1. An Evaluation of a New Alcohol Policy for Massachusetts State Colleges and Universities John R. Knight, MD* ; Sion Kim Harris, PhD*; Lon Sherritt, MPH*; Kathleen Kelley, MBA*; Shari Van Hook, PA-C, MPH*; Henry Wechsler, PhD ¥ *The Center for Adolescent Substance Abuse Research (CeASAR) at Children’s Hospital Boston, Harvard Medical School ¥National College Alcohol Study, Harvard School of Public Health

2. Acknowledgements The Robert Wood Johnson Foundation Substance Abuse Policy Research Program Massachusetts Board of Higher Education (MBHE) Administrators and students from participating Massachusetts colleges and universities

3. Massachusetts College Alcohol Study Events Summary September 1997September 1997 Deaths of two Mass. college students Deaths of two Mass. college students October 1997October 1997 MBHE enacts new alcohol policy MBHE enacts new alcohol policy September 1998September 1998 Massachusetts College Alcohol Study begins Massachusetts College Alcohol Study begins Nov. 1998 - May 1999 Time 1 data collection Nov. 2000 - May 2001 Time 2 data collection

4. Massachusetts College Alcohol Study Features of MBHE Policy (10/97) 1)Limit alcohol to certain supervised areas on campus 2)Segregate housing for students > 21 3)Require advance registration of social events with alcohol 4)Ban hazing 5)Implement “3 strikes and you’re out” disciplinary policy 6)Provide alcohol education programs 7)Develop working relationships with cities and towns 8)Enforce all federal, state and local laws 9)Notify parents about violations (added 6/99)

5. Massachusetts College Alcohol Study Features of MBHE Policy (10/97) 1)Limit alcohol to certain supervised areas on campus 2)Segregate housing for students > 21 3)Require advance registration of social events with alcohol 4)Ban hazing 5)Implement “3 strikes and you’re out” disciplinary policy 6)Provide alcohol education programs 7)Develop working relationships with cities and towns 8)Enforce all federal, state and local laws 9)Notify parents about violations (added 6/99)

6. Massachusetts College Alcohol Study Features of MBHE Policy (10/97) 1)Limit alcohol to certain supervised areas on campus 2)Segregate housing for students > 21 3)Require advance registration of social events with alcohol 4)Ban hazing 5)Implement “3 strikes and you’re out” disciplinary policy 6)Provide alcohol education programs 7)Develop working relationships with cities and towns 8)Enforce all federal, state and local laws 9)Notify parents about violations (added 6/99)

7. Massachusetts College Alcohol Study Features of MBHE Policy (10/97) 1)Limit alcohol to certain supervised areas on campus 2)Segregate housing for students > 21 3)Require advance registration of social events with alcohol 4)Ban hazing 5)Implement “3 strikes and you’re out” disciplinary policy 6)Provide alcohol education programs 7)Develop working relationships with cities and towns 8)Enforce all federal, state and local laws 9)Notify parents about violations (added 6/99)

8. Massachusetts College Alcohol Study Study Objectives To measure student drinking rates across schools within a single state-wide public college systemTo measure student drinking rates across schools within a single state-wide public college system To assess student and administrator perceptions of enforcement of their school alcohol policyTo assess student and administrator perceptions of enforcement of their school alcohol policy To assess level of association between school drinking rates and policy enforcementTo assess level of association between school drinking rates and policy enforcement

9. Massachusetts College Alcohol Study Study Objectives To measure student drinking rates across schools within a single state-wide public college systemTo measure student drinking rates across schools within a single state-wide public college system To assess student and administrator perceptions of enforcement of their school alcohol policyTo assess student and administrator perceptions of enforcement of their school alcohol policy To assess level of association between school drinking rates and policy enforcementTo assess level of association between school drinking rates and policy enforcement

10. Massachusetts College Alcohol Study Study Objectives To measure student drinking rates across schools within a single state-wide public college systemTo measure student drinking rates across schools within a single state-wide public college system To assess student and administrator perceptions of enforcement of their school alcohol policyTo assess student and administrator perceptions of enforcement of their school alcohol policy To assess level of association between school drinking rates and policy enforcementTo assess level of association between school drinking rates and policy enforcement

11. Massachusetts College Alcohol Study Hypotheses Student drinking rates and alcohol policy enforcement levels will vary across the individual colleges, despite uniform policyStudent drinking rates and alcohol policy enforcement levels will vary across the individual colleges, despite uniform policy Variation in drinking rates will be associated with school-level factors, including level of policy enforcementVariation in drinking rates will be associated with school-level factors, including level of policy enforcement

