Appendices - Dartmouth Collegewebapp.dartmouth.edu/nchip/uploads/NCHIP_whitepaper_App_FINAL.pdf · LEARNING COLLABORATIVE ON HIGH-RISK DRINKING WHITE PAPER LEARNING COLLABORATIVE

Using a Public Health and Quality Improvement Approach to Address High-Risk Drinking

with 32 Colleges and Universi es

LEARNING COLLABORATIVE ON HIGH-RISK DRINKING

AppendicesWhite Paper—March 2014

LEARNING COLLABORATIVE ON HIGH-RISK DRINKING WHITE PAPER


Note: Click on Appendix title to be linked to appropriate page.

Appendices

A. Participating Institutions -‐ Learning Collaborative on High-‐Risk Drinking

B. NCHIP Faculty Expert Bios

C. Driver Diagram—Reducing High-‐Risk Drinking and Associated Harms

D. Outcome Measurement Strategy

E. Process Measures Library

F. Cornell University Team Storyboard—June 2013, Summative Congress

G. Meetings, Webinars, Presentations, and Press

H. PDSA Documentation Template

I. Learning Session 2 Pre-‐work Package—Environmental Assessment

J. Frostburg State University System Dashboard

K. Program Evaluation Mid-‐Project Report

L. Realist Evaluation Main Report and Faculty Response

M. List of PDSAs/New Initiatives

N. Statistical Process Control Charts—High-‐Risk Drinking Rates for 12

Reporting Institutions (De-‐Identified)

O. Statistical Process Control Charts—Medical Care Encounter Rates for 10


P. Statistical Process Control Charts—Law Enforcement Encounter Rates for 10




Appendix A:

Participating Institutions

Participating Institu

tions



Appendix A

TEAM TEAM MEMBERS

Acadia University Callie Lathem Student Wolfville, Nova Scotia Kiara Clory Student Public Darren Kruisselbrink Associate Professor, Recreation Management & Kinesiology Undergraduate Enrollment: Terry Lane Director, Student Resource Center 4,300 Sara Lochhead Vice-‐President, Enrollment & Student Services James Sanford Senior Director, Student Affairs Boston University Laura Collins Manager Special Projects, Institutional Research (Data Collection Specialist) Boston, MA Elizabeth Douglas Manager, Wellness and Prevention Services Private Kenneth Elmore Dean of Students Undergraduate Enrollment: Peter Fiedler Vice-‐President for Administrative Services 16,500 David McBride Director, Student Health Services Tibor Palfai Director, Clinical Programs Scott Pare Boston University Police Department Thomas Robbins Chief, Police Services Brown University Nancy Barnett Associate Professor of Behavioral & Social Sciences (Research) Providence, RI Natale Basil Associate Director, Residential Programs Private Margaret Klawunn Vice President For Campus Life and Student Services Undergraduate Enrollment: Francie Mantak Director, Health Education 6,100 Nadine Mastroleo Assistant Professor of Behavioral & Social Sciences Marylou McMillan Vice President of Campus Life & Student Services Allen Ward Senior Associate Dean, Student Life Bucknell University Chip Marrara Assistant Dean of Students Lewisburg, PA Jennifer Albright Assistant to the Dean of Students Private Kevin Foster Assistant Director of Residential Education for Fraternity Affairs Undergraduate Enrollment: Judy Grisel Professor of pPsychology, C. Graydon and Mary E. Rogers Faculty Fellow 3,500 Andy Hirsch Director of Media Communications Maisha Kelly Associate Athletics Director/Senior Woman Administrator Kelly Kettlewell Associate Director Psychological Services/ Psychologist Doug Lauver Operations Captain, Department of Public Safety Susan Little Lantz Dean of Students J.T. Ptacek Professor of Psychology Dan Remley Associate Dean of Studies Laura Yeckley Assistant Director of Campus Activities and Programs



Appendix A

Colgate University Ali Berkman Student Hamilton, NY Scott Brown Associate Vice President and Dean of Students Private Bill Ferguson Campus Safety Personnel Undergraduate Enrollment: Brenda Ice Director of Residential Life 2,800 Jane Jones Counselor Psychology Service and Coordinator of Alcohol and Drug Education Michael Maningas Director, Center for Leadership and Student Involvement Julia Martinez Assistant Professor of Psychology Merrill Miller Team Physician Owen Myers Student Aaron Robertson Professor of Mathematics Fouad Saleet Assistant Dean for Campus Life Brendt Simpson Director of Institutional Planning and Research, Special Assistant to President for Legal Affairs Kim Taylor Dean, Second Year Students Cornell University Travis Apgar Robert G. Engel Associate Dean of Students / Fraternity and Sorority Affairs Ithaca, NY Joseph Burke Director of Residential Programs Private Janet Corson-‐Rikert Gannett Health Services, Director of Health Services, Assistant Vice President Undergraduate Enrollment: Greg Eells Associate Director of Health Services 13,900 Marne Einarson Assistant Director, Institutional Research & Planning Adam Gitlin Student, Class of 2013 Mary Beth Grant Judicial Administrator Hollis Hanley Student Catherine Holmes Associate Dean of Students for Student Activities Kent Hubbell Robert W. and Elizabeth C. Staley Dean of Students, Professor of Architecture Deb Lewis Gannett Health Services, Health Educator II Timothy Marchell Director, Mental Health Initiatives Colin Foley President, Inter-‐Fraternity Council Eric Silverberg Cayuga’s Watchers Carlin Van Holmes President, PanHellenic Association Alex Boehrer Cornell Emergency Medical Services John Mueller Student Susan Murphy Vice President of Students & Academic Services Vice President Brendan O'Brien Director, International Students and Scholars Office Christopher Sanders Student Kathy Zoner Administration Chief Cornell Police



Appendix A

Dartmouth College Elizabeth Agosto Special Assistant to the Dean of the College Hanover, NH Justin Anderson Assistant Vice President for Media Relations Private Caitlin Barthelmes Alcohol and Other Drug Programs Coordinator Undergraduate Enrollment: Brian Bowden Specialist, Alcohol & Other Drugs Education, Dick's House 4,200 Ann Bracken Physician/Associate Director for Assessment Donald Brooks Assistant Athletic Director, Performance Paul Christensen Professor Kristi Clemens Assistant Dean, Office of Dean of Undergraduates William Conaway Student Lynn Foster-‐Johnson Acting Director, Institutional Research Jeremy Guardiola Presidential Fellow Brandon Harrington Dartmouth Peak Performance Health Initiatives Coordinator Aurora Matzkin Director of Health Promotion and Student Wellness Matt Moses Student Salman Rajput Student Samuel Waltemeyer Coordinator of Greek Letter Organizations and Societies (GLOS) Michael Wooten Director of Residential Education DePauw University Cindy Babington Vice President Student Life Greencastle, IN Stewart Burns Student Private Quamina Carter Alcohol and Drug Resource Coordinator Undergraduate Enrollment: Kelly Harms Student 2,400 Meggan Johnston Director of Community Standards Michael King Research Analyst Patrick Mitchell Greek Life Coordinator Angela Nally Greek Life Coordinator Pamela Propsom Professor, Psychology Cara Setchell Associate Dean of Students Dorian Shager Dean of Campus Life Duke University Andrew Hanna Student Durham, NC Jeff Kulley Assistant Director for Clinical Services Private Donna Lisker Associate Dean, Undergraduate Education Undergraduate Enrollment: John Looney Physician, Psychiatry Department 6,500 Larry Moneta Vice President for Student Affairs Tom Szigethy Director of the Wellness Center Cole Taylor Assistant Director of Assessment and Research, Division of Student Affairs Sue Wasiolek Assistant Vice President for Student Affairs and Dean of Students



