1. Focused Strategies for One College Social Event were Associated with Reductions in Binge Drinking Campus Wide Nancy Barnett Brown University Center for Alcohol and Addiction Studies Supported with funding from NIAAA

2. Background
Prevention and treatment of young adult alcohol abuse is a significant research and public health priority (NIAAA, 2002; USDHHS, 2007; CASA, 2007).
Few examinations of recommended environmental strategies or event-specific prevention
Data collection/surveillance challenging

3. Campus History
A student organized (alcohol-free) campus-specific event was associated with a high number of alcohol incidents each year.

4. Objective
To evaluate pre-post differences in drinking and alcohol-related consequences on a historically problematic night using daily drinking data from an in-progress study.

5. Campus-wide Environmental Changes in 2006
Campus dialogue and policy reviews
Changes in student event planning policies
Enhanced advising/management/oversight by Student Activities Office, including greater level of review/discussion of event plans with student management
Professional event services used more often
(i.e. the review report and associated changes that were happening across campus)
Using DeJong and Langfords matrix, the intervention level was group and institution level, and the intervention content was modifying environmental factors, protecting students from consequences
In many ways, the changes at the event itself would have little to no impact on drinking levels for this event (unless we were preventing people from sneaking it in), it was the clear messaging, campus conversation, and communication in advance of this event and experienced at related events that would have had primary responsibility for any behavior changes.

6. Specific Event Changes: Pre-event Planning
Clear articulation of organization goals and organizational buy-in about changes
Improved promotional plan
Prevention messages included in advertisement
Statement about exclusion of intoxicated individuals
Changes publicized in campus paper
Modified ticket sales
Number of attendees limited; staffing designed for that specific number
Increased cost to encourage investment; tickets not transferable
Advance ticket sales only; IDs checked against list to gain entry.
All guests received event policies at time of purchase; sales conducted at administrative office.
Specific strategies for this particular event
The effort focused on first-year students, who composed the majority of overly-intoxicated students last year
Organizational buy-in not only for the event but buy-in into their responsibility as event hosts.
This modification to party management reflects NIAAA Task Force on College Drinking “Tier 3” strategies (i.e.,. those that have “evidence of logical and theoretical promise, but require more comprehensive evaluation”), including increasing enforcement at campus-based events that promote excessive drinking, and adopting campus-based practices that appear to be capable of reducing high-risk use.
In many ways, the changes at the event itself would have little to no impact on drinking levels for this event (unless we were preventing people from sneaking it in), it was the clear messaging, campus conversation, and communication in advance of this event and experienced at related events that would have had primary responsibility for any behavior changes.
Buying tickets early and having the warning messages on advertisements gave students a sense of commitment to the event and the chance to plan ahead.

7. Specific Event Changes: Increased Prevention and Monitoring
Improved party management and security
Increased number of student event coordinators
Required training for coordinators
Non-student professional security staff and student life staff present
Pre-gaming prevention
Increased monitoring in residences in hours before event
Security and student managers monitored entrances for intoxication
Line outside was deliberate; provided adequate time for assessment
Medical evaluation available on site
Institutution and group level interventions
Content was on modifying environmental factors, protecting health, and providing treatment (medical

8. Program and Policy Levels
Areas of Strategic Intervention
Program and Policy Levels
Individual
Group
Institution
Community
Society
Prevention
Knowledge, Attitudes, Skills, Self Efficacy, Behavioral Intentions
Environmental Change
Alcohol-Free Options
Normative Environment
Alcohol Availability
Alcohol Marketing and Promotion
Policy Development and Enforcement
Health Protection
Intervention and Treatment
There were requirements for advertisements
Knowledge was targeted through promotional materials
Behavioral intention was a focus by increasing prices and sending messages about intoxicated people not being admitted
Health protection through on site EMS and
Intervention and treatment – people available to provide treatment, conduct evaluations, recognize intoxication and refer students.
Source: DeJong & Langford, 2002

