Health Promotion Education in the Systems Engineering Curriculum. Ellen J. Bass Associate Professor Department of Systems and Information Engineering Susan E. Bruce Director, Gordie Center for Alcohol & Substance Education Department of Student Health

The social norms approach Approach to fixing exaggerated beliefs about the normal frequency and consumption habits of others with regard to alcohol The social norms approach has been used to counter misperceptions

The social norms approach Social Norms Approach Collect baseline data Develop simple, truthful, and consistent messages that highlight lower-risk drinking norms and protective behaviors Ensure credibility of the message source Deliver the message to the target population Support message retention within the population

A natural link between human factors engineers and the social norms approach Human Factors EngineeringSocial Norms Approach Characterize end user decision making Collect baseline data Develop functional requirements Develop simple, truthful, and consistent messages that highlight lower-risk drinking norms and protective behaviors User review/testingEnsure credibility of the message source Field testDeliver the message to the target population Iterate toward the final product Support message retention within the population

Path to the embrace of the social norms approach An evolving career that includes: Characterizing and modeling human judgment and decision making Developing methods to design and evaluate decision support interventions Developing methods to design and evaluate training Focusing on projects with tangible impact on society –Engaging students and collaborators in meaningful research and design (to me and to them) Developing pedagogical interventions that are effective and engage students Risk taking –Not following the traditional path –Ignoring those who do not share the value system

Path to the embrace of the social norms approach An evolving career that includes: Characterizing and modeling human judgment and decision making Developing methods to design and evaluate decision support interventions Developing methods to design and evaluate training Focusing on projects with tangible impact on society –Engaging students and collaborators in meaningful research and design (to me and to them) Developing pedagogical interventions that are effective and engage students Risk taking –Not following the traditional path –Ignoring those who do not share the value system Developing pedagogical interventions that are effective and engage students

Pedagogical interventions that engage the students Social norm marketing campaigns –Senior design projects –Independent studies Also alcohol education through curriculum infusion –Class case studies Engages students in engineering course content and alcohol education

Senior Design

The Foxfield Races

Beta Test Sample –EDHS 224, Substance Abuse and Society –SYS 3034, Systems Evaluation –Fraternity Foxfield Halloween # of Drinks Hours Drinking

Curriculum Infusion in System Evaluation Course Are the Foxfield Races an event that CASE should investigate or would resources be better utilized on other events? Should resources to educate students on high-risk drinking at Foxfield be applied to all students? What are the negative consequences of student drinking at Foxfield, if any? Are students potentially engaging in drunk driving? Are students well-prepared for the day at Foxfield? Do they have enough food and non-alcoholic beverages? Are students aware of the existing services to help them (transportation options, first aid, etc.)? Are there barriers to using them?

Drinking at Foxfield vs Other Times Average BACs during Sunday through Wednesday are statistically less then all other days measured Of the remaining days ANOVA analysis shows that Thursday is the only day that has BACs that are statistically unequivelent to Foxfield Individual 95% CIs For Mean Based on Pooled StDev Level Thurs (------*------) Fri (------*------) Sat (------*------) Football (------*------) Halloween (------*------) Foxfield (------*------)

22% had to serve as caretakers for their intoxicated friends. 3.6% experienced unwanted sexual advances 5.4% experienced personal property damage 10.9% experienced physical pushing, shoving, or hitting.

Papers based on this initial work Guha, P.N., Bass, E. J., & Bruce, S. E. (2006). A survey to investigate student drinking norms at Foxfield. IEEE Systems and Information Engineering Design Symposium. Charlottesville, VA, April 28, Came back after graduating! Included insights from SYS 3034 Guha, P.N., Bass, E. J., & Bruce, S. E. (2007). I drink, I get drunk, I fall down, no problem: An analysis of college binge drinking and related decision making behaviors. IEEE Systems and Information Engineering Design Symposium. Charlottesville, VA, April 27, 2007.

5 students redesigned survey over spring break of 3 rd year (motivated by SYS 3034) One student analyzed data over summer person Capstone team in

UVa Systems and Information Engineering Horses? There Are Horses at Foxfield? An Analysis of College Student Hazardous Drinking and Related Decision Making Behaviors University of Virginia April 25, 2008 Matthew White, Marin Odioso, Monica Weaver, Michael Purvis, Ellen Bass, and Susan Bruce Funded in part by the Office of Health Promotion IEEE Systems and Information Engineering Design Symposium. Charlottesville, VA, April 25, 2008.

Did You See a Horse at Foxfield? A Social Norms Approach for Targeting the Negative Consequences of Hazardous Drinking Marin Odioso, Michael Purvis, Monica Weaver, Matthew White, Ellen J. Bass, and Susan E. Bruce Systems and Information Engineering University of Virginia April 25, 2008 Funded by Office of Health Promotion, Z Society, The Network, UVA Parents Program, and Foxfield Racing Association

Approach Five-step social influence model (Haines, 1996) 1.Collect baseline data 2.Develop messages that highlight lower-risk drinking norms and healthy intervention norms 3.Ensure credibility of the message source 4.Deliver the message to the target population 5.Support message retention within the population This project is the first time this model is used to target a specific event at UVA. Little published data elsewhere.

Campaign Objectives Decrease number of students experiencing black outs during Foxfield by 50% from 9% to 4.5%. Decrease drinking before Foxfield by 20% from 48.8% to 39.1% Decrease the gap between the perceived and actual average number of drinks consumed at Foxfield by 50% from 4 a drink difference to only 2 drinks. Decrease impaired driving by 50% from 1.2% to 0.6%. Increase student awareness of the First Aid Tent location from 50.6% to 70%. Increase participation in the Savvy Fox sober driver program by 10% from 525 to 577 people.

Step 3: Ensure credibility of the message source: focus groups and stakeholder feedback Step 2: Develop messages that highlight lower-risk drinking norms and healthy intervention norms Step 4: Deliver messages to target population: posters, cups, and newspaper ads

Flyers, Posters, Ads, Cups, …

Curriculum Infusion SYS 3034: continue to create and evaluate cases –Learning Assessment grant I learned something new about [alcohol or drinking] [distracted driving ]

Curriculum Infusion SYS 3034 continue to create and evaluate cases –Learning Assessment grant I have changed my [drinking] [driving] behavior because of things I learned from doing the case

Curriculum Infusion Students continue to volunteer for course credit to continue the work Planning an interdisciplinary capstone –ADAPT (Alcohol and Drug Abuse Prevention Team) Working to engage faculty in other systems courses And disciplines

Students seeing the campaign elements reported consuming fewer drinks than those who did not see the specific elements: Stay hydrated poster (1.1 fewer drinks; t 2,445 =2.31, p=.021); Savvy Fox program poster (1 fewer drink; t 2,445 =2.066, p=.039); Signs of alcohol poisoning poster (0.9 fewer drinks; t 2,445 =1.68, p=.093); Free transportation home poster (0.9 fewer drinks; t 2,445 =1.89, p=.060); First aid tent location poster (0.8 fewer drinks; t 2,445 =1.74, p=.082); Tangible impact on society

Moving forward… Create a culture of integrating health behavior topics into science and engineering courses Develop materials to facilitate the integration Encourage other faculty to try similar approaches