaged, interventions available from commercial or noncommercial sources (such as eCHECKUP TO GO) or that have a consistent, standardized process (such as 21st birthday cards). The strategies labeled “generic” covered the content areas described above, but did not meet the branded or standardized criteria and had unique designs that were examined in one or just a few studies.

To develop and implement your own version of a PFI or PNF, contact the lead author of one or more papers that tested a generic approach (see References for Personalized feedback intervention (PFI): Generic/other and Normative re-education: Electronic/mailed personalized normative feedback (PNF): Generic/other, respectively) or partner with behavioral scientists on campus to determine what you might include in your program. For ideas on comparative measures, see the methods sections of studies of generic programs. At a minimum, creating a generic PFI or PNF requires these measures:

  • For the campus as a whole: How much and how often students drink
  • For individuals targeted by the intervention: Drinking behavior, perceived drinking behaviors of peers, alcohol-related problems, and, often, the use of protective strategies such as alternating between alcoholic and non-alcoholic beverages

To provide students with tailored feedback based on their responses, you might recruit a campus colleague or student with expertise in design, computing, or a related field to create a database that allows you to integrate assessment responses into feedback messages. Most studies of PFI and PNF included in CollegeAIM delivered this feedback electronically to students, either in person on a computer in a campus office or via a URL sent to the student via email. 

We are planning to conduct routine alcohol screenings and interventions through our health and counseling centers. Which screening tools should we use? Where can we find resources to train staff to deliver screenings and interventions with fidelity?

Start by using screening tools that have been tested in a college setting. One study (Schaus et al., 2009) screened 8,700 students who presented as new patients at a large university health center using a single question about heavy drinking in the past 2 weeks (5 or more drinks per occasion for men or 4 or more drinks for women; the same question recommended by NIAAA’s Clinician’s Guide, Helping Patients Who Drink Too Much, but with a shorter time frame). They then conducted a randomized trial of a two-session intervention with the 2,500 students (28 percent) who screened positive, which indicated that brief interventions delivered by primary care providers in a student health center could reduce high-risk drinking. Additional screening tools are ranked in a comparative study by Winters et al. (2011), which recommends those found most effective in identifying student alcohol problems that required intervention. If you plan to provide interventions along with screening, you can find free and low-cost training and resources through the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Higher Education Center for Alcohol and Drug Misuse and Recovery at Ohio State University.

Resources needed to train staff on the use of an intervention will vary, depending on which intervention you choose (e.g., BASICS, ASTP, or personalized feedback intervention). SAMHSA’s National Registry of Evidence-based Programs and Practices provides information on trainers for specific programs. You might also contact the lead authors of papers describing the efficacy of a particular approach to ask for trainer recommendations. In addition, the Addiction Technology Transfer Center maintains a registry of trainers and offers training through its regional centers. Whichever course you choose, speak with multiple trainers before entering into an agreement to ensure a good fit. Be sure to request cost estimates and inquire about minimum training requirements; meaningful differences exist across trainers that may make an intervention more or less feasible for your campus.

References

Schaus JF, Sole ML, McCoy TP, Mullett N, & O’Brien MC. Alcohol screening and brief intervention in a college student health center: A randomized controlled trial. Journal of Studies on Alcohol and Drugs Supplement, Jul(16):131‒41, 2009.

Winters KC, Toomey T, Nelson TF, Erickson D, Lenk K, & Miazga M. Screening for alcohol problems among 4-year colleges and universities. Journal of American College Health, 59(5): 350‒57, 2011.

About specific environmental-level strategies

Where can we find models of campus-community collaboration that have been effective in reducing student alcohol use and related consequences?

Several campus-community collaborations can serve as models in reducing student drinking, such as the following:

  • Impact of a Randomized Campus/Community Trial to Prevent High-Risk Drinking Among College Students (Wolfson et al., 2012);
  • Alcohol Risk Management in College Settings: The Safer California Universities Randomized Trial (Saltz et al., 2010);
  • Effects of a college community campaign on drinking and driving with a strong enforcement component (McCartt et al., 2009);
  • Evaluating a Comprehensive Campus-Community Prevention Intervention to Reduce Alcohol-Related Problems in a College Population (Saltz et al., 2009); and
  • Reducing DUI Among US College Students: Results of an Environmental Prevention Trial (Clapp et al., 2005.

