Assessment of attitude and behavior related to alcohyol use in col lege students after­ par t i c i pat i on in an alcohol awareness program by Charlotte H. Foresther. Thesis Nurs. 2909 F717a c.2 ASSESSMENT OF ATTITUDE AND BEHAVIOR RELATED TO ALCOHOL USE IN COLLEGE STUDENTS AFTER PARTCIPATION IN AN ALCOHOL AWARENESS PROGRAM By Charlotte H. Foresther, RN, BSN Submitted in Partial Fulfillment of the Requirements for the Degree Master of Science in Nursing Edinboro University of Pennsylvania Approved by: Judith Schilling, CRNP, PhD^/ Committee Chairperson 'XSmJ Ellen Pfadt, RN, MSN Committee Member Mary Anm Committei feine/r, RN, MSN o./ Date ' /U4 Xi Date Date lember jfl Z> V' C Acknowledgements I would like to take this opportunity to express my most sincere thanks to all of those without whose support this project would never have been completed. Grateful appreciation is extended to my committee of Mary Anne Weiner, Ellen Pfadt, and chairperson, Dr. Judith Schilling for their guidance. Thanks to Dr. Janet Geisel for the initial send-off and for occasionally listening to me whine. But most importantly I would like to thank my husband and my daughter for their unending patience and encouragement. Thanks to my Mom for her prayers, to my Dad for always being just over my shoulder, and to God for His unending love. My most humble thanks to each and every one of you. Abstract Assessment of Attitude and Behavior Related to Alcohol Use in College Students After Participation in an Alcohol Awareness Program Literature indicates that college students have a higher prevalence of alcohol use than their noncollege counterparts (U.S. Department of Health and Human Services, 1991). Heavy drinking causes problems for the drinker, threatens the quality and safety of the college experience for nondrinking students, and increases costs for colleges. (Harvard School of Public Health, 1995). Colleges and universities have developed programs to combat binge drinking (five or more drinks in one sitting for men, four for women), and to heighten campus awareness of the problem (Harvard School of Public Health, 1995). Edinboro University of Pennsylvania has such a program in place. Using the Core Alcohol and Drug Survey, this study evaluated the program’s effectiveness by measurement of change in: (a) self-reported alcohol use, (b) negative consequences resulting from alcohol use, (c) student perception of other students’ use of alcohol, and (d) awareness of campus alcohol and drug policies. A comparison of pretest (N-68) and posttest (n=19) results showed percentage changes but Chi Square testing rejected a relationship between program participation and change in behavior or attitude toward the use of alcohol. ii Table of Contents Content Page Abstract ii Chapter 1: Introduction 1 Background of the Problem 1 Statement of the Problem 4 Theoretical Framework 4 Statement of Purpose 7 Definition of Terms 8 Assumptions 8 Limitations 8 Summary 9 Chapter 2: Review of the Literature 10 Stepped Approach 11 Education Programs of the Alcohol Beverage Industry. 12 Prevention Programs Aimed at Young People 13 College Study 19 Edinboro University Program 19 Summary 20 Chapter 3: Methodology iii Content Page Null Hypothesis 21 Operational Definition 21 Research Design 21 Instrumentation 21 Sample 23 Informed Consent 24 Setting and Procedure 24 Data Analysis 25 Summary 25 Chapter 4: Results 26 Demographics 26 Measurement 31 Self-Reported Use 32 Negative Consequences Resulting From Alcohol Use 35 Student Perception of Other Students’ Use of Alcohol 35 Awareness of Campus Alcohol and Drug Policies 36 Extent of Alcohol Use Change 39 Summary 40 Chapter 5: Discussion 41 43 Conclusions iv Content Page Limitations 43 Recommendations 43 Summary 44 v List of Figures Page Figure 5 1. Revised Health Promotion Model vi List of Tables Table Page 1. College Class of Population 27 2. Age of Population 27 3. Sample Gender Distribution of Population 28 4. Residence of Population 28 5. Employment Status of Population 29 6. Living Arrangements: Where 29 7. Living Arrangements: With Whom 30 8. Distribution of Grade Point Average 30 9. Enrollment Status 31 10. Place of Permanent Residence 31 11. Past Two Weeks Report of 5 or More Drinks at One Sitting 33 12. Average Number of Drinks Consumed in a Week 34 13. Never Having Negative Conseguences Resulting From Alcohol Use.... oz 14. Perception of Average Campus Alcohol Use 38 15. Campus Situation on Alcohol and Drugs.............................. 39 16. Extent of Change in Alcohol Use Within the Last 12 Months 40 vii 1 Chapter I Introduction Studies show that college students’ drinking constitutes a major challenge to public health (Wechsler, Molnar, Davenport, & Baer, 1999). Edinboro University of Pennsylvania, a medium-sized public university in northwestern Pennsylvania has attempted to address this problem through the use of an Alcohol Awareness Program to which participants are referred under judicial procedures of the Student Code of Conduct. The purpose of this study was to examine the effect of this program upon the attitudes and behaviors of its participants. The theoretical framework for this study was the revised Health Promotion Model (Pender, 1996). It postulates that health promotion is multi­ dimensional in nature, and that the health of individuals is directly affected by the community, environment, and society in which they live. Situational influences have direct impact upon health promoting behaviors (Pender). It was the hypothesis of this research that the Alcohol Awareness Program has positive situational influence upon its participants and will, therefore, stimulate them toward the health promoting activity of alcohol avoidance. Assumptions, definitions of terms, and limitations to the study are also discussed in this chapter. Background of the Problem Misuse of alcohol, as well as other drugs, by this nation s youth has 2 come to be considered a major societal problem. Alcohol is the most widely used drug on the college campus (Presley, Meilman, & Lyerla, 1993). College students across the nation report consuming an average of five drinks per week, with males consuming 7.5 drinks and females 3.2 drinks per week (Presley, Meilman, & Lyerla, 1993). Overall, 41.8% of these nationally surveyed students reported having binged in the past 2 weeks, defined as consuming five or more drinks in one sitting for men, four for women (Presley et al, 1993). Edinboro University of Pennsylvania, where this research was conducted, used the Core Drug and Alcohol Survey, as designed by the Instrument Selection Committee of the Fund for the Improvement of Post­ secondary Education (FIPSE) (Presley et al, 1993), in 1996. The institution’s research personnel chose a random list of students from the total enrollment of 6,144. Representatives of the Wellness Program administered the survey to these 685 students. It was found that 53% of students reported binge drinking in the previous 2 weeks, with 49% reporting some form of public misconduct and 33% experiencing some kind of serious personal problem during the previous year (Edinboro University of Pennsylvania, 1996). It was also found that only 32% of the students knew that the campus had an alcohol and drug prevention program. Alcohol related health consequences are many, with the most serious being death via automobile crashes, suicide, acute alcohol intoxication or, 3 eventually, alcohol-related diseases (U.S. Department of Health and Human Services [DHHS], 1991). Despite laws restricting minors from purchasing alcohol, underage drinking continues to be a significant public health problem (Treiman & Beck, 1996). Alcohol use by college students is associated with academic problems, emotional problems, violence, and physical injuries (Wechsler, Fulop, Padilla, Lee, & Patrick, 1997). The culture of the campus, the opportunity to be independent of daily parental control, the need to conform, and the insecurity of this new environment, may all make college students vulnerable to heavy drinking (DHHS, 1991). When they do drink, college age students tend to be more reckless, with a growing trend toward drinking with the clear intent of becoming intoxicated, and drinking to the point of regurgitation or unconsciousness. There also is some evidence developing to show that drinking is heavier in colleges where campuses are isolated as compared with those in large urban areas (DHHS, 1991). College students’ drinking is risky and dangerous, especially considering that many young people are heavy episodic or binge drinkers (Wechsler, Molnar, Davenport, & Baer, 1999). The data indicate that behavioral norms for alcohol consumption vary widely among students and across campuses and, therefore, it may not be possible to design a one size fits all” approach to address the issue (Wechsler et al, 1999). 