Document Sample
Behavior Powered By Docstoc
					Anthony Passalacqua & Jared Scott Tesler
Theories and Models in Health Education
December 14, 2009

            Binge Drinking: College Students Ages 18 to 24

What is Binge Drinking?

          The National Institute of Alcohol Abuse and Alcoholism defines binge
           drinking as a pattern of drinking that brings a person’s blood alcohol
           concentration (BAC) to 0.08 grams percent or above.
          This typically happens when men consume 5 or more drinks, and when
           women consume 4 or more drinks, in about 2 hours.
          What do the numbers show?
               o The prevalence of binge drinking among men is 2 times the prevalence
                  among women.
               o Binge drinkers are 14 times more likely to report alcohol-impaired
                  driving than non-binge drinkers.
               o About 90% of the alcohol consumed by youth under the age of 21
                  years in the United States is in the form of binge drinks.
               o About 75% of the alcohol consumed by adults in the United States is
                  in the form of binge drinks.
               o The proportion of current drinkers that binge is highest in the 18- to
                  20-year-old group (51%).

Phase One: Social Assessment

                                       Quality of Life

Deaths due to unintentional injuries related to drinking alcohol

Injuries effecting the spinal cord and brain

Depression, stress, and alcoholism


“Binge drinking is associated with many health problems, including, but not limited to:
unintentional injuries (car crashes, falls, burns, and drowning); intentional injuries
(firearm injuries, sexual assault, and domestic violence); alcohol poisoning; sexually
transmitted diseases; unintended pregnancy; children born with Fetal Alcohol Spectrum
Disorders; high blood pressure, stroke, and other cardiovascular diseases; liver disease;

neurological damage; sexual dysfunction; and poor control of diabetes” (Centers for
Disease Control and Prevention, 2008).

Phase Eight: Outcome Evaluation

Substance abuse officials will conduct outcome evaluations, by looking at:

      unintentional injuries of students caused by alcohol-related incidents

      intentional injuries where alcohol played a factor

      alcohol-related illnesses, such as alcohol poisoning recorded at institution medical

      school police logs dealing with alcohol-related offenses

Phase Two: Epidemiological, Behavioral, and Environmental Assessment




Binge Drinking: “Binge drinking during college may be associated with mental health
disorders, such as compulsiveness, depression, anxiety, or early deviant behavior”
(Substance Abuse and Mental Health Services Administration, n.d.); “according to
national surveys, the prevalence of binge drinking among men is two times the
prevalence among women” (Centers for Disease Control and Prevention, 2008).

Unintentional Injuries: Car crashes, falls, burns, and drowning (Centers for Disease
Control and Prevention, 2008).

Intentional Injuries: Firearm injuries, sexual assault, and domestic violence (Centers for
Disease Control and Prevention, 2008).

Drunk Driving: “About one-half of all fatal traffic crashes among 18- to 24-year-olds
involve alcohol, and many of those killed are college students” (National Institute on
Alcohol Abuse and Alcoholism, 2005).

Physical Aggression: “Certain negative consequences associated with heavy drinking,
such as property damage and aggression, are more common among men than among

women; this pattern is not surprising, because male college students consume more
alcohol, on average, than female students” (National Institute on Alcohol Abuse and
Alcoholism, 2005).

Heavy Drinking: “Data from the College Alcohol Study (Wechsler, et al., 1999) of full-
time students at one hundred and fourteen four-year institutions indicated that the median
number of drinks consumed by all students, regardless of drinking status, was one-point-
five, yet the median number of drinks per week for frequent heavy episodic drinkers was
fourteen-point-five drinks per week; one in five students, it was found, was a frequent
heavy episodic drinker; this study showed that behavioral norms for alcohol consumption
varied widely among students and across colleges; this suggests the utility of looking at
the characteristics of institutions where heavy episodic drinking takes place; campuses
where heavy episodic drinking takes place are different environments, because of the
behavior of the students and, therefore, it is useful to learn more about them” (Presley,
Meilman, and Leichliter, 2005).


Type of Residence: “Although parents and peers were both influential in defining
standards of drinking, peers were more influential in terms of affecting actual drinking
behavior; normative influences vary for college students depending on where they reside
while attending school; students may seek out certain environments based on their
expectancies of alcohol use; in a survey of six hundred and six Rutgers University
undergraduates, O’Hare (1990) found that there were differences in drinking rates
depending on the living arrangements; commuters living at home were more likely to be
lighter drinkers than students who lived on campus; O’Hare found that men were twice as
likely to be heavy drinkers if they lived on campus; differences in drinking levels were
found for Core Survey respondents based on whether they lived in on- or off-campus
housing; the average number of drinks per week and the number of heavy episodic
drinking episodes were all higher for on-campus residents as compared with off-campus
residents, and students with the highest levels of consumption and heavy episodic
drinking episodes were those who lived in a fraternity or sorority house” (Presley,
Meilman, and Leichliter, 2005).

