Running head: BINGE DRINKING AWARENESS
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Binge Drinking Awareness Health Promotion Project
Emily Mendel, Brianna McKenney, Latifah Gray, Lindsey Gamrat, Hannah Crist, Brooke Bevins
Indiana University
School of Nursing
Author Note
All authors are fourth semester students enrolled in a baccalaureate of nursing program on
Indiana University’s Bloomington campus.
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Abstract
Binge drinking is a highly prevalent problem in society that can lead to a large number of
negative consequences. Addressing the issues that contribute to one’s drinking is the first step in
initiating an intervention. The presenting group provided an educational event on binge drinking
as an intervention to a group of college students. The audience felt as though the content of the
presentation was relative and appropriate for their particular demographic. The presenting group
gained practice in community education to use in their future nursing careers as well as felt
satisfied that they provided a successful intervention to educate their audience.
Keywords: alcohol awareness, binge drinking, college students, health promotion, service
learning
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Binge Drinking Awareness Health Promotion Project
Binge drinking is considered a rising problem in today’s society that is mainly seen in the
young adult population. The group, in efforts to educate the public of this problem, conducted a
presentation about binge drinking to college freshman women and men in a dormitory. In
creating the presentation, the Health Belief Model was a tool used to help with identifying the
needs of the target population in order to better help the group meet the needs of the individuals
(Edelman & Mandle, 2010). The goal of the presentation was to provide safe drinking tips and
alternatives to binge drinking in order to decrease the amount of binge drinking and also increase
safety in situations where alcohol is consumed. A questionnaire was used during the presentation
to help the men and women evaluate their own drinking habits as well as relay to the presenting
group what knowledge they gained during the presentation. Many of the students did not know
what binge drinking truly was; so because of the lack of knowledge they had, they participated in
it.
Background
Binge drinking is a problem that is all too common in society; especially among college
campuses. The Center for Disease Control and Prevention states that binge drinking is defined as
a “pattern of drinking that brings a person’s blood alcohol concentration (BAC) to 0.08 grams
percent or above” (CDC, 2010). This typically occurs when within a two hour time frame, a male
consumes five or more drinks or a female consumes four or more drinks (CDC, 2010). One drink
is defined as one 12-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5
ounces of 80-proof liquor (NIAAA, 2012).
The prevalence of binge drinking in the United States is astonishingly high. Of adults
who drink, 92% have reported binge drinking in the past 30 days. Of all alcohol consumed by
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adults, 75% is in the form of binge drinks. As for youth under 21 years of age, 90% of alcohol
they consume is in the form of binge drinks. In fact, 51% of all binge drinkers fit into the 18-20
age group (CDC, 2010). According to Edelman and Mandle, 24% of young adults have admitted
to binge drinking in the past 30 days and alcohol consumption rates are increasing. Young adults
usually drink less frequently than adults, but when they do they consume much larger amounts of
alcohol (Edelman and Mandle, 2010). As for young adults who attend college, more than 40%
have engaged in binge drinking in the past two weeks (NIAAA, 2012). Men are more likely than
women to engage in binge drinking. Despite the high amount of alcohol involved though, studies
have shown that most people who binge drink are not alcohol dependent (CDC, 2010).
Binge drinking has long been associated with many negative consequences. The Centers
for Disease Control and Prevention outline some of the major health risks as injury (both
intentional and unintentional), alcohol poisoning, sexually transmitted diseases, unintended
pregnancy, babies born with fetal alcohol syndrome, cardiovascular problems, liver disease,
sexual dysfunction, neurological damage, and poorly controlled diabetes (CDC, 2010). The
National Institute on Alcohol Abuse and Alcoholism points out that college binge drinkers have
an increased risk for many adverse effects in addition to the health consequences such as sexual
abuse, injuries, assault, unsafe sex, academic problems, and vandalism (NIAAA, 2012).
Healthy People 2020 has set several objectives to decrease substance abuse such as binge
drinking. In regards to adolescents, they would like to increase the number who refrain from
using alcohol, who disapprove of alcohol use by peers, and who perceive great risk associated
with alcohol abuse. They would like to decrease the number of adolescents who reported using
alcohol in the past 30 days and decrease the prevalence of binge drinking overall. This would
include adolescents, college students and adults. Along with these goals, they hope to decrease
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the annual alcohol consumption, decrease instances of impaired driving, decrease the number of
deaths attributed to alcohol, and increase the number of people who receive treatment for alcohol
abuse (United States Department of Health and Human Services, 2012).
