Group First Step Brief Motivational Interviewing with Statistically High Risk Groups Julie Lyzinski, M.Ed., L.P.C. Tamarah Smith-Dyer, M.S. Office of Alcohol and Other Drug Program Initiatives University of Pennsylvania

Background Brief Motivational Interviewing (BMI) – B.A.S.I.C.S. model: Well Researched Effectiveness* – Based on: Harm Reduction Stages of Change Theory – Recommended: NIAAA (2002) tier 1 – Effective: With Individuals* – Efficient: Ideal for use in college settings (Dimeff, *(Dimeff, L. A. et al., 1999; Walters & Baer, 2006; NIAAA, 2002).

Why Cohort-Based Intervention? Addresses the impact of group culture on high risk AOD behaviors – Peer influence is reported as: The most common environmental risk factor for alcohol use in adolescence * The single best predictor of young adult drinking* – Community norms are linked to drinking rates.** Research of cohort BMI interventions is limited. *Jessor & Jessor (1977) and Kandel & Andrews (1987) **Walters & Baer (2006) (p. 5)

Why Cohort-Based Intervention? Group First Step – Facilitates change within a specific group's culture – In turn, creates safer, healthier group environments – AND simultaneously impacts individuals' behavior within the group.

Background BMI in a group setting – Strengths Increases access/decrease resources Addresses cultural/environmental contributors to high risk drinking -Group traditions (formal/informal) -Attitudes toward AOD use -Group expectations/Peer pressure Impacts campus wide behaviors – Weakness Limited research

Using BMI in a Group Intervention Components: 1.Pre-survey (online) 2.Individual feedback form ( ) 3.Group feedback (verbally during meeting) 4.Group meeting (~2 hours): – Risk Behavior Continuum – Small/large group discussion – Group data feedback – Identify misperceptions/discrepancies – Education/information – Harm Reduction 5.Post-survey (online)

Using BMI in a Group Risk Behavior Continuum: 12 realistic scenarios involving AOD Break into groups of 4-5 Students rate the scenarios (high, moderate or low risk) Return to large group to discuss ratings: – Why? – If high risk, what would make the situation moderate or low risk? – If low risk, at what point would this become a high risk situation?

Using BMI in a Group Example: “A student smokes marijuana 3 or more times a week.” Common response: low to moderate risk *some will think it is high risk Discussion points: How many of you have smoked pot in the past 2 months? – Challenge w/ survey data What do you know about marijuana? What level of use would make this scenario high risk? – Common response: daily or several times a day What risks are involved with this level of use? What risks are involved with your definition of “high” risk use? Some key information Does this change your perspective? If so, how?

Using BMI in a Group Pre- Post Assessment / Personalized Feedback Assessment: – Measure high risk behaviors – Measure negative consequences – Measure protective factors – Measure culture change

Using BMI in a Group Pre- Post Assessment / Personalized Feedback Feedback: – Individualized feedback on BAC levels: last, highest & typical drinking occasion based on students sex, weight, time, quantity provided in survey – Information about how to stay safe – Define “what is a drink”

Using BMI in a Group Assessment and Feedback

NATIONAL DATA: Effectiveness of BMI Individuals Substantial amount of literature showing significant positive changes in drinking and related behaviors See reference sheet

Unrelated NATIONAL DATA: Effectiveness of BMI Groups- Unrelated students Limited research – 1992 thru 2007: Four studies (2 experimental/2 pre-post)* Involved unrelated students – Significant decreases in Alcohol consumption BAC *see reference sheet

Related NATIONAL DATA: Effectiveness of BMI Groups- Related students One study (2001) – Received both individual & group intervention – Significant decreases in Alcohol consumption BAC

PENN DATA: Effectiveness of BMI Measures of High Risk Drinking Measures included – BINGE DRINKING (4/5 drinks last 2 weeks) + BAC (>.08) – High risk drinking + FREQUENCY (4+ last 2 weeks) – Chronic high risk drinking

PENN DATA: Effectiveness of BMI Individuals & Groups (combine data) Population level assessment Annual Alcohol, Other Drug & Wellness survey Compared changes between ’05 and ’08 Significant decreases For entire population Significantly greater decreases for FS participants

PENN DATA: Effectiveness of BMI Individuals & Groups (combine data) First Step No First Step N Binge Drinking-10% -7% Chronic HR Drinking-14% -7% Negative Consequences-19%-16% Marijuana Use-20% -8% Cocaine Use -4% -2% Table 1. Decreases in AOD Use and Related Behaviors (AY 2004/05 – AY 2007/08)

PENN DATA: Effectiveness of BMI Groups of Fraternities & Sororities Program Participant Assessment Pre/Post surveys Compared 2 weeks prior and 2 months post Results Reflective of program goals 1.HIGH RISK DRINKING: Decreased 2.PROTECTIVE FACTORS: Increased 3.NEGATIVE CONS.: Decreased