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 factorsEnvironmental Community factorsManagement 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.Dry campus 2.Specific restrictions to access 3.Parental notification 4.Mandatory referral 5.Limiting advertising 6.Increasing alcohol price 7.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 Phone: 217/ Fax: 217/ Technical Assistance; Conferences and Trainings; Communication and Clearinghouse Materials; Assessment, Program Planning, and Evaluation; Collaboration and Networking; Strategic Planning; Policy Review; Funding