National Institute on Alcohol Abuse and Alcoholism’s College Alcohol Intervention Matrix 2 of 5
Review of the National Institute on Alcohol Abuse and Alcoholism's College Alcohol Intervention Matrix (AIM) and practical application for professionals working in higher education to reduce high-risk drinking and associated harms.
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[00:00:01.150]Thank you very much,
[00:00:02.100]and good morning to everybody.
[00:00:03.230]It is, it's 7:45 at home,
[00:00:06.020]so the good news is that I get to work in about 15 minutes
[00:00:08.730]and I'm gonna really wake up in the middle
[00:00:09.950]of this presentation.
[00:00:12.499]Which bodes well for all of us.
[00:00:13.390]I do wear two hats at the University of Washington.
[00:00:15.730]I'm a faculty member in psychiatry and behavioral sciences
[00:00:18.763]and I'm part of a team that, for years,
[00:00:20.790]has been doing research on college student alcohol use,
[00:00:23.790]more recent, marijuana use,
[00:00:25.640]since there's nothing exciting in my state
[00:00:27.890]to talk about with that.
[00:00:30.350]Prescription stimulant use, but importantly,
[00:00:32.360]approaches to how we work with students on those issues.
[00:00:35.210]The other half of my job involves trying to bring
[00:00:37.580]what the science says to our students.
[00:00:39.590]So I work with Greek life, the residence halls,
[00:00:43.400]counseling center, health center,
[00:00:45.363]really in the individually focused approaches.
[00:00:51.369]And I must say, I feel very at home,
[00:00:53.500]'cause much like students at UW,
[00:00:54.890]these rows are completely empty.
[00:00:56.740]These are the good students right here,
[00:00:58.310]and the troublemakers are back there,
[00:00:59.750]and so I'll keep an eye on you guys.
[00:01:02.420]I wanna echo something Ian said.
[00:01:04.920]Linda Major is a hero in our field,
[00:01:06.990]and I truly, what a gem you have in the state of Nebraska.
[00:01:10.830]I was texting with a friend from Oregon,
[00:01:12.170]who's like, she's a prevention all star.
[00:01:13.880]Be sure to say hi, so just know,
[00:01:16.170]truly how much respect nationally there is
[00:01:18.470]for the work that you've all done here,
[00:01:20.190]including the work you've done with coalitions
[00:01:22.880]and groups like this.
[00:01:24.320]So I just wanna start by acknowledging
[00:01:26.490]the National Institute on Alcohol Abuse and Alcoholism
[00:01:29.300]really drove this ship, and they said we need to get
[00:01:31.800]this alcohol intervention matrix out there,
[00:01:33.570]and we worked most closely with Vivian Faden,
[00:01:36.250]Shuly Babitz and Fred Donadeo.
[00:01:38.310]I wanna certainly acknowledge the four members
[00:01:40.540]of the CollegeAIM teams from UW and Minnesota not here,
[00:01:43.900]but I told Toben how fun this is gonna be
[00:01:45.610]presenting with him.
[00:01:46.500]He's one of my favorite presenters,
[00:01:47.880]but we've never actually tag teamed before,
[00:01:49.420]so it'll be great to be part of a presentation together.
[00:01:53.240]Megan Hopkins, who is not only unbelievably patient
[00:01:56.480]in lining all this up, but really pulled this off,
[00:01:59.530]so thank you again to Megan,
[00:02:01.097]and again, acknowledging Linda Major.
[00:02:03.960]The last time I was here,
[00:02:07.461]Linda really made my experience more exciting,
[00:02:11.010]but it's kinda like when you buy a lottery ticket
[00:02:12.870]for someone for their birthday.
[00:02:14.700]I mean, it's like you either got a million dollars
[00:02:16.480]for me or nothing.
[00:02:19.132]So I hope it's not the nothing,
[00:02:20.150]and she said, "I want you to come to the,"
[00:02:23.140]we were looking at times for me to come,
[00:02:24.370]and University of Washington was playing Nebraska,
[00:02:26.370]and I got an amazing football experience,
[00:02:28.330]where I actually got to,
[00:02:31.350]this is completely black.