Appendix A

Frostburg State University April Baer Project Coordinator/Wellness Program, Department: Student & Educational Services Frostburg, MD Lyndsey Baker Coordinator of the Frostburg Community Coalition Public Tom Bowling Vice President Student Educational Services Undergraduate Enrollment: Spencer Deakin Director/Counseling & Psychological Services 4,700 Jeff Graham Assistant Vice President of Student Services Jesse Ketterman Dean of Students Robert Smith Assistant Vice President, Planning, Assessment and Institutional Research Tyler Southerly Student Don Swogger Director of Substance Abuse, S.A.F.E. Office Ahmad Tootoonchi Dean/College of Business Lincoln College Partnership Phil Bakken Student Lincoln, NE Linda Becker Dean of Students, Union College Private Thomas Cardwell Dean of Students, Southeast Community College Undergraduate Enrollment: Joy Citta Captain, Lincoln Police Department 32,400 Geri Cotter Assistant Dean of Students at Nebraska Wesleyan University Matt Hecker Dean of Students, University of Nebraska-‐Lincoln Linda Major Assistant to the Vice Chancellor for Student Affairs Linda Schwartzkopf Director, Greek Affairs Phil Tegeler Executive Director, Cornhusker Place Owen Yardley Chief, University Police Department Lehigh University Gina Abrams Assessment Specialist, Office of the Vice Provost for Student Affairs Bethlehem, PA Maddy Eadline Assistant to the Vice Provost and Director Special Projects Private Linda Harbrecht Director, University Communications Undergraduate Enrollment: Peter Costa Director of Prevention Strategies 4,900 Chris Liang Associate Professor Margaret Munley Institutional Research Analyst Thomas Novak Associate Director -‐ Student Health Services John Smeaton Vice Provost for Student Affairs University of Minnesota Colin Burke Student Minneapolis, MN Dana Farley Bystander Training Program Development Boynton Health Service Public Mark Groberski Counselor, University Counseling Services Undergraduate Enrollment: Matt Levine Program Director, Office for Fraternity and Sorority Life 30,400 Charles Miner Deputy Chief of Police Toben Nelson Assistant Professor Gerald Rinehart Vice President, Student Affairs Kendre Turonie Student & Community Relations Amelious Whyte Chief of Staff



Appendix A

Northwestern University Susan Campbell Department Assistant for Health Promotion and Wellness Evanston, IL Lisa Currie Director of Health Promotion and Wellness Private Susan Cushman Alcohol & Other Drugs Prevention Coordinator Undergraduate Enrollment: Mary Desler Senior Assessment Analyst 8,400 Jennifer Dowd Graduate Assistant Mary Goldenberg Director of University Residential Life Dominic Greene Director of Fraternity & Sorority Life Ellen Herion Fingado Assistant Director of Student Conduct & Conflict Resolution Burgwell Howard Assistant Vice President for Student Engagement Daniel McAleer Deputy Chief of Police Jim Neumeister Director of Student Conduct & Conflict Resolution Ohio University Mary Kate Gallagher Peer Educator, Student Senator Athens, OH Jenny Hall-‐Jones Assistant Dean Of Student Affairs Public Terry Koons Campus Involvement Center, Associate Director Undergraduate Enrollment: Char Kopchick Assistant Dean Of Students, Campus Programs 22,000 Joni Wadley Associate Director for Academic & Student Assessment Princeton University Emily Aronson Campus Life Writer and Special Projects Assistant, Communications Princeton, NJ Farrah Bui Student, Class of '14 Private Cynthia Cherrey Vice President for Campus Life Undergraduate Enrollment: Janet Finnie Director, Administrations and Associate Director, University Health Services 5,100 Maria Flores-‐Mills Associate Dean, Office of the Dean of Undergraduate Students Ninette Hupp Senior Project Specialist, University Health Services Joshua Katz Professor, Classics John Kolligian Executive Director, University Health Services Jed Marsh Vice Provost for Institutional Research Santiago Martinez Student Sean Morey Athletics Administrator, Athletics Michael Olin Associate Dean, Office of the Dean of Undergraduate Students Paul Ominsky Executive Director of Public Safety Claire Perkins Executive Assistant, University Health Services Joshua Rabinowitz Professor, Department of Chemistry



Appendix A

Purdue University Miriam Brown Alcohol, Tobacco and Other Drug Education Coordinator W. Lafayette, IN John Cox Purdue University Chief of Police Public Ashley Darnell Assistant Director of Off-‐Campus Student Services, Housing and Food Services Undergraduate Enrollment Lee Gordon Assistant Vice President for Student Affairs 30,100 Robert Haddix Purdue Student Government Executive Director of Campus Outreach Lisa Heinold Associate Director, Residential Life Mark Kebert Director of Risk Management Jane Krause Clinical Associate Professor of Pharmacy Practice Tammy Loew Health Advocacy Coordinator, Student Wellness Office Nancy Maylath Director, Student Wellness Office Fred McCall Assistant Director, Fraternity, Sorority, Cooperative Life Stephanie Orstad Graduate student Kelly Pistilli Academic Advisor, Center for Pre-‐Professional Advising Kevin Ply Purdue University Fire Chief Susan Prieto-‐Welch Director, Counseling and Psychological Services (CAPS) Jeffrey Stefancic Associate Dean of Students, Office of Student Rights and Responsibilities Diedra Tate Safety and Compliance Administrator, Office of the Dean of Students Tricia Tort Associate Director: Fitness and Wellness, Division of Recreational Sports Dan Whiteley Student Data Steward and Learning Outcomes Analyst, VP Student Affairs Sewanee Alex Bruce Associate Dean of Students The University of the South Eric Hartman Dean of Students Sewanee, TN Allison Horick Student Private Brittany Macon Student Undergraduate Enrollment: John McCardell Vice-‐Chancellor 1,400 Alex Middleton Student Dave Spaulding Director of the University Counseling Center Karen Tharp Interim Director of Health Services Kristin Weyman Assistant Director of Residential Life Southern Methodist Evelyn Ashley Assistant Dean of Student Life Standards University Ernest Jouriles Professor and Chair Ph.D Dallas, TX Galen Laprocido Community Health Educator Private Mary Logan Special Assistant, Assessment and Evaluation Undergraduate Enrollment: Jan McCutchin Coordinator, Center for Alcohol & Drug Abuse Prevention 7,000 John Sanger Director, Center for Alcohol & Drug Abuse Prevention Anthony Tillman Assistant Provost for Strategic Initiatives and Director of Student Retention Lori White Vice President for Student Affairs



Appendix A

Stanford University Greg Boardman Vice Provost for Student Affairs Stanford, CA Jarreau Bowen Assistant Director, Office of Alcohol Policy & Education Private Jennifer Calvert Residential Education Undergraduate Enrollment: Ralph Castro Associate Dean of Student Affairs, Director, Office of Alcohol Policy & Education 7,000 Ira Friedman Associate Vice Provost for Student Affairs Deborah Golder Associate Vice Provost and Dean of Residential Education Keith Humphreys Research Professor in Psychiatry & Behavioral Sciences Sam Saenz Alcohol Educator, Office of Alcohol Policy & Education Laura Wilson Director of Public Safety Stony Brook University Peter Baigent VP for Student Affairs Stony Brook, NY Ahmed Belazi Program Evaluator and Assessment Lead Public Neil Farrell University Police Undergaduate Enrollment: Amy Hammock Assistant Professor of Preventive Medicine, Graduate Program in Public Health 16,300 Jenny Hwang Associate Dean/Director of University Counseling Smita Majumdar Das Assistant Director for Prevention and Outreach Aleef Rahman NCHIP Program Development Coordinator Charles Robbins Vice Provost for Undergraduate Education; Dean of Undergraduate Colleges Lara Hunter Substance Abuse Counselor University of New Rosemary Caron Associate Professor Hampshire Kevin Charles Assistant Vice President Student Affairs Durham, NH Paul Dean Deputy Police Chief Public Melissa Garvey ATOD Educator/ Counselor Undergraduate Enrollment: Kathleen Grace-‐Bishop Director of Education 11,900 Kristen Jurus NCHIP Intern Mark Rubinstein Vice President for Student and Academic Services University of Maryland Mickey Arora Health Education Coordinator Baltimore County Fritzie Charne-‐Merriwether Special Assistant to the Vice-‐President of Student Affairs Baltimore, MD Joel DeWyer Associate Director, Programs & Services -‐ The Commons Public Davonya Hall Assistant Director -‐ Student Judicial Programs Undergraduate Enrollment: Jes Lassiter Community Director, Residential Life 11,000 Tisha Travaglini Graduate Student Nancy Young Vice President for Student Affairs U. Maryland Eastern Shore Kimberly Poole-‐Sykes Associate Professor/Principal Investigator, ATOD Prevention Center Princess Anne, MD Lauresa Wigfall Director, ATOD Prevention Center Public Undergraduate Enrollment: 3,900



