1. MARYANNE JACONIS, M.S. LENA NEWLIN, M.P.H., C.H.E.S. DAVE COZZENS, PH.D. CHARLIE KSIR, PH.D. MIKE DORSSOM, M.A. Alcohol Screening at the University of Wyoming

2. Agenda Background & Context: University of Wyoming PDSA Cycles Results Challenges Future Directions

3. University of Wyoming Public land grant university Only 4-year institution of higher education in Wyoming Approximately 13,000 students Located in southeast corner of Wyoming, in Laramie, population 31,000.

4. Alcohol Concerns at UW Sources: National College Health Assessment, Spring 2001, Spring 2011

5. Alcohol Concerns at UW UW Police Department Arrests Source: Wyoming Association of Sheriffs and Chiefs of Police, 2011 Average BAC Underage Consumption of Alcohol0.144 DUI0.131 DUI (minor)0.101 DUI Crash BAC0.14

6. Alcohol, Wellness Alternatives, Research, & Education (AWARE) Program Harm Reduction Approach 3-in-1 Framework: Educational Services at 3 levels  Individual student  Mandated education for policy violators  Evidence Based Approach: BASICS, ASTP, Motivational Interviewing, Alcohol EDU  Student population as a whole  Alcohol EDU for all freshmen, freshmen/parent orientation, peer education, Safe Ride, alternative late night programming, etc.  Campus and surrounding community  Coalitions (A-team, CoPSA), alcohol policies and ordinances, Summit, NCHIP, TiPS training for local distributors, etc.

7. National College Health Improvement Project (NCHIP) Teams from 32 colleges and universities form a Learning Collaborative on High-Risk Drinking 18 months focused on evaluation and measurement techniques to identify and implement the most effective ways to reduce high-risk drinking “Plan-Do-Study-Act (PDSA)” Cycles

8. Alcohol Screening at UW No systematic campus-wide screening as primary prevention Individual-based interventions occurred only after an alcohol violation Aim: To reach students where they are already receiving services

9. PDSAs for Systematic Campus-Wide Screening Systematic Campus- Wide Screening University Counseling Center Student Health Services Career Services & Advising Psychology Training Clinic Counselor Education Training Clinic Peer Education

10. Screening Measures AUDIT  10 questions  Score 0-7: Low risk drinking  Score 8-18: May be experiencing or at risk of experiencing health consequences as a result of drinking  Score 19-40: Possible alcohol dependence AUDIT-C  3 questions  Scale of 0-12  Positive for alcohol misuse (men) 4+  Positive for alcohol misuse (women) 3+ Administered by:  Licensed mental health providers, graduate student trainees, medical staff, peer educators

11. University Counseling Center PDSA Cycles ActPlan StudyDo One Clinician All Clinicians for 50 screenings All Clinicians for One Semester All Clinicians for One Year Institutionalization Feedback

12. Positives Negatives Easy for front office to hand out Feasible to incorporate into UCC’s electronic medical records system Picked up information that clinicians may not have caught (e.g., drinking & driving) Able to supplement conversation Gives more comprehensive picture of what’s going on with student One more form for clients to fill out Limited time How to do referrals? University Counseling Center: Feedback from PDSAs

13. Academic Year 2011-2012 Academic Year 2011-2012 July 1, 2012 – April 11, 2013 July 1, 2012 – April 11, 2013 400 AUDITS Scored 0-7: 306 (76%) Scored 8-18: 79 (20%) Scored 19-40: 15 (4%) 565 AUDITS Score 0-7: 440 (78%) Score 8-18: 95 (17%) Score 19-40: 30 (5%) AUDIT Results University Counseling Center

14. Spring Semester 2012 July 1, 2012-April 1, 2013 261 AUDIT-Cs Scored 0-3: 187 (72%) Scored 4-12: 74 (28%) 448 AUDIT-Cs Score 0-3: 448 (73%) Score 4-12: 164 (27%) AUDIT Results Student Health Services

15. Psychology Training Clinic Psychology Training Clinic Counselor Education Training Clinic Spring semester 2012 through April 29, 2013 45 AUDITS Score 0-7: 38 (84%) Score 8-18: 5 (11%) Score 19-40: 2 (4%) Spring semester 2012 32 AUDITS Score 0-7: 23 (72%) Score 8-18: 6 (19%) Score 19-40: 3 (9%) AUDIT Results Mental Health Training Clinics

16. Wyoming Union Athletic Department March 5, 2012 38 AUDITS Score 0-7: 25 (66%) Score 8-18: 13 (34%) Score 19-40: 0 (0%) April 4, 2012 27 AUDITS Score 0-7: 22 (81%) Score 8-18: 4 (15%) Score 19-40: 1 (4%) AUDIT Results Peer Education

17. AUDIT AUDIT-C Score 0-7: 76% Score 8-18: 19.3% Score 19-40: 4.3% Score 0-3: 72.5% Score 4-12: 27.5% Overall Summary of Results

18. Following Up No follow-up (608) Advised talking with health provider (100) Advised to reduce drinking (37) Advised to stop drinking (1) Out-patient referral (2) Inpatient referral (4) Referral to AWARE (8)

19. General Challenges Extra time for clinicians More forms for clients to fill out Training of screeners Personalized feedback Referrals out Poor fit within the system (Center for Advising and Career Services) Inconsistent completion of recommendations by screeners Changes to AWARE referral system necessary

20. Future Directions Determine what are the next steps Increase screening locations Institutionalization of AUDIT and AUDIT-C screenings across campus More screenings by peer educators across campus Continue to integrate screening as part of comprehensive approach

21. Questions? Maryanne Jaconis, M.S. Clinical Psychology Doctoral Student Psychology Department mjaconis@uwyo.edu Lena Newlin, M.P.H., C.H.E.S. AWARE Program Coordinator, Assistant Director University Counseling Center University of Wyoming Phone: 307-766-2187 lnewlin@uwyo.edu lnewlin@uwyo.edu