4 Statement of the Problem In the previously mentioned Core Alcohol and Drug Survey used to measure usage of drugs and alcohol at Edinboro University, a medium-sized public university in northwestern Pennsylvania, 49% of the respondents reported some form of public misconduct during the past year as a result of drinking or drug use (Edinboro University of Pennsylvania, 1996). In the same survey, 33% reported experiencing a serious personal problem such as sexual assault or injury. The campus Alcohol Awareness Program deals with students who have been referred under judicial procedures of the Student Code of Conduct for a violation of the Zero Tolerance for Alcohol and Other Drugs Policy. The effects of the Alcohol Awareness Program, specifically change in their participants’ usage and perceptions of alcohol and drugs, had not previously been assessed by measurement of changes in: (a) self-reported alcohol use, (b) negative consequences resulting from alcohol use, (c) student perception of other students’ use of alcohol, and (d) awareness of campus alcohol and drug policies. Theoretical Framework Nola J. Pender (1996) described her revised Health Promotion Model as an attempt to depict the multi-dimensional nature of persons interacting with their environment as they pursue health. As shown in Figure 1, each person has individual characteristics and experiences that affect their subsequent actions (Pender, 1996). 5 INDIVIDUAL CHARACTERISTICS AND EXPERIENCES BEHAVIOR-SPECIFIC COGNITIONS AND AFFECT BEHAVIORAL OUTCOME PERCEIVED BENEFITS OF ACTION 4 PERCEIVED BARRIERS TO ACTION PRIOR RELATED BEHAVIOR IMMEDIATE COMPETING DEMANDS (low control) AND PREFERENCES (high control) PERCEIVED SELF-EFFICACY -1 ACTMTV-RELATED AFFECT _ i PERSONAL FACTORS Biological Psychological Sodo-oiltaral INTERPERSONAL INFLUENCES (Family. Peers, Providers); Norms. Support Models 4 COMMITMENT TOA PLAN OF ACTION HEALTH PROMOTING BEHAVIOR SITUATIONAL INFLUENCES Options Demand Chantctenstlcs Aesthetics Figure 1. Revised Health Promotion Model. From Pender, 1996, p. 67. 6 The best predictors of future behavior are prior related behavior and the formation of habits that can or cannot be beneficial (Pender, 1996). Each person has been shaped biologically, psychologically, and culturally, and it is these factors that affect any health promoting behavior. The second part of Pender’s revised model constitutes the behavior-specific cognitions that influence a successful intervention. These include perceived benefits of action, or positive outcome expectations. Further, perceived barriers are viewed as the personal costs of undertaking a certain behavior. Perceived self-efficacy is a judgment of one’s ability to accomplish a specific outcome. Activity-related effect has to do with how a person felt prior to, during, and following a certain health-promoting behavior. Interpersonal influences affecting health promoting behavior include family, peer, provider, and societal pressures or encouragement to commit to a certain plan of action. Lastly, situational influences are cues that cause an individual to be drawn to, or alienated from, a certain behavior. When a preponderance of these behavior-specific cognitions is positively oriented, the individual is committed to a plan of action. Strong commitment may be sustained if immediate competing demands and preferences, such as work or family responsibilities, do not intrude upon the health-promoting behavior. The Alcohol Awareness Program affords students the opportunity to examine attitudes and values, gain knowledge about alcohol, explore drinking habits, and make informed decisions about future use. Behavior 7 modification and life style change may be perceived as benefits of action (Pender, 1996). Perception of self-efficacy is essential to activate behavioral changes (Pender). It is the hope of health awareness providers that information on alcohol, and encouragement for students to explore their own attitudes and values, will supply the interpersonal and situational influences needed to cause a decrease in the students’ use of alcohol. The nurse practitioner would assist clients in the identification of benefits and barriers to action. This provision of a positive interpersonal influence, would promote good health behavior. Statement of Purpose The purpose of this study was to examine the effect of the Alcohol Awareness Program at a medium-sized public university in northwestern Pennsylvania upon the attitudes and behaviors of its student participants, as measured by changes in: (a) self-reported alcohol use, (b) negative consequences resulting from alcohol use, (c) student perception of other students’ use of alcohol, and (d) awareness of campus alcohol and drug policies. A standardized Core Drug and Alcohol Survey was given to 68 students in the fall of 1999 prior to their participation in the Alcohol Awareness Program. In the spring of 2000 a shorter version of the same test was sent to those same students in order to assess any change in attitudes toward alcohol, as well as any change in the amount of alcohol consumed. 8 Definition of Terms The terms utilized in this study were defined as follows; 1. A drink is a 12 ounces of beer, a 4 ounce glass of wine, 12 ounces of wine cooler, or a serving of liquor that can be drunk in one swallow, taken straight or in a mixed drink (Harvard School of Public Health, 1995). 2. Binge drinking is five or more drinks in a row, one or more times during a 2 week period for men, and four or more drinks in a row, one or more times during the same period for women (Harvard School of Public Health, 1995). 3. Perception is direct or intuitive recognition: intelligent discernment and a capacity for comprehension (Gove, 1976) Assumptions The assumptions of this study were as follows: 1. The participating students were able to read and understand the questions on the survey. 2. Research participants answered the questions honestly. 3. Students took their referral to the Alcohol Awareness Program seriously, as evidenced by attendance and participation. Limitations The following were the limitations of this study: 1 The study sample was comprised of a small number of students representative of those referred to the Alcohol Awareness Program at a 9 public university in northwestern Pennsylvania. Findings, therefore, may not be generalizable to other populations. 2. It is difficult to attribute causal factors to the effects of intervention by the Alcohol Awareness Program. Summary The misuse of alcohol, as well as other drugs by our nation’s youth, has come to be considered a major societal problem (Presley, Meilman & Lyerla, 1993). College students’ consumption of alcohol, especially binge drinking, continues to be a serious problem for students and their institutions (Wechsler, Fulop, Padilla, Lee, & Patrick, 1997). The nature, extent, and associated problem of heavy episodic or binge drinking is the number one campus life concern for colleges nationwide (Harvard School of Public Health, 1995). The Revised Health Promotion Model developed by Nola J. Pender (1996) was the conceptual framework used for this study. This model was viewed as a useful way to predict those individuals who would or would not commit to a plan of action leading to health promoting behavior (Pender, 1996). This is an issue that is of importance to family nurse practitioners since adolescents are an important part of their practice. The responsible use of alcohol by these adolescents is a learned behavior that will have far reaching effects upon their future health and safety. This chapter also stated the purpose of the study, defined limitations, and stated assumptions. 