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Comparison of an In-Class vs. Online Alcohol Diversion Program to Reduce Alcohol Consumption and Negative Consequences Among College Students: Findings from a 2-year study. David Salafsky, MPH Carlos Moll, MPH Peggy Glider, Ph.D. The University of Arizona. Background. - PowerPoint PPT Presentation
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Comparison of an In-Class vs. Online Alcohol Diversion Program to Reduce Alcohol
Consumption and Negative Consequences Among College Students:
Findings from a 2-year study
David Salafsky, MPHDavid Salafsky, MPHCarlos Moll, MPH Carlos Moll, MPH
Peggy Glider, Ph.D.Peggy Glider, Ph.D.
The University of ArizonaThe University of Arizona
Background
Diversion program began with AA-based 1-hour Diversion program began with AA-based 1-hour groups led by students in recoverygroups led by students in recovery
1988 – New staff member did literature review 1988 – New staff member did literature review and identified two models to incorporate: Marlatt and identified two models to incorporate: Marlatt (Skill Building) and Perkins & Berkowitz (Social (Skill Building) and Perkins & Berkowitz (Social Norms). New program (Student Health Alcohol Norms). New program (Student Health Alcohol and Drug Education [SHADE] was increased to and Drug Education [SHADE] was increased to two 1-hour sessions led by graduate studentstwo 1-hour sessions led by graduate students
1995 – Incorporated more of Marlatt’s work 1995 – Incorporated more of Marlatt’s work through a curriculum developed at the University through a curriculum developed at the University of Wisconsin. Moved to two 2-hour sessions of Wisconsin. Moved to two 2-hour sessions taught by professional stafftaught by professional staff
Background
2000 – New staff hired and given the task 2000 – New staff hired and given the task of reviewing literature and updating of reviewing literature and updating program. Incorporated elements of program. Incorporated elements of BASICS, focusing on risk reduction. BASICS, focusing on risk reduction. Moved to three 2-hour sessionsMoved to three 2-hour sessions
Through all changes, no evaluation was Through all changes, no evaluation was conducted due to lack of funding for staff conducted due to lack of funding for staff and incentivesand incentives
Background
2005 – Dean of Students expressed interest 2005 – Dean of Students expressed interest in moving to an online diversion program. in moving to an online diversion program. Before making change, Campus Health Before making change, Campus Health wanted to test efficacy of existing program wanted to test efficacy of existing program against online programmingagainst online programming
June 2005 - Received U.S. Department of June 2005 - Received U.S. Department of Education grant to test these two modalitiesEducation grant to test these two modalities
In-class Format
6 hour class (3 sessions over 3 weeks)6 hour class (3 sessions over 3 weeks) Average class size = 15 studentsAverage class size = 15 students ParticipatoryParticipatory 5 different instructors5 different instructors Standard lesson plan, with potential for Standard lesson plan, with potential for
variation due to discussion and instructorvariation due to discussion and instructor
On-line Format
Third Millennium ClassroomsThird Millennium Classrooms ““Under the Influence”Under the Influence” 2-3 hours to complete2-3 hours to complete Conducted individually online anywhereConducted individually online anywhere No potential for content variabilityNo potential for content variability
In-class Content Standard drinksStandard drinks BAC calculationBAC calculation Alcohol in the bodyAlcohol in the body Physiological effectsPhysiological effects Moderation skills/Protective strategiesModeration skills/Protective strategies Normative feedbackNormative feedback Negative consequencesNegative consequences
Online Content
e-CHUGe-CHUG Levels of alcohol useLevels of alcohol use Alcohol and other drugsAlcohol and other drugs BAC calculationBAC calculation Consequences of misuseConsequences of misuse Tools for changeTools for change
Evaluation Methods
Random assignment Random assignment ConsentConsent Baseline (in-person for both groups)Baseline (in-person for both groups) 3-month online follow-up3-month online follow-up
Survey Instrument
DemographicsDemographics Alcohol consumption measuresAlcohol consumption measures Protective factorsProtective factors Stages of changeStages of change Norms perceptionsNorms perceptions Negative consequencesNegative consequences
Sample Diversion referrals from Residence Life & Dean of Diversion referrals from Residence Life & Dean of
StudentsStudents Total diversion referrals: Total diversion referrals:
Online = 537Online = 537
In-class = 504In-class = 504 Total baseline: Total baseline:
Online = 430 (80.1% of baselines)Online = 430 (80.1% of baselines)
In-class = 449 (89.1% of baselines)In-class = 449 (89.1% of baselines) Total matched pairs:Total matched pairs:
Online = 264 (64.7% of baselines)Online = 264 (64.7% of baselines)
In-class = 286 (71.3% of baselines)In-class = 286 (71.3% of baselines)
Demographics
63% Male63% Male Average age = 19Average age = 19 80% Live in residence halls80% Live in residence halls 78% Freshmen78% Freshmen 83% Caucasian83% Caucasian 28% Greek affiliation28% Greek affiliation No significant differences between groupsNo significant differences between groups
Outcomes
Both formats effectiveBoth formats effective Significant reductions in:Significant reductions in:
Usual # drinksUsual # drinks Nights they partyNights they party Perception of peer drinkingPerception of peer drinking Protective behaviorsProtective behaviors Negative consequencesNegative consequences
0.08
0.085
0.09
0.095
0.1
0.105
0.11
0.115
Online In-class
BAC Comparison
Baseline
Post
Modality Comparisons
Online In-class
Pre Post p-value
Pre Post p-value
% 1-2 times
52.0 59.4
ns
46.0 66.1
.000% 3-5 times
33.1 31.5 39.6 24.7
% 6 or more
14.9 9.1 14.4 9.1
Frequency of 5 or more drinks
Comparing of Heavy Drinkers
• Defined as usually having > 6 drinks when they party• Approximately half of each group• Programming focuses on harm and risk reduction• Higher risk group
Alcohol Use in Heavy Drinkers
All drinking behaviors improved for both All drinking behaviors improved for both online and in-class groups:online and in-class groups: Drinks per weekDrinks per week Drinks they usually have when they partyDrinks they usually have when they party Drinks last time they drankDrinks last time they drank Drinks per hour last time they drankDrinks per hour last time they drank BAC last time they drankBAC last time they drank
Protective Factors in Heavy Drinkers
0
10
20
30
40
50
Online In-class
% Who stop drinking 1-2 hours before going home
Pre
Post
Significant improvements for the in-class group only
0
5
10
15
20
25
30
35
Online In-class
% who alternate with non-alcoholic beverages
Pre
Post
Significant improvements for the in-class group only
051015202530354045
Online In-class
% who set a limit on the number of drinks they will have
Pre
Post
Significant improvements for the in-class group only
0
5
10
15
20
25
Online In-class
% women who pace themselves to 1 or fewer drinks per hour
Pre
Post
* Based on women who usually have 5 or more drinks* Based on women who usually have 5 or more drinks
Significant improvements for the in-class group only
0
5
10
15
20
25
Online In-class
% men who pace themselves to 2 or fewer drinks per hour
Pre
Post
Significant improvements for the in-class group only
Negative Consequences in Heavy Drinkers
Significant improvements for the in-class group only
010
203040
506070
80
Online In-class
% who had a headache/hangover past 30 days
Pre
Post
0
10
20
30
40
50
60
Online In-class
% who got sick or threw up in the past 30 days
Pre
Post
Significant improvements for the in-class group only
0
2
4
6
8
10
12
Online In-class
% who were warned about their alcohol use by a health care provider in the past 30 days
Pre
Post
Significant improvements for the in-class group only
0
5
10
15
20
25
30
35
40
Online In-class
% who were late to work or school in the past 30 days
Pre
Post
Significant improvements for both groups
0
5
10
15
20
25
30
35
Online In-class
% who missed work or school in the past 30 days
Pre
Post
Significant improvements for both groups
0
5
10
15
20
25
30
Online In-class
% who got into trouble at work or school in the past 30 days
Pre
Post
Significant improvements for both groups
Limitations
No control over online contentNo control over online content Differences other than modalityDifferences other than modality Multiple in-class instructorsMultiple in-class instructors
Difficulty with follow-upDifficulty with follow-up Relatively short follow-up period (3 months)Relatively short follow-up period (3 months)
Lessons Learned
Both formats were effectiveBoth formats were effective In-class had more impact on:In-class had more impact on:
Frequency of heavy drinking & BACFrequency of heavy drinking & BAC Protective behaviorsProtective behaviors Heavy drinkers as a groupHeavy drinkers as a group
Next Steps
Based on evaluation, online component Based on evaluation, online component (e-CHUG) was added to in-class format(e-CHUG) was added to in-class format
Develop online curriculum based on in-Develop online curriculum based on in-class componentsclass components
Continue evaluation of revised diversion Continue evaluation of revised diversion programmingprogramming
Contact Information David SalafskyDavid Salafsky [email protected]
Carlos MollCarlos [email protected] ext. 202520-295-9339 ext. 202
Peggy GliderPeggy [email protected]