The Safer California Universities study, funded by NIAAA, examined a variety of environmental-level strategies that could be implemented on campuses and in their surrounding communities. A free toolkit for implementing the collaborative model is available.

References
Clapp JD, Johnson M, Voas RB, Lange JE, Shillington A, & Russell C. Reducing DUI among US college students: Results of an environmental prevention trial. Addiction, 100(3): 327‒34, 2005.

McCartt AT, Hellinga LA, & Wells JK. Effects of a college community campaign on drinking and driving with a strong enforcement component. Traffic Injury Prevention, 10(2):141‒47, 2009.

Saltz RF, Paschall MJ, McGaffigan RP, & Nygaard PMO. Alcohol risk management in college settings: The Safer California Universities Randomized Trial. American Journal of Preventive Medicine, 39(6):491–99, 2010.

Saltz RF, Welker LR, Paschall MJ, Feeney MA, & Fabiano PM. Evaluating a comprehensive campus-community prevention intervention to reduce alcohol-related problems in a college population. Journal of Studies on Alcohol and Drugs Supplement, Jul(16):21-27, 2009.

Wolfson M, Champion H, McCoy TP, Rhodes SD, Ip EH, Blocker JN, et al. Impact of a randomized campus/community trial to prevent high-risk drinking among college students. Alcohol Clinical and Experimental Research, 36(10):1767–78, 2012.

Most alcohol-related deaths among college students nationwide result from driving under the influence. What can alcohol and other drug program staff, working with campus leadership, do about this?

Any strategy that reduces alcohol use by students who drive can help prevent driving under the influence (DUI). In addition to intervening to reduce alcohol consumption directly, if alcohol-impaired driving is a current or potential problem at your school, you may wish to:

  • Become familiar with interventions shown effective in reducing alcohol-impaired driving, both in college and in general populations. A number of proven strategies for reducing driving under the influence in general populations also apply to the college population. Some of the most effective include sobriety checkpoints, well-planned mass-media campaigns, and community mobilization. Two good resources are the Guide to Community Preventive Services’ Motor Vehicle-Related Injury Protection: Reducing Alcohol-Impaired Driving and the National Highway Safety and Transportation Administration’s Countermeasures That Work report.
  • Encourage and support campus and community police department efforts to implement and enforce evidence-based DUI-prevention measures.
  • Seek models of campus-community collaboration toward this goal; see, for example, a program that effectively combined a campus social marketing campaign with increased community law enforcement of DUI laws (Clapp 2005; McCartt et al., 2009).

Most of the strategies you’ll find in CollegeAIM focus on reducing student alcohol use as a way of lowering the risks of all harmful consequences. One of the few exceptions is safe-rides program strategy, which is included because many colleges employ this strategy with the hope of reducing DUI. Although college safe-rides programs make sense on the surface and are widely used, to date they have not been studied enough to determine their effectiveness.

References
Clapp JD, Johnson M, Voas RB, Lange JE, Shillington A, & Russell C. Reducing DUI among US college students: Results of an environmental prevention trial. Addiction, 100(3): 327‒34, 2005.

McCartt AT, Hellinga, LA, & Wells JK. Effects of a college community campaign on drinking and driving with a strong enforcement component. Traffic Injury Prevention, 10(2):141‒47, 2009.

About responding to potential objections or challenges

How do I respond to people who say, “College drinking has been around forever and students are always going to drink, so why bother?”

A good counterpoint question is, “With so many students drinking alcohol and so many negative consequences, how can we not take action?” Supporting points include:

  • Campuses are responsible for the safety and well-being of their students. The consequences of underage and high-risk student drinking are many, sometimes lifelong, and often severe.
  • Campuses that do not use evidence-based prevention strategies may put themselves at legal risk if there is civil litigation.
  • Colleges have a mission to educate students and prepare them for successful careers and futures. Alcohol use interferes with this mission by lowering academic engagement and grades and by raising the risk of “stopping out” or dropping out.
  • If campuses do not change alcohol access, expectations, norms, and consequences for violations, then students will correctly assess that the costs of alcohol use are low while perceiving high social benefits. Student drinking and problems will likely continue at the same levels.
  • A significant percentage of college students drink very little or not at all, and their safety and quality of life is often negatively affected by the drinking of others. Campuses have a responsibility to protect them and their rights.