Size and Region: “Research from the Core Institute has shown that size of institution is
generally associated with quantity of alcohol consumed, with students at smaller schools
consuming greater amounts of alcohol on an average weekly basis than students at larger
schools; it has also been consistently shown that students at schools in the northeast
section of the United States consume more alcohol and have higher episodic drinking
rates than students in other sections of the country, with the north central region not far
behind; these sections of the country also show the highest figures for occasional heavy
use, and annual and thirty-day prevalence rates among young adults generally (Presley,
Meilman, and Leichliter, 2005).

Coed College Housing: “A new study in the Journal of American College Health finds
that students placed by their universities in coed housing are 2.5 times more likely to

binge drink each week than students placed in all-male or all-female housing; more than
500 students from five college campuses around the country participated in the study;
42% of students in coed housing reported binge drinking on a weekly basis; 8% of
students in gender-specific housing reported binge drinking weekly” (Science Daily,

Fraternities: “86% of fraternity residents report binge drinking” (Substance Abuse and
Mental Health Services Administration, n.d.); “leaders of fraternities tend to be among
the heaviest drinkers and the most out-of-control partiers, according to researchers at
Cornell University and Southern Illinois University at Carbondale; their national survey
of 25,411 students at 61 institutions reveals that Greek leaders are helping to set norms of
binge drinking and uncontrolled behavior” (Cornell Science News, 1997).

Society: “Acceptance of dangerous drinking is encouraged through mass media, peer
attitudes, role models, and the attitude of society in general; ways that this acceptance is
demonstrated include: movies, videos, music, and television that glorify drinking and
drunken behavior; sports figures, movie stars, peers, and local role models that appear to
gain popularity, sex appeal, and fun from alcohol, with no ill-effects; and lack of negative
consequences, either formal (laws and enforcement) or informal (social disapproval) for
those who engage in dangerous drinking or create problems while drunk, sending the
message that drinking is accepted, as is intoxicated behavior (drunk driving, assault,
vandalism, and public nuisance)” (, 2005).

Availability: “The more licensed liquor establishments in an area, the more likely
individuals are to drink; there is a 15-16% difference in individuals’ positive attitudes
towards drinking and an 11% increase in alcohol consumption, attributable to the density
of alcohol outlets in their neighborhood; this is also true of college students; the levels of
drinking and participation in binge drinking are higher when there are more alcohol
outlets near campus; studies have shown that the lower the price of alcohol, the more
people will drink; drink price specials, kegs, and other sources of low-priced alcohol
encourage binge drinking and intoxication; underage individuals are more likely to drink
when alcohol is readily available to them; this includes being able to buy alcohol on their
own at a bar or store, having others be able to buy it for them with little fear of
consequences, and having the opportunity to drink freely at keg parties or other social
events” (, 2005).

Advertising and Marketing: “Americans are bombarded with alcohol advertising;
expenditures for beer advertising are estimated at over $3.74 billion per year; broadcast
liquor advertising expenditures rose more than 620% between 1995 and 1997; alcohol
advertising helps create an environment that suggests that alcohol consumption and over-
consumption are normal activities, and contributes to increased alcohol consumption;
research has shown that media and advertisements are perhaps the most significant
predictor of adolescents’ knowledge about beer, current drinking behavior, and
intentions to drink” (, 2005).

Public Policies and Reinforcement: “Laws and regulations around alcohol affect the
community as a whole and can help change social norms, thereby affecting alcohol use;
examples of laws and regulations that have been shown to reduce underage alcohol use,
binge drinking, and the consequences of intoxicated behavior include: requiring
responsible alcohol beverage service training for bar owners and servers; eliminating
drink specials or setting minimum prices for drinks; strengthening laws concerning hours
of sale, density of retail outlets, and other factors affecting alcohol availability; funding
stronger enforcement of existing laws; passing stricter laws concerning drunk driving and
serving intoxicated drinkers; instituting keg registration and increasing penalties on those
who sell to, buy for, or serve underage drinkers; reducing advertising and alcohol
sponsorship of events; and restricting alcohol use or sale in parks, public places,
community events, and stadiums” (, 2005).

Phase Seven: Impact Evaluation

Universities and colleges will conduct impact evaluations to see to what extent the
programs are having an effect

Surveys will be sent out to all students, asking them to:

      rate the severity of student alcohol problems at their institution

      describe the quality of alcohol policies and educational or prevention efforts

      rate the overall success of their educational/prevention programs

      offer their opinions of the programs
      offer ideas in order to make educational/prevention programs more effective

Phase Three: Educational and Ecological Assessment

                                   Predisposing Factors

Genetics (alcoholism)

Growing up with binge drinking within the household


Family demographics

Efficacy beliefs

Coping ability

                                  Reinforcing Factors

Media influence

Peer influence/pressure

Perception of minimal risk

Perception that friends do not disapprove of binge drinking

Perception of high normative drinking

                                    Enabling Factors

College environment

Rules and regulations

Phase Six: Process Evaluation

College Board will have assigned substance abuse officials

Substance abuse officials will determine the extent to which the programs were actually
implemented throughout the nation