9. Data from Ongoing Study
Sample: 3 cohorts of incoming undergraduates randomly sampled, oversampling for ethnic minorities. Total enrollment for this analysis N = 360 (44.7% male, 57.4% white).
Complete a survey prior to arriving at college, and biweekly online surveys of alcohol use, marijuana use, tobacco use, and alcohol-related experiences through their sophomore year. Response rate for the event weeks assessed = 91.3%.
Using this convenience sample, event-day reports were extracted for each of the two years (2005 and 2006).
Survey questions unrelated to event; no questions about party attendance

11. Cohort Comparisons
No significant differences in sex or race by cohort or class year.
No cohort differences in baseline (pre-frosh) or early frosh heavy drinking (reports in the six weeks prior to the target day).
Important to note that we first checked cohort differences. Since many of our comparisons were across cohorts, we first confirmed no demographic or drinking differences between cohorts.
When the same cohort was used, we had different subgroups and confirmed that there were no preexisting differences in these groups as well.

12. Measures Covariates Event day Demographics
Sex, race, age
First six weeks freshman year, average number of heavy drinking days per week
Event day
Alcohol consumption
Any alcohol use
Heavy drinking
Number of drinks
Estimated Blood Alcohol Concentration
Alcohol consequences
Any alcohol consequences
Medical events

13. Cohort Freshmen Sophomores Total (N = 360)1 --
(Sophomores in 2005)
N = 63
(38.1% male;
65.1% White) 63 2
(Freshmen in 2005)
N = 99
(49.5% male;
53.5% White)
(Sophomores in 2006)
N = 90
(47.8% male;
57.8% White)
189
(48.7% male;
55.6% White) 3
(Freshmen in 2006)
N = 108
(41.7% male;
108 *
No significant differences in sex or race by class or cohort year
No cohort differences in baseline or early frosh drinking
*Not the same students; no baseline differences in drinking

14. Any Drinking % who drank at all 2005 2006 Freshmen 46.5% 41.7%
(n = 99 in 2005; 108 in 2006)
Sophomores 28.6% 36.7%
(n = 63 in 2005; 90 in 2006)
All (n = 162 in 2005; 198 in 2006) 39.5% 39.4% ns ns ns ns
Freshmen 2005 vs. freshmen 2006, χ2(1) = 0.48, ns.
Freshmen 2005 vs. sophomores 2006 (same class of students), χ2(1) = 1.86, ns.
Sophomores 2005 vs. sophomores 2006, χ2(1) = 1.09, ns
All 2005 vs. 2006, χ2(1) = 0.00, ns.

15. Heavy Drinking % who drank heavily 2005 2006 Freshmen 34.3% 21.3%
(n = 99 in 2005; 108 in 2006)
Sophomores 20.6% 18.9%
(n = 63 in 2005; 90 in 2006)
All (n = 162 in 2005; 198 in 2006) 29.0% 20.2% * * ns
When all of these individual comparisons were entered into separate logistic regression equations, using sex, age, race (white/non), pre-frosh number of heavy drinking days per month and prior frosh number of heavy drinking days per week drinking as covariates, year predicted heavy drinking at .05 to .01, with the exception of sophomores.
Logistic regression for freshmen, controlling for prior heavy drinking in freshman year, B = -1.30, p < .01.
Covariate was number of heavy drinking days in first six weeks of freshman year
Logistic regression for cohort 2, which is freshmen to sophomores, controlling for prior heavy drinking in freshman year, B = -1.19, p < .01.
When all are compared from 2005 to 2006, controlling for heavy drinking in the first six weeks of freshman year, year significantly predicts less drinking, B = -0.91, p<.01 †
Freshmen 2005 vs. freshmen 2006, χ2(1) = 4.41, p < .05.
Freshmen 2005 vs. sophomores 2006 (same class of students), χ2(1) = 5.72, p < .05.
Sophomores 2005 vs. sophomores 2006, χ2(1) = 0.07, ns
2005 vs. 2006, χ2(1) = 3.77, p < .06.