[00:02:33.880]That does not bode well at all,
[00:02:35.460]since on my computer, that's not what it looks like.
[00:02:40.520]Due to budget cuts, we're eliminating the slides.
[00:02:44.925]Well, I was supposed to show you
[00:02:46.346]a picture I took from the field,
[00:02:47.365]and even though we lost that day,
[00:02:48.198]I still won, because I learned something even better
[00:02:50.680]about Lincoln, and there's the picture.
[00:02:53.060]So there's, I took this picture.
[00:02:54.360]That's a lot of red.
[00:02:55.193]I still get nervous when I see red.
[00:02:58.500]But even though we lost, you know when you can lose,
[00:03:00.826]but still feel like you won something?
[00:03:01.659]I learned about the glory of the runza,
[00:03:04.160]which let me tell you right now,
[00:03:05.600]that's a good invention.
[00:03:07.990]Do you want bread?
[00:03:08.880]No, no thank you.
[00:03:09.713]Do you want bread with meat and cabbage in it?
[00:03:14.612]'Cause the answer there is always yes.
[00:03:16.410]So I do wanna acknowledge that this is,
[00:03:19.410]a lot of people say, wow, we're finally looking
[00:03:21.580]at college student drinking,
[00:03:22.610]but this is not new.
[00:03:24.050]This is officially, over a 70 year journey.
[00:03:27.490]Without doing any disrespect to the history of this,
[00:03:30.210]because we've had to look at some of the history,
[00:03:31.970]I just wanna show you a couple highlights.
[00:03:34.530]People debate what the first article
[00:03:36.370]ever written about college student drinking is,
[00:03:38.570]and we think it was from 1945.
[00:03:41.200]We haven't been able to find something earlier than that,
[00:03:43.280]but it was a really short article.
[00:03:45.630]That must've been a great time to be a professor,
[00:03:47.350]'cause the lit reviews were really short,
[00:03:49.350]'cause there was like,
[00:03:50.540]well, there's no literature to look at,
[00:03:51.890]so two references is perfect.
[00:03:55.610]But Clements Collard Fry, in 1945,
[00:04:00.700]wrote a very short article that was really a heads up
[00:04:04.260]to the academic community,
[00:04:05.880]and some of the stuff written in there is laughable,
[00:04:08.470]if we read it now.
[00:04:09.380]Some of it could've been written yesterday, but Fry says
[00:04:12.526]the biggest troublemakers on campus were the faculty,
[00:04:16.270]and he said, if you look at parties,
[00:04:18.070]it's the faculty that are the troublemakers.
[00:04:19.667]"These parties are often attended by faculty members,
[00:04:22.147]"some of whom are selected to respond to the chant,
[00:04:24.037]"Old Professor so-and-so is in the alcohol ward."
[00:04:27.160]Say the person's name, "Drink, drink, drink.
[00:04:29.587]"Cheers or moans, and laughter
[00:04:30.917]"follow this performance according to the speed
[00:04:33.017]"with which the professor empties his glass.
[00:04:35.267]"These parties break up after a few hours
[00:04:36.977]"of song and good fellowship.
[00:04:38.987]"They do not occur often,
[00:04:40.317]"but are part of the life of colleges
[00:04:41.927]"and are accepted by the community as such."
[00:04:44.160]We would never accept this now.
[00:04:46.020]So I think what this highlights
[00:04:47.423]is that even things that people are like,
[00:04:49.330]well, it's a tradition, they can change.
[00:04:51.180]Traditions can change.
[00:04:52.620]Things that seem like they've been around,
[00:04:54.120]in quotes, "forever", things that seem that they've been,
[00:04:57.000]quote, "accepted by the community as such"
[00:04:59.450]can and do change.
[00:05:00.860]You've seen that here, both in this community,
[00:05:03.030]and even state wide, and so it really is acknowledging
[00:05:05.430]some of those changes.
[00:05:07.000]They talk about Greek life, and they say,
[00:05:10.857]"Wine is often served at fraternity dinners
[00:05:13.237]"in the hope that members will learn
[00:05:14.357]"to appreciate proper wines with food."
