Rebecca Caldwell & Aimee Hourigan
University of North Carolina Wilmington
ACPA Annual Conference
March 2011
Session Objectives
Participants will:
 Learn about men’s and women’s unique risk
factors for high-risk drinking.
 Consider how gender-specific risk factors can be
integrated into campus-wide alcohol prevention
programs, including enhancing evidence-based
interventions for adjudicated students.
 Examine evidence of the effectiveness of a genderbased alcohol education class.
Our Roadmap
 Literature Review
 Gender-based Interventions Framework
 Conclusions & Discussion
Your Initial Thoughts
 What would be your greatest concern about splitting
mandated students into single gender pairs?
 What would be the benefit of working with mandated
students in single gender group setting?
 How would it benefit men?
 How would it benefit women?
 How might it not help men?
 How might it not help women?
College Men and Drinking
 Traditional Male Gender Role and Alcohol
 Paradox of Masculinity: Powerful and Powerless
 Development as a Man in a Alcohol-dominated
Environment
Men’s Drinking Culture
 Two Routes to Problem Drinking:
 Stereotypical beliefs about masculinity that include
heavy drinking.
 Gender role stress or conflict, for which alcohol is a
coping mechanism.
College Women and Drinking
 Strong traditional female role is negatively correlated
to drinking
 Drinking as a way to be in relation with others
 High-risk female drinkers have high sociability expectations
and low expectation of impairment.
 Social motives endorsement linked to alcohol-related
consequences
 Problem drinking in women tied to a need to be
assertive and not to be dominated in social situations
Women’s Drinking Culture
 Compensating for a perceiving lack of power and
control in social situations.
 Escaping the masculine orientation of daily life and to
express stereotypically female traits.
 Drinking as a social scene where one forms and
enhances relationships.
Adjudicated Students
 Students who receive campus alcohol violations report:
 Greater alcohol consumption
 More heavy drinking days per month
 More alcohol-related consequences
 Adjudicated are participants in heavy drinking
cultures.
University of North Carolina
Wilmington
 Mid-sized 4-year public university on coast of North
Carolina
 Student body: 58% female, 89% white.
 Began alcohol prevention & intervention programs in
1988 (FIPSE Recipient)
 Comprehensive substance abuse prevention program
 Environmental management
 Evaluation focus
Intervention components at each level of the
Social Ecological Framework (SEF)
SEF Level
Interventions
Intrapersonal
Gender-specific prevention and harm reduction messages
integrated into first-year academic seminars
One-day “Summit on Masculinity, Health, and Leadership”
Interpersonal
“Men Advocating for Responsible Choices,” a men’s health
advocacy student organization
“Gender and Alcohol Peer Educators” peer facilitators
Peer-led single-sex small group norms interventions
“Gender Encounter” facilitated discussion groups
Organizational
Gender-based harm reduction alcohol education for all new
fraternity and sorority members
Living-Learning Community about gender, alcohol , and health
Men’s leadership floor in a residence hall
Community/Policy
National expert speaker presentation on gender and alcohol
Gender-based social norms campaign targeting descriptive and
injunctive norms
Advocacy to address gender-based advertising in Wilmington
Items in red: most rigorously evaluated, findings included in model program application.
Selected Outcomes
Campus-Wide Outcome:
 18% reduction in high-risk drinking among men
 14% reduction in high-risk drinking among women.
Intervention-Specific Outcomes:
 First-year students receiving classroom intervention
drink less across first semester.
 Both perceptions and behaviors targeted by social
norms campaign are reduced.
Campus-Specific Data re:
Mandated Students
High risk drinking:
Judicial (Last Month)
Judicial (Last Week)
Campus-wide Survey (2
Weeks)
82.9%
64.8%
48.9%
Consequences:
Consequence experienced in
the Last Year
Judicial
Campus
Average
Performed poorly on test or
project
47.9%
16.9%
Drove under the influence
54.1%
27.1%
Had a memory loss
65.1%
24.6%
NIAAA Recommendations for
Reducing Problem Drinking in
College Students
Increasing individual motivation to change
2. Changing knowledge and beliefs
3. Provide behavioral skills to limit consumption
4. Changing students’ perceptions about fellow
students’ drinking behavior and attitude.