10 Chapter II Review of the Literature This chapter reviews current literature concerning various alcohol awareness/prevention programs. It provides the reader with a selective overview of studies that have been done relating to the success or failure of education about substance abuse, from the elementary to the college level. Over the years, many administrations have opted to keep a low profile on alcohol prevention efforts at their universities (Harvard School of Public Health, 1995). However, the passage of the Drug Free Schools and Campuses Act in 1990 (revised in 1997, 1998, & 1999) affected the educational priorities on all college campuses. The 1999 amendments required that, as a condition of receiving funds or any other form of financial assistance under any Federal program, an institution of higher education must certify that it had adopted and implemented a drug prevention program (Education Department General Administrative Regulations, 1999). Edinboro University has developed a 5 to 6 hour course in alcohol education, to which students are referred by a Student Code of Conduct judicial procedure after violating the university policy of zero tolerance (Edinboro University of Pennsylvania, 1999). The purpose of this study was to evaluate the effectiveness of that alcohol education program. Although there have been a plethora of substance abuse prevention and education programs on university campuses in the past few years, most 11 go unevaluated and lack a theoretical perspective to help define and interpret relevant data (Cummings, 1997). Not only is it imperative that we know which programs or parts of programs are or are not successful, but we need to know why and how an intervention works so that other institutions might adopt such measures (Cummings). Stepped Approach. i ypically, group or individual counseling has been the only treatment option addressing the problem of alcohol consumption on university campuses (Black & Coster, 1996). The Stepped Approach Model (SAM) provides intervention in sequence, each of five treatment steps increasing in intensity from minimal intervention programs to individual treatment sessions. Black and Coster studied 3,880 students at the main campus of a large midwestern university via a survey questionnaire. The survey contained 74 open-ended questions. Topics covered included drinking history, drinking behavior, frequency, consumption, and interest in alcohol programs. A Kendall rank order correlation indicated reliability of the questions. Students rated their interest in each of the five steps of the alcohol reduction program, which was sponsored by the student health center on campus. A brief description of each step was given, then a question followed asking students to rate their interest on a 4-point Likert-type scale. Responses were analyzed by gender. Net change between adjacent steps, using the percentage of all participants with no interest in the step, was assessed with 12 a standardized z statistic. Data showed that interest in the program descended as steps ascended. Interest was decreased the least between steps 1 and 2. Interest then continued to decrease between steps 2 and 3, and stayed constant for both sexes thereafter. Generally, however, the students lacked interest in any intervention. Alcohol Education Programs Sponsored by the Alcohol Beverage Industry. A study to compare alcohol industry trade-sponsored education programs was done in 1984 and again in 1996 (Houghton, 1998). Members of the trade association were organizations such as the Beer Institute in the United States or the Scotch Whiskey Association in the United Kingdom. Letters and questionnaires about their programs were sent to 50 of these organizations in 1984, and 88 were surveyed in 1996. In 1984, 13 members or 26% responded that they did sponsor alcohol education programs, while 32 members or 36% responded in the same manner by 1996. Twice as many programs were in operation in 1996 than in 1984. The survey looked at four areas: the level and type of program activity, program evaluation, the message on which the program was focusing, and the level of collaboration between the association and other groups concerned with alcohol education (Houghton, 1998). A breakdown by type of activity from the positive responders showed alcohol education programs focusing on (a) the general public, (b) schools and colleges, (c) alcohol and traffic, (d) professional education, (e) employment settings, (f) educational research, and (g) those 13 programs listed as “others.” Comparing the focus of these programs, in 1996 drinking and driving was clearly the main topic of programs for young people, while in 1984 the larger issue was to drink in moderation. No number comparisons were given. The survey found that the trade associations themselves were evaluating their own programs. Houghton indicated that there was some increased attempt by the organizations to sponsor more autonomous evaluations in 1996 than in 1984. Independent program evaluations were felt to be essential in the future. Prevention Programs Aimed at Young People: Elementary-Middle School Age. A 2 year longitudinal study was done with 526 California students from two junior high schools, gathering data on the onset and prevention of smoking, alcohol, and drug abuse (McAlister, Perry, Killen, Slinkard, & MacCoby, 1980). Through intensive education by teams of five to seven trained high school students, 340 students in an experimental school were taught to resist social pressures that would lead them toward the use of alcohol, tobacco, and drugs. The objective was to increase the students commitment not to start smoking and to psychologically inoculate them against peer pressure. In the control school, 186 students were exposed to a general course of health education. Because the researchers were concerned about the possibility of encouraging alcohol and drug use by asking about it, only smoking onset was measured three times yearly until 14 the end of the first year of study. Using an anonymous self-reported survey, the researchers found that the estimated onset rate for cigarette smoking was 8.4% per year in the control school, but only 3.2% per year in the experimental school. These numbers were shown to be significant (p<0.05). At second year follow-up, there were significant differences in the numbers of students reporting being drunk during the past week between the control and experimental group: 16.2% for the control versus 5.6% for the experimental (p<0.01). A Norwegian study, reported in the journal Addiction, compared two different school-based alcohol prevention programs for 7th graders with a nontreated control group (Wilhelmsen & Laberg, 1994). Prevention programs were conducted at twelve schools with a total of 955 students participating. Four schools were randomly assigned to each of two conditions and the program was implemented over 2 months in 1992. The four remaining schools served as a control group. The two prevention programs were based on social-cognitive theory and differed only in the level of participation by teachers and peer leaders. In four of these schools the roles of teachers and peer leaders were highly specified and the program was outlined in great detail, while in another four schools responsibility was equally shared by the teacher and the peer leaders, and the program was outlined in much less detail. Peer-led groups discussed tradition, norms, pressure to drink, and attitudes. Believing that the less structured program would produce greater 15 student involvement, the researchers hypothesized that this version would be more effective in producing changes in alcohol use. Evaluation was by pre and post-survey, measuring intention to abstain and actual alcohol use. An ANOVA was used to test pre-post test differences, with analyses of covariance conducted in order to test the differences between the two prevention programs and the control group. Contrary to the researchers’ expectation, students in the highly specified group reported a significantly higher intent to abstain from alcohol use (p<0.01) than did the students in the less role specified group. The highly specified program was also more successful in preventing actual alcohol use (p<0.05). A 3 year study of a substance abuse program for rural adolescents was reported by Stevens and Mott (1996). The cohort study was conducted in New Hampshire among 4,406 children who were in elementary school, in junior high school, or in 10th grade in 1987. This was a rural population of broad economic range and was felt to be representative of rural children in New Hampshire. Three research arms were included: (a) a comprehensive school curriculum called “Here’s Looking At You, 2000;” (b) “Here’s Looking At You, 2000,” a parenting communication course, and a community task force; and (c) control schools that agreed not to implement any curriculum, parenting course, or community task force during the study period. Baseline questionnaires were collected. Interventions were then begun and continued for 36 months. Annua, follow-up data were collected. Analyses were done 16 concerning students’ initiation of cigarettes, marijuana, other illicit drugs, spitting tobacco, and alcohol use. Some positive prevention results were achieved for cigarettes, marijuana, other illicit drugs, and spitting tobacco, but no effects were found for any of the interventions for alcohol use at 36 months. Among all research subjects reaching high school, only 6.3% had not initiated drinking. Black, Tobler, and Sciacca (1998) reported a meta-analysis of 120 drug (alcohol, cigarettes, and illicit drugs) prevention programs conducted in schools with students in grades six through eight, and funded by the National Institute on Drug Abuse. The study focused on: (a) positive program features, (b) reasons for falsely concluding that peer programs are ineffective, (c) features of two models that compared interactive to non­ interactive programs, and (d) designing and implementing high quality, peerled programs. The interactive programs were shown to be superior to non- interactive