When campuses and their surrounding communities can join forces to stop alcohol abuse

Not only is alcohol use pervasive among U.S. college students, who typically drink more than their same-aged, non-college peers, but college students also seem to lag behind their peers in 'maturing out' of harmful drinking patterns. There has been little examination of interventions that link community-level and campus-level environments. A unique study that assessed this two-pronged approach to reducing high-risk drinking in and around college campuses has found that it is highly effective in decreasing severe and interpersonal consequences of drinking.

Results will be published in the October 2012 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

" use by U.S. college students is a major public health problem," said Mark Wolfson, a professor with the Wake Forest Baptist Medical Center as well as lead author for the study. "Most college students drink, whether of legal age or not, and many drink at levels that reflect heightened risk. We also know that college students typically drink more than their same-aged , and that these elevated levels of high-risk drinking translate into negative health and social consequences, both for the student him or herself, as well as others in terms of unintentional injury deaths as well as blackouts, being the victim of a sexual assault, engaging in unprotected sex, and driving under the influence of alcohol."

Wolfson said it is important to note that colleges typically do not exist in isolation from the surrounding community, and that students very likely live, shop, drink, etc., in the area immediately surrounding the campus. Thus, a community-level intervention, he said, just makes sense.

"One example of this would be for college officials to partner with community residents and city leaders and change enforcement practices and policies related to loud and unruly student parties, which can pose significant risks for the partygoers as well as those living in residential areas containing rented houses and apartments adjacent to campus," said Wolfson. "Our study is unique in that it included a focus on colleges and the surrounding community, it used a community organizing approach, it involved implementation of environmental strategies, and that in taking this approach, we were able to demonstrate an impact."

"There have been a number of community-reach initiatives in the past, but very few have addressed the college population," added Ralph Hingson, director of the Division of Epidemiology and Prevention Research at NIAAA. "It is important to protect all students on and off campuses, as college life should be a safe environment for all students."

Wolfson and his colleagues assigned 10 universities in North Carolina to either an Invention or Comparison condition. Those universities designated as an Intervention school were assigned a campus/community organizer, who formed a campus/community coalition that developed and implemented a three-year strategic plan designed to reduce high-risk drinking and alcohol-related consequence among college students. Numerous outcome measures were garnered from a web-based survey of students at each university.

"We found that a community organizing approach to planning and implementing environmental strategies on the college campus and in the surrounding community can reduce rates of negative consequences that stem from high risk drinking by college students," said Wolfson. "More specifically, this approach was associated with significant decreases in severe consequences due to the students' own drinking and alcohol-related injuries caused to others."

"It is a key finding that this this approach can reduce alcohol-related harms," said Hingson. "This is a pivotal study because it shows a reduction in alcohol-related harms that some college students can cause other , including reductions in physical harms caused by other drinking students. If we can chip away at this, it is a major accomplishment."

"Another important contribution is to the field of research," said Wolfson. "We have identified the usefulness of measuring the 'dose' of the intervention, at the site level, which is important and something of a methodological innovation, I think."

The next step, added Wolfson, is an "implementation manual" he and his colleagues are developing for college officials to use if they want to try implementing the intervention approach used in the study on their own campus.

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