Upload
others
View
1
Download
0
Embed Size (px)
Citation preview
1
The Alcohol Prevention Compass
Kimberley Timpf, Senior Director of Partner Education
August 3, 2016
Considering the Full Spectrum of Evidence
Sites include the Higher Education Center, Social Norms
Institute, Promising Practices Sourcebook,
NIAAA, SAMHSA, Institute of Medicine
Data Collection from Credible Web Sources
• Practitioners with demonstrated success
• Notable researchers
• More than 200 people interviewed at over 150
institutions and organizations
Discussions with Key Informants in the Field
+33 alcohol prevention strategies investigated
+6,000 journals and
magazines
+400 articles reviewed,
summarized and analyzed
Detailed Literature Review and Analysis
Success Is Measured Along Multiple Dimensions
3
Changed Minds Changed Actions Changed Outcomes
Attitudes toward drunk driving Frequency of alcohol use ER visits
Knowledge of hard alcohol use risk Drinking to get drunk Blackouts
Awareness of campus policies Pregaming behavior Nausea, vomiting
Willingness to participate in alcohol-free options
Fake ID use DUI’s
Knowledge of genetic factors in alcohol use
Doing shots Alcohol violations
Understanding of BAC Typical BAC Recidivism
Ability to set limits on alcohol use Heavy episodic drinking occurrences Academic performance
Belief that drinking is the “cool thing to do”
Drinking the night before an exam Neighborhood complaints
External Determinants
of Behavior
Quantifying the Impact: Step 1
4
Source: National Institute on Drug Abuse (2014)
Step 1: Core Outcomes
Behavior (Alcohol Use)
Negative Consequences
of Behavior
Personal Determinants
of Behavior
Behavioral Intentions
• 26% reduction in total consumption
• 37% decrease in heavy episodic drinking
1 point each, 3 points max
2 points each, 6 points max
1 point each, 3 points max
Quantifying the Impact: Steps 2-4
5
Step 2: Effect Size
0 - <10% change = 0 pts
10 - <20% change = 1pt
20+ % change = 2 pts
Step 3: Sustained Effects
< 1 week = 0 pts 8 – 30 days = 1 pt 31 days – 6 months = 2 pts
6 months – 1 year = 3 pts 1 year + = 4 pts
Step 4: Methodology
Anecdotal Evidence = X1 Published Case Study = X2 Quasi-Experimental = X4
Randomized Control Trial = X6
Calculating Average Impact Score Across Articles
Total Impact Scores
# of articles = Final Impact Score
= TOTAL Impact Score per Article
Coding the Research: How it Works
6
Step 1: Core Outcome
Step 2: Effect Size
Step 3: Sustained Effects
Step 4: Methodology
Behavior (Alcohol Use) • 26% reduction in total
consumption = • 37% decrease in heavy
episodic drinking =
+2 +2
+2
+2
< 6 months = +2 RCT = 6
Consequences of Alcohol Use • 30% reduction in personal
problems = • 28% reduction in academic
consequences =
+3 +3
+2
+2
Subtotal = 10 8 2
TOTAL = 120
+ + x
Kypri et al. (2004)
Social Norms Marketing is Put to the Test
Determining the Cost of Each Strategy
Sample Strategy Cost Analysis: Social Marketing
Public Sources of Information Anecdotal Data from Campuses
Social Marketing Strategies (HEC) Institution Prorated Cost
Evaluation (Core Survey)
Advertisements: $239 University of Florida $83,235
Newspaper Ads $4,200 University of Virginia $6,569
Flyers & posters $5,210 Purdue University $4,630
Graphic designer $1,375 McCartney University $32,000
TOTAL $11,024
Cost Considerations
Activities Employees Materials/Media Total Cost: Institution Size
Average Cost of Social Marketing Across Sources: $27,491