programs in preventing drug use among adolescents. Positive program features were found to include face-to-face peer interactions, planned activities, student generated role-plays, age-appropriate experience, modeled and rehearsed interpersonal skills, and feedback from peers. No statistically significant differences were found between programs led by peers or educators, but all needed to be trained as facilitators, and to understand the value of the interactive approach. Peer programs previously found to be ineffective were determined to have been poorly designed, poorly 17 implemented, or conducted with little administrative support. Two studies were seen as exemplary (Black, Tobler, & Sciacca, 1998): (a) Botvin and colleagues conducted a 20-session cognitive-behavioral program for substance abuse prevention with 1,311 7th grade students from ten suburban New York junior high schools, designed to reduce interpersonal pressure to use drugs. Clinical success was found with interactive groups to be 9.5%, but only 1% with non-interactive; (b) Perry and Grant focused on four different countries, and found that students in peer-led programs demonstrated significantly lower alcohol use scores than did students in the teacher-led and control programs (p<0.04). The researchers recommended the use of school-based programs to identify at-risk youth, and the use of the peer-led model. A prevention program in Appleton, Wisconsin was conducted for students in grades two through six (Kearney & Hines, 1980). The study involved 935 students in an experimental group, and 449 students in a control group. The program was based upon the premise that people who develop drug/alcohol problems do so because of personal problems. Trained teachers taught self-esteem, decision making, and drug information/drug attitudes for the experimental group. The control group proceeded with classes as usual. The Piers-Harris Children’s Self Concept Scale was used to assess self-esteem, and team-developed instruments measured attitude, decision making, and drug facts. Children in the 18 experimental group significantly increased their feelings of self-worth (£<0.05), increased their decision making abilities (p<0.001), increased their factual knowledge about drugs (p<0.001), and improved their attitude towards use and misuse of drugs (p<0.001). A 2 year follow-up study of a social-cognitive intervention to prevent substance abuse was reported by Snow, Tebes, Arthur, and Tapasak (1992). An Adolescent Decision-Making Program was implemented when students were in the 6th grade. The initial participants consisted of 1,360 students enrolled in the public schools of two southern New England towns during the academic years of 1980-81 and 1981-82. Six hundred and eighty of the 6th grade students were designated as a control group, while the other 680 received an intervention that involved skills in decision making, group dynamics, and utilization of appropriate support systems. A substance abuse survey was adapted to rate frequency of substance use during the past year on a 7-point scale (never, once or twice, less than once a month, once or twice per month, once per week, two or three times per week, almost every day). Program and control groups were then compared on their use versus nonuse of substances when they reached 8th grade. Students who participated in the 6th grade intervention had a lower mean use of tobacco by 8th grade at a trend level of significance (p<0.09). Logistic regression analyses also were conducted to determine whether the intervention significantly predicted substance use (defined as tobacco, alcohol, 19 marijuana, LSD, amphetamines, barbiturates, heroin, inhalants, and cocaine) at the 8 grade follow-up. For alcohol use, a negative program effect was observed, a significantly higher proportion of intervention students reported alcohol use at 8th grade (p<0.03). College Study. An analysis of a prevention program developed at Wellesley College used a self-reported pretest to evaluate knowledge, behaviors, and attitudes about drinking (Gleason, 1994). Project WAIT (Wellesley Alcohol Informational Theater) used a substance abuse counselor to recruit, train, and direct a troupe of six to eight volunteer students who presented improvisational skits from materials they choose on topics such as peer pressure, sexual abuse, drunk driving, and other high risk situations. Afterwards, the troupe members and educator lead discussions. Surveys of those who were sophomores in 1988 and in 1990 showed that the number of students who had been intoxicated at least 40 times was reduced from 12% to 9% in the following 2 year period. When asked how many times they had been intoxicated in the previous 30 days, the number who said none increased from 44% to 54%, and those reporting five or more times decreased from 14% to 5%. Edinboro University Program The program with which this study is concerned is the Alcohol Awareness Program at Edinboro University of Pennsylvania. It is a 5 to 6 20 hour alcohol education course to which students may be referred under the judicial procedures of the Student Code of Conduct for a violation of the zero tolerance policy against alcohol or drugs. During four sessions, the students are given the opportunity to: (a) examine their attitudes regarding alcohol and its use, (b) obtain knowledge about the physiological, psychological, social, and legal effects and consequences of alcohol use/abuse (c) explore their own alcohol drinking habits, and (d) make informed decisions about future alcohol use. Throughout the course, students keep a drinking journal concerning the circumstances that surrounded each drinking episode, amount drunk, and behavior related to its use. Other self-assessment drinking instruments were used to provide individualized feedback to students. Summary This chapter has provided a review of the literature concerning various prevention programs. Although many substance abuse prevention and education programs have been ongoing at universities and colleges, few have been reported or evaluated (Cummings, 1997). It is the purpose of this study to evaluate one such college-level alcohol awareness program. 21 Chapter III Methodology This chapter describes the methodology that was utilized to assess the attitude and behavior changes related to alcohol use in college students after participating in an alcohol awareness program. Using the Core Alcohol and Drug Survey, attitudinal and behavioral changes were evaluated in 68 students referred to a campus alcohol awareness program. Included in this chapter are the hypothesis, operational definitions, research design, instrumentation, sample, informed consent, setting and procedure, and data analysis utilized for this study. Null Hypothesis The hypothesis of this study was that the Alcohol Awareness Program would not change the attitude or behavior of participants of the program, and that no changes would be shown in self-reported alcohol use, in negative consequences resulting from alcohol use, in perception of campus norms concerning alcohol use, or in the awareness of campus alcohol and drug policies. Operational Definitions The following terms are defined as they were used in this study. 1. Negative consequences are having had a hangover, performed poorly on a test, had trouble with authorities, damaged property, having been involved in arguments or fights, driving under the influence, missing classes, 22 suffering memory loss, being suspicious of having an alcohol problem , or having considered suicide (Presley, Meilman, & Lyerla, 1993) 2. Alcohol use is measured by the self-reported number of drinks consumed per week, and by episodes of binge drinking. 3. Campus policy awareness is measured by students’ responses to questions about the campus environment, policy enforcement on the campus, and their own desire for a substance free environment. 