Appendix A

University of Rhode Island Katrina Dorsey Coordinator, Off Campus Living Kingston, RI Daniel Graney Assistant Director Student Life, Substance Abuse Education Public Chad Henderson Director, Health Services Undergraduate Enrollment: Mark Wood Professor, Psychology 12,900 University of Vermont Gary Derr Vice President Executive Operations & Chief of Staff Burlington, VT Tricia Frazer Business Support Administrator Public Diana Gonzalez Student Life Professional Undergraduate Enrollment: Chris McCabe Assistant Vice President Athletic Marketing and Business Development 10,500 Michael Muuszynski Student Nicholas Negrete Student Life Professional Jon Porter Clinical Assistant, Professor, Director Center for Health &Wellbeing Annie Stevens Associate Vice President Kelly Thorne Health Care Professional Patience Whitworth Assistant Dean for Assessment, Student Learning, and Technology Vanderbilt University Clayton Arrington Senior Director Office of the Dean of Students-‐Student Campus Events Nashville, TN Mark Bandas Associate Provost and Dean of Students Private Kiersten Chresfield Student Undergraduate Enrollment: Katherine Drotos Coordinator, Student Health and Wellness 6,800 Andrew Finch Faculty, Human and Organizational Development Dorothy Gager Alcohol and Drug Counselor Steven Gentile Graduate Student John Greene Associate Dean of Students, Student Health and Wellness Louise Hanson Medical Director, Student Health Center Patricia Helland Associate Dean, Office of the Dean of Students Richard Iannelli Associate Director, Institutional Research Tina Smith Assistant Dean of Students, Student Health and Wellness Randy Tarkington Senior Director, Residential Education Mary Yarbrough Executive Director of Vanderbilt's Faculty/Staff Health and Wellness Programs Nina Warnke Assistant Dean, Ingram Commons Cari Drinnon Student G.L. Black Assistant Dean of Students, Student Conduct and Academic Integrity



Appendix A

Washington University in St. Louis

Josh Aiken Student Danielle Bristow Director of First Year Programs

St. Louis, MO Justin Carroll Associate Vice Chancellor for Students/Dean of Students Private Mamatha Challa Student Undergraduate Enrollment: Betsy Foy Student Health Service, Assistant Director Student Health & Counseling 7,300 Steve Givens Associate Vice Chancellor for Public Affairs Alan Glass Assistant Vice Chancellor and Director of Habit Health and Wellness Center Nicole Gore Assistant Dean, College of Arts & Sciences Mike Hayes Director of Greek Life Melany Lopez Student Ryan Miller Residential College Director Molly Pierson Residential College Director Sharon Stahl Dean of the First Year Center, Vice Chancellor for Students Joe Worlund Associate Athletic Director

Wellesley College Stacie Allen Area Coordinator for Residence Life Wellesley, MA Vanessa Britto Director, Health Services Private Robin Cook-‐Nobles Director of Counseling Services Undergraduate Enrollment: Debra DeMeis Dean of Students 2,200 Philip DiBlasi Lieutenant, Campus Police Megan Edwards Psychology & Assistant Director, Group & Outreach, Counseling Services Ashley Longseth Student Annick Mansfield Research Analyst, Institutional Research Monica Setaruddin Student Class of 2014 Joe Swingle Lecturer, Department of Sociology Claudia Trevor-‐Wright Assistant Director of Health Education Wesleyan University Scott Backer Assistant Director of Student Life/Student Conduct Middletown, CT Rick Culliton Dean of Campus Programs Private Tanya Purdy Director of Health Education Undergraduate Enrollment: Andrew Trexler Student Affairs Committee Officer 2,900 Nicole Updegrove Wesleyan Student Assembly Officer Joyce Walter Director of Health Services Michael Whaley Vice President for Student Affairs Michael Whitcomb Director of Institutional Research



Appendix A

University of Wyoming David Cozzens Dean of Students / Associate Vice President for Student Affairs Laramie, WY Mike Dorssom Associate Research Scientist Public Maryanne Jaconis AWARE Program Graduate Assistant Undergraduate Enrollment: Charles Ksir Professor, Psychology 10,200 Lena Newlin Substance Abuse Prevention Coordinator Yale University Garrett Fiddler Student Affairs Fellow New Haven, CT W. Marichal Gentry Dean of Student Affairs Private Cynthia Langin Analyst, Institutional Research Undergraduate Enrollment: Hannah Peck Student Affairs Fellow 5,400

1



Appendix B

Appendix B:

NCHIP Expert Faculty Bios

2



Appendix B

FACULTY MEMBER CURRENT POSITION SELECT PUBLICATIONS M. Dolores Cimini, Ph.D. (2011-‐present)

Director, Middle Earth Peer Assistance Program, nationally recognized alcohol abuse prevention program, University at Albany SUNY

“Changes in Protective behavioral strategies and alcohol use among college students,” Drug and Alcohol Dependence (2011)

“Conscientiousness, protective behavioral strategies, and alcohol use: testing for mediated effects,” Journal of Drug Education (2009)

Jason Kilmer, Ph.D. (2011-‐present)

Research Assistant Professor, Psychiatry, Center for the Study of Health and Risk Behaviors and Assistant Director of Health and Wellness for Alcohol and Other Drug Education, University of Washington

“Reducing the harms of college student drinking: How Alan Marlatt changed approaches, outcomes, and the field,” Addiction Research and Theory (2012)

“Applying harm reduction strategies on college campuses,” College Student Alcohol Abuse: a Guide to Assessment, Intervention and Prevention, Murphy & Barnett Eds., Wiley & Sons (2012)

“The impact of college student substance use: Working with students on campus,” Substance Use in College Students, White & Rabiner Eds. Guilford Press (2011)

Linda Major, M.A. (2011-‐present)

Director for the Center of Civic Engagement & Project Director NU Directions,

“Campus-community solutions,” The Metropolitan Universities: an International Forum (2000)

Toben Nelson, Sc.D. (2013-‐present)

Associate Professor, School of Public Health, Division of Epidemiology & Community Health, University of Minnesota

“An implementation model to increase the effectiveness of alcohol control policies,” American Journal of Health Promotion (2013 )(with Traci Toomey)

Preventing Binge Drinking on College Campuses: A Guide to Best Practices, Hazeldon Publishing (2012) (co-authored with KC Winters and V. Hyman)

“Screening for Alcohol Problems Among 4-year colleges and universities,” Journal of American College Health (2011).

Lloyd Provost, M.S. (2011-‐present)

Improvement Advisor with Associates in Process Improvement & Senior Fellow at the Institute of Healthcare Improvement (IHI).

“Judgment sampling: a health care improvement perspective,” Quality Management in Health Care (2012)

“Analytical studies: a framework for quality improvement design and analysis,” BMJ Quality & Safety (2011)

The Health Care Data Guide: Learning from Data for Improvement, Jossey-Bass (2011)

3



Appendix B

Robert Saltz, Ph.D. (2011-‐present)

Prevention Research Center, Berkeley CA

“Enlisting Bars and Restaurants in the Prevention of Intoxication and Subsequent Harms: Why It Matters,” American Journal of Preventive Medicine (2011) (with Traci Toomey)

“Types of Drinkers and drinking setting: An application of a mathematical model,” Addiction (2011)

“Alcohol Risk management on college settings: The Safer California Universities Randomized Trial,” American Journal of Preventive Medicine (2010)(2010). Traci Toomey, Ph.D.

