Solving the College Binge Drinking Problem: Behavior Design Solutions

+solving the college binge drinking problem:

by Benjy Mercer-Golden Stanford University

behavior design solutions

+my goal

To persuade Stanford freshmen to not engage in binge drinking behavior1 on the weekends.

1 As defined by the U.S. National Institute on Alcohol Abuse and Alcoholism: “A pattern of alcohol consumption that brings the blood alcohol concentration (BAC) to .08% or more. This pattern usually corresponds to 5 or more drinks on a single occasion for men or 4 or more drinks on a single occasion for women, generally within about 2 hours.”

+why? this is important because…

Lessening alcohol intake for college students can have enormous benefits to academic, social, physical & psychological health.

defining the problem

Nearly half of American college students are binge drinkers (44%).

Most binge drinkers do not consider themselves to have a problem with drinking.

Binge drinkers are more likely than “healthy” drinkers to experience common alcohol-related problems (violence, physical injuries, liver damage, cognitive damage, etc.).

Source: 17,000+ student Harvard School of Public Health study. Published in Journal of American Medical Association. http://jama.jamanetwork.com/article.aspx?articleid=383597

+prevailing sentiment

Colleges have an obligation to provide programs that aim to reduce binge drinking.

These programs consistent of educational components (for all students) and treatment (for frequent binge drinkers).

among “alcohol experts,” doctors & university administrators

+the existing solution

+

AlcoholEdu AlcoholEdu is an online educational program used by (required of) 36% of college freshmen1. It takes about 2-3 hours to complete and is designed to walk students through both the scientific facts on alcohol intake and a personal reflection on a student’s own drinking habits.

1 http://www.outsidetheclassroom.com/solutions/higher-education/alcoholedu-for-college.aspx

+

does it work?

Yes. Kind of. It’s produced solid results, but the problem of widespread binge drinking on college campuses is still not going away.

+ part of the problem is that students hate it

+

it’s time to re-think the paradigm.

+

problems with the status quo

i.  The means of “educating” students about drinking is often officious and moralistic.

ii.  AlcoholEdu and other “solutions” are boring.

iii.   University administrators (and law enforcement) have the viewpoint of “cracking down” on college (especially underage) binge drinking. This is wrong.

+let’s be smart on binge drinking, not tough on it.

+applying behavior design

principles

+my research I brainstormed 24 behaviors that I would like to see happen on Stanford campus regarding alcohol usage and policy. My guiding design principles:

•Don’t try to tell college students what to do and not to do; let them form their own habits •Make it easier/simpler/more feasible to choose to drink less •Motivate students to drink less without forcing any significant lifestyle sacrifices •Trigger students to reflect on their drinking habits in thoughtful conversations •Create fun alternatives to binge drinking •Use social pressure to create healthier habits •Experiment with environmental changes: make alcohol more or less available – which works better?

behavior priority map

We cannot get this behavior to happen We can get this behavior to happen

24 behaviors, mapped by impact and feasibility

ABOVE THE LINE: high-impact, feasible behaviors

Given limited resources, these are the behaviors I would choose to prioritize.

We can get this behavior to happen

GETTING MORE SPECIFIC mapping solutions for one behavior

+ examples of tests I did

+FOUR TESTS

I ran four basic “tests” on college students to get them to do four positive behaviors that I hypothesized would help accomplish my goal:

I.  RA has a casual conversation with freshman about drinking habits early on in school year.

II.  Parents talk on the phone (or in person) with their (college student) child about drinking habits.

III.  Host a non-drinking social event off campus with students who frequently binge drink.

IV.  Student re-watches “AlcoholEdu” video module and seriously discusses it in small group setting.

+I. RA-freshman conversation

+the test

I asked my friend, an RA in a freshman dorm, to hold random alcohol-related meetings with 10 of his freshmen.

I asked permission to sit in on each of these meetings and casually observe the conservations.

+my big takeaway

What few people realize is that…

The best way of collecting reliable quantitative and qualitative data and opinions on alcohol policies is through casual, trusting RA-student conversations.

+what I learned

I know this because…

Every student spoke candidly and honestly about drinking habits, regrets and errors.

Useful data:

•30% of students admitted to binge drinking when asked. Then, when provided with NIAAA official definition, 70% said they binge drink.

•All students cited a general “lack of other things to do” on weekends.

+II. Parent-child conversation

+the test

Four separate mothers talked with their child (three sons, one daughter) about drinking habits during Thanksgiving break.

Three children were freshmen in college, one sophomore.