16. Number of Drinks 2005 2006 adj.M (SD) adj.M (SD)
adj.M (SD) adj.M (SD)
Freshmen 3.0 (4.2) 2.1 (3.5)
(n = 99 in 2005; 108 in 2006)
Sophomores 2.1 (3.5) 1.9 (3.4)
(n = 63 in 2005; 90 in 2006)
All (n = 162 in 2005; 198 in 2006) 2.7 (4.0) 1.9 (3.4) * * ns
Analysis of covariance using sex, age, race, and prior freshman drinking as covariates. (Same result with regression)
When you look at number of drinks only among those who drank, the reduction in number of drinks is about the same, 1-2 drinks lower in the second year, but the results are not as significant. Could be the size of the sample? *
Freshmen 2005 vs. freshmen 2006, F(1,200) = 4.62, p < .05.
Freshmen 2005 vs. sophomores 2006 (same class of students), F(1,183) = 5.86, p < .05.
Sophomores 2005 vs. sophomores 2006, F(1,147) = 1.05, ns.
2005 vs. 2006, F(1,353) = 5.86, p < .05.

17. Estimated BAC 2005 2006 adj.M (SD) adj.M (SD)
adj.M (SD) adj.M (SD)
Freshmen .064 (.095) .044 (.076)
(n = 99 in 2005; 108 in 2006)
Sophomores (.067) (.058)
(n = 63 in 2005; 90 in 2006)
All (n = 162 in 2005; 198 in 2006) (.086) .037 (.068) * ** ns
We get tehse when we use heavy drinking as covariate
Using f6wkbac as covariate things change to become not as significant *
Freshmen 2005 vs. freshmen 2006, F(1,191) = 4.60, p < .05.
Freshmen 2005 vs. sophomores 2006 (same class of students), F(1,178) = 8.11, p < .01.
Sophomores 2005 vs. sophomores 2006, F(1,143) = 0.89, ns.
2005 vs. 2006, F(1,340) = 6.47, p < .05.

18. Results
The proportion of freshmen and sophomores who reported drinking on the night of the party did not change from 2005 to 2006 (39%).
There was a consistent pattern of reduced heavy drinking, number of drinks, and estimated BAC.
The proportion of students who drank heavily reduced (29% vs. 20%, ES = .21, a 30% reduction).
The reduction in heavy drinking was greater among first-year students (34.3% in 2005 vs. 21.3% in 2006, ES = .34; a 38% reduction).
Average intoxication (estimated BAC) decreased by 23%.
Freshmen had been targeted

19. Results
No significant differences were found in the number of students who reported past-week negative alcohol consequences. (21.6% vs. 23.7%).
No reduction in EMS evaluations, but severity of cases was lower.
Didn’t do number of consequences because there was a high number of 0s.
Didn’t look at consequences only in drinkers on spg night because we can’t know their consequences happened on that day.

20. Conclusions
Lowered risk was reflected in rates of heavy drinking and in severity of medical cases on a night that historically had a high number of alcohol-related incidents.
Reductions were noted in a campus wide representative sample of freshmen and sophomore students, suggesting a broad impact of the prevention strategies on the campus at large, not just among party attendees.
Although there were no cohort differences, analyses controlled for demographics and prior drinking.

21. Limitations Non-experimental design
Alternative explanation: something else about the event or its attendants changed
No measure of party attendance or of specific consequences experienced that night
Not able to establish which of the many strategies used were effective
Lots of things occurred on this campus in this year, including a lot of attention to the party planners.
It is possible the event itself changed behavior (institutional memory? PTSD??)

22. Implications for Prevention
Multi-pronged but directed approaches may reduce hazardous drinking.
Additional campus resources required for implementation of similar strategic approaches.

23. Acknowledgments NIAAA Ricky Gresh Margaret Klawunn Frances Mantak
Michelle Loxley
Cheryl Eaton