4. Perception of campus norms is measured by students’ responses to questions about average student alcohol use, where alcohol is used, activities participated in, and the association of alcohol with these activities. Research Design This study utilized an evaluation survey pretest-posttest research design. The goal of the survey was to gather information regarding four variables: (a) self-reported alcohol use, (b) negative consequences resulting from alcohol use, (c) perception of other students’ use of alcohol, and (d) awareness of campus alcohol and drug policies. Instrumentation The Core Alcohol and Drug Survey was used in this research (Appendix A). It was specifically designed by the Instrument Selection Committee of the Fund for the Improvement of Postsecondary Education (Presley, Meilman, & Lyerla, 1993) for use with a higher education population, and covers the following topical areas: demographics including 23 year in school, age, ethnic origin, marital status, gender, employment, living arrangements including place of permanent residence, academic achievement including self-reported grade average, full- or part-time status, activities participated, perceptions of campus substance abuse policies and their enforcement, average number of drinks consumed per week, frequency of binge drinking, patterns of use of alcohol, as well as other drugs, age of first use of alcohol, perceptions of others’ use, location of use, negative consequences of use, family history of substance abuse problems, and desire for an alcohol- and drug-free social environment. There are 39 multiple-response questions. Although subjects complete the entire survey, this research only included responses to questions 5, 12, 14, 15, 19, 21, and 33. For the remaining questions, data were not assessed. In order to ensure reliability, the Cronbach alpha and item-to-total-test correlations were performed (Presley et al., 1993). To ensure test-retest reliability the Pearson product-moment correlation coefficient (r) was used. In general, the data indicated that the Core Alcohol and Drug Survey is a stable, reliable instrument (Presley et al.). To guarantee content-related validity for this instrument, a panel reviewed each item using the inter-rater agreement for item inclusion of 0.9. Sample The target population Included those students referred during the tall of 1999 to the Alcohol Awareness Program, under judicial procedures of the 24 Student Code of Conduct at Edinboro University of Pennsylvania, for an infraction of the university’s zero tolerance policy against alcohol and drugs. Attendance was mandatory but subjects were given the option of declining to participate in this study. Sixty-eight students completed the pretest survey. The posttest sample consisted of 19 respondents. Informed Consent The completion and return of the survey to the researcher constituted informed consent. The surveys were completed anonymously, and only grouped data were reported. The research qualified for expedited human subjects review at Edinboro University of Pennsylvania. Setting and Procedure A medium-sized public university in northwestern Pennsylvania was the site of this research. The Alcohol Awareness Group leader, using the Core Alcohol and Drug Survey, collected pretest data from 68 students who participated in the program during the fall 1999 semester. Six weeks later, a letter and questionnaire containing questions 6, 12, 14, 15, 19, 21 and 33 (Appendix B and Appendix C) were mailed to 55 students whose addresses were known. Of those surveys, one on-campus letter came back, and eight off-campus ones came back marked “insufficient address.’’ A second letter (appendix D) with the survey was again sent out to remind those who failed to respond to the first mailing. Nineteen completed surveys were finally returned. 25 Data Analysis Data were analyzed using the Chi Square test for independence between two variables. The null hypothesis stated that there is no relationship between the variables and that the frequencies are due to random sampling from a population. Findings were reported in table form, comparing pretest and posttest responses about self-reported use of alcohol, negative consequences resulting from alcohol use, perception of other students’ use of alcohol, and awareness of campus alcohol and drug policies. Though information regarding the abuse of substances other than alcohol was collected, it was not reported in the results of this research. Summary The purpose of this study was to evaluate the effectiveness of a college campus alcohol awareness program. This was determined through analysis of data obtained from the Core Alcohol and Drug Survey, pretest and posttest, using a convenient sample of students referred to the Alcohol Awareness Program at a public university in northwestern Pennsylvania. In this chapter the research hypothesis was discussed. Operational definitions, research design, instrumentation, sample, informed consent, setting and procedure, and data analysis were also provided. 26 Chapter IV Results This chapter presents the results obtained from the Core Alcohol and Drug Survey. Students referred to the Alcohol Awareness Program in fall of 1999 by the Student Judicial Committee were given the survey prior to their participation. A posttest was mailed in spring 2000 to participants whose addresses were known. Data from the pretest and the posttest were compared. Demographics The research sample consisted of those students referred to the Alcohol Awareness Program by the Student Judicial Officers. Of this group, 68 students completed the pretest. Participants were representative of each college class plus non degree students (Table 1). Ages ranged from 18 to 24 years, with 62% (n=42) of the students being less than 21 years of age, which is the legal drinking age in Pennsylvania (Table 2). Ethnically, 82 % (n=56) reported themselves to be white, and all answered that they were single. There were slightly more males than females (Table ), students (n=58) lived on than off campus (Table 4), and 58 /o worked p time or not at all (Table 5). Living arrangements were such that 53% (n ) lived in a house or apartment (Table 6), and 75% (n=51) with a roommate(s) (Table 7). Cumulative grade point average varied, with 92 % (n=62) reported 27 a letter grade of C or better (Table 8). Table 1 College Class of Population (N=68) Class N % Freshman 17 25 Sophomore 26 39 Junior 13 19 Senior 10 15 Non-degree seeking 1 1 Other 1 1 Table 2 Age of Population (N=68) Age N % 18 years 6 9 19 years 19 28 20 years 17 25 14 20 4 6 2 3 2 3 4 6 21 years 22 years 23 years 24 years No Response 28 Table 3 Gender Distribution of Population (N=68) Gender N % Male 36 53 Female 27 40 5 7 Residence N % On-campus 37 32 Off-campus 21 54 No Answer 9 13 No Answer Table 4 Residence of Population (N=68) 29 Table 5 Employment Status of Population (N=68) Employment N % Working Full-time 6 10 Working Part-time 24 35 Not Working 34 51 No Answer 3 4 Table 6 Living Arrangements: Where (N=68) Where N % House/apartment 38 56 Residence Hall 26 38 Fraternity/sorority 2 3 Approved Housing 0 0 Other 0 0 No Answer 2 3 Lastly, demographics showed that 96% (n=65) were full-time students (Table 9), and that 75% were permanent Pennsylvania residents (Table 10.) 30 Table 7 Living Arrangements: With Whom (N=68) With Whom Living N % With Roommate(s) 51 75 Alone 9 14 With Parent(s)/children 3 4 With Spouse 0 0 Other 0 0 No Answer 5 7 Letter Grade N % A+ 2 3 A 3 4 B+ 9 13 21 32 C+ 9 13 C 18 27 D+ 1 1 D 2 3 No Answer 3 Table 8 Distribution of Grade Point Average (N=68) B 4 31 Table 9 Enrollment Status (N=68) Student Status N % Full-time 65 96 Part-time 2 3 No Answer 1 1 N % 51 75 USA, but out of state 3 4 Country other than USA 1 2 13 1 Table 10 Place of Permanent Residence (N=68) Residence In-State No Answer -Measurement The effectiveness of Edinboro University’s Alcohol Awareness Program was measured by: (a) self-reported alcohol u (b)consequences (c) student perception of other students’ use of resulting from alcohol use, 32 alcohol, and (d) awareness of campus alcohol and drug policies The questions on the Core Alcohol and Drug Survey that best represented these area were question 12 regarding the campus situation on alcohol and drugs, question 14 concerning how many times during the past 2 weeks, five or more drinks had been consumed at one sitting, question 15 asking the average number of drinks consumed in a week, question 19 concerning perception of the number of times the average campus student uses drugs and alcohol, question 21 asking the number of times during the past year that the student had experienced various negative consequences as a result of alcohol or drug use, and question 33 inquiring about any change in alcohol use during the past 12 months. Self-Reported Use Self-reported alcohol use was measured by questions 14 and 15. The pretest results showed that during the 2 weeks prior to the Alcohol Awareness Program, 24% (n=16) of the respondents had five or more drinks at one sitting on one to three occasions. Of that same group, 28/o (n 19) reported no such binges. Posttest results showed that, although 47% (n=7) of respondents had one to three occasions of binge drinking, 37 /o (n 7) had no such occasions. Comparison is shown in Table 11. In responding to t question concerning the average number of drinks consumed each pretest students reported having as few as zero drinks and as many a Of this group, 35% (n=24) stated that they drank zero to seven 33 36% (n-35) reported drinking seven to 21 drinks each week. There remained another 26% (n=18) who drank between 21 and 70 drinks per week. Table 11 Past Two Weeks Report of Five or More Drinks at One Sitting (N=68, n=19) Binges Pretest (N) % Posttest (n) % None 19 28 7 37 Once 4 6 3 16 Twice 12 18 4 21 3 to 5 16 24 3 16 6 to 9 9 13 1 5 10 + 7 10 1 5 