(2011-‐2013) Director, Alcohol Epidemiology Program and Professor, School of Epidemiology & Community Health, University of Minnesota

“Adopting local alcohol policies: a case study of community efforts to regulate malt liquor sales,” American Journal of Health Promotion (2012) (with Toben Nelson)

“The association between density of alcohol establishments and violent crime in urban neighborhoods,” Alcoholism: Clinical and Experimental Research (2012)

“Enforcing alcohol policies on college campuses: Reports from college enforcement officials,” Journal of Drug Education (2012)

Thomas Workman, Ph.D. (2011-‐present)

Principal Communication Researcher and Evaluator, Health Program at American Institutes for Research (AIR)

“Rethinking Higher Education’s Strategy on Marijuana,” Leadership Exchange (Summer 2013)

“The Reluctant Consumption of Evidence-Based Decision Making,” Health Communication (2010)

1



Appendix C

Appendix C:

Driver Diagram

2



Appendix C

• Reduc&on)in)Harm)(%))

• Reduc&on) in)High4Risk)Drinking)(%)))

Drinker(

Environment(

System(

Peers(

Parents(understanding,(recogni8on,(ac8ons(

Community(coali8ons((Police/Campus(Security,(Faculty,(State,(Community(volunteers,(Local(ordinances,(Media,(Driving)(

Rou8ne(Screening(

Post(intoxica8on(follow(up(

Recogni8on(of(acute(Rx(need(

Transport(Clinical(assessment,(acute(management(of(toxic(drinker(

Student(awareness(/(understanding(Parent(awareness(/(understanding,(ac8ons(

PreFsports(events(

Residences(living(policies,(prac8ces(

AlcoholFfree(social(programming(

Data(used(for(management,(policy,(prac8ce(development.(

Standards(for(reliable(prac8ce(

Adap8ve(responses(to(current,(emerging,(evolving(reali8es(

High(risk(events(

Student(Health(Service(vigilance,(incorpora8on(into(rou8ne(care(

PreFsocial(ac8vity(

Policy(enforcement(

System(“connec8ons”(known,(used(

Student(awareness/(understanding(

Limited(retail((access(to(alcohol(

Limited/managed(social(access(to(alcohol(

Enforced(alcohol(laws(

Social(norms(re:((dangerous(alcohol(use(&(recogni8on(of(legal(risks,(harm(

Bars/outlets(

Alcohol(distributors,(promo8on(policies,(prac8ces(

Policy(adherence(

Managed(physical(proximity(to(public(drinking(spaces(

Explicit(rela8on(to(college(mission(

Risk(iden8fica8on,(management(

Acute(toxicity(management(

Preven8on(

Interdependence(

Context,(aim(

Reliable(opera8ons(

Resiliency(

Explicit(rela8on(to(community(

Effec8ve(Brief(Interven8on(

Targeted(Screening(

Follow(up(/(feedback(

High(risk(student(groups(

Timing(Fidelity(Delivery(

Structure(Data(sharing(

Policy(development(

Theory(of(the(Drivers(of(Change(to(Reduce(HRD(&(Harms(

1



Appendix D

Appendix D:

Outcome Measurement Strategy

Learning Collaborative on High-Risk Drinking1

Learning Collaborative on High-Risk Drinking

WELCOME

Please note: The following is an explanation of quality improvement methods that supplements the Proposed Measures recommendations and provides some tools for teams to use.

QUALITY IMPROVEMENT

What is Quality Improvement (QI)?1

• QI is a formal approach to improving a system or process – such as increasing efficiency, assuring consistency withevidence based recommendations, and reducing harm or error.

• QI requires the combined and persistent efforts of everyone – students, faculty and educators, campus staff,researchers, administrators – in order to make changes that will lead to better student outcomes (health andwell-being), better system performance (prevention, management and treatment of intoxication) and betterprofessional development (learning).

• The PDSA cycle is one model used in QI. To make improvements, a team must be clear about what it is tryingto accomplish and how it will know that a change has occurred and led to improvement – this approach involves rapidcycles of tests in the environment while maintaining a frequent and consistent schedule of data collection onbehaviors or outcomes of interest.

Measurement in Quality Improvement2,3

• Measurement is a critical part of testing and implementing changes in QI; measures tell a team whether the changesthey are making actually lead to improvement.

• In improvement work, the team uses a balanced set of measures that integrates multiple sources and types of data(e.g. measurable data, self-reported data and contextual data). Data for these measures are typically plottedgraphically over time using a “run chart,” a simple and effective method used in QI to determine whether thechanges are leading to improvement.

Science of Improvement: Establishing Measures2,3

• Measurement for quality improvement is different than measurement used in research. This difference is outlined inthe following table.

1Batalden PB, Davidoff F. What is ‘‘quality improvement’’ and how can it transform healthcare? Qual Saf Health Care 2007;16:2-3 doi:10.1136/qshc.2006.022046

2Institute for Healthcare: Measures. http://www.ihi.org/knowledge/Pages/Measures/default.aspx

3Institute for Healthcare: Establishing Measures. http://www.ihi.org/knowledge/Pages/HowtoImprove/ScienceofImprovementEstablishingMeasures.aspx

Measurement Strategy: Quality Improvement References

Learning Session 1

Please note: The following is an explanation of quality improvement methods that supplements the NCHIP Measurement Recommendations and provides some tools for teams to use in designing their improvement efforts.

Appendix D


QUALITY IMPROVEMENT CONT

Measurement for Research Measurement for Learning and Process Improvement

Purpose To discover new knowledge To bring knowledge into daily practice for action

Tests One large “blind” test (randomization) Many sequential, observable tests

Biases Control for as many biases as possible through study design and statistical controls

Stabilize the biases from test to test to see trends

Data Gather extensive data across a number of domains

Gather “just enough” data to learn and move to another cycle

Duration Can take long periods of time to obtain results “Many small tests of changes” accelerate the rate of improvement

Types of Measures2,3

QI uses a balanced set of measures across all improvement efforts: outcomes measures, process measures, and balancing measures. • Outcome Measures: How does the system impact students, their health and well-being? (Example: high-risk drinking rate.)• Process Measures: Are the parts/steps in the system performing as anticipated? Are we on track in our efforts to

improve the system? (Example: proportion of students presenting for care at health center who are screened forhigh-risk drinking.)

• Balancing Measures: Are changes designed to improve one part of the system causing new problems in other partsof the system? What are impacts on other stakeholders? (Example: medical care encounter rate rises as a result ofnew amnesty program.)

• Context: NCHIP has focused on gathering information about the context for each member institution (i.e., theparticular characteristics of each institution that might influence the processes and outcomes that a team isworking to improve).


Learning Session 1

DATA ANALYSIS

Plotting Data Over Time

Plotting data over time using a run chart is a common method used in QI to determine whether implemented changesare leading to improvement. Changes (PDSAs focused on the individual, environment, system/policy, etc.) are annotated on the run chart to ascertain whether they are temporally associated with improvement in the process oroutcomes. Several types of charts are used to display the data over time.

Run Charts4,5

• A run chart / time series chart displays observed data in a time sequence. Often, the data displayed represent some aspect of the output or performance (i.e. percent reporting high-risk drinking). The mean or median may be displayed.• There are three probability-based rules (shift, trend or run; details are not presented here) that are used to objectively analyze a run chart for evidence of nonrandom patterns in the data. These are appropriate for quality improvement projects – where improvement is planned and expected – and have been shown to be effective in detecting signals in a wide range of applications. Run charts create a foundation for more complex statistical process control charts.

4Perla RJ, Provost LP, Murray SK. The run chart: a simple analytical tool for learning from variation in healthcare processes. BMJ Qual Saf 2011;20:46-51

5Callahan CD, Griffen DL. Advanced statistics: Applying statistical process control techniques to emergency medicine: a primer for providers. Acad Emerg Med 2003;10:883-890

Institute for Healthcare: Establishing Measures. http://www.ihi.org/knowledge/Pages/HowtoImprove/

Please note: Run charts are the statistical method provided to teams to display data on the IHI Extranet.

