Transcript Environmental Management: An Approach to Alcohol and Other

Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Dr. Charles Eberly and Becky Markwell
Illinois Counseling Association State Conference
November 8, 2002
Springfield, Illinois
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Alcohol Use Among College Students – The Context
•Pressing public health concern (Wechsler and
Wuethrich, 2002)
•Increasing legal concern for institutions (Bickel and
Lake, 1999)
•Public relations concern
•Most of what has been done in terms of alcohol
prevention has shown little efficacy (Walters, Bennett,
Noto, 2000)
•NIAAA report represents a specific “Call to Action”
aligned with the best thinking on what works
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
What Do We know About Effective Prevention?
•Special issue of Journal of Studies on Alcohol in March
2002 represents a coalescing of what is known about
alcohol use among college students, effective prevention
and intervention.
•What can be asserted with some certainty?
•Basic guidelines on good and not so good practices.
•Contextual nature of policy adoption.
•Overall alcohol use in decline (30 year trend), with fewer people
in moderate category (polarization of drinking behavior).
•Increase in highest risk group with highest consumption patterns.
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Annual High-Risk College Drinking Consequences
•1400 college students between the ages of 18 and 24 die
each year from alcohol-related unintentional injuries
•500,000 students are unintentionally injured
•600,000 students are assaulted by another student who
has been drinking
•70,000 students are victims of alcohol-related sexual
assault or date rape
•400,000 students had unprotected sex and more than
100,00 students report having been too intoxicated to
know if they consented to having sex
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Annual High-Risk College Drinking Consequences
•25% of college students report academic consequences of
their drinking
•More than 150,000 students develop an alcohol-related health
problem and between 1.2 and 1.5% of students indicate that
they tried to commit suicide due to drinking or drug use
•2.1 million students drove under the influence of alcohol
•110,000 students were arrested for an alcohol-related violation
•31% of college students met criteria for a diagnosis of alcohol
abuse
•6% met criteria for a diagnosis of alcohol dependence
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Prevention in the College Context
•Universal Prevention
•Targeted Prevention
•Indicated Prevention
•Early Intervention (Most institutions have
strong infrastructure built around this)
•Intervention
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Environmental Risk Factors in the College Context
•Group membership
•Housing (Greek and on-campus)
•Leadership positions (hold 2 or more)
•Access to alcohol
•Students in transition
•Media advertising
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Individual Risk Factors in the College Context
•History of problem drinking (including family
drinking)
•Gender
•Self-regulation skills
•Stress
•Personality traits
•Attitudes and beliefs about alcohol
•Age
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Targeting Risk Factors
•Universal Prevention
Universal education and policy approaches
•Targeted Prevention
Environmental risk variables targeted preventatively
Policy and enforcement in targeted formats
•Indicated Prevention
Individual risk variables targeted preventatively
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Basic Premise
People’s behavior is shaped by the physical, social,
legal, and economic environment in which they
live, work, and play…
In order to produce a large-scale
change in student drinking we must
work to change the campus and
community environment.
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Traditional AOD Prevention Strategies
Focus on Individual Change
•Early Intervention
•Treatment
•Education
•peer education
•curriculum infusion
•alcohol awareness week events
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Basic Orientation and Education
Programs Are Not Enough
We cannot expect students to say
“no” to high-risk drinking when
their environment tells them “yes.”
William DeJong, Higher Education Center for Alcohol and Other Drug Prevention
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Ecological Framework
Individual factors (students)
Peer factors (students)
AND
Institutional factors
Environmental
Community factors
Management
Public policy
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Effective Environmental Interventions
Age 21 Drinking Law
Over 18,200 lives and over $32 billion in economic
costs saved since 1975
Mandatory Seat Belt Laws
“Enforcement sends belt use to about 80 percent”
Insurance Institute for Highway Safety
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Factors in the Environment Contributing to
AOD Use
•Unstructured free time for students
•Widespread belief that college alcohol and other drug
abuse is acceptable
•Aggressive alcohol promotions targeting college
students
•Abundantly available, inexpensive alcohol
•Inconsistently enforced laws and policies
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Five Domains for Environmental Management
•Offer alcohol-free social, extracurricular, and public
service options
•Change the normative environment and correct
misperceptions of social norms
•Restrict the marketing and promotion of alcohol
•Limit alcohol availability
•Increase enforcement of laws and policies
Adapted from The Higher Education Center for Alcohol and Other Drug
Prevention
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Problem:
Students have a great deal of unstructured time
and too few alcohol-free social options.