Cost estimates prorated for institution of 10,000 undergraduates
Caveats, Assumptions and Interpretive Guidance
1 Optimal Implementation 2 Context Matters 3 No Silver Bullets 4 Values Not Static
Cases and studies were discounted where
• They lacked fidelity
• Lack of efficacy was attributed to mediating factors
• Clearly some approaches work best on certain kinds of campuses
• Literature and cases provide and “average” impact across campuses
• Individual approaches not as effective as complementary ones
• The goals was more clarity around approaches, not necessarily their combined synergy
• The literature and field continues to evolve
• Partner input is encouraged
STRATEGY Score $ Reach
Breathalyzer Feedback -13.3 $500 10%
Invited Speakers 0.0 $3,000 5%
BAC Cards 3.0 $1,000 10%
Fatal Vision Goggles 3.3 $700 8%
Medical Amnesty 8.0 $7,000 70%
Curriculum Infusion 8.3 $4,500 5%
TIPS for the University 11.0 $33,950 30%
RA Training 11.1 $1,348 49%
21st Birthday Cards 11.1 $5,045 22%
Fake ID Policies 12.0 $0 30%
Parent-Based Interventions 12.8 $2,000 25%
Parental Notification 13.3 $2,000 37%
RBS Training 13.5 $1,225 45%
Safe Rides 14.0 $89,899 21%
Peer Engagement 14.5 $9,473 25%
Substance-Free Housing 15.8 $0 2%
Friday Classes 16.0 $0 60%
STRATEGY Score $ Reach
Limiting Drink Specials 16.5 $0 15%
Social Marketing 17.3 $12,927 60%
Prime For Life 18.5 $3,915 6%
Small Group Social Norms 19.5 $2,340 30%
Policies 21.2 $8,520 40%
Alcohol-Free Options 22.0 $27,570 9%
Bystander Intervention 22.0 $19,746 12%
Social Norms Marketing 27.8 $14,400 60%
Alcohol Price and Taxation 29.6 $0 45%
Alcohol Skills Training Program 35.0 $9,090 6%
Comprehensive Environmental Efforts 36.9 $29,000 50%
Parent-Based Intervention + BASICS 48.0 $17,334 19%
BASICS 51.1 $19,535 3%
Online Education 52.6 $8,690 16%
SBI in Healthcare Setting 56.7 $14,771 35%
Group Motivational Enhancement 72.7 $11,872 28%
The Raw Data of the Analysis
11
Do No Harm
A Visual Depiction of the Findings
1. Invited Speakers
2. Safe Rides
3. Breathalyzer Feedback
4. Prime for Life
5. Fake ID Policies
6. Substance-Free Housing
7. Curriculum Infusion
8. BASICS
9. Limiting Drink Specials
10. Parental Notification
11. Comprehensive Environmental Efforts
12. RA Training
13. Parent-Based Intervention + BASICS
14. Bystander Intervention
15. Small Group Social Norms
16. BAC Cards
17. Group Motivational Enhancement
18. TIPS for the University
19. Alcohol Skills Training Program
20. 21st Birthday Cards
21. Online Education
22. Parent-Based Intervention
23. RBS Training
24. Friday Classes
25. Medical Amnesty
26. Social Marketing
27. Peer Engagement
28. Social Norms Marketing
29. SBI in Healthcare Setting
30. Alcohol-Free Options
31. Alcohol Price and Taxation
32. Fatal Vision Goggles
33. Policies
12
Do No Harm
Justify and
Evaluate Consider and Execute with Care
Interpreting Placement
Make a case
The Prevention “Sweet Spot”
10 80 20 30 40 50 60 70 0
13
Do No Harm
Justify and
Evaluate Consider and Execute with Care
Interpreting Placement
Make a case
The Prevention “Sweet Spot”
Two Tools to Inform Effective Prevention
14
EverFi Compass College AIM
33 strategies 60 interventions
Universal, Selective, Indicated Individual and Environmental
Impact Score/Average Cost Effectiveness Rating/Cost Range
Points assigned according to behavioral impact, effect size, effect length, and type of study.