Appendix D


DATA ANALYSIS CONT

Run Charts Cont


Learning Session 1

Statistical Process Control Chart5

• Statistical Process Control Charts incorporate statistical methodology and can be used to confirm trends.• A Shewhart control chart is a QI tool used to help a team understand variation in the data. Of particular interest is

determining whether the variation in a process is that which is expected by random chance or due to somethingspecial in the process, such as an event or improvement intervention. There are specific rules for determining whena signal – or a statistically significant change – has occurred, such as a single point outside the chart’s controllimits, or a certain number of points above the center line (mean/median); again the details for these rules are notpresented here. It is also important to establish a stable baseline in order to effectively demonstrate changes fromthat baseline; generally, about 20 points are recommended to establish this baseline.

• Statistical control charts are a progression of the run chart and provide an analytically robust methodology to fosterongoing examination of the processes in ways that traditional statistical data tables do not. A real-time focusallows the opportunity for intervention while the process is still occurring. Improved outcomes will come only as aresult of thoughtful analysis and understanding of the processes that are producing these outcomes.

• The NCHIP Measurement Team can provide assistance if institutions are interested in using more advancedmethods.

http://en.wikipedia.org/wiki/File:SimpleRunChart.jpg

http://en.wikipedia.org/wiki/File:Xbar_chart_for_a_paired_xbar_and_R_chart.svg

Appendix D


SURVEY METHODS6

Sampling

To obtain data for these analytical charts, NCHIP Collaborative Teams will capture both measurable data (medical care and law encounter rates) and collect data through surveys (self-reported high-risk drinking rate and attendant harms). Below are some sampling methods.

Simple random sampling (SRS)

• SRS is a basic sampling technique in which a group of subjects (a sample) is selected from a larger group (apopulation). Each individual is chosen entirely by chance; thus, each member of the population has an equalchance of being included in the sample. Simply put, SRS refers to a sampling method that has the followingproperties: (1) The population consists of N subjects; (2) the sample consists of n subjects; and,(3) all possible samples of n subjects are equally likely to occur.

• Many statistical methods assume that a simple random sample has been used for data collection.

Sampling With Replacement and Without Replacement

When sampling is done multiple times on a population, elements can potentially be selected more than one time (e.g., we are sampling with replacement). The benefit of this approach is ease of administration (no need to keep track of who has been sampled). The down side is that students may receive multiple survey requests.

1/9th (1/12th) Non-Replacement Method

• Define the population of subjects (N). [Example: All students currently enrolled and attending classes on campus,or entire student population (enrolled and on or off campus).]

• Obtain current up-to-date list of enrolled student email addresses at start of the Academic Year that fit thepopulation parameters.

• Determine whether you will sample 1/9th or 1/12th of your population (depending on the number of monthsstudents are in session).


Learning Session 1

Generate Samples in Excel: 1. Use the random number generator function to generate a list of random numbers;2. Match the first 1/9th (or 1/12th) of the student population email list to the corresponding random numbers to

obtain the sample (n) for the first month; and,3. Choose the subsequent 1/9th (or 1/12th) of the student population to use for the next month. Repeat this process

for each month, ensuring that the team does not select the same student email more than once.

Generate Samples in SAS: 1. Import your list of email names into SAS.2. Use Proc SurveySelect to select the samples.

Alternative Sampling Approaches

• A random sample of 50-100 students per months can be sampled with or without replacement (with replacementmay have less power and may be less representative depending on overall student population, but will provide valueof tracking data in real-time).

• Coordination among departments within your institution may help to reduce survey burden and redundancy insurveying by providing opportunities for the core (standard) survey items to be added to existing and / or plannedsurveys.

Alternative Modes of Surveying

Paper, electronic, and phone surveys are all viable options.

Please note: The NCHIP Measurement Team can provide assistance to generate samples in other statistical programs.6Carey, Raymond G. Improving Healthcare with Control Charts: Basic and Advanced SPC Methods and Case Studies. 2003: American Society for Quality, Milwaukee, WI.

Appendix D


ADDITIONAL CONSIDERATIONS

IRB Review Each institution is responsible for determining whether activities related to NCHIP require an IRB review on their

respective campuses. NCHIP cannot determine the need for review. An open and ongoing conversation with an IRB contact is ideal any time methods are developed.

Stratification of SamplesWhile stratification may be desirable for some teams, each institution must remain mindful of the risks to student privacy presented by the small sub-group sizes that may result from stratifying. NCHIP suggests that institutions work

closely with their CPHS/IRB to ensure that they remain in compliance with FERPA and institutional policies on student privacy.

Survey Fatigue

Simple random sampling without replacement is recommended as it allows each institution to keep a pulse on how their process is responding to changes implemented while limiting the potential for survey fatigue since each student

will only be surveyed once each Academic Year.

Sample Size

Each institution should have a yearly representative sampling method (e.g., ACHA NCHA, CORE) in use. In addition, itis essential to collect frequent small samples over time as outlined earlier. It is ideal that these samples are representative of the entire student population, especially for outcome measures, and that power is maximized; however, even a small convenience sample can provide useful information and guide improvement efforts. Run charts can be used for any sampling method while statistical process control charts require adequate sample size. The following is a brief explanation of power calculations in statistical process control charting.


Learning Session 1

Response Rates Response rates, or the number of responses to the survey divided by the number of respondents sampled, on self-

report surveys may vary widely and low response rates can limit the power to show significant change. To increase response rates NCHIP recommends to:

• Keep the survey short by using the brief two-question survey consisting of 10 items (described previously).• Follow-up with a reminder for non-responders.

Please note: If response rates are consistently low, an institution may use PDSA test of change to determine how to improve them. Many institutions use incentives to increase response rates among their student populations.

Appendix D


ADDITIONAL CONSIDERATIONS CONT

Example Calculations1. Determine the proportion or rate of the outcome. High-risk drinking is used here as an example. NCHIP baseline pre-work data showed a range of high-risk “binge” drinking rates from 0.19 to 0.69. (p)2. Determine the undergraduate student population. NCHIP baseline pre-work data showed that total undergraduate populations ranged from 1,455 to 30,836 students. (N)3. Calculate the proposed number of students for each sample at 1/9th of the population. (S)4. Calculate the expected monthly survey responses (sample size) given the response rate (RR). (n)5. Multiply the expected number of completed surveys by the average proportion/rate of binge drinking (i.e.,

Column 4 * Column 1 in table below). (n * p)6. Determine if the product in Column 5 meets the minimum number required to ensure valid statistical results (is it

greater than 5?).

1 2 3 4 5 6

p(high-risk drinking rate)

N(student body)

s(1/9th surveyed monthly)

n(# responding; RR = 0.33)

n * pDecision

n * p > 5?

0.1912 1,455 162 54 10 YES

0.6881 1,455 162 54 37 YES

0.1912 30,836 3,426 1,142 218 YES

0.6881 30,836 3,426 1,142 786 YES


Learning Session 1

Survey Administration

• Many institutions already have a system in place for surveying students using programs such as Qualtrics, SNAP,StudentVoice and SelectSurvey. For those who do not, the use of SurveyMonkey or similar vendor is recommendedas a viable option for obtaining de-identified data.

• See this link for security specifications: http://www.surveymonkey.com/Monkey_Security.aspx.

Template Survey Introduction Dear ,

is actively involved in the National College Health Improvement Project’s (NCHIP) Learning Collaborative on High- risk Drinking (http://www.nchip.org/alcohol/), the aim of which is to reduce high-risk drinking behaviors and associated harms on

college and university campuses. In order to better understand your experiences with alcohol and guide prevention efforts, we would appreciate your responses to this brief ANONYMOUS survey.

To take the survey, please click here: .

Thank you for your participation,

NCHIP Team / IR Team

Power Calculation for Statistical Control ChartsThe minimum sample size needed to ensure the statistical control charts will yield valid results is ensured by following the rule:

n * p > 5 where:

• p is the average proportion or rate of the outcome (e.g. high-risk drinking)• N is the student population• S is the number of students surveyed monthly (1/9th or 1/12th of student body)• n is the number students responding to survey• n * p is the test to make sure you have sufficient power (i.e. > 5).