Phase Four: Administrative and Policy Assessment and Intervention Alignment

                                 Educational Strategies

                             Policy Regulation Organization

Phase Five: Implementation

To help deal with predisposing factors

Before freshman students come to school for classes, we want them to fill out a
questionnaire and survey

      Beck Depression Inventory-II

      Alcohol Expectancy Questionnaire-Adolescent

      The Self-Efficacy Scale

Students that score high on this questionnaire will report to their school counseling
service and speak with assigned substance abuse officials

Alcohol education for incoming freshmen:

      Incoming freshman must take a required alcohol educational seminar

      Incoming students in fraternities, sororities, or athletics must go through a
       required alcohol educational seminar

To help deal with reinforcing factors

Media influence:

      Discourage any media influence on campus towards the selling or distribution of

      Create school-wide media towards the dangers of binge drinking

Students caught distributing or holding events where alcohol is served while on campus
will have to undergo a weekly evening alcohol seminar for approximately four weeks

To help deal with enabling factors

Alcohol free campuses:

      One in three colleges, alcohol is not permitted on campus for any student,
       regardless of age

Alcohol-free residence halls:
    Forty-three percent of all schools, including those that are dry campuses, banned
      alcohol in all campus residence halls

Restriction at college-sponsored, on-campus events:

      Restricting alcohol use at sponsored sporting events, tailgating events, post-game
       parties, homecomings, dances, on-campus banquets, and alumni events

Create an alcohol-free committee or club that sponsors weekly events for students to be
involved in—whether it be fairs, movie nights, or an on-campus alcohol-free dance club

Schools Nationwide:

    The most popular actions taken include the following:
         providing counseling and treatment services for students with abuse
         conducting alcohol education programs for freshmen
         restricting alcohol use at home athletic events
         conducting alcohol education toward fraternities and sororities
         only 34% of schools banned alcohol for all students on campus
         44% restricted alcohol use at several college-sponsored, on-campus events
         schools that conduct social norms campaigns were much less likely to
           restrict on-campus students’ alcohol use:
                the alcohol industry is a significant funder of alcohol education
                    programs on college campuses
                both the United States Department of Education and the alcohol
                    beverage industry have awarded millions of dollars in grants to
                    schools that perform social norms campaigns
                there is no scientific evidence that supports the effectiveness of
                    such student-oriented approaches as alcohol education programs
                    and social norms campaigns

Binge drinking in adolescents and college students. (n.d.). Substance Abuse and
       Mental Health Services Administration. Retrieved from

Biscaro, M., Broer, K., & Taylor, N. (2004). Self efficacy, alcohol expectancy, and
       problem-solving appraisal as predictors of alcohol use in college students.
       College Student Journal, 38, 541.

Brochures & flyers: The effects of environmental factors on alcohol use and abuse.
      (2005). Retrieved from

Centers for Disease Control and Prevention. (2008). Alcohol—quick stats on binge
       drinking. Department of Health and Human Services. Retrieved from

Coed college housing connected to frequent binge drinking. (2009). Science Daily.
      Retrieved from

Grace-Kobas, L. (1997). Fraternity leaders are the heaviest drinkers, national
      study shows. Cornell Science News. Retrieved from

High-risk drinking in college: What we know and what we need to learn. (2005).
       National Institute on Alcohol Abuse and Alcoholism. Retrieved from

Naimi, T. S., Brewer, R. D., Mokdad, A., Denny, C., Serdula, M. K., & Marks, J. S.
       (2003). Binge drinking among US adults. JAMA, 289, 70-75. Retrieved from

National Institute of Alcohol Abuse and Alcoholism. (2004). NIAAA council
       approves definition of binge drinking. NIAAA Newsletter, 3, 3. Retrieved from

Presley, C. A., Meilman, P. W., & Leichliter, J. S. (2005). College factors that
       influence drinking. The National Advisory Council on Alcohol Abuse and
       Alcoholism. Retrieved from

Quick stats: Binge drinking. (2008). Centers for Disease Control and Prevention.
       Retrieved from
       Shean, G., & Baldwin, G. (2008). Sensitivity and specificity of depression
       questionnaires in a college-age sample. The Journal of Genetic Psychology, 169,

Stein, L. A. R., Katz, B., Colby, S. M., Barnett, N. P., Golembeske, C., Lebeau-
        Craven, R., & Monti, P. M. (2006). Validity and reliability of the alcohol
        expectancy questionnaire—adolescent, brief. Journal of Child & Adolescent
        Substance Abuse, 16, 115-125.

Strano, D., Cuomo, M., & Venable, R. (2004). Predictors of undergraduate student
        binge drinking. Journal of College Counseling, 7.

Wechsler H., Seibring, M., Liu, I-C., & Ahl, M. (2004). Colleges respond to student
      binge drinking: Reducing student demand or limiting access. Journal of
      American College Health, 52.