1. Social Cognitive Theory Based Predictors of Alcohol Use and Binge Drinking Among Asian Indian International Students in Mid-Western Universities
Samrat Yeramaneni, MBBS
Manoj Sharma, MBBS, CHES, PhD
Donald I. Wagner, HSD

2. Alcohol? Top five risk factors for disease burden (Rehm et al., 2004)
Globally - One-third (4%) burden of disease (Rehm et al., 2004)
Highest rate of alcohol use and associated problems – yrs age group (Ham & Hope, 2003)
Most popular substance abuse among college students (Prendergast, 1994)
Alcohol use - 95% college students (Yu & Shacket, 2001)
Factor aggravating the seriousness of problem - Binge Drinking
Binge drinking - 42% to 44% college students (Wechsler et al., 2000)

3. Alcohol Related Tragedies
Alcohol related problems - 18% college students (Slutske, 2005)
Academic, psychosocial, and health consequences (Delva et al., 2004)
Drinking and Driving – Over one half million injured (Leppel, 2006)
Alcohol related traffic fatalities - 1,400 college students (Hingson et al., 2002)
Second hand effects – higher police visits, disruption of sleep, property damage, verbal, physical, and sexual violence (Hingson et al., 2002)

4. Problem Statement The purpose of the study was to determine,
If the problem of alcohol use and binge drinking existed among Asian Indian International college students
Role and relation of situational perceptions, expectations (outcome expectancies * outcome expectations), self-efficacy and self-control as predictors of alcohol use and binge drinking based on Social Cognitive Theory

5. Asian Indian International Students?
Limited studies among international college students
Few studies done among Asian Pacific Islanders (APIs)
No studies done among Asian Indian college students
94.5% lifetime prevalence and 78.6% current prevalence (past 30 days) of alcohol use; among Asian American college students (So & Wong, 2006)
Percentage of drinkers and percentage of heavy drinking in APIs were lower when compared to the Caucasians (Makimayoto,1998)
Generality of results to all subgroups
Diverse predictors 5

6. Methodology Design: Cross sectional study Convenience sample
Sample size was calculated with an alpha of 0.05 and power of 0.80 with an projected effect size of This way a sample size of 197 was arrived (Polit & Hungler, 1999, P. 495)
Institutional Review Board (IRB) approval from University of Cincinnati and Ohio State University
International student’s office & Indian Students' Association – Weekly newsletter
Informed Consent
Confidentiality and Anonymity
Duration of study – 12 weeks (March’ 08 – June’ 08) 6

7. Instrumentation
Survey instrument: 46- item scale was developed and validated for face and content validity by a panel of six experts in a two round process
Six sections
Demographics
Frequency of Alcohol use and Binge drinking
Situational perceptions
Expectations (Outcome Expectations x Outcome Expectancies)
Self-efficacy
Self-control
Cronbach’s alpha and test-retest reliability coefficients for all the subscales were found to be over 0.75
Web based/Online – Survey Monkey TM 7

8. Demographics of the sample
Age:
Mean – 25 yrs
Gender:
Males – 68.2%
Females – 31.8%
Class:
Graduates – 63.7%
Doctoral – 21.6%
Alcohol use:
Male – 65.3%
Female – 55.1%
Total – 62%
Marital Status
Single – 87.8%
Married – 9.4%
GPA
Mean – 3.61
Number of years stayed in USA
Mean – 5 years & 6 months

9. Mean and Standard Deviations
Dependent Variables:
Average number of alcoholic drinks consumed in a typical week
Binge drinking - Over the last 30 days, number of days one had five or more drinks (male) and four or more drinks (female)
Number of days alcohol consumed during the past 30 days
Variables N
Minimum
Maximum
Mean
Std. Deviation
Average drinks consumed in a week
152 1 31
4.02
4.479
Binge drinking 12
1.69
2.517
Number of days alcohol consumed during the past 30 days 27
6.05
4.680

10. Mean and Standard Deviations
Number of years since drinking alcohol
Age at which Indian students started drinking alcohol
Variables N
Minimum
Maximum
Mean
Std. Deviation
Number of years since drinking alcohol
152 1 15
4.66
2.836
Age at which drinking alcohol was started 10 34
20.63
2.783

11. Mean and Standard Deviations
SCT constructs (Independent variables):
Total Situational Perceptions (Total SP)
Total Expectations (Total EXP)
Total Self-Efficacy (Total SE)
Total Self-Control (Total SC)
Variables N
Possible Range
Observed Range
Mean
Std. Deviation
Total SP
131
0 – 20
0 – 15
8.05
3.158
Total EXP
0 – 128
34.23
29.001
Total SE
0 – 24
16.19
6.152
Total SC
0 – 28
0 - 28
18.74
7.542