Posttest results showed an increase of 18% in the zero to seven drink group, totaling 53% (n=10). The second grouping, seven to 21 drinks per week, increased to 42% (n=8), and only one student (8%) reported having more than 21 drinks each week. Pretest results showed the average n of drinks consumed per week to be 17.06, while the average posttest consumption was reported as 8.79 drinks. A frequency comparison of 34 pretest and posttest drink consumption per week is shown in Table 12 Using the Chi Square to analyze the independence of data reported for the pretest and posttest categories of answers to this question (fi=0.05), the obtained values were found to be greater than the critical value. There was shown to be a statistically significant relationship between the participation in the Alcohol Awareness Program and a decrease in drinking. Table 12 Average Number of Drinks Consumed in a Week (N-68, n-19) Number of Drinks Pretest (N) % Posttest (n) % 0-7 24 35 10 53 7-14 12 18 6 32 15-21 12 18 2 10 22-56 16 23 1 5 57-72 2 3 0 0 2 3 0 0 No Answer 35 Negative Consequences Resulting From Alcohol Use Negative consequences were measured by students’ reports of the number of times that they had experienced various problems related to drinking. Those who reported “never” having experienced a hangover decreased in the posttest to 11% (n=2) from 18% (n=12) in the pretest. Twelve percent (n—8) of pretest students reported never having experienced trouble with alcohol, and one incidence of trouble was reported in 56% (n=38). Posttest students reported no trouble 16% (n=3) of the time, and one episode of trouble 68% (n=13) of the time. All other indications of negative experiences saw increases in the “never” range (Table 13). Though percentages would indicate a trend toward decreased negative consequences, Chi Square testing of all sections of the negative consequence question showed no significant differences before or after attending the Alcohol Awareness Program. The null hypothesis was accepted that any changes in negative consequences from alcohol use due to random sampling of the population. Student Perception of Other Students Use of Alcohol A question relating to students' perception of other students' use of alcohol was addressed by asking them how often they felt the average student on their campus uses tobacco, alcohol, and vanous individua! drugs. Responses to all sections were collected Out oniy the one concerniing alcohol use was addressed in this study. An almost identical percentage of 36 students felt that other students used alcohol at least once a week or more. Pretest students reported 92% (n=63) used alcohol at that frequency, while posttest responders felt that 95% (n=18) did so. Using the Chi Square to establish relationship between the Alcohol Awareness Program and increased perception, no relationship was shown at the 95% level of confidence. Awareness of Campus Alcohol and Drug Policies Five questions were grouped under the heading of the campus situation on alcohol and drugs, and these were used to address any change in awareness of campus policies. Of the pretest responders, 87% (n=59) answered that the campus did have alcohol and drug policies. On the posttest, 100% (n=19) of the students gave the same positive answer. Eighty-four percent (n=57) of pretest students felt that these policies are enforced, while 100% (n=19) of the posttest students responded positively. Being aware of the existence of an alcohol and drug prevention program reported by 59% (n=40) of those students taking the pretest, and 84/o (n 16) of those taking the posttest. Campus concern about the prevention of alcohol and drug use was reported by 72% (n=49) of those responding to the pretest, while 93% (n=14) of those taking the posttest responded p Only 9% (n=6) of those taking the pretest and 5% (n=1) of those taking the posttest responded that they were aetiveiy invoked in efforts to prevent drug 37 Table 13 Never Having Negative Consequences Resulting From Alcohol Use (N=68, n=19) Pretest (N) % Posttest (n) % Hangover 12 18 2 11 Poor Testing 35 51 11 63 8 12 3 16 Damaged Property 51 75 13 84 Argument or Fight 27 40 10 63 Nausea/Vomiting 20 29 6 32 Drinking and Driving 36 53 12 68 Missed a Class 24 35 8 42 Been Criticized 33 49 11 58 Drinking Problem 44 65 13 79 Memory Loss 29 43 9 47 Regretted Something 24 35 9 47 55 80 15 95 Arrested for DUI 42 62 13 79 Been Sexual Victim 57 84 14 95 Sexual Aggressor 55 81 14 89 Unsuccessful Stoppage 79 95 54 15 Thought Suicide 84 100 57 15 Tried Suicide 13 Been Hurt 49 79 33 Negative Experience Authority Trouble 38 Table 14 Perception of Average Campus Alcohol Use (N=68, n=19) Pretest % Posttest % Never 0 0 0 0 1 Time/Year 0 0 1 5 6 Times/Year 0 0 0 0 1 Time/Month 0 0 0 0 2 Times/Month 1 1 0 0 1 Time/Week 20 29 5 26 3 Times/Week 19 28 9 48 5 Times/Week 13 20 1 5 Every Day 11 16 3 16 6 0 0 Use No Answer 4 and alcohol use problems on campus. Each of these awareness questions was tested for a relationship between participation Program and a change in attitude using the Ch' hypothesis was accepted and no relationship wa q in the Alcohol Awareness . For each, the null The difference in percentages was merely one of random sampling (Table 15) 39 Table 15 Campus Situation on Alcohol and Drugs (N=68, n=19) Aware of Situation Pretest % Posttest % Campus Policy 59 87 19 100 Enforcement 57 84 19 100 Prevention Program 40 59 16 84 Campus Concern 49 72 18 95 Actively Involved 6 9 1 5 Extent of Alcohol Use Change Students were asked to assess their own self-perceived change in alcohol use within the past 12 months. Of the pretest students L had decreased, while 47% (n=9) of those posttested felt the felt that their use same. A personal use increase was reported by 28% (n=19) of the pretest students and by 11% (n=2) of the posttest students. Again, the Chi Square test showed this to be a difference of random sampiing rather than a posrttve relationship between the Aicoboi Awareness Program and attitude change (Table 16). 40 Table 16 Extent of Change in Alcohol Use Within the Last 12 Months (N=A8 n=19) Change Pretest (N) % Increase 19 28 2 10 About the Same 21 31 7 37 Decreased 22 32 9 47 Have Not Used 1 1 1 6 No Answer 5 8 0 0 Posttest (n) % Summary This chapter has presented the results of the pretest and posttest Core Alcohol and Drug Survey, as administered to participants of the Alcohol Awareness Program on the campus of Edinboro University, a medium sized public university in Northwest Pennsylvania. These results were presented through descriptive analysis and evaluated for a positive level of confidence at 0.9 using the Chi Square. 41 Chapter V Discussion This chapter provides a summary of results of a Core Alcohol and Drug Survey administered to students of Edinboro University for an infraction of the drug and alcohol policies. Conclusions, recommendations, and study limitations are discussed. This study concerned those students of Edinboro University who were referred to the Alcohol Awareness Program by the Student Judicial Committee during the fall of 1999. Sixty-eight of the attending students responded to a pretest, while 19 responded to the posttest. The majority of these students were under 21 years of age, and 82% were white. Gender slightly favored males, and most of the population lived off-campus, The great majority of the students reported that they maintained at least a C grade average. Resuns described by percentages pointed to an increase in alcoboi awareness by the participants of the Alcohol Awareness Program There was a 25% decrease in self-reported alcohol use, with the averag . 17 06 at the time of the pretest to 8.79 17.06 at the of drinks per week decreasing from „™,onces resulting from alcohol use reported on the posttest. Negative con rmnnce on riod noor performance on . ♦ fpwer students reported poo p showed similar improvement. Few , nhol use. These same students tests or missed classes related to a c blackouts or reported decreased legal problems and f 42 sexual misconduct. They reported fewer suicidal thoughts and fewer injuries to themselves. Responders to both the pretest and the posttest had a similar perception of frequency of campus use of alcohol. Both assumed that 93% to 95% of the campus students used alcohol at least once each week. Awareness of campus policies and their enforcement increased from 87% to 100%. Awareness of campus efforts for alcohol and drug prevention increased from 59% at the time of pretest to 84% on the posttest. However only 5% to 9% of these same students were actively involved in any efforts to prevent alcohol and drug use. Although percentages at most levels of the Core Alcohol and Drug survey showed some increase in awareness, Chi Square tests of each question showed no relationship between participation in the Alcohol Awareness Program and change of attitude and behavior at a 0.95 level of acceptance. The changes were due to random sampling. This result supported the literature of The Stepped Approach Model (Black & Coster, 1996) which reported that student interest in the program decreased as intensity of intervention increased, and that students generally lacked interes •n any intervention. The results of this research did not support the Revised Health Promotion Model (Pender. 