Goal:
Offer wide range of alcohol-free options
Possible activities:
•Promote consumption of non-alcoholic beverages at events
•Open or extend hours of recreational facilities
•Promote student service-learning and volunteer opportunities
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Problem:
Widespread belief that college alcohol and
other drug abuse is normal
Goal:
Create health-promoting normative
environment
Possible activities:
•Increase alcohol-free residence units
•Reform academic policies, standards, and schedule
•Correct misperceptions of campus drinking behavior
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Problem:
Aggressive alcohol promotions target
college students
Goal:
Restrict marketing and promotion of
alcohol
Possible activities:
•Ban or restrict alcohol advertising on campus
•Ban or restrict alcohol industry sponsorship of events
•Limit party or event announcements
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Problem:
Alcohol is abundantly available and
inexpensive
Goal:
Limit alcohol availability
Possible activities:
•Institute an RBS program on- and off-campus
•Limit alcohol container size in on- and off-campus settings
•Limit number and concentration of alcohol outlets near
campus
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Problem:
Laws and policies are not consistently enforced
Goal:
Increase enforcement of laws and policies
Possible activities:
•Increase sanctions and prosecution of students who violate
campus policies and local laws
Campus
•Parental notification, “three strikes, you’re out”
Community
•Undercover operations at retail outlets
•Monitor off-campus parties by police
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Three Phases of Policy Adoption
1. Development
2. Implementation
3. Enforcement
Policy adoption and effectiveness is tightly
linked to the method of policy adoption and
enforcement in a particular college context.
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Evidence on Policy Approaches
1.
2.
3.
4.
5.
6.
7.
Dry campus
Specific restrictions to access
Parental notification
Mandatory referral
Limiting advertising
Increasing alcohol price
Universal education
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Misunderstandings about Environmental
Management
Misunderstanding # 1
Environmental Management simply means
tougher alcohol policies.
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Environmental Management…
•Can include tougher policies and stricter
enforcement
•Can also include:
-higher academic standards
-changes in academic calendar
-improved service-learning opportunities
-improved student housing
-improved social and recreational options
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Misunderstanding # 2
Environmental Management
overlooks key individual factors.
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Environmental Management…
•Is part of a comprehensive approach
to prevention
•Works best when fully integrated
with other approaches
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Misunderstanding # 3
Environmental Management
penalizes all students, not just heavy
drinkers.
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Environmental Management…
•Any alcohol consumption poses at least some risk
•Majority of alcohol-related problems are not caused by
heavy drinkers (heavy drinkers are proportionately
over-involved)
•All students are negatively affected by heavy alcohol
consumption and its consequences
•Strategies affecting the entire student population will
be the most effective
•Majority of students support new policies and tougher
enforcement
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Student Support for Stricter Enforcement
•Sanctions for alcohol-related violence: 89.8%
•Sanctions for repeat violations: 77.2%
•Penalties for fake IDS: 66.5%
•Undercover operations at retail outlets: 52.6%
Higher Education Center for Alcohol and Other Drug Prevention
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Misunderstanding # 4
Environmental Management has no
supportive evidence.
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Environmental Management…
•Consistent with public health approaches
to other health problems
•Grounded in rigorous research on
community coalitions and alcohol control
•Supported by case study evidence
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Human Behavior is Shaped by the
Environment
•The ability to plan and restructure our
environment for the express purpose of shaping
our behavior is a distinctly human quality.
•Planning the campus/community environment is
too important to leave to the alcohol industry.
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Advantages of Environmental Management
Puts emphasis on institutional, community,
and public policy change
-Conforms with general field of public health
-Conforms with emerging case law
Must take reasonable steps to deal
with foreseeable risk
-Area of weakness in current efforts
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Barriers/Challenges
•Powerful economic interest of alcohol and tobacco,
advertising and hospitality industries
•Social norms that accept or encourage high-risk
substance use
•Tension in our society between concept of individual
freedom and government regulation
•Resistance and disagreement among prevention
specialists regarding what is most effective
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Components of Successful College Prevention
Programs
1. Develop a multi-faceted (3-in-1) approach
a. individual students
b. student population as a whole
c. college and surrounding community
2. Form a campus task force or campus/community
coalition
3. Identify campus risk factors (collect and use data)
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Components of Successful College Prevention
Programs
4. Choose strategies that are developmentally
appropriate for college students
5. Use approaches based on evidence of effectiveness
6. Limit time spent on single events, fear appeals,
mock crashes
7. Focus on reducing risk factors and enhancing
protective factors
8. Evaluate your efforts
Environmental Management: An Approach to
Alcohol and Other Drug (AOD) Prevention
Illinois Higher Education Center for Alcohol, Other
Drug and Violence Prevention
Office of Safety Programs
Eastern Illinois University
600 Lincoln Avenue
Charleston, IL 61920
Phone: 217/581-2019 Fax: 217/581-6621
www.collegeaodvprevention.org
Technical Assistance; Conferences and Trainings; Communication
and Clearinghouse Materials; Assessment, Program Planning, and
Evaluation; Collaboration and Networking; Strategic Planning;
Policy Review; Funding