1.
(Larimer & Cronce, 2002)
Literature Review on Interventions
for Adjudicated Students
 Effective individual interventions: Alcohol Skills
Training Program & BASICS
(Fromme, Marlatt, Baer, & Kivlahan, 1994; Dimeff, Baef, Kivlahan, &
Marlatt, 1999)
 Group motivation enhancement- mixed findings
(Fromme & Corbin, 2004; Walters, Bennett, & Miller, 2000)
 Adaption of Motivational Interviewing (AMI) effective
with heavy drinkers and men
(LaBrie, Lamb, Pederson, & Quinlan, 2006)
Alcohol Violation
Typical Conduct Outcome
1st Alcohol Violation
Gender-specific Challenging Decisions
class.
$50 Fee.
2nd Alcohol Violation
BASICS 2-session Intervention
BASICS Follow-Up/Booster with Substance
Abuse Counselor
$75 Fee.
Parental Notification
Disciplinary Probation
3rd Alcohol Violation
Suspension Likely.
Marijuana Violation
Typical Conduct Outcome
1st Marijuana Violation
BASICS 2-session Intervention
BASICS Follow-Up/Booster with Substance
Abuse Counselor
$75 Fee.
Parental Notification
Disciplinary Probation
2nd Marijuana Violation
Suspension Likely.
Conduct Violation Logistics
Challenging Decisions class
 Evolution from a instruction model: CBT background- change thinking
and change behavior
 Developed into an Adaption of Motivational Interviewing program




Personalized feedback
Normative challenge
Decisional balance
Goal setting
 Received Dept. of Ed. Grant focusing on gender with other target
areas
 Were reading articles on gender
 Wrote grant to broaden gender efforts including judicial class
 Received evaluation commitment from Dean of Students office
Class Outline
 Introductions & Something  Expectancy Challenge




They’d Like to Learn
Good, Bad, and Ugly
Reasons for Drinking
Discussion- gender
perceptions
B.A.C. & Alcohol Use
Information
“Good Zone” moderation
training (BiPhasic
Response)
Protective strategy training






placebo effect, bar lab
studies
Consequences- blackouts,
DWI, Alcohol Poisoning
Alcohol & Sex
Risk Factors, Signs of
Addiction, How to Help a
Friend
Normative Feedback
Decisinal Balance
Behavioral Goal Setting- one
goal to try for next 30 days
Gender-Specific Content
 Normative feedback
 Alcohol and sex
 Sexual assault risk reduction
 Bystander intervention material
 Red flags for women
 Consent for men
 Alcohol risk reduction
 Which works best for each gender
 Recognizing a problem
 “That Guy” or “That Girl” gender-specific symptoms
 How to help a friend
Good, Bad, Ugly Facilitation
 Directions
 Make 3 columns on the board
 Write “Good” at the top left. Ask students to name
everything that is good/ that they like about drinking.
Write down their answers verbatim(ish).
 Label the middle column “Bad” and the right column
“Ugly.” These can be differentiated by severity or by
short and long-term consequences. Again, ask students
what could be bad or ugly.
 After they can completed their lists, ask them what they
notice.
 Most will start with more negative than positive, then
lead to discussion on how most good things happen at
low doses. The higher the dose, the more likely a bad or
ugly consequence can happen.
Decisional Balance Worksheet
Facilitation
 Directions:
 Make a list of both the pros/advantages and
cons/disadvantages of drinking less than you currently
drink. Please complete this exercise however it is the
most meaningful for you.
 Please create a goal that ties into one of your advantages
Adapted from LaBrie, J.W., Pederson, E.R., Earleywine, M., & Olsen, H.
(2006)
Facilitation & Fidelity
 Personalized feedback is referenced throughout the class.
 Classes now taught by same gender pair
 Graduate student in substance abuse treatment program
which emphasizes motivational interviewing
 Have taken coursework and been promoted by their M.I.
professor
 Team meets regularly and adjusts order and content to
maximize effectiveness
 Much of the change is in the order; felt in the discussion.