12. Massachusetts College Alcohol Study Hypotheses Student drinking rates and alcohol policy enforcement levels will vary across the individual colleges, despite uniform policyStudent drinking rates and alcohol policy enforcement levels will vary across the individual colleges, despite uniform policy Variation in drinking rates will be associated with school-level factors, including level of policy enforcementVariation in drinking rates will be associated with school-level factors, including level of policy enforcement

13. Massachusetts College Alcohol Study Study Sample Eligibility criteriaEligibility criteria 4-year public institutions of higher education in Mass. 4-year public institutions of higher education in Mass. Substantial residential student population Substantial residential student population Colleges included (n=11):Colleges included (n=11): University of Massachusetts campuses (3) University of Massachusetts campuses (3) Mass. state colleges (8) Mass. state colleges (8) Colleges excluded (n=16 ):Colleges excluded (n=16 ): 2-year community colleges (15) 2-year community colleges (15) No substantial residential student population (1) No substantial residential student population (1)

14. Massachusetts College Alcohol Study Data Collection Method At each school, surveys mailed to… Dean of StudentsDean of Students (Nov – Dec 1998) Campus Security ChiefCampus Security Chief (Nov – Dec 1998) Random sample of 225 studentsRandom sample of 225 students (Apr – May 1999)

15. Massachusetts College Alcohol Study Data Collection Tools Student Survey*Student Survey*  Demographics  Drinking behaviors and associated problems  Perceptions of school policy enforcement  Involvement with disciplinary system due to alcohol violations Administrator Surveys*Administrator Surveys*  Reactions toward policy change and perceived enforcement of policies Adapted from National College Alcohol Study instruments developed by Henry Wechsler * Adapted from National College Alcohol Study instruments developed by Henry Wechsler

16. Massachusetts College Alcohol Study Measures Student Binge Drinking Definition Proportion consuming... 5+ drinks in a row at least once in prior 2 weeks (men)*5+ drinks in a row at least once in prior 2 weeks (men)* 4+ drinks in a row at least once in prior 2 weeks (women)*4+ drinks in a row at least once in prior 2 weeks (women)* * Source: Harvard School of Public Health College Alcohol Study

17. Massachusetts College Alcohol Study Student Perception of Policy Enforcement “In your opinion, how strongly does your school enforce its alcohol policy?”  Proportion of students reporting “enforced” or “strongly enforced”

18. Massachusetts College Alcohol Study Dean and Campus Security Perception of Enforcement (14 items) 9 items: Level of enforcement in different settings or events (e.g., dorm parties, on- campus events, fraternity/sorority parties)9 items: Level of enforcement in different settings or events (e.g., dorm parties, on- campus events, fraternity/sorority parties) 5 items: Regularity of use of practices to limit student drinking (e.g., stop/search students entering dorms, check IDs at campus events)5 items: Regularity of use of practices to limit student drinking (e.g., stop/search students entering dorms, check IDs at campus events)

19. Massachusetts College Alcohol Study Data Analyses Dean and Campus Security Chief Enforcement Score:Dean and Campus Security Chief Enforcement Score:  Responses to 14 items summed and percent of possible total calculated Unit of analyses: SchoolUnit of analyses: School Pearson’s r or Spearman’s rho calculated for associationsPearson’s r or Spearman’s rho calculated for associations

20. Massachusetts College Alcohol Study Student Sample Demographics Total N = 1,252Total N = 1,252 Response rate 56% (range 49% - 65%) Response rate 56% (range 49% - 65%) 59% Female59% Female 88% White non-Hispanic88% White non-Hispanic 51% under 21 years51% under 21 years 50% lived on campus50% lived on campus 4% fraternity or sorority members4% fraternity or sorority members

21. Massachusetts College Alcohol Study Drinking Patterns of Students at Mass. State Colleges and Universities, 1999 Abstain (did not drink in past year) Abstain (did not drink in past year) Drank - No Binge (drank in past year but did not binge in past 2 weeks) Drank - No Binge (drank in past year but did not binge in past 2 weeks) Occasional Binge (binged 1-2 times in past 2 weeks) Occasional Binge (binged 1-2 times in past 2 weeks) Frequent Binge (binged 3+ times in past 2 weeks) Frequent Binge (binged 3+ times in past 2 weeks) 12% 26% 33% 29% Total N = 1,252