[00:05:17.160]And then, "Although milk and soft drinks
[00:05:18.757]"are extremely popular in American colleges,
[00:05:21.017]"the consumption of them being greater
[00:05:22.307]"than other beverages,
[00:05:23.457]"a special snobbism is something to be associated
[00:05:25.937]"with the appreciation and knowledge of fine wines."
[00:05:28.650]But Fry goes on to say, but heads up, everybody.
[00:05:31.650]I'm starting to wonder if the point of some of these parties
[00:05:34.310]is actually to get drunk,
[00:05:36.180]and if it is, we should probably be aware of that.
[00:05:38.480]So he actually warned that a state of intoxication
[00:05:40.753]could be the primary purpose of some events.
[00:05:43.390]He goes on to say now that World War II is coming to an end,
[00:05:46.440]what are we gonna do to support returning veterans,
[00:05:49.210]what role might alcohol play in coping
[00:05:51.150]when under pressure in the college setting?
[00:05:52.760]And that's something that, of course, on college campuses,
[00:05:55.450]we're looking at right now.
[00:05:57.980]It took years, though, before people actually started
[00:05:59.920]shedding light on is this an issue?
[00:06:02.050]And the first national study,
[00:06:03.250]and it's what many people attribute to be the first article,
[00:06:06.716]it took eight years, but it came out in 1953.
[00:06:10.220]Strauss and Bacon did the first widespread study
[00:06:12.430]of drinking at 27 colleges and documented
[00:06:15.190]that yeah, this is, in fact, a thing.
[00:06:18.030]It took a long time for me, in Google Images,
[00:06:20.500]to find that picture, because this report's
[00:06:22.790]actually really hard to find.
[00:06:24.220]And fortunately, for me,
[00:06:25.500]I knew that I was looking for that report,
[00:06:27.060]because in Google, when I Googled,
[00:06:29.084]this article, Strauss and Bacon,
[00:06:31.650]Google Images mainly gave me the composer Johann Strauss,
[00:06:34.848]and bacon, which we can all agree is delicious.
[00:06:40.710]So jump forward, skipping a lot of time, 50 years.
[00:06:44.270]In April of 2002, the National Institute
[00:06:46.960]on Alcohol Abuse and Alcoholism released
[00:06:49.040]a Call to Action Taskforce Report,
[00:06:50.660]which is still downloadable at their website.
[00:06:53.540]All of these slides, as a pdf,
[00:06:54.940]will be sent to you when this is done,
[00:06:56.590]so know that these links will be there.
[00:06:59.170]But they organized what works in impacting college drinking
[00:07:02.860]into four tiers.
[00:07:04.170]They looked at first, what do we know
[00:07:05.650]works with college students in reducing drinking,
[00:07:08.176]consequences or both?
[00:07:10.080]And to have at least have evidence,
[00:07:11.470]there need to be two or more studies,
[00:07:13.350]with a randomized controlled component,
[00:07:16.350]and with behavioral outcomes.
[00:07:18.070]Tier two, what do we know works
[00:07:19.670]with the general adult population that we can try,
[00:07:22.119]with college settings?
[00:07:24.580]Tier three, what has logical and theoretical promise,
[00:07:26.930]but just needs to be studied further?
[00:07:28.796]Tier four, what just doesn't work?
[00:07:32.700]There was an update, that when that came out,
[00:07:35.350]this was front page news.
[00:07:36.660]Front page news in numerous outlets.
[00:07:38.649]Ralph Hingson made estimates based on population data
[00:07:42.020]about the impact to loss of student life.
[00:07:44.850]The hardest part of working in this field
[00:07:46.300]is when there's a student death,
[00:07:48.010]and looked at really, what this was doing
[00:07:50.770]on our college campuses,
[00:07:52.260]and so people got it, and for at least,
[00:07:54.240]when this first came out,
[00:07:55.470]there was a lot of enthusiasm both on and off campus,
[00:07:58.360]to look at how we could respond.