Appendix D



Appendix E

Appendix E:

Process Measures Library

SOCIO-‐ECOLOGICAL LEVEL

INITIATIVE OR INTERVENTION POSSIBLE PROCESS MEASURES


Appendix E

INDIVIDUAL

SCREENING § Percent Screened § Percent positive screened § Percent received motivational intervention from provider § Referral:

− Percent referred for follow up − Percent students that follow up − Time to follow up for positive screens − Time to follow up for students not receiving motivational intervention − Incidents post screen − Incidents post motivational intervention

§ Sustainability § Fidelity of provider doing motivational interventions

BRIEF MOTIVATIONAL INTERVENTION

§ Referrals − Number referred to BASICS including preventive with high-‐risk groups − Number referred to BASICS through judicial system − Number referred to BASICS through residential life − Number mandated brief motivational intervention

§ Completion − Percent completed brief motivational intervention − Percent follow up with Alcohol and Other Drugs (AOD) and treatment

§ Cycle Time − Time from incident to referral − Time from incident to first session screening − Time from incident to second session screening − Time from incident to completion

§ Post Drinking Behaviors − Follow up after 60 days − Follow up after 90 days − Follow up after 120 days

§ Follow up after 180 days/1 year




Appendix E

EDUCATION; AWARENESS-‐ATTITUDES, BEHAVIOR CHANGES

§ Prior to attending the prevention series: − What was your attitude regarding your substance using behavior? − There is no reason to change, there is no concern − There may be behavior to change, but not now − I am making a plan on cutting back my substance use − I have implemented my plan to cut back my substance us − I have been maintaining my ongoing change in reduced substance use

§ After attending the prevention series: − What is your current attitude on your substance use? − There is no reason to change, there is no concern − There may be behavior to change, but not now − I am making a plan on cutting back my substance use − I have implemented my plan to cut back my substance use − I have been maintaining my ongoing change in reduced substance use − Pre-‐post survey questions tailored to content of session

INTERPERSONAL

FRESHMAN CLASS § Pre-‐matriculation Online Tool − Percent incoming students who completed online survey/tool − Number of reminder emails sent − Number of days the intervention site was open − Percent non-‐responders − Percent non-‐responders followed up with intervention − Responders vs. non-‐responders high-‐risk drinking and harms at 60 days, 90 days, beyond

§ Greek Involvement − Percent of freshmen drinking during recruitment week collected by survey − Average number of drinks consumed among attendees collected by survey − Number of freshmen that attended a fraternity-‐sponsored event within the first 2 weeks among all who responded to the survey

− Number of freshmen that attended a fraternity-‐sponsored event within the first 4 weeks among all who responded to the survey

− Number attending late night, alcohol-‐free social options




Appendix E

− Percent being told expectations for alcohol use by peer leaders

PARENT ENGAGEMENT § Number of visits to web/blog sites § Number of parents attending education sessions § Survey

− Interest level in receiving information − Percent of parents having conversations with students (e.g. before high-‐risk events) − Number of parents notified after student alcohol violation − Percent students reporting change in drinking behaviors as a result of parent engagement

− Percent change in beliefs/attitudes regarding risk

BYSTANDER INTERVENTION

§ Training − Number of students trained − Costs of the training − Number of materials distributed and the costs − Pre/post-‐ knowledge, skills, and attitudes-‐ e.g. identify signs of alcohol poisoning, how to help and intervene with students in need

− Incidents in students who go through training − High-‐risk drinking and harm rates in students who go through training

§ Intervention − Number of events in attendance − Number of times intervened (and qualitative information regarding the situation) − Number of calls made; level of BAC among calls − Helping behaviors-‐survey items, number of medical amnesty calls

ON CAMPUS

COMMUNICATION & MESSAGING

§ Student message texting data § Media tracking: social media, campus media § Peer leader reports § Language saturation evidence § Number of visits to policy, information web pages § Survey data-‐ message awareness, message agreement § Saturation-‐ evidence of language/messaging being repeated by non-‐spokespersons § Number of articles in student newspaper, blogs




Appendix E

RESIDENCE HALLS § Number of citations § Number of hospital transports for intoxication § Cost of property damage § Qualitative data-‐ e.g. knowledge, skills, attitudes-‐ RAs, residents § High-‐risk drinking rates and harms pre/post initiative § Parental notification-‐ number of phone calls, letters to parents

SOCIAL NORMS § General student response, awareness § Exposure-‐-‐ percent of students who notices § Saturation-‐-‐ number of times they notice § Pre/post responses for targeted campaigns § Google analytics-‐-‐ number of visits; number of pages visited; visit duration; percent bounce rate; Facebook likes

§ Cost; program maintenance

SOCIAL OPTIONS § Costs of events § Number of sponsoring organizations § Number of students in attendance § Average amount of time students spent at event § Incident reports § Survey-‐ using real-‐time technology (e.g. iPod touches) § Events they aren't going to-‐ bars, parties, other campus events-‐ due to attendance at alcohol-‐free event

§ Consumption before the event § Consumption patterns on evenings that students attended alcohol-‐free events vs. other evenings




Appendix E

SPECIAL EVENTS § Tracking of the strategies implemented to reduce risk for each special event − Policy changes—who is invited/allowed/guest lists, how much alcohol is served, etc. − Communication − Marketing − Safety and enforcement − Food/Hydration − Prevention strategies-‐ e.g. alternative entertainment, focus − Design-‐ where is the event, what are the entrances, identification of legal drinkers (e.g. wristbands)

§ Key Indicators − EMS calls − Number of transports − Number of police transports − Number of judicial sanctions − Number of ejections from the event − Number turned away at entrance due to drunkenness − Cost of property damage, maintenance, and housekeeping reports

OFF CAMPUS

ALCOHOL AVAILABILITY & ACCESS

§ Mapping of alcohol density § Number of compliance checks and results § Number of ID checks and results (alcohol purchases) § Number of fake IDs confiscated; survey question regarding percent reporting use of fake IDs

§ Responsible server training and results § Alcohol use, access at campus events, off campus events § Keg registration § Alcohol outlets § Drink Prices and Specials

− Promotional ads-‐ establishments close to campus (observational) − Availability of large volumes of alcohol (24, 30 can cases, kegs, party balls) − Percent of off premise establishments that provide at least one type of beer promotion − Percent of establishments offering happy hours; specials on weekends − Prices per drink




Appendix E

COMMUNITY RELATIONS

§ Number of coalition members and roles represented § Number of coalitions in the state § Negative consequences § Number of complaints § Number of noise citations § Number of public drunkenness § Where-‐ GIS mapping of "hot spots"

OFF CAMPUS INTERVENTIONS

§ Social Host Training − Number trained, cost − Pre/post survey-‐ knowledge, skills, attitudes − Number of citation, alcohol incidents at trained students' parties

§ Parties − Number of kegs registered − Number of parties registered − Number of student citations, arrests, DUIs − Number of noise citations, complaints − Number of violations to living contracts

1



Appendix F

Appendix F:

Cornell University Team Storyboard

0

5

10

15

20

25

30

Fall 2011 Spring 2012

11 −

12

12

− 1

3

13

− 1

4

Indiv

idual

s

& H

igh

Ris

k G

roups

Screening for alcohol problems during medical visits at the health center. X X X

Coordinated care for intoxicated students treated at hospital, including introduction of SBIRT (Screening, Behavioral Intervention, and Referral to Treatment) administered by local treatment agency.

− X X

Delivery of BASICS (Brief Alcohol Screening and Intervention for College Students) to students referred to a local agency by the city court following off-campus violations.

X X X

Envir

onm

ent

& C

omm

unit

y

Education, enforcement, and late-night programming to reduce drinking by 1st year students during Orientation. X X X

Policy change regarding 1st year students’ relationship to Greek system during the fall semester. X X X

Alcohol-free recruitment and new member orientation period for Greek system. X X X

Coordinated city and campus police patrols of off-campus areas during high-risk periods. X X X

Social norms messages to correct students’ misperceptions about alcohol use and attitudes toward drinking. − X X

Community-wide education about state “Good Samaritan” law to encourage bystanders to call for help in AOD-related emergencies.