Many public health problems share the history of “being around forever” (e.g., smoking cigarettes, traffic injuries and fatalities). However, many of these same public health problems have demonstrated progress over many years of concerted efforts. While we cannot eliminate them altogether, we can reduce their toll.

Some people continue to wonder if campus officials could better manage student drinking if the minimum legal drinking age were reduced to age 18. What does the research say?

Research consistently affirms the public health benefits of setting the minimum legal drinking age (MLDA) at 21 years old. In short, the age 21 MLDA saves hundreds of lives every year. It also reduces alcohol-related harm in the long run as well as the short term. Each year, up to 900 lives are saved because of fewer alcohol-related traffic fatalities among underage drivers, according to estimates from the National Highway Transportation Safety Administration. Moreover, a recent literature review (DeJong & Blanchett, 2014) states that the age 21 MLDA has reduced alcohol consumption among youth, along with a number of associated harms they might have experienced as adults, including alcohol dependence and suicide. The review also notes that the majority of U.S. adults age 18 and up oppose lowering the drinking age to 18, and concludes that “the current law has served the nation well by reducing alcohol-related traffic crashes and consumption among youth, while also protecting drinkers from long-term negative outcomes.”

Reference

DeJong W, & Blanchette J. Case closed: Research evidence on the positive public health impact of the age 21 minimum legal drinking age in the United States. Journal of Studies on Alcohol and Drugs, 75(Suppl. 17):108‒15, 2014.

How do I respond to comments that efforts to reduce alcohol-related problems on our campus may just shift them to off-campus locations?

Research suggests that displacement does not necessarily occur nor is even likely, particularly when campuses and communities collaborate in prevention efforts. Studies of campuses and communities that took part in two major multisite programs―the Safer California Universities Randomized Trial (Saltz et al., 2010) and the “A Matter of Degree” program (Nelson, Weitzman, & Wechsler, 2005)―did not find evidence of problem displacement among drinking locations or an increase in drinking and driving. Even had there been some displacement, however, a key question is whether the overall (or “net”) effect is for the better.

To reduce the likelihood of problem displacement, develop community partnerships or form a coalition to implement complementary strategies. Because drinking contexts and alcohol problems are naturally dynamic, one important joint activity is to monitor where students drink and experience problems. In addition, work with local law enforcement and outlets to reduce access and enforce consequences. Alcohol-related problems should not shift off-campus unless access to alcohol is easier there, and the consequences weaker.

References

Nelson TF, Weitzman ER, & Wechsler H. The effect of a campus-community environmental alcohol prevention initiative on student drinking and driving: Results from the “A Matter of Degree” program evaluation. Traffic Injury Prevention, 6(4):323‒30, 2005.

Saltz RF, Paschall MJ, McGaffigan RP, & Nygaard PMO. Alcohol risk management in college settings: The Safer California Universities Randomized Trial. American Journal of Preventive Medicine, 39(6):491–99, 2010.

Campus revenue is declining. How can we build a case for investing in prevention?

A strong argument is that not taking steps to reduce student alcohol use and related problems has its own costs, many of which affect the campus budget and may be more expensive than the prevention costs in the long run.

For colleges, student alcohol use contributes to the costs of campus security and health care as well as repair of damaged property. Colleges also could be at risk of civil litigation for failing to enact prevention measures before serious injuries or damages occur. In addition, alcohol-related attrition can generate substantial costs to recruit and enroll replacement students.

For students and their families, student alcohol use can result in poor academic performance, withdrawal from school, and difficulty in finding post-graduate employment, which may in turn also reduce alumni donations. Each of these outcomes represents the decreased value or loss of an investment in a college education.

Consider building your case for prevention around the economic benefits of addressing campus alcohol-related problems. Any plans to improve student retention, achievement, and post-graduate employment rates should include efforts to reduce student alcohol misuse and related harm.

What can we accomplish with a limited budget?

A good first step in determining where to invest limited funds is to take a look at your existing prevention and intervention strategies. Are there opportunities to redirect financial or staff resources from ineffective strategies to effective strategies? In CollegeAIM, strategies with higher effectiveness and lower costs are listed in the upper-left quadrant.