[00:08:00.000]There was an update that came out in 2007.
[00:08:02.353]There have been a range of scientific papers,
[00:08:05.200]but this College Alcohol Intervention Matrix
[00:08:07.530]is really the first significant update since 2002.
[00:08:12.230]Toben's gonna talk about some of the research he did,
[00:08:13.800]and I didn't wanna take from that at all
[00:08:15.190]about the degree to which campus administrators
[00:08:17.420]are even aware of these issues,
[00:08:19.060]but it brought us to CollegeAIM,
[00:08:22.840]which the goal is can we move beyond tiers?
[00:08:25.130]The ideas of tiers of effectiveness,
[00:08:26.570]this tier one, tier two, tier three, tier four,
[00:08:29.410]on the one hand, it was a great way to organize
[00:08:31.139]these approaches, but it's really acknowledging
[00:08:34.473]that there are individual and environmental approaches,
[00:08:37.990]and that it's all about a strategic plan.
[00:08:40.570]If a campus says, we're gonna do this one thing.
[00:08:43.713]What else are you going to do?
[00:08:46.127]What package deal are you going to look at?
[00:08:48.427]And that's literally where the move occurred
[00:08:51.300]to the CollegeAIM matrix.
[00:08:54.250]The overarching goal?
[00:08:55.330]How do we increase the likelihood that science,
[00:08:57.550]its research that informs interventions
[00:08:59.530]to address drinking on campuses,
[00:09:01.520]both by providing a framework for schools
[00:09:03.490]to compare and choose what we know is out there
[00:09:06.780]that works, in the scientific literature?
[00:09:09.320]I wanna acknowledge, I made reference to these teams.
[00:09:12.410]I only half joke when I say of all six,
[00:09:14.380]I'm fairly convinced I was the sixth most valuable player
[00:09:17.170]on the team.
[00:09:18.380]The respect, I can say that our UW team has for Toben
[00:09:22.340]and what his group, Traci Toomey,
[00:09:24.230]the head of the environmental strategies team,
[00:09:26.051]and worked with Toben and Kathleen Lenk.
[00:09:28.870]Mary Larimer, who I have the honor of working with
[00:09:32.512]since I was an undergrad, actually.
[00:09:34.700]I was an undergrad, in 1989, when I was 11,
[00:09:38.583]working, that part was a joke,
[00:09:41.019]working with Mary as a grad student at the time.
[00:09:44.910]Jessica Cronce, who's left the University of Washington,
[00:09:46.647]and is at the University of Oregon,
[00:09:48.579]really, on top of friends,
[00:09:50.946]people I respect so much in this field.
[00:09:54.240]And this was a lengthy process,
[00:09:55.640]as I know Toben can attest.
[00:09:56.750]Phase I, identify what should be included in CollegeAIM,
[00:10:00.210]and identify the dimensions
[00:10:01.980]in which they should be evaluated,
[00:10:03.550]plus look at how to code these.
[00:10:05.960]Phase II involved identifying, reviewing,
[00:10:08.260]and then rating all that literature
[00:10:10.430]on college alcohol interventions,
[00:10:11.880]and ultimately, rated almost 60 interventions
[00:10:14.720]on multiple dimensions.
[00:10:16.260]There's a lot on this slide, and that's intentional.
[00:10:18.030]It's really to show you how much
[00:10:20.040]was actually sorted out here.
[00:10:21.900]They were looked at, in terms of relative effectiveness,
[00:10:25.310]based on higher effectiveness, moderate, and limited,
[00:10:27.840]things that were just not effective,
[00:10:29.660]but then approaches where the jury was still out.
[00:10:32.170]There was either insufficient evidence,
[00:10:33.900]hard to interpret outcome data,
[00:10:35.235]the amount and quality of research,
[00:10:37.549]the cost for not only bringing this to a campus
[00:10:40.980]or to a community, but then adopting,
[00:10:42.700]implementing and maintaining it.
[00:10:44.600]The relative magnitude of barriers.
[00:10:46.653]Who needed to be the one to implement this,
[00:10:48.850]in terms of staffing expertise?