No structure for the conversation, no scripted questions, no “goals”.

One requirement: parent had to explicitly say there was no “judgment or punishments” that would come from the talk.

+my big takeaway

What few people realize is that…

College students drink more—and will be more honest about their drinking habits—than their parents thought.

+what I learned

I know this because…

In follow-up conversations with me, each parent said their child drinks more than they imagined but was also pleasantly surprised by how open (and willing to listen/discuss) their kids were.

Students were not drinking more on average than their peers. Therefore parents surprised by drinking norms rather than their own child’s drinking.

+III. sober event

+the test

I hosted a dinner party for 18 college students (my friends).

All of these college students drink regularly. Many binge drink.

No alcohol served before, during or after dinner.

+my big takeaway

What few people realize is that…

In the right context, it can seem normal to not serve alcohol at an event for heavy-drinking college students.

+what I learned

I know this because…

Taking people away from their normal environment (an on-campus party, likely at a fraternity) removes the expectation of drinking.

Multiple people commented on the delight of not drinking for a night.

Overwhelming positive feedback: People had just as much fun without drinking.

+IV. re-watch Alcohol Edu video & discuss

+the test

Play a three-minute clip from the Alcohol Edu program for a group of three or four college students (students have already done program before they came to college).

Have a 10-minute conversation between the students in response to the video.

Prompt: “Did the video get you thinking about your own drinking habits?

+my big takeaway

What few people realize is that…

Even things students view as useless (like a boring Alcohol Edu program) can be triggers to effective, casual conversations.

+what I learned

I know this because…

Everyone hates AlcoholEdu. Period. This trial confirmed that sentiment.

Students are unwilling to admit they learned much from it.

But in conversations afterwards, students talked openly and honestly, admitted to being unhappy with their (excess) drinking habits, wished for alternative activities, etc.

+ conclusions

+findings that surprised me

I.  Parents can actually be an effective voice in limiting binge drinking. Parent-child conversations can be open, honest and productive.

II.  It’s really not that hard to organize social events for college students that don’t involve drinking. And they can be just as fun.

III.  The trigger really doesn’t matter, but getting spontaneous conversations to happen about drinking habits is important.

+but my biggest takeaway…

Behavior change is predicated on getting people to do what they already want to do.

Contrary to conventional belief, many (most?) college binge drinkers want to drink less.

+a lack of alternatives

Most often, students who binge drink cite a lack of alternatives: “There’s nothing else to do on a Friday night except get drunk!” From a body of evidence in student interviews (and from personal experience), this belief seems pervasive and somewhat grounded in reality.

+

what does this all mean for alcohol policy at Stanford (and other universities)?

+1. we must create two kinds of alternatives to binge drinking

•Build student center open on weekend nights with movies, bowling alley, restaurants, etc. •Stanford pays for off-campus events on Friday and Saturday nights (cultural events in San Francisco) •Host weekly movie nights in freshmen dorms (Stanford pays for catered food) •Once-a-month mandatory fun events with no drinking for freshmen dorms (outing to the beach)

•Create safer, RA-supervised, relaxed culture of moderate drinking

•Encourage beer/wine drinking instead of liquors/spirits

•Stanford pays for beer kegs for freshmen dorms

•Stanford pays for beer kegs at fraternity parties to discourage pre-gaming them

Not drinking at all Drinking, but not binging

+2. we should place more value in casual conversations on drinking

Stanford should ask all parents to talk with their kids about drinking before coming to school and at each break during freshmen year.

Implement mandatory one-on-one conversations between RAs and freshmen during first week of school.

If a student vomits from drinking, RA should check in with student once a week for the next month.

All of these conversations can be casual, lighthearted, low-pressure situations.

+3. combine these practices with existing education programs

AlcoholEdu and required info sessions on drinking play a role in limiting college binge drinking.

But offering information from an official source — an online program or an administrator— is only part of the solution. Some students will immediately dismiss this.

That’s where these lessons from behavior design come in. What I’ve proposed is not mutually exclusive with existing policies. They are designed to add to and reinforce them.

+some final questions

Should college binge drinking be treated as a legality issue? I say this is counterproductive.

Should it be treated as a health issue (the current approach— providing education + treatment)? This has lots of merit.

Or should it be treated as a social issue—as a fundamental flaw in the college lifestyle (namely through a lack of alternatives and an avoidable culture of excess when students do drink)?

I think it’s both a health and a social issue. And we should treat it as one in constructing policy.

+thank you for viewing!

+ questions? feedback? contact me: Benjy Mercer-Golden benjym@stanford.edu