Collaborate with local community organizations, such as local law enforcement, to share costs of implementing and enforcing environmental prevention strategies. Additional avenues for collaboration and cost-cutting can include partnering with other local and regional colleges to diffuse costs in areas such as:

  • Training--by holding joint training workshops
  • Service delivery--by sharing health care providers, intervention trainers, and emergency transport services
  • Ongoing maintenance of services--by sharing computer support staff for personalized feedback interventions and staff supervisors to maintain fidelity of in-person interventions

We’ve tried prevention strategies in the past and were not successful—how can we stay motivated?

It’s important to think long-term about success. Changes in social norms or the local drinking environment, for example, happen slowly. In addition, consider how you are defining success. An increase in alcohol-related transports to the emergency department may appear to indicate a lack of success with a prevention program, but it actually may represent a reduction in severe alcohol-use consequences because students are more willing to call for help for a friend who needs it.

If your efforts are not achieving their stated goals, it may be that the target of your efforts, your measures of success, or both were too broad to make it possible to show effectiveness.  For example, you may be quite successful in reducing intoxication at football games, but a global measure of alcohol consumption would be unlikely to reveal that improvement. Focus on a specific time, place, subgroup, or combination of these variables, then use an outcome measure tailored to that strategy.

In moving forward:

  • Think comprehensively and focus on a plan of action using evidence-based strategies.
  • Engage a variety of constituencies. Work collaboratively with campus and community partners to strengthen the commitment to prevention. Students can be a source of energy and ideas for enhancing the safety and quality of life on their campus.
  • Set realistic, measurable objectives.
  • Gather new evaluation data to chart your progress (see the FAQ on monitoring campus alcohol problems).
  • Keep up with the research literature (see the FAQ on this topic).
  • Find ways to institutionalize structures and programs to make them less susceptible to changes in administration.
  • Celebrate the small successes along the way.
  • Persevere.

About CollegeAIM and ongoing research

How did the research teams arrive at ratings for the various strategies?

Six leading college alcohol intervention researchers worked in two teams of three, one team for individual-level approaches and one for environmental-level approaches, to produce ratings for the strategies. Their goal was to rate not only the interventions’ relative effectiveness, but also practical measures such as the relative costs to adopt and maintain the strategies and the magnitude of the implementation barriers. In addition, they assessed the quality and amount of research and coded for helpful descriptors such as public health reach, target and research populations, and staffing expertise needed. 

The teams first searched the research literature through 2012 to find studies and reviews for each strategy. Seminal studies from 2013 were added following the first round of reviews. The ratings were derived through both quantitative and qualitative processes. Researchers used the quantitative methods specified in the matrices’ legends and footnotes to estimate the effectiveness and amount of research for individual-level strategies, as well as the amount and quality of research for the environmental-level strategies. For estimated effectiveness for the environmental strategies, as well as estimated costs and barriers for all strategies, they used a qualitative process of assigning rating codes independently—based on literature reviews, direct knowledge of strategies in practice, or both—then resolving discrepancies through discussion and referral to the literature to reach a consensus.

Once the CollegeAIM analysis was completed, an additional 10 prominent college alcohol intervention researchers reviewed the many ratings and designations—720 data points in total—and provided insightful comments. The teams discussed all comments with NIAAA and incorporated the feedback into revisions, which then went through additional cycles of review and revision. Thus, CollegeAIM reflects a multistage process involving analysis, consensus, and review by a total of 16 prominent professionals with expertise in addressing alcohol issues on college campuses.

To keep CollegeAIM current, NIAAA plans to update it regularly.

What are some ways to keep up with the research literature on college alcohol interventions?

One convenient way is to have research abstracts or summaries delivered by email on a regular basis. A good source of curated studies is newsletters from professional support organizations, such as the National Center on Safe Supportive Learning Environments’ Higher Education e-Digest or the Higher Education Center’s UReport.

You can also set up automated searches for college alcohol intervention studies, using the National Institutes of Health’s PubMed database. For example, an NIAAA search under “AA [grant support] college student alcohol intervention” produced this list of studies. PubMed offers a tutorial on how to automate these searches and have results e-mailed to you, or your campus library might help you set this up.

If you find a new study that appears useful, be sure to assess the rigor of the study methods before making program decisions. If this is not your area of specialty, it’s a good idea to consult with campus experts in the behavioral and social sciences for their perspectives on the study methods and conclusions. (See the FAQ on strategies that are less well studied.)