1996) stating that perceived benefits of action should spur a person to commit to a plan of action that would result in health Promoting behavior. The Alcohol Awareness Program did attempt to change 43 the attitude of its participants such that they would perceive the benefits of decreased alcohol use, commit to a that decrease, and adopt a health promoting lifestyle. No significant relationship was shown. Conclusions This study indicated that the Alcohol Awareness Program at Edinboro University is not having a significant effect upon the behavior or attitude of students toward the use of alcohol. Although percentage changes between the pretest and posttest demonstrated some trend of improvement, the Chi Square test of significance showed these changes to be due to random sampling. Limitations The greatest limitation to this study was the small sample size due io the inability to ensure posttest participation by those who responded to the pretest. The study results may, therefore, not be generalizable to other populations. With the posttest response rate of only 30 /o, all conclusions are subject to varied interpretation. Recommendations A larger pretest sample would be beneficial. Most importantly, an improved ability to track those initial participators in the program wou greatly improve the validity of the results. 44 Summai This chapter has provided a discussion of the research findings. Data indicated a percentage improvement following participation in the Alcohol Awareness Program but Chi Square testing did not support positive changes as measured by self-reported alcohol use, negative consequences resulting from alcohol use, student perception of other students’ use of alcohol, and awareness of campus alcohol and drug policies. Conclusions concerning these findings, recommendations for future research, and limitations of the study were provided. References Black, D., & Coster, D. (1996). Interest in a stepped approach model (SAM): Identification of recruitment strategies for university alcohol programs. Alcoholism, 23(1), 1-16. Black, D., Tobler, N., & Sciacca, J. (1998). Peer helping/involvement: An efficacious way to meet the challenge of reducing alcohol, tobacco, and other drug use among youth. Journal of School Health, 68(3), 87-93. Cummings, S. (1997). An empowerment model for collegiate substance abuse prevention and education programs. Journal of Alcohol & Drug Addiction, 43(1), 46-62. Edinboro University of Pennsylvania (1996). [Core Drug and Alcohol Survey-Executive Summary]. Unpublished raw data. Education Department General Administrative Regulations/ 34, Parts 74-86, Code of Federal Regulations (1999) (to be codified at 74.26 and 80.26). Gleason, N. (1994). Preventing alcohol abuse by college women: A relational perspective 2. Journal of American College Health 43(1), 15-24. Gove, P. (Ed.). (1976). Webster's third new international dictionary. Springfield, MA: G. & C. Merriam Company. Harvard School of Public Health (1995). Binge drinking on American college campuses. Boston, MA: Weschler, H. Houghton, E. (1998). A comparative analysis of alcohol education programs sponsored by the beverage alcohol industry. Journal of Alcohol & Drug Addiction, 43(3), 15-32. Kearney, A., & Hines, M. (1980). Evaluation of the effectiveness of a drug prevention education program. Journal of Drug Education 10(2), 127134. McAlister, A., Perry, C., Killen, J., Slinkard, L, & MacCoby, N. (1980). Pilot study of smoking, alcohol, and drug abuse prevention. American Journal of Public Health, 70(7), 719-721. Pender, N. J. (1996). Health promotion in nursing practice (2nd ed.). Stamford, CT: Appleton & Lang. Presley, C., Meilman, P., & Lyerla, R. (1993). Alcohol and drugs on American college campuses (Vol. 1). Carbondale, IL: Southern Illinois University-Carbondale. Snow, D., Tebes, J., Arthur, M., & Tapasak, R. (1992). Two-year follow-up of a social-cognitive intervention to prevent substance use. Journal of Drug Education, 22(2), 101-114. Stevens, M., & Mott, L. (1996). Rural adolescent drinking behavior. Three-year follow-up in the New Hampshire substance abuse prevention study. Adolescence, 31(121), 159-168. Treiman, K., & Beck, K. (1996). Adolescent gender differences in alcohol problem behaviors and the social context of drinking. Journal of School Health, 66(8), 299-304. U. S. Department of Health and Human Services (1991). Alcohol practices, policies, and potentials of American colleges and universities (An OSAP white paper). Rockville, MD: Lewis D. Eigen. Wechsler, H., Fulop, M., Padilla, A., Lee, H., & Patrick, K. (1997). Binge drinking among college students: A comparison of California with other states. Journal of American College Health 45, 273-277. Wechsler, H., Molnar, B., Davenport, A., & Baer, J. (1999). College alcohol use: A full or empty glass. Journal of American College Health, 47 (6), 247-253. Wilhelmsen, B., & Laberg, J. (1994). Evaluation of two student and teacher involved alcohol prevention programs. Addiction, 89(9), 157 169. r Appendix A Core Alcohol and Drug Survey _________________ Long Form A o 1 2 3 4 5 6 7 8 9 FIPSE Core Analysis Grantee Group B o 1 2 3 4 5 6 7 8 9 C o 1 2 3 4 5 6 7 8 9 D o 1 E o 1 2 3 4 5 6 7 8 9 2 3 4 5 6 7 8 9 Core Institute Student Health Programs Southern Illinois University Carbondale, IL 62901 Please use a number 2 Pencil. 1. Classification: 2. Age: Freshman Sophomore Junior Senior Grad/professional Not seeking a degree Other o 5. Gender: Male Female 3. Ethnic origin: American Indian/ Alaskan Native .... Hispanic Asian/Pacific Islander White (non-Hispanic) Black (non-Hispanic) Other 0 1 1 2 2 3 3 4 4 5 5 6 6 7 7 8 8 9 9 4. Marital status: Single Married Separated ... Divorced Widowed 7. Are you working? 6. Is your current residence as a student: On-campus Off-campus A+ A A- B+ B B- C+ C C- D+ D D- F 10. Some students have indicated that alcohol or drug use at parties they attend in and around campus reduces their enjoyment, often leads to negative situations, and therefore, they would rather not have alcohol and drugs available and used. Other students have indicated that alcohol and drug use at parties increases their enjoyment, often leads to positive situations, and therefore, they would rather have alcohol and drugs available and used. Which of these is closest to your own view? Have available Not have available With regard to drugs? With regard to alcohol? ph. Student status: ' i Full-time (12+ credits). . . . Part-time (1-11 credits) . . 13. Place of permanent residence: In-state USA, but out of state . . . . Country other than USA . . 14. Think back over the last two weeks. How many times have you had five or more drinks at a sitting? None Once Twice 3 to 5 times 6 to 9 times 10 or more times drink is a bottle of beer, a glass °f wine, a wine cooler, a shot glass °f liquor, or a mixed drink. Yes, full-time .... Yes, part-time .. .. No 8. Living arrangements: A. Where: (mark best answer) 9. Approximate cumulative grade point average: (choose one) I Form 194 For additional use: House/apartment/etc Residence hall Approved housing Fraternity or sorority .... Other B. With whom: (mark all that apply) With roommate(s) Alone With parent(s) With spouse With children Other . don’t know no yes 12. Campus situation on alcohol and drugs: a. Does your campus have alcohol and drug policies? b. If so, are they enforced? c. Does your campus have a drug and alcohol prevention program? d. Do you believe your campus is concerned about the prevention of drug and alcohol use?......................... e. Are you actively involved in efforts to prevent drug and alcohol use problems on your campus? 15. Average # of drinks* you consume a week: (If less than 10, code answers as 00,01,02, etc.) o 1 2 3 4 o 5 5 1 2 3 4 6 6 7 7 8 8 9 9 ©Core Institute: 1989. 1990. 