The title of my talk
is "Research and Prevention, - Where Should They be Headed?" We heard last
night from Carol Kumpfer, Director of CSAP, that there is a great disconnect
[Slide 2] and I couldn't agree
with her more-the disconnect between research and practice. She spoke eloquently
about the problem of getting researchers involved in higher education research
- alcohol and drug prevention and higher education --and getting good,
effective evaluation research, that is, getting research about what works
and more research and evaluation about the nature of our various college
populations. And so in the face of the great disconnect and the need to
create closure between research and practice, I would suggest that we need
an agenda to move forward now from our stage of exploring promising practices
to documenting effective prevention results. We need to know what works
and be moving in those directions. Certainly we have much data, we could
use a lot more - but we have much data about the various problems out there
- but we know very little about what kinds of strategies are most effective.
Where has theory and
evaluation research led us to date?
[Slide 3] Traditionally, prevention strategies have focused on reactive
strategies. Let's fix the problem once it's broken, let's deal with the
problem users, the abusers, etc. We've gone long beyond that limited approach
and moved to strategies that we have been calling for years "proactive"
strategies. Those proactive strategies are designed to address potential
problems in populations before they start or before they become highly
problematic. Amidst those proactive strategies then we first saw strategies
that tried to treat and work with individuals, protecting individuals and
give them equipment, if you will, to avoid alcohol and other drug abuse
as individuals. We then moved our thinking to the environment. And that's
closer to really where we are today - in addressing collegiate environments
and what can we do to make those healthier and more protective places.
The discussion and research now, I think, is coming out of this environmental
movement and takes two tacks. Really, they're not independent or entirely
separate, but I'm focusing on one so I divide them. The first tact is what
I would call the Public Policy strategy - creating restrictions on the
environment, legal policy restrictions, creating punitive measures and
controls to what extent we can resolve problems there. Frankly, I think
that the question is still open to what extent these can be effective in
college populations. We don't have good evaluation research yet, as many
have said, about whether these kinds of environmental controls can work
and be highly effective in college situations.
The other approach,
I would say, that we've been taking, and the one I've been promoting the
most, is the focus on perceptions of social norms in college populations.
And the social norms approach has been one that's been emphasizing creating
more information and communicating to students about what the norms actually
are out there in college populations, regardless of whether we think they're
acceptable or not, because we now know the research is overwhelmingly clear
that students misperceive their campus and peer norms in an exaggerated
fashion in high degree and those misperceptions come back to have a negative
impact on the students on their own campus. So, what do we know about these
misperceived alcohol and other drug norms? [Slide
4] The research shows that they exist in all types of colleges; they
exist in all regions, all size programs. I've been working on a variety
of studies - a couple of years ago we were looking at data in New York
State. Core surveys of students showed that across New York State, students
misperceived the alcohol and other drug norms grossly in an exaggerated
fashion, even though rates and problem use are significant. I've looked
at other states - in New Jersey I've been working with a consortium there
where we're finding the same thing. Working with Phil Meilman and Cheryl
Presley and others of the Core Institute I've looked at national data showing
the same pattern across the board at colleges nationwide. We know that
this phenomenon exists in primary and secondary schools, as well. It also
exists across sub-populations of youth; it's not just men, not just women,
not just certain ethnic groups, not just students who are living in residence
halls but also commuter students, also Greeks organizations, independents,
and so forth. They have different levels of actual use but the misperceptions
are widely held across populations. We know that this these misconceptions
exist in state-wide populations of young adults, as well. I've been working
most recently with Montana State University in a study of young adults
in Montana, both college students and non-college students. We've found
that the misperceptions exist statewide in the actual levels in comparison
with the perceived levels of what we call "binge drinking" and also with
regard to protective behaviors, such as whether or not one will intervene
in a drinking and alcohol-impaired situation, for example. We know that
the misperceptions exist across attitudes, behaviors and for policies,
too. And this is where I think the misperceptions of social norms approach
and the public policy approach have some potential for working together
because if one can get more information out that students support public
policy, those policies that are invoked may be more effective and reduce
the possibility of backlash. Furthermore, misperceptions exist for all
types of drugs.
What are some of the
examples of strategies currently being employed on campuses across the
nation to reduce misperceptions? [Slide
5] Many schools have introduced mass media print campaigns over the
past few years and we have lots of examples of that in case studies and
workshops. Schools are now introducing multi-media and communications efforts
to reduce misperceptions. There are workshops for social groups, orientation
programs and various academic programs and cocurricular programs to reduce
misperceptions - again, getting the word out about what the actual norms
are versus what students think their peers are doing. And also we're developing
this approach within curriculum infusion initiatives as well. So all of
these are ways in which we've begun to address the problem of misperceptions.
When is the social norms
approach most effective in reducing alcohol and other drug abuse?
[Slide 6] What I'm finding in my own research is that when the dosage
is high, that is, when students are constantly exposed to messages, information,
discussion, debate about what the actual norms are, in an ongoing and intense
way, that kind of social marketing begins to make an effect. The approach
is also most effective when we use synergistic strategies, that is, when
the strategies that we use to reduce misperceptions can serve to facilitate
each other-- when strategies are inter-linked in campus prevention programs.
Well, what's the effect of
this? [Slide 7] Let me give you some local
information and then some information beyond my own campus. I have been looking
at case study evaluation research on the effects of social norm programs, and
they reveal marked results in model programs. That's where I think we're finally
seeing evaluation research show significant pay-off. Let me give you an example
of a project at my own institution - we were running a massive misperceptions
reduction campaign over an 18 month period - and these are rates of change in
problems. [Slide 8] First of all, we reduced
the perception of what we call heavy drinkers at parties and bars by 15%. We
reduced the actual heavy drinking at parties and bars by 15%. We reduced the
frequent heavy drinking rate by 21%. In terms of consequences of drinking, because
we reduced the heavy drinking and the highest end heavy drinking which produces
most of the consequences, we have seen even more significant reductions in some
of the typical negative effects of drinking. Property damage reported as a result
of heavy drinking was down by 36%; missing classes as a result of drinking was
down by 31%; unprotected sex as a result of drinking was down by 40%; and black-outs
or memory loss as a result of drinking was down by 25%. These are massive and
significant - all statistically significant - all tested with time one to time
two evaluation data.
How does this relate in terms
of other schools? We're finding similar effects in the rates of binge drinking
reduction at different schools as well, not just my own institution. And what
I've done is look at the data over 2 year periods-- different two-year time
spans between 1989 and 1998. [Slide 9] The
different projects used somewhat different measures of what we call heavy drinking,
but I standardized all of them to measure the rate of reduction in binge drinking
on each campus. I've already mentioned that our institution which is a private
small liberal arts college in upstate New York produced a 21% reduction. Also,
in the southwest the University of Arizona has produced a 21% reduction. Western
Washington University demonstrated a 20% reduction and Northern Illinois University
an 18% reduction using this approach. These are examples from all over the country,
in all types of universities, that witnessed double-digit reductions. So I think
there's a lot of hope there. I also think there are a lot of challenges and
concerns that we still need to talk about [Slide
10] with regard to the recent reports about "binge" drinking in
the media, our concept of "binge" drinking and how that influences
what we're doing in terms of communicating messages about what the norms are,
and we need to assess more protective behaviors, but my time is up for now.
Thanks for your interest in my thoughts.