The health belief model is a set of criteria that is used to predict and explain behaviors
and determine how able an individual is to act on behalf of his or her own health. There are
seven elements that make up the health belief model. According to Edelman and Mandle, the
components of this model include individual perceptions and readiness to change, how much the
individual values health, perceived susceptibility to a health problem, perceived seriousness of
the disease, risk factors for a disease, perceived benefits of health action, and perceived barriers
to promotion action” (2010).
This model is important to health care professionals because it helps to identify the needs
of individuals and the things that can be done to help the individual make healthy changes. It
shows an individual’s values and beliefs; which are then used as a guide to help form action
plans and educational methods that the individual is more likely to follow (Edelman & Mandle,
2010). Edelman and Mandle state that the model can be used to “explain responses to symptoms,
disease, prescribed treatments, and potential health problems” (2010).
The Health Belief Model was used as the foundation for this project with the purpose of
creating and evaluating a program concerning binge drinking. The model helped identify the
target population and some of the reasons as to why this certain population engages in binge
drinking. It also aided in identifying the educational needs of the population and how effective
the education might be.
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Intervention
During the presentation, several drinking habits and ways to help modify characteristics
that can lead to binge drinking were discussed. Addressing the issues that contribute to one’s
drinking is the first step in initiating an intervention. There are some aspects that students cannot
change such as gender, genetics, and past experiences just to name a few; but there are many
aspects that can be altered. Making adjustments to one’s surroundings, such as new friends, new
environment and different ways to cope with issues can be a good start in modifying drinking
habits. Whether a person decides to stop drinking alcohol or not, the goal of the presentation was
to speak about nontoxic ways to drink if students do decide to consume alcohol. Practicing safe
drinking can potentially save lives; whether it’s the person drinking or others around them.
Setting a limit to how many drinks one will have and assigning a designated driver are positive
behaviors in making sure that an individual is secure and protected against harm (Engs, 1987).
Eating high-protein foods before having a drink can reduce the absorption time of alcohol and
prevent becoming too intoxicated. Keeping one’s drink within sight around other people and not
accepting drinks from anyone can prevent the risk of poisoning or added drugs to the drink
(Engs, 1987). These are all examples of practicing safe drinking.
The CAGE questionnaire is a tool to identify a person’s outlook on his or her drinking
habits. The C stands for feeling the need to cut down on drinking. The A stands for feeling
annoyed by other’s criticism of one’s drinking. The G stands for having guilty feelings towards
drinking; and finally the E stands for needing a morning eye opener after drinking the night
before (Edelman & Mandle, 2010). The presenting group presented this questionnaire to an
audience to obtain their viewpoints of their own drinking habits. If a person answered yes to two
or more of the questions presented above, then they may have a binge drinking problem. Many
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resources are available to assist students in obtaining help in regards to their destructive drinking
habits.
As stated earlier, the Health Belief Model (HBM) is a model that addresses the
relationship between a person’s beliefs and behaviors. If a student does not believe that they have
a binge drinking problem, then they are most likely not willing to change or choose healthier
behaviors. Students’ perceptions of the seriousness of binge drinking as well as their
susceptibility to being harmed can influence their actions to improve habits. The HBM helped
the presenting group understand how the individuals may view their own health and what actions
they may need to take to better their well-being. An individual’s perceptions, modifying factors,
and their likelihood of action all contribute to whether or not they will take part in preventing
illnesses and choosing a healthier way of living (Edelman & Mandle, 2010).
Outcomes
The CAGE questionnaire was distributed to the audience present at the group’s
presentation. There were a total of eleven students present. There were students ranging from
nineteen to twenty-one years of age. Ten of the students were female and one was male. The
students were asked to answer YES or NO to four questions relating to their drinking habits. One
student does not engage in drinking alcohol so she was not able to answer the following
questions. The students were asked: Have you ever felt you should cut down on your drinking?
Every student answered NO. The presenting group asked the question: Have people annoyed
you by criticizing your drinking? Four students answered NO, while six students answered YES
to the question. The students were asked: Have you ever felt bad or guilty about your drinking?