12. Cross Tabulations Cross tabs for Gender * Do you drink alcohol Gender
Chi-Square
p - value
Yes No
Total
2.322
0.128
Male
Count
109 58
167
% within gender
65.3%
34.7%
100.0%
% within drinking alcohol
71.7%
62.4%
68.2%
Female 43 35 78
55.1%
44.9%
28.3%
37.6%
31.8%
152 93
245
62.0%
38.0%

13. Cross Tabulations cont..
Cross tabs for Gender * Dependent Variables
Gender * Variable
Chi-Square df
p - value
Gender * Average number of drinks consumed in a week
21.530 14
0.089
Gender * Binge drinking
23.162 11
0.017
Gender * number of days alcohol consumed during the past 30 days
19.479 19
0.427

14. Cross Tabulations cont..
Cross tabs for Gender * Independent Variables
Gender * Variable
Chi-Square df
p - value
Gender * Total SP
23.398 14
0.054
Gender * Total EXP
63.695 66
0.558
Gender * Total SE
33.075 23
0.080
Gender Total SC
25.879 24
0.359

15. Multiple Regressions
Multiple regressions for average number of drinks consumed in a week & Independent variables with Gender
Model
Unstandardized Coefficients
Standardized Coefficients t
p - value B
Std. Error
Beta
(Constant)
Total SE
0.095
0.021
0.085
0. 005
0.357
1.109
4.339
0.270
0.000
Total SC
0.321
0.020
-0.011
0.115
0.005
0.004
0.340
-0.229
2.795
4.234
-2.855
0.006
Variable
Adjusted R2
Total SE
0.121
Total SC
0.167

16. Multiple Regressions cont..
Multiple Regressions for binge drinking & Independent variables with Gender
Model
Unstandardized Coefficients
Standardized Coefficients t
p - value B
Std. Error
Beta
(Constant)
Total SE
0.335
0.088
0.628
0. 036
0.209
0.534
2.431
0.594
0.016
Variable
Adjusted R2
Total SE
0.036

17. Multiple Regressions cont..
Multiple regressions for number of days alcohol consumed in the past 30 days & Independent variables with Gender
Model
Unstandardized Coefficients
Standardized Coefficients t
p - value B
Std. Error
Beta
(Constant)
Total SE
0.358
0.019
0.077
0. 004
0.360
4.661
4.383
0.000
Total SC
0.577
0.018
-0.011
0.103
0.004
0.342
-0.246
5.606
4.285
-3.079
Variable
Adjusted R2
Total SE
0.123
Total SC
0.177

18. Conclusions cont..
No significant relationship (p>0.05) was found between gender and alcohol use
No significant relationship (p>0.05) was found between gender and average number of drinks consumed in a typical week
No significant relationship (p>0.05) was found between gender and number of days alcohol consumed in the past 30 days
Significant relationship was found (p<0.01) between gender and binge drinking in the past 30 days

19. Conclusions cont..
No significant relationship (p>0.05) was found between gender and the four constructs of SCT; Situational Perceptions, Expectations, Self-efficacy and Self Control
In case of average number of drinks consumed in a week, the significant predictors were Self-efficacy (p<0.00) and Self Control (p<0.005)
In case of Binge drinking, the only significant predictor was Self-efficacy (p<0.01)
In case of number of days alcohol consumed in the past 30 days, the significant predictors were Self-efficacy (p<0.00) and Self Control (p<0.00)

20. Implications for Practice
Publicize the actual facts and correct damaging misperceptions
Intervention programs at university level are needed that focus primarily on:
Insights pertaining to alcohol use and its habits
students expectancies as well as the valuations of their expected drinking outcomes
Self-efficacy
Self Control
Social Cognitive Theory (SCT) – Excellent framework to design such interventions
Internet based initiatives

21. Implications for Practice
Special emphasis should be focused on strengthening the intercultural competencies of the international students
Cognitive –behavioral skills based programs should be implemented
Interventions focusing on student’s perceptions and constructions
Emphasis on changing characteristics of individual drinkers, such as their knowledge, attitudes, and perceptions
Additional constructs associated with alcohol use needed to be studied
cognitive and evaluate constructs - Perceived control & Perceived norms)
psychosocial variables - Anxiety, Social Support & Acculturation)

22. Limitations
There was no random selection of subjects introducing selection bias in the study
Data were all based on
self-report
One day memory recall
Reading and understanding ability of participants
The findings presented here are limited to two universities located in one unique region of the United States
Because of the cross-sectional nature of the data, there is a major concern for causal direction
Research needs to be done to identify and develop more valid measures of the construct of binge drinking