Facilitator Feedback
 Male Facilitation:
 Importance of facilitators with social capital among the
participants
 Discussion of peer pressure and masculinity.


E.g. If you drink in response to a taunt, you will always lose.
Deconstructing how acting to “man up” actually manipulates
and “weakens” them individually.
 Consent conversations allow men to ask questions and
give each other feedback.
 Participants are less distracted, have less reason to show
off for women.

Use facilitator social capital to address men who posture
Facilitator Feedback
 Female Facilitation:
 Facilitators need to be able to creative a comfortable,
non-judgmental environment for discussion.
 Power of heavy drinking women in discussion with each
other about consequences.
 Sexual assault disclosures and discussions about
protective behaviors are common.
Evaluation Evolution
 Class now began with a pre-test
 Initially tried to require pre-test before class but were
unsuccessful
 45-day post-test was required
 Included divisional learning outcomes for hearing
process
 Use, consequences, and protective strategies
 Readiness to Change scales
Learning Outcome
 Example: As a result of attending the Student Conduct
experience, I better understand the effects of my
behavior on (agree or strongly agree):
100%
80%
60%
40%
20%
0%
77.9%
74.5%
73.2%
Reductions in Drinking Behavior
 Men:
 Binge drinking (5 or more in the last 2 weeks)
 Number of drinks per week
 Days drinking per month
 Women
 Binge drinking (3, 4, and 5 or more in the last 2 weeks)
 Days drinking per month
Reductions are statistically significant differences between means from pretest to 45-day post-test (97% response rate) at p=0.05 or above.
Binge Drinking Men
(5 or More Last 2 Weeks)
45
40
35
30
25
Pre-Test
20
Post-Test
15
10
5
0
None
Once
Twice
3-5 Times 6-9 Times10 or more
Binge Drinking Women
(5 or More Last 2 Weeks)
80
70
60
50
40
Pre-Test
30
Post-Test
20
10
0
None
Once
Twice
3-5 Times 6-9 Times10 or more
Reduced Consequences
 Men
 Trouble with police or R.A.s
 Played drinking games
 Memory loss
 Women
 Trouble with police or R.A.s
 Thought I might have a problem
 Memory loss
 Said something I regretted
Reductions are statistically significant differences between means from
pre-test to 45-day post-test (97% response rate) at p=0.05 or above.
Reduced Consequences
Men
Women
3.5
3
2.5
3
2
2.5
1.5
2
1
1.5
0.5
1
0
0.5
0
Trouble
Played
Memory
with Police Drinking
Loss
or R.A.s
Games
“In the last 30 days, on how many days did you experience the following as a result of
your drinking?”
Increased Protective Behaviors
 Men and Women:
 Chose not to drink
 Alternated alcoholic and non-alcoholic beverages
 Determine a limit in advance
 Pace to one or fewer drinks per hour
 Women
 Eat a full meal before drinking
 Calculate your B.A.C.
 Men
 Avoid drinking games
Reductions are statistically significant differences between means from pretest to 45-day post-test (97% response rate) at p=0.05 or above.
Differences by Motives
 Drinking Motives Questionnaire- Cooper, 1994.
 4 Motives:




Enhancement
Social
Coping
Conformity
 Score of up to 30 on each of the four scales
 Social motives have been found to be the best predictor
of heavy drinking (frequency, days per month, drinks
per occasion)- Cronin, 1997
Binge Drinking by Motive
Men
3.5
3
2.5
2
1.5
1
0.5
0
Women
Pre
Post
3.5
3
2.5
2
1.5
1
0.5
0
* Indicates statistically significant differences in means at .05 or above.
Pre
Post
Average Number of Drinks by
Motive
Men
7
6
5
4
3
2
1
0
Women
Pre
Post
4.4
4.2
4
3.8
3.6
3.4
3.2
* Indicates statistically significant differences in means at .05 or above.
Pre
Post
Differences by Motives
 Students who indicated social motives had the greatest
increases in protective behaviors and decreases in
consequences & drinking behaviors.