X X X

Late-night alcohol-free programming during first six weeks of fall semester. − X X

Programming at a campus pub as a venue for entertainment and moderate drinking. − X X

Development of Cayuga’s Watchers, a student-led organization to train peers to identify and intervene in high-risk situations at parties.

X X X

Syst

em

Coordinated institutional response to alcohol incidents through a weekly case review. X X X

Consequences that are swift, certain and meaningful for individual and group violations of policies. X X X

Highlighted Initiatives

Campus Improvement Team (A-G)

National College Health Improvement Project: Summative Congress, June 2013

Our overall goals are to reduce:

• high-risk alcohol use by Cornell community members

• underage consumption of alcohol by Cornell students

• harm caused to Cornell community members who use AOD

• negative second-hand effects on others caused by Cornell community members who use AOD

Janet Corson-Rikert Associate VP for Campus Health;

Executive Director, Gannett Health Services

Travis Apgar Associate Dean of Students, Fraternities, Sororities, and

Independent Living

Campus Improvement Team (H-Z)

NCHIP Experience: Lessons Learned

Greg Eells Director,

Counseling & Psychological Services, Gannett Health Services

Kent Hubbell Dean of Students;

Professor of Architecture

Deborah Lewis Alcohol Projects Coordinator

Gannett Health Services

Kathy Zoner Chief,

Cornell University Police

Aim Statement

www.gannett.cornell.edu

Susan Murphy Vice President,

Student & Academic Services

Brendan O’Brien Director,

International Students and Scholars

Harm from AOD use among all repondents (in past year)

Fall 2005

Baseline

Fall 2012

Memory loss 32% 30%

Missed class 25% 18%

Performed poorly on important test/project

16% 8%

Sustainability Plans

Joe Burke Associate Dean of Students;

Director, Residential Programs

Tim Marchell Director,

Mental Health Initiatives, Gannett Health Services

Mary Beth Grant Judicial

Administrator

Organizational structures:

• The Executive Committee on Campus Climate, Health, and Safety, comprised primarily of university vice-presidents, vice provosts, and deans, provides high-level leadership and oversight

• The President’s Council on AOD supports coordination and communication among student leaders, faculty, and staff on AOD issues

• Cornell’s NCHIP team is chaired by the Vice President for Student and Academic Services. It reports to the President of the University to ensure the successful implementation of the over-arching system

Research plans for 2013–2014:

• a survey of 1st year students at four weeks into the fall semester

• a random sample survey of undergraduates in Fall 2013 and Spring 2014

• a population-based survey of men participating in Interfraternity Council recruitment

• a random sample survey about Slope Day

• monitor police encounter rates, calls for emergency medical services, and hospital transports for alcohol-related emergencies

• EMS call and transport data are based on a September—April academic year.

• Cornell’s Good Samaritan Protocol and the New York State Good Samaritan Law both aim to encourage people to seek help in an AOD-related medical emergency without fear of judicial or legal consequences.

Sarah Balik Executive Vice President,

Student Assembly (student)

Geoffrey Block Member,

Student Assembly (student)

Alexandra Boehrer Executive Director,

Emergency Medical Services (student)

Marne Einarson Associate Director,

Institutional Research and Planning

Colin Foley President,

InterFraternity Council (student)

Catherine Holmes Associate Dean of Students;

Student Activities

Kirsten Post Eynav Health Educator

Gannett Health Services

Eric Silverberg President,

Cayuga’s Watchers (student)

Carlin Van Holmes President,

PanHellenic Association (student)

Satisfaction with late-night alcohol-free options% students who agree or strongly agree with the following statement:

Fall 2011

Spring 2012

Fall 2012

“There are enough late-night (e.g., after 11 pm) social activities that don’t involve alcohol.”

43% 45% 47%

High-risk drinking (5+ drinks for males, 4+ for females) in past two weeks

Spring 2011

Baseline

Fall 2011

Spring 2012

Fall 2012

Spring 2013

All respondents

44% 49% 48% 43% 41%

Greek 70% 75% 69% 72% 68%

Non-Greek 33% 40% 39% 35% 30%

% of students who saw social norms media messages

Fall 2012

Spring 2013

Target *

all students 39% 74% 56–78%

1st year students only 64% 92% 87–97%

(* Target based on UVA research)

Specifically, we sought to reduce:

1. rates of high-risk drinking among 1st year students involved in the Greek-system by 25%; similarly, we will reduce the rate of high-risk drinking among non-Greek 1st year students by 10%

2. rate of extreme high-risk drinking (typically consume 8+ drinks when drinking) among all students by 20%

3. rates of harms experienced from alcohol use by all students by 20%

4. rates of secondary harms experienced from others’ alcohol use by all students by 20%

Locations where 1st year students consumed alcohol during the 1st four weeks of the fall semester

Among 1st year drinkers: 2011 2012

Residence hall 33% 37%

Off-campus house or apartment 74% 68%

Fraternity house 47% 58%

Fraternity apartment/annex 55% 60%

Bar or restaurant 10% 8%

Other location 23% 19%

Bi-weekly team meetings, with administrators, staff, and student leaders have:• Improved communication regarding the reasons behind policy changes

• Enhanced team coordination and improved focus on strategic and timely decision-making

• Used staff resources judiciously by delegating the management of NCHIP work to the Alcohol Projects Coordinator

• Increased motivation to address many interventions simultaneously

Evaluation has helped us to:• Engage in data-driven strategic planning

• Monitor the implementation of interventions with process measures

• Track behavioral outcomes

The PDSA process has allowed us to:• Take risks with pilots that may not work

• Start with small interventions

• Stay accountable to each other by documenting our actions

• Stay accountable to the work by collecting data to evaluate the intervention

Process Measures

3% decrease

in high-risk d

rinking

among Greek

-

affiliated stu

dents

9% decrease

in high-risk

drinking

among non

-Greek

affiliated

students

7% decrease

in high-risk drink

ing

among all studen

ts

Harms from alcohol use

reduced (9% – 50%)

# of late-night events at student pub

Drinking INCREASED in

residence halls and in fraternity houses,

apartments, & annexes

1. Alcohol-free recruitment week for Greek system:• Reduced % of 1st year students who drank

• Fewer # of drinks consumed among those who drank

• Fewer hospital emergency transports

• Student leaders report substantial change based on lived experience

2. Coordinated institutional response to alcohol incidents through a weekly case review:• Decreased length of time from incident to parental notification by 55 days

3. Consequences that are swift, certain, and meaningful for individual and group violations of policies:• Reduced the # of students experiencing a 3rd time alcohol violation by 37%

• 79% of students with a 3rd violation received treatment at a licensed facility

• In the past year, 8 fraternities faced disciplinary action for alcohol and hazing-related incidents

Campus Improvement Team Initiatives

0

30

60

90

120

150

180

12-1311-1210-1109-1008-0907-0806-0705-0603-0402-0301-02

6378

7167 62

5363

5260

Cornell University EMS alcohol-related calls and hospital transports (2001-2013)

5462

69

7791

155

89

120

117

132

174

NY State Good Samaritanlaw implemented: 9/11

High profile alcohol-related fatalitiesCornell Medical Amnesty

Protocol implemented: 8/02

# alcohol-related calls% transported

01-

02

02-

03

03

-04

05

-06

06

-07

07-

08

08

-09

09

-10

10-1

1

11-1

2

12-1

3

140

59

Cornell University EMS alcohol-related calls and hospital transports

2001—2013

Selected Outcome Measures

Appendix G

Appendix G:

Meetings, Webinars, Presentations, and Press

DATE PRESENTATION AUDIENCE

Appendix G

PRESENTATIONS Oct. 2011 Learning Collaborative on High-‐Risk

Drinking Class of 1955 Dartmouth College, Hanover NH

Dec. 2011 Adapting the Breakthrough Series Learning Collaborative Model for Use in the Higher Education Environment (Poster Presentation)

IHI International Scientific Symposium, Orlando, FL

Jan. 2012 A Learning Collaborative Approach to High-‐Risk Drinking on College Campuses (roundtable presentation)

