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Challenging College Alcohol Abuse

Challenging College Alcohol Abuse (CCAA) is a social norms and environmental management program aimed at reducing high-risk drinking and related negative consequences among college students (18 to 24 years old). The intervention was developed at the University of Arizona based on work previously done at Northern Illinois University. CCAA uses a campus-based media campaign and other strategies to address misperceptions about alcohol and make the campus environment less conducive to drinking. Studies have shown that college students tend to perceive their peers' level of drinking to be higher than it actually is, which in turn influences their own drinking behavior. CCAA's media campaign addresses these misperceptions by (1) communicating norms using data from surveys conducted at the university, (2) educating students on less-known or less-understood facts related to alcohol, and (3) offering an opportunity to change the "public conversation" around alcohol use among students, staff, and the local community. Advertisements and articles in the school newspaper, press releases, campus displays, and other media are used to communicate factual information about alcohol and drugs and related topics such as health and wellness, sexual assault, and sexually transmitted diseases. CCAA provides small grants to fund and promote non-alcohol social events that compete with traditional drinking occasions. Some media coverage is targeted to higher-risk groups such as fraternity and sorority chapters, freshmen, women, and students living in residence halls. CCAA also includes components aimed at faculty and staff, parents, and the local community, such as encouraging increased restrictions and monitoring of on-campus and off-campus alcohol use.

Descriptive Information

Areas of Interest Substance abuse prevention
Outcomes Review Date: January 2007
1: Heavy drinking
2: Frequent drinking
3: Attitudes/beliefs related to alcohol
4: Consequences of alcohol and drug use
Outcome Categories Alcohol
Drugs
Ages 18-25 (Young adult)
Genders Male
Female
Races/Ethnicities Data were not reported/available.
Settings School
Other community settings
Geographic Locations Urban
Implementation History CCAA was first implemented at the University of Arizona in 1994. It has been continually implemented, evaluated, and refined each year since then, and as of 2007 continues to be an active component of the university's Campus Health Service.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No
Evaluated in comparative effectiveness research studies: No
Adaptations The University of Arizona CCAA staff has received funding to implement and evaluate social norms campaigns targeting specific at-risk groups, such as freshmen and sorority and fraternity members, in addition to the general undergraduate media campaign.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Universal

Quality of Research
Review Date: January 2007

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Glider, P., Midyett, S. J., Mills-Novoa, B., Johannessen, K., & Collins, C. (2001). Challenging the collegiate rite of passage: A campus-wide social marketing media campaign to reduce binge drinking. Journal of Drug Education, 31(2), 207-220.  Pub Med icon

Supplementary Materials

Johannessen, K. (2000). Challenging the collegiate rite of passage: The University of Arizona. Final Report.

Johannessen, K., Glider, P., Collins, C., Hueston, H., & DeJong, W. (2001). Preventing alcohol-related problems at the University of Arizona's Homecoming: An environmental management case study. American Journal of Drug and Alcohol Abuse, 27(3), 587-597.

Outcomes

Outcome 1: Heavy drinking
Description of Measures This outcome was measured using an item on the Core Alcohol and Drug Survey. Researchers surveyed samples of freshmen at the University of Arizona in 1995, 1997, and 1998 (while CCAA was being implemented). Students were asked how often they had five or more drinks per occasion in the last 2 weeks.
Key Findings Over 3 years of implementing CCAA at the university (1995 to 1998), the percentage of surveyed freshmen who reported having five or more drinks per occasion at least once in the last 2 weeks decreased from 43% to 31% (p < .01).
Studies Measuring Outcome Study 1
Study Designs Preexperimental
Quality of Research Rating 2.5 (0.0-4.0 scale)
Outcome 2: Frequent drinking
Description of Measures This outcome was measured using an item on the Core Alcohol and Drug Survey. Researchers surveyed samples of freshmen at the University of Arizona in 1995, 1997, and 1998 (while CCAA was being implemented). Students were asked how often they used alcohol within the last year. Frequent drinking was defined as drinking alcohol three or more times per week.
Key Findings Over 3 years of implementing CCAA at the university (1995 to 1998), the percentage of surveyed freshmen who reported using alcohol three or more times per week in the past year decreased from 22% to 17% (p < .05).
Studies Measuring Outcome Study 1
Study Designs Preexperimental
Quality of Research Rating 2.5 (0.0-4.0 scale)
Outcome 3: Attitudes/beliefs related to alcohol
Description of Measures This outcome was measured using items on the Health Enhancement Survey. Researchers surveyed all members of fraternity/sorority houses and residence halls at the University of Arizona in 1996, 1997, and 1998 (while CCAA was being implemented). Students were asked about alcohol-related knowledge, attitudes, and perceptions (e.g., how much college students drink when they party, how they feel and how they think others feel about attending alcohol-free parties and school events, and the relationship between drinking and sexual opportunity).
Key Findings Comparisons between 1996 and 1998 survey data revealed that over 2 years of implementing CCAA:

  • The percentage of survey respondents who said they believed "most college students have five or more drinks when they party" decreased from 58% to 40% (p < .01).
  • The percentage who said they believed "most [University of Arizona] students drink heavily during spring break" decreased from 85% to 78% (p < .01).
  • The percentage who said they believed "drinking alcohol increases sexual opportunity" decreased from 61% to 52% (p < .01).
  • The percentage who said they believed "alcohol-free events are not as much fun as events with alcohol" decreased from 37% to 27% (p < .01).
  • The percentage who said they "would rather go to a party that served alcohol than one that did not" decreased from 58% to 48%.
  • The percentage who said they believed "most college students are not interested in alcohol-free events" decreased from 51% to 41% (p < .01).
Studies Measuring Outcome Study 1
Study Designs Preexperimental
Quality of Research Rating 1.9 (0.0-4.0 scale)
Outcome 4: Consequences of alcohol and drug use
Description of Measures This outcome was measured using items on the Core Alcohol and Drug Survey. Researchers surveyed samples of freshmen at the University of Arizona in 1995, 1997, and 1998 (while CCAA was being implemented). Students were asked about consequences of alcohol and drug use in the past year (e.g., getting into a fight or argument, getting into trouble with campus police or other campus authorities, memory loss, being taken advantage of sexually, doing poorly on a test or project, and missing class).
Key Findings Comparisons between 1995 and 1998 survey data revealed that over the course of 3 years of implementing CCAA:

  • The percentage of survey respondents who reported getting into a fight or argument after drinking alcohol in the past year decreased from 32% to 20% (p < .01).
  • The percentage who reported getting into trouble with campus police or other campus authorities in the past year after alcohol or drug use decreased from 18% to 6% (p < .01).
  • The percentage who reported a memory loss in the past year after alcohol or drug use decreased from 33% to 24% (p < .05).
  • The percentage who reported being taken advantage of sexually in the past year after alcohol or drug use decreased from 15% to 8% (p < .05).
  • The percentage who reported doing poorly on a test or project in the past year after alcohol or drug use decreased from 22% to 15% (p < .05).
  • The percentage who reported missing class in the past year after alcohol or drug use decreased from 34% to 25% (p < .05).
Studies Measuring Outcome Study 1
Study Designs Preexperimental
Quality of Research Rating 2.5 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 18-25 (Young adult) 70.2% Female
29.8% Male 		Data not reported/available

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures 		Validity
of Measures 		Fidelity Missing
Data/Attrition 		Confounding
Variables 		Data
Analysis 		Overall
Rating
1: Heavy drinking 3.0 3.5 2.5 86 1.0 2.5 2.5
2: Frequent drinking 3.0 3.5 2.5 86 1.0 2.5 2.5
3: Attitudes/beliefs related to alcohol 2.0 2.0 2.5 86 0.5 2.5 1.9
4: Consequences of alcohol and drug use 3.0 3.5 2.5 86 1.0 2.5 2.5

Study Strengths

The Core Alcohol and Drug Survey is an established instrument. Internal consistency of measures was tested. While many claim that media campaigns can be effective in setting norms and affecting perceptions of norms (for better or worse), few studies have actually demonstrated the strength of this relationship, and even fewer have done so with college students.

Study Weaknesses

Test–retest reliability of instruments was not assessed. While the author noted the instruments had "concurrent validity," the exact meaning of this validity was not clear. The Health Enhancement Survey had content validity only. The relatively low response rates to the Core Alcohol and Drug Survey make response bias a concern, particularly given that it is not known whether survey respondents are representative of all college freshmen. The investigators did not meet the sample size and desired return rates recommended by the developer of the Core Alcohol and Drug Survey (South Illinois University Carbondale). History is also a threat to internal validity, as other policy changes occurred concurrently.
Readiness for Dissemination
Review Date: January 2007

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Class outlines and materials

Evaluation instruments and protocols

Johannessen, K., Collins, C., Mills-Novoa, B., & Glider, P. (1999). A practical guide to alcohol abuse prevention: A campus case study in implementing social norms and environmental management approaches. Tucson, AZ: University of Arizona Campus Health Service. Retrieved January 2007 from http://www.socialnorms.campushealth.net/images/guidebook-files/guidetoalcoholprevention.pdf

Program Web site, http://www.socialnorms.campushealth.net

University of Arizona Campus Health Service posters and newsletters

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials 		Training and Support
Resources 		Quality Assurance
Procedures 		Overall
Rating
2.3 1.5 2.5 2.1

Dissemination Strengths

The program Web site describes the five-step implementation process and offers links to a variety of materials and tools that could be adapted by a potential implementer. Numerous surveys and focus-group outlines are provided to help measure the intervention's impact. The online guide provided also devotes a chapter to outcome measurement and offers recommendations to future implementers on developing appropriate evaluations.

Dissemination Weaknesses

While the implementation materials describe in general terms what program components are required for replication, adapting the program in other localities may be difficult because all of the materials are specific to the development site (University of Arizona). No structured training program is offered for prospective implementers, and no ongoing training or mentoring is provided for campuses in the process of implementing the program. Intervention fidelity standards are not explicit. No guidance is provided for using or interpreting results from the included survey instruments.
Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description Cost Required by Developer
A Practical Guide to Alcohol Abuse Prevention, posters, newsletters Free Yes
Training, support, and quality assurance information Contact the developer Contact the developer

Additional Information

The cost for 1 year's implementation of the CCAA social norms media campaign, including staff time and materials development, is approximately $25,000. Additional staff time for environmental management, survey development, administration and analysis, and consultation and supplies is an additional cost of approximately $25,000.
Replications

No replications were identified by the developer.
Contact Information

To learn more about implementation or research, contact:
Peggy Glider, Ph.D.
(520) 621-5973
glider@email.arizona.edu

Consider these Questions to Ask (PDF, 54KB) as you explore the possible use of this intervention.

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