 Women increased 9 of 11 protective behaviors.
Decreased 3 of 4 significant consequences, average
drinks per night and per week.
 Men increased 6 of 11 protective strategies. Decreased 3
of 4 motives, binge drinking, and average number of
drinks per night.
 The social enhancement motive yielded similar
findings although not as strong.
Differences by Motives
 Men who indicated higher than median coping
motives had no statistically significant reductions in
drinking behaviors.
 Least amount of changes in consequences & protective
behaviors.
 Women who indicated higher than median
conformity motives had no statistically significant
reductions in drinking behaviors.
 Men who indicated this motive had the most reductions
in drinking-related consequences.
Readiness to Change
 Readiness to Change Questionnaire
 3 Scales: Pre-Contemplation, Contemplation, Action
 Scales Not Mutually Exclusive
Average Number of Drinks Per
Occasion by Readiness to Change
Women
Men
7
6
5
5.78
5.21
6.28
5.52
5.78
5.05
4
3
2
1
0
Pre-Cont*
Cont.*
Action*
Contemplation motive linked to highest
number of consequences (4) and
protective behaviors (10)
4.5
4
3.5
3
2.5
2
1.5
1
0.5
0
3.97
3.63
Pre-Cont.*
3.68
3.41
3.77
3.26
Cont.*
Action*
Action motive linked to highest number
of consequences (4) and protective
behaviors (7)
Rebecca Caldwell
University of North Carolina Wilmington
caldwellr@uncw.edu
Aimee Hourigan
University of North Carolina Wilmington
hourigana@uncw.edu
References
 Barnett, N.P., & Read, J.P. (2005). Mandatory alcohol intervention for alcoholabusing college students: A systematic review. Journal of Substance Abuse
Treatment, 29, 147-158.
 Barnett, N.P., Trevyaw-O’Leary, T., Fromme, K., Borsari, B., Carey, K.B., Corbin,
W.R., et al. (2004). Brief alcohol interventions with mandated or adjudicated
college students. Alcoholism: Clinical and Experimental Research, 28(6), 966-975.
 Caldwell, P.E. (2002). Drinking levels, related problems, and readiness to change
in a college sample. Alcoholism Treatment Quarterly, 20(2), 1-15.
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Development
and validation of a four-factor model. Psychological Assessment, 6, 117-128.
 Cronin, C. (1997) Reasons for drinking versus outcome expectancies in the
prediction
of college student drinking. Substance Use & Misuse, 33, 1287-1311.
References
 Dimeff, L.A., Baer, J.S., Kivlahan, D.R., & Marlatt, G.A. (1999). Brief alcohol
screening and intervention for college students: A harm reduction approach. New
York: The Guilford Press.
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negative consequences among mandated and voluntary college students. Journal
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negative consequences among mandated and voluntary college students. Journal
of Consulting and Clinical Psychology, 72(6), 1038-1049.
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References
 LaBrie, J.W., Lamb, T., Pedersen, E.R., & Quinlan, T. (2006). A group motivational
interviewing intervention reduces drinking and alcohol-related consequences in
adjudicated college students. Journal of College Student Development, 47, 267-580.
 LaBrie, J.W., Pederson, E.R., Earleywince, M., & Olsen, H. (2006). Reducing heavy
drinking in college Males with the decisional balance: Analyzing an element of
Motivational Interviewing. Addictive Behaviors, 31, 254-263.
 LaBrie, J.W., Tawalbeh, S., & Earleywine, M. (2006). Differentiating adjudicated from
nonadjudicated freshmen men: The role of alcohol expectancies, tension, and concern
about health. Journal of College Student Development, 47(5), 521-534.
 Larimer, M.E., & Cronce, J.K. (2002). Identification, prevention, and treatment: A review
of individual-focused strategies to reduce problematic alcohol consumption by college
students. Journal of Studies on Alcohol (Suppl. 14), 148-163.
 Walters, S.T., Bennett, M.E., & Miller, J.H. (2000). Reducing alcohol use in college
students: A controlled trial of two brief interventions. Journal of Drug Education, 30(3),
361-372.