Rating codes assigned based on literature reviews and direct knowledge of strategies
Examining the Intersections
15
21st BIRTHDAY CARDS Impact Score: 11
AIM: Lower Effectiveness
SBI IN A HEALTHCARE SETTING
Impact Score: 29 AIM: Higher Effectiveness
Examining the Intersections: Some Direct Comparisons
16
Score/Rating $ # Articles
Breathalyzer Feedback -13.3 $500 3 (1)
Skills training, alcohol focus: Blood alcohol concentration (BAC) feedback alone Too few studies Mid-range costs 2
Medical Amnesty 8.0 $7,000 1 (1)
Establish amnesty policies Too few studies Lower costs 1
21st Birthday Cards 11.1 $5,045 8 (1) Normative Re-education: Electronic/mailed personalized normative feedback (PNF)—Event-specific prevention (21st birthday cards)
Lower Effectiveness
Lower Cost 2
Limiting Drink Specials 16.5 $0 6
Restrict happy hour/price promotions Higher
effectiveness Lower costs 10
Alcohol-Free Options 22 $27, 570 17 (1)
Required alcohol-free programming Too few studies/
mixed results Higher Cost 3
Social Norms Marketing 27.8 $14,400 22
Conduct campus-wide social norms campaign Lower
effectiveness Mid-range costs 16
BASICS 51.1 $19,535 16 (2)
Brief motivational intervention (BMI) In-person – Individual (e.g., BASICS) Higher
effectiveness Mid-range cost 20+
Classification
Cost # Articles
Lower Effectiveness
Lower Cost 2
BAC’s higher in one study; students reported they would drink more in 2 of the three studies.
Can resources be redirected to more effective strategies?
Can staff and funding resources be redirected to more effective strategies?
Assess for effectiveness on an individual campus.
Have a clear understanding of whether or not such a policy is needed.
(#)= articles in common
Examining the Intersections: Requires a Closer Look
17
Score/Rating $ # Articles
Comprehensive Environmental Efforts 36.9 $29,000 12
e.g., Prohibit alcohol use/sales at campus sporting events Moderate effectiveness Mid-range
costs 6
Online Education 52.6 $8,690 38 (10)
Multi-component education-focused program: AlcoholEdu for College Higher effectiveness Higher costs 5
Personalized feedback intervention, eCHECKUP TO GO (formerly eCHUG) Higher Effectiveness Lower costs 11
Alcohol 101 Plus Too few studies Lower costs 3
Screening and Brief Intervention in Healthcare Setting 56.7 $14,771 7
Brief motivational intervention (BMI) In-person – Individual (e.g., BASICS) Higher effectiveness Mid-range
cost 20+
Individual-level strategies delivered by health professionals – not rated by CollegeAIM NS NS NS
Curriculum Infusion 8.3 $4,500 7
Unable to identify equivalent or similar NA NA NA
Peer Engagement (peers administering MI’s, lifestyle management courses, etc.) 14.5 $9,473 11 (2)
Brief motivational intervention (BMI) In-person – Individual (e.g., BASICS) Higher effectiveness Mid-range
cost 20+
Classification
Cost # Articles
Lower Effectiveness
Lower Cost 2
Understand the differences between the two and also ask: Who is your intended audience? What is your goal? Where can you reduce costs?
Discrepancy likely due to what outcomes are prioritized for each scoring process.
Compass includes all online programs in one category; Matrix specifies. Cost varies based on level of service and support provided, e.g., data and analytics, training, customer support, etc.
Compass category includes studies of multiple policy and enforcement strategies used together (e.g., AMOD); Matrix includes specific strategies under the Environmental category.
(#)= articles in common
Universal Recommendations Apply to Both Tools
18
1
2
3
4
5
Be intentional with efforts and gather data on whether they succeed Programming with a Purpose
Don’t try to do it all – a few targeted interventions can be very effective The “Comprehensive” Trap
Stay attuned to new research to inform your efforts An Emerging Picture
Implement programs strategically to mitigate costs Knowing How to Spend
Test your messages and strategies against the research base, behavior theory, and your instincts Beyond the Research
6 Prevention efforts must complement each other The Value of Synergy
7 The best strategy is grounded in data Data-driven Success
8 Make decisions based up on your culture, allies, and resources Campus Fit