1991- 1"2' 1993' 1994' 16. At what age did you first use... (mark one for each line) a. b. c. d. e. f. g. h. i. j. Tobacco (smoke, chew, snuff) .. Alcohol (beer, wine, liquor)*.... Marijuana (pot, hash, hash oil). •_ Cocaine (crack, rock, freebase) Amphetamines (diet pills, speed) Sedatives (downers, ludes) Hallucinogens (LSD, PCP) . • ■ Opiates (heroin, smack, horse) inhalants (glue, solvents, gash^ Designer drugs (ecstasy, MDMA) k. Steroids ................................... l. Other illegal drugs •other than a few sips %% i b k Vs s i I i i ■ ■ i i ■ ■ i i ■ ■ ■ i ■ ■ ■ i ■ ■ ■ ■ ■ ■ ■ ■ h ■ - I 17. Within the last year about how often have you used... (mark one for each line) a. b. c. d. e. f. g. h. i. j. k. l. rj -A cP o' , $* 1 % % $ % $ : £ V i % % %% % Tobacco (smoke, chew, snuff) . . Alcohol (beer, wine, liquor) .... Marijuana (pot, hash, hash oil) Cocaine (crack, rock, freebase) Amphetamines (diet pills, speed) Sedatives (downers, ludes) .... Hallucinogens (LSD, PCP) .... Opiates (heroin, smack, horse) Inhalants (glue, solvents, gas).. Designer drugs (ecstasy, MDMA) Steroids Other illegal drugs 19. How often do you think the average student on your campus uses... (mark one for each line) a. b. c. d. e. f. g. h. i. j. k. l. CP % ? $% % ? t t a> 1 o' -A ? %% i% \% 9_% \_ X3 £ £ O £ 2- ' % Tobacco (smoke, chew, snuff) . . Alcohol (beer, wine, liquor) .... Marijuana (pot, hash, hash oil) Cocaine (crack, rock, freebase) Amphetamines (diet pills, speed) Sedatives (downers, ludes).... Hallucinogens (LSD, PCP) .... Opiates (heroin, smack, horse) Inhalants (glue, solvents, gas).. Designer drugs (ecstasy, MDMA) Steroids Other illegal drugs ■ * 1 20. Where have you used... (mark all that apply) . % a. Tobacco (smoke, chew, snuff).. C b. Alcohol (beer, wine, liquor) .... c. Marijuana (pot, hash, hash oil)-------------------------------d. e. f. g. h. j. j. Cocaine (crack, rock, freebase) Amphetamines (diet pills, speed) Sedatives (downers, ludes).... U - - - Hallucinogens (LSD, PCP) .... Opiates (heroin, smack, horse) - - - - . Inhalants (glue, solvents, gas).. \ Designer drugs (ecstasy, MDMA)1 k. Steroids l. Other illegal drugs : --------- = -r \ .......... 22. Have any of your family had alcohol or other drug problems: (mark all that apply) Spouse Brothers/sisters Mother Children Mother ’ s parents Father None Father’s parents Stepmother Aunts/uncles Stepfather 18. During the past 30 days on how many days did you have: (mark one for each line) a. Tobacco (smoke, chew, snuff) .. b. Alcohol (beer, wine, liquor) .... c. Marijuana (pot, hash, hash oil)., d. Cocaine (crack, rock, freebase) e. Amphetamines (diet pills, speed) f. Sedatives (downers, ludes) .... g. Hallucinogens (LSD, PCP) .... h. Opiates (heroin, smack, horse) i. Inhalants (glue, solvents, gas) .. j. Designer drugs (ecstasy, MDMA) k. Steroids l. Other illegal drugs 21. Please indicate how often you have experienced the following due to your drinking or drug use during the last year... (mark one for each line) a. Had a hangover b. Performed poorly on a test or important project c. Been in trouble with police, residence hall, or other college authorities d. Damaged property, pulled fire alarm, etc e. Got into an argument or fight o fo 6> b' ip ■$> \ *»XXX X o <2, « Ethnic or racial harassment Threats of physical violence Actual physical violence .... Theft involving force or threat of force e. Forced sexual touching or fondling f. Unwanted sexual intercourse 26. How do you think your close friends feel (or would feel) about you... (mark one for each line) If yes Trying marijuana once or twice Smoking marijuana occasionally Smoking marijuana regularly Trying cocaine once or twice Taking cocaine regularly Trying LSD once or twice 9- Taking LSD regularly b- Trying amphetamines once or twice a. b. c. d. '• Taking amphetamines regularly ........................ J- Taking one or two drinks of an alcoholic beverage (beer, wine, liquor) nearly every day Taking four or five drinks nearly every day ■ • • ■ '• Having five or more drinks in one sitting........... ^•Taking steroids for body building or improved athletic performance............................ yes no a. b. c. d. e. f. g. Male students .. Female students Faculty/staff.... Alumni Athletes Fraternities .... Sororities 29. Campus environment: (mark one for each line) % O no 28. On this campus, drinking is a central part in the social life of the following groups: (mark one for each line) a. Does the social atmosphere on this campus promote alcohol use? b. Does the social atmosphere promote other drug use? c. Do you feel safe on this campus? .. o % %& yes a. Breaks the ice b. Enhances social activity c. Makes it easier to deal with stress d. Facilitates a connection with peers e. Gives people something to talk about.... f. Facilitates male bonding g. Facilitates female bonding h. Allows people to have more fun i. Gives people something to do j. Makes food taste better k. Makes women sexier l. Makes men sexier m. Makes me sexier n. Facilitates sexual opportunities n/a a. b. c. d. 27. Do you believe that alcohol has the following effects? (mark one for each line) % no yes 30. Compared to other campuses with which you are familiar, this campus’ use of alcohol is... (mark one) Greater than other campuses Less than other campuses About the same as other campuses ■ 31. Housing preferences: (mark one for each line) a. If you live in university housing, do you live in a designated alcohol-free/ drug-free residence hall?. ................ b If no, would you like to live in such ’ a residence hall unit if it were available? yes no 32. To what extent do students > CZ O fi1 O CD O — £ § E — E CD CD a> — CD £ £ 8 E tn 'a> o I— O co m 8 ‘J3 T5 E a. Tobacco (smoke, chew, snuff) .... b. Alcohol (beer, wine, liquor) g. Driven a car while under the influence h. Missed a class i. Been criticized by someone I know.............................................. j. Thought I might have a drinking or other drug problem................... k. Had a memory loss l. Done something I later regretted... ~ o. e. Amphetamines (diet pills, speed). ~ ~ J. Sedatives (downers, ludes) - - g. Hallucinogens (LSD, PCP) ~ h. Opiates (heroin, smack, horse) ... — 30 O V s. Been hurt or injured................... j - 33. To what extent has your alcohol use changed within the last 12 months? Increased About the same - - - x X X X X 2 - j. Designer drugs (ecstasy, MDMA) l. Other illegal drugs ■ sexually Have taken advantage of another sexually...................................; ” Tried unsuccessfully to stop using PSeriously thought about suicide .. qr. Seriously tried to commit suicide.. d. Cocaine (crack, rock, freebase)... k. Steroids o m. Been arrested for DWI/DUI n. Have been taken advantage of c. Mariquana (pot, hash, hash oil) - ~ i. Inhalants (glue, solvents, gas) Please indicate how often you have tn as experienced the following due to your E drinking or drug use during £ tn co o cd as the last year... E CD g -S S aS o (mark one for each line) £ - 5h— CO o “? — ? co Decreased I have not used alcohol ^ppe.ncLlx. C EDINBORO UNIVERSITY ° F PENNSYLVANIA February 28, 2000 Mary Anne Weiner, MS, RN-C. Coordinator, Wellness Program Ghering Health Center Edinboro, PA 16444 (814)732-2839 or 2949 Fax (814) 732-2666 Internet: weiner@edinboro.edu Dear Student: Last fall you took part in the University’s Alcohol Awareness Program. As part of the program, you ere asked to complete the Core Alcohol and Drug Survey. If you chose to complete it, you were told that it would be part of a study of student attitudes and behaviors regarding alcohol and other drugs. In an attempt to begin to evaluate the effectiveness of the Alcohol Awareness Program, we are requesting now that you complete the enclosed - much brieferquestionnaire. As before, your responses will be totally anonymous and will be part only of a grouped and non-specific data set. There is no information on the questionnaire or return envelope to indicate who you are. This letter and questionnaire are being sent to all students who participated in the program, and who are registered for classes this spring. Your answers will help us to determine whether changes need to be made to the Alcohol Awareness Program and whether additional or other things might be more helpful. We ask that you return the questionnaire to this office by March 16. An envelope is enclosed for your convenience. Please feel free to call me if you have any questions. Your assistance is gieatly appreciated. Sincerely, Mary Anne Weiner, MS, RN-C. Coordinator, Alcohol Awareness Program I Appe.ncLix V EDINBORO UNIVERSITY OF PENNSYLVANIA Mary Anne Weiner, MS, RN-C. Coordinator, Wellness Program Ghering Health Center Edinboro, PA 16444 (814) 732-2839 or 2949 Fax (814) 732-2666 Internet: weiner@edinboro.edu March 23, 2000 Dear Alcohol Awareness Program Participant: About three weeks ago we sent you a copy of the enclosed survey to help determine whether the Alcohol Awareness Program needs any changes. Because there were no identifiers on the surveys we have no idea who has sent them back and who hasn’t. If you already returned it to us, thank you!!!! You can discard this letter and know that we very much appreciate that you did so (and you’ve just received a free stamp). If you did not return the survey, please, would you do so now? Your input is important. Once again, a self-addressed, stamped envelope is enclosed for your convenience. If you have any questions, please feel free to call me. We would appreciate your sending back the survey as quickly as possible. Sincerely, Mary e einer