22. Massachusetts College Alcohol Study Drinking Patterns of Students at Mass. State Colleges and Universities, 1999 Abstain (did not drink in past year) Abstain (did not drink in past year) Drank - No Binge (drank in past year but did not binge in past 2 weeks) Drank - No Binge (drank in past year but did not binge in past 2 weeks) Occasional Binge (binged 1-2 times in past 2 weeks) Occasional Binge (binged 1-2 times in past 2 weeks) Frequent Binge (binged 3+ times in past 2 weeks) Frequent Binge (binged 3+ times in past 2 weeks) 12% 26% 33% 29% Total N = 1,252

23. Massachusetts College Alcohol Study Drinking Patterns of Students at Mass. State Colleges and Universities, 1999 Abstain (did not drink in past year) Abstain (did not drink in past year) Drank - No Binge (drank in past year but did not binge in past 2 weeks) Drank - No Binge (drank in past year but did not binge in past 2 weeks) Occasional Binge (binged 1-2 times in past 2 weeks) Occasional Binge (binged 1-2 times in past 2 weeks) Frequent Binge (binged 3+ times in past 2 weeks) Frequent Binge (binged 3+ times in past 2 weeks) 12% 26% 33% 29% Total N = 1,252

24. Massachusetts College Alcohol Study Drinking Patterns of Students at Mass. State Colleges and Universities, 1999 Abstain (did not drink in past year) Abstain (did not drink in past year) Drank - No Binge (drank in past year but did not binge in past 2 weeks) Drank - No Binge (drank in past year but did not binge in past 2 weeks) Occasional Binge (binged 1-2 times in past 2 weeks) Occasional Binge (binged 1-2 times in past 2 weeks) Frequent Binge (binged 3+ times in past 2 weeks) Frequent Binge (binged 3+ times in past 2 weeks) 12% 26% 33% 29% Total N = 1,252

25. Massachusetts College Alcohol Study Drinking Patterns of Students at Mass. State Colleges and Universities, 1999 Abstain (did not drink in past year) Abstain (did not drink in past year) Drank - No Binge (drank in past year but did not binge in past 2 weeks) Drank - No Binge (drank in past year but did not binge in past 2 weeks) Occasional Binge (binged 1-2 times in past 2 weeks) Occasional Binge (binged 1-2 times in past 2 weeks) Frequent Binge (binged 3+ times in past 2 weeks) Frequent Binge (binged 3+ times in past 2 weeks) 12% 26% 33% 29% Total N = 1,252

26. Massachusetts College Alcohol Study Overall Binge Drinking Rates Among 11 Mass. State Colleges and Universities, 1999 Range:  71% to 36% (among all ages)  73% to 37% (among underage) Variation only partially explained by student demographics

27. Massachusetts College Alcohol Study Student Perception of Policy Enforcement: Overall Sample How strongly enforced?How strongly enforced?  66% enforced/strongly enforced  20% weakly or not at all enforced  14% didn’t know policy Student perception of enforcement level related to own drinking levelStudent perception of enforcement level related to own drinking level  74% of binge drinkers felt enforced/strongly enforced  56% of abstainers or drinkers who didn’t binge

28. Massachusetts College Alcohol Study % Students Reporting Policy Enforced or Strongly Enforced by School, 1999 Wide variation across schools (35% to 90%).Wide variation across schools (35% to 90%). Only about 1/2 of variation explained by binge rate, gender, age, and on- campus housing.Only about 1/2 of variation explained by binge rate, gender, age, and on- campus housing.

29. Massachusetts College Alcohol Study Correlation Between Administrator Enforcement Scores and School Binge Rates * Pearson’s correlation coefficient p<0.10 Campus Security (n=10 ) Deans(n=11) Percent Binge: All Students-.45.30 On-Campus Students On-Campus Students-.40.24 Underage Students Underage Students-.47.22 Percent Frequent Binge: All Students All Students -.61* -.61*.42 On-Campus Students On-Campus Students-.46.20 Underage Students Underage Students -.60* -.60*.37

30. Massachusetts College Alcohol Study Correlation Between Administrator Enforcement Scores and School Binge Rates * Pearson’s correlation coefficient p<0.10 Campus Security (n=10 ) Deans(n=11) Percent Binge: All Students-.45.30 On-Campus Students On-Campus Students-.40.24 Underage Students Underage Students-.47.22 Percent Frequent Binge: All Students All Students -.61* -.61*.42 On-Campus Students On-Campus Students-.46.20 Underage Students Underage Students -.60* -.60*.37