[00:10:51.090]Strategy level, is this something that's nationwide,
[00:10:53.880]statewide, local, or, in fact, bound to campus?
[00:10:57.580]The public health reach, the targeted population,
[00:11:00.032]the research population.
[00:11:01.574]You know, was this something that was chosen,
[00:11:03.850]found to work truly with college students,
[00:11:06.710]or with the general adult population
[00:11:08.600]that we have every reason to believe
[00:11:09.600]it would still work with college students?
[00:11:11.910]For individual level only, we looked at short
[00:11:14.100]and long term effects, and duration of those effects.
[00:11:17.110]And then the primary modality.
[00:11:18.660]Was this done individual in person, or individual targeted?
[00:11:22.540]Was it group, was it online?
[00:11:25.710]Phase III was this iterative review process.
[00:11:28.610]I can say, safely, I don't know
[00:11:29.980]if you would disagree or agree,
[00:11:31.510]I don't think there's any published article
[00:11:33.060]that's gone through more peer view ever.
[00:11:34.969]What was done was 10 additional college alcohol researchers,
[00:11:39.460]blind to us at the time,
[00:11:41.040]they've since been identified.
[00:11:42.431]We viewed what both teams did, sent back pages of feedback,
[00:11:48.080]and said, you need to address all of this.
[00:11:49.880]We would address it, we'd send it back,
[00:11:51.670]they'd say, you still need to address this,
[00:11:53.920]we'd address it, we'd send it back,
[00:11:55.650]and only when there was agreement
[00:11:57.037]between the team that developed this and the reviewers
[00:11:59.950]did they say we're good to go.
[00:12:01.810]And so through multiple rounds of review and revision,
[00:12:05.790]there was this consensus process that was able
[00:12:07.780]to take these decades of research and all these studies
[00:12:11.490]into a user friendly tool.
[00:12:14.394]This is a ridiculous slide.
[00:12:17.090]I'm married to a sixth grade teacher,
[00:12:18.400]who teaches 11 year olds how to do PowerPoint, so.
[00:12:20.970]They're my competition.
[00:12:22.713]And I don't like them, frankly.
[00:12:25.688]But she's the first person, when she sees slides like this,
[00:12:28.260]she's like, why?
[00:12:29.093]Why do you do that?
[00:12:29.926]I'm like, because this is not meant to be digested.
[00:12:31.760]It's meant to go, whoa.
[00:12:33.430]And when you look at how much is in this,
[00:12:35.560]all of these strategies are reviewed in CollegeAIM,
[00:12:39.390]and it's these approaches that we'll be talking about
[00:12:42.140]over the course of the day.
[00:12:44.390]You can download CollegeAIM at this website,
[00:12:48.440]and they make available a pdf, and you can order the pdf,
[00:12:51.800]which is genuinely pretty.
[00:12:54.130]But it's honestly the HTML version that's awesome,
[00:12:57.670]in terms of being able to play with it,
[00:12:59.400]and as best as I can, I'll even try to bring to life
[00:13:02.140]some of what the HTML version does.
[00:13:05.230]The question is how can schools,
[00:13:06.530]or even coalitions use CollegeAIM?
[00:13:09.670]There's a chance to review individual
[00:13:11.700]and environmental strategies to get a sense
[00:13:13.240]of really, what's out there.
[00:13:15.636]What are you doing on campus?
[00:13:17.780]What's the evidence for it?
[00:13:19.200]If it's a lot of evidence, great,
[00:13:21.180]but what could you do to complement that?
[00:13:23.250]If, in a limited resource environment,
[00:13:26.118]we're spending a lot of resources
[00:13:28.670]on something that's not that effective,
[00:13:30.280]what could we replace?
[00:13:31.660]So finding new evidence based options
[00:13:33.460]to replace to less effective strategies,
[00:13:36.480]or if there are gaps, ways to address those gaps,
[00:13:40.510]and the idea is that anyone,
[00:13:41.700]whether it's a committee, even an individual person
[00:13:44.770]who's then gonna pool together these sheets,
[00:13:47.320]anyone reviewing