NASPA AOD Conference, Atlanta GA

Jan. 2012 Learning Collaborative on High-‐Risk Drinking

NIAAA College Presidents Working Group, Dartmouth College, Hanover NH

Mar. 2012 Learning Collaborative on High-‐Risk Drinking

Hanover Alcohol Working Group, Dartmouth College, Hanover NH

Mar. 2012 Learning Collaborative on High-‐Risk Drinking: Update

Center for Leadership & Improvement (CLI) at TDI, Hanover NH

Oct. 2012 The Use of Data to Inform Efforts Northwestern Regional Conference on High Risk Drinking on College Campuses, Evanston IL

Oct. 2012 Learning Collaborative on High-‐Risk Drinking: Latest Update & Future Directions

Center for Leadership & Improvement (CLI) at TDI, Hanover NH

May 2012 Using Improvement Methodology to Address High-Risk Drinking in Student Health

ACHA Conference, Chicago IL

Dec. 2012 A Quality Improvement Collaborative to Reduce High-‐Risk Drinking and Associated Harms Among College Students

AHI International Scientific Symposium, IHI, Orlando, FL

Jan. 2013 Insights on College Alcohol Harm Prevention from the NCHIP Learning Collaborative

NASPA AOD Conference, Ft. Worth TX

Mar. 2013 NCHIP in Review Ivy Plus Dean’s Meeting, Dartmouth College, Hanover NH

Mar. 2013 Medical Care Transport Data and the Emergency Department (Poster Presentation)

Regional Academic Emergency Medicine Conference, Providence RI

DATE PRESENTATION AUDIENCE

Appendix G

Apr. 2013 Insights on College Alcohol Harm Prevention from the NCHIP Learning Collaborative

DCARE Symposium, Dartmouth College, Hanover NH

Apr. 2013 Insights on College Alcohol Harm Prevention from the NCHIP Learning Collaborative

Alcohol Policy 16 Conference, Washington, DC

May 2013 NCHIP – A Learning & “Implementation” Collaborative

Maryland State Educational Conference, University of Maryland, Baltimore County

Dec. 2013 Learning Collaborative on High-‐Risk Drinking

Interagency Coordinating Committee on the Prevention of Underage Drinking, Washington, DC

Jan. 2014 Applying Quality Improvement Methods to High-‐Risk Drinking

NASPA AOD Conference, San Diego, CA

DATE PRESENTATION FACULTY AND GUEST SPEAKERS

1

Appendix G Appendix G

MEETINGS Jul. 2011 Learning Session 1 (LS1) –

Fairlee VT Paul Batalden, M.D., Dolores Cimini, Ph.D., Jason Kilmer, Ph.D., Jim Yong Kim, M.D., Ph.D., Linda Major, M.A., Lloyd Provost, M.S., Bob Saltz, Ph.D.

Jan. 2012 Learning Session 2 (LS2) – Austin TX

Tom Casady, M.A., Dolores Cimini, Ph.D., Jason Kilmer, Ph.D., Jim Yong Kim, M.D., Ph.D., Linda Major, M.A., Lloyd Provost, M.S., M. Bob Saltz, Ph.D., Traci Toomey, Ph.D., Tom Workman, Ph.D.

Jul. 2012 Learning Session 3 (LS3) – Washington DC

Susan Albertine, Ph.D., Dolores Cimini, Ph.D., Vivian Faden, Ph.D., Jason Kilmer, Ph.D., Jim Yong Kim, M.D., Ph.D., Linda Major, M.A., Toben Nelson, Sc.D., Lloyd Provost, M.S., Bob Saltz, Ph.D., Traci Toomey, Ph.D., Tom Workman, Ph.D.,

Jun. 2013 Summative Congress – Boston MA

Dolores Cimini, Ph.D., Phil Hanlon, Ph.D., Jason Kilmer, Ph.D., Linda Major, M.A., Toben Nelson, Sc.D., Lloyd Provost, M.S., Bob Saltz, Ph.D., Traci Toomey, Ph.D., Tom Workman, Ph.D.


2


WEBINARS (ALL COLLABORATIVE AND SMALL GROUP CALLS) Jul. 2011 Accelerating Improvement Lloyd Provost, M.S.

Improvement Advisor, Associates in Process Improvement, Senior Fellow of the Institute of Healthcare Improvement (IHI)

Aug. 2011 Involving Parents in High-‐Risk Drinking Prevention and Intervention Efforts

M. Dolores Cimini, Ph.D. Assistant Director for Prevention & Program Evaluation, Director, Middle Earth Peer Assistance Program, Adjunct Clinical Professor, School of Education, University of Albany

Aug. 2011 Discussing Substance Use During Clinical Visits

Jason R. Kilmer, Ph.D. Research Assistant Professor, Psychiatry and Assistant Director of Health & Wellness for Alcohol and Other Drug Education, Division of Student Life, University of Washington

Sep. 2011 Measurement Strategy Training: Session I

NCHIP

Sep. 2011 Measurement Strategy Training: Session II

NCHIP

Sep. 2011 Considering Prepartying in the College Setting

Jason R. Kilmer, Ph.D. Research Assistant Professor, Psychiatry and Assistant Director of Health & Wellness for Alcohol and Other Drug Education, Division of Student Life, University of Washington Eric R. Pedersen, Ph.D. University of Washington and VA San Diego Health Care System

Oct. 2011 Presentation on the Intoxicated Student

Michael Fleming, M.D., M.P.H. Professor of Family Medicine, Northwestern University, Member of the Institute of Medicine (IOM)

Oct. 2011 Linking PDSAs and Process Measures

Mark Splaine, M.D., M.S. Assistant Professor of The Dartmouth Institute and of Community & Family Medicine

Feb. 2012 The Role of Strategic Communication in Environmental Change

Tom Workman, Ph.D. Principal Communication Researcher and Evaluator, American Institutes for Research

Mar. 2012 The Role of Enforcement in an Environmental Approach to Reduce High-‐Risk Drinking by Young Adults

Tom Casady, M.A. Director of Public Safety, Lincoln, NE

Apr. 2012 Building Effective Systems: Integration and Effective Use of Resources

Traci L. Toomey, Ph.D. Director, The Alcohol Epidemiology Program, University of Minnesota

Apr. 2012 Hard Alcohol Tim Foster, M.A. Dean of Student Affairs, Bowdoin College


3


May 2012 Taking a Systems Approach – Safer CA Universities Project

Bob Saltz, Ph.D. Senior Scientist and Associate Director, Prevention Research Center, Pacific Institute for Research and Evaluation

May 2012 Social Norms Campaigns on College Campuses

Brian Freidenberg, Ph.D. Addiction Behaviors Specialist M. Dolores Cimini, Ph.D. Assistant Director for Prevention & Program Evaluation, Director, Middle Earth Peer Assistance Program, Adjunct Clinical Professor, School of Education, University of Albany

May 2012 Community Coalitions Tammy Loew, M.A. Health Advocacy Coordinator, Student Wellness Office, Purdue University

May 2012 Individual-‐Focused College Student Drinking Prevention: Defining What Works, What Might, and What Doesn’t

Jessica M. Cronce, Ph.D. and Jason M. Kilmer, Ph.D. Center for the Study of Health & Risk Behaviors, Department of Psychiatry & Behavioral Sciences, University of Washington

Jun. 2012 Assessing Well-‐Being in College: The Duke Social Relationships Project

Steven R. Asher, Ph.D. and Molly Stroud Weeks, Ph.D. Department of Psychology & Neuroscience, Duke University

Aug. 2012 Insights Into Why Students Engage in High-‐Risk Drinking and How to Tap Into Informal Social Support

Thomas Vander Ven, Ph.D. Associate Professor, Department of Sociology and Anthropology, Ohio University

Sep. 2012 Do Parents Still Matter in College? Some Things We Know (And Don’t Know Yet)

Mark Wood, Ph.D. Professor, Department of Psychology, University

Documents

Appendices - Dartmouth Collegewebapp.dartmouth.edu/nchip/uploads/NCHIP_whitepaper_App_FINAL.pdf · LEARNING COLLABORATIVE ON HIGH-RISK DRINKING WHITE PAPER LEARNING COLLABORATIVE