Two students have felt guilty, while the other eight have not felt guilty. The final question asked
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was: Have you ever had a drink first thing in the morning to steady your nerves or get rid of a
hangover? Everyone responded NO to the question asked.
The presenting group debriefed after the presentation about what went well as well as the
aspects that they could have better improved. The group decided that the equipment used to
display the presentation could have been prepared in advance. This would have eliminated the
issue of beginning after the scheduled time due to technical difficulties. The group could also
have been more prepared by having their slides memorized, rather than reciting the information
verbatim off the slide. It probably would have been more of an effective interaction if the group
had used strategies that would have engaged the audience. The audience did feel as though the
content of the presentation was relative and appropriate for their particular demographic.
Many of the students stated that before the presentation, they did not know what binge
drinking consisted of. It was brought to the student’s attention how easily it was to drink the
particular amount of alcohol that is considered binge drinking. The students felt like the videos
in the presentation were very effective and relative to the subject matter.
Nursing Implications
Theory is tied to community service because it provides perspective into the approach in
which a program or convention could be presented to the community. The Health Belief Model
allowed the presentation to be geared towards educating the public on their perceived
susceptibility and dangers. At the same time, however, the group offered a way to continue
drinking without falling prey to those circumstances. There was an evident community need for
this type of education. Many of the girls living on this floor were going into the Greek system
and were frequently exposed to binge drinking and alcohol on a regular basis. The students were
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able to write on the bottom of their evaluations what parts of the presentation they learned from,
and it was evident that the students gained a better understanding on what binge drinking really
was. The presenting group and students were both able to reflect on the presentation by
evaluations filled out by the students and reviewed by the group. The problem with some of the
presentation was that much of the information has already been taught to the students due to a
mandatory program that they had to complete prior to beginning freshman year called
AlcoholEdu. This could also be considered as a strength with backing up AlcoholEdu knowing
about binge drinking. Another strength to be considered from the presentation was how the
group addressed safer ways to consume alcohol because it was realistically more effective rather
than trying to teach them not to drink at all.
This project was effective in meeting a community need for education and backing up
previous education, but future reaching out to different populations would also be beneficial.
Taking the presentation to high school seniors to give them awareness before they head to
college or having similar presentations in all of the dormitories within the first month of school
would expose the new college students to the realities of drinking and safe drinking habits. Also,
setting up class visit presentations in collaboration with professors may be beneficial to ensure
that the presenters would have a large group to reach out to.
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References
Centers for Disease Control and Prevention (CDC). (2010, July 20). Fact sheets: Binge drinking.
Retrieved from http://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm
Edelman, C.L. & Mandle, C.L. (2010). Health Promotion through the lifespan (7th ed.). St.
Louis : Mosby.
Engs, R. C. (1987). Alcohol and other drugs: Self responsibility. Manuscript submitted for
publication, Indiana University, Bloomington, IN. Retrieved from
http://www.indiana.edu/~engs/hints/holiday.html
National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2012, February). Statistical
snapshot of college drinking. Retrieved from
http://www.niaaa.nih.gov/Pages/default.aspx
United States Department of Health and Human Services (2012). Substance abuse. Retrieved
from http://healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicid=40
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Appendix A
Group Rules
1. If someone does not show up to the presentation then they will have 25% taken off of their
grade for the presentation. This is not implemented if there is a valid excuse for missing the
presentation.
2. If someone does not show up to the presentation they will also have 25% taken off of their
final grade. This is not implemented if there is a valid excuse for missing the final presentation.
3. If an email is sent before 6pm that day, it should be responded to that day if appropriate.
However, if the email is sent later than 6pm, group members must respond to the email within 24
hours. If group members do not implement this, it will be taken into consideration when giving
group evaluations.
4. If a group member does poorly on the paper and is asked to redo her section of the paper, she
must put in quality effort to fix her section or 5% will be taken off this paper’s grade.
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Appendix B
Results
CAGE Questionnaire Responses
N=11
No
Cutting down
0 (0%)
Yes
11(100%)
Annoyed by criticism
4 (36%)
7 (64%)
Guilty feelings
2 (18%)
9 (82%)
Eye opener
0 (0%)
11(100%)
.