31. Massachusetts College Alcohol Study Correlation Between Administrator Enforcement Scores and School Binge Rates * Pearson’s correlation coefficient p<0.10 Campus Security (n=10 ) Deans(n=11) Percent Binge: All Students-.45.30 On-Campus Students On-Campus Students-.40.24 Underage Students Underage Students-.47.22 Percent Frequent Binge: All Students All Students -.61* -.61*.42 On-Campus Students On-Campus Students-.46.20 Underage Students Underage Students -.60* -.60*.37

32. Massachusetts College Alcohol Study Summary of 1999 Results Binge drinking rates varied significantly among Mass. public colleges and universities.Binge drinking rates varied significantly among Mass. public colleges and universities. Despite a uniform policy, enforcement practices varied among schools.Despite a uniform policy, enforcement practices varied among schools. Stronger enforcement by campus security was moderately associated with lower school binge drinking rates.Stronger enforcement by campus security was moderately associated with lower school binge drinking rates.

33. Massachusetts College Alcohol Study Study Limitations Self-reported informationSelf-reported information Potential selection bias due to 44% student non-response ratePotential selection bias due to 44% student non-response rate Small number of schoolsSmall number of schools Cross-sectional studyCross-sectional study Other key informants not surveyed; i.e., Resident AssistantsOther key informants not surveyed; i.e., Resident Assistants

34. Massachusetts College Alcohol Study Study Strengths Able to look system-wide following a policy changeAble to look system-wide following a policy change Multiple key informant perspectivesMultiple key informant perspectives  Students  Deans of Students  Campus Security Chiefs

35. Massachusetts College Alcohol Study Implications/ Recommendations Colleges should consider:Colleges should consider: Review of policy and enforcement practices Review of policy and enforcement practices Support for “front-line” enforcement personnel (e.g., campus security, RA’s) Support for “front-line” enforcement personnel (e.g., campus security, RA’s) Enhancing communication among administrators involved in policy enforcement Enhancing communication among administrators involved in policy enforcement

36. Massachusetts College Alcohol Study Implications/ Recommendations Colleges should consider:Colleges should consider: Review of policy and enforcement practices Review of policy and enforcement practices Support for “front-line” enforcement personnel (e.g., campus security, RA’s) Support for “front-line” enforcement personnel (e.g., campus security, RA’s) Enhancing communication among administrators involved in policy enforcement Enhancing communication among administrators involved in policy enforcement

37. Massachusetts College Alcohol Study Implications/ Recommendations Colleges should consider:Colleges should consider: Review of policy and enforcement practices Review of policy and enforcement practices Support for “front-line” enforcement personnel (e.g., campus security, RA’s) Support for “front-line” enforcement personnel (e.g., campus security, RA’s) Enhancing communication among administrators involved in policy enforcement Enhancing communication among administrators involved in policy enforcement

38. Massachusetts College Alcohol Study Implications/ Recommendations Colleges should consider:Colleges should consider: Review of policy and enforcement practices Review of policy and enforcement practices Support for “front-line” enforcement personnel (e.g., campus security, RA’s) Support for “front-line” enforcement personnel (e.g., campus security, RA’s) Enhancing communication among administrators involved in policy enforcement Enhancing communication among administrators involved in policy enforcement

39. Massachusetts College Alcohol Study Article Reference Knight JR, Harris SK, Sherritt L, Kelley K, Van Hook S, Wechsler H. Heavy drinking and alcohol policy enforcement in a statewide public college system. Journal of Studies on Alcohol. 64(5): 696-703. (2003)

40. Massachusetts College Alcohol Study Dean and Campus Security Perception of Enforcement (14 items) 9 items: Perceived level of enforcement in different settings or events9 items: Perceived level of enforcement in different settings or events »“Rarely enforced” »“Enforced when violations are blatant or reported »“Aggressively enforced in all circumstances”

41. Massachusetts College Alcohol Study Dean and Campus Security Chief Perception of Enforcement cont’d. 5 items: Perceived regularity of use of practices to limit student drinking such as…5 items: Perceived regularity of use of practices to limit student drinking such as… »Stop or search students entering dorms or residence halls »Check student IDs at campus events

42. Massachusetts College Alcohol Study MA Aggregate Trends in Student Drinking and Marijuana Use, 1999-2001 Percent of Students * * * Statistically significant difference, p<0.05

43. Massachusetts College Alcohol Study Percent Change in Student Binge Drinking Rates Across 11 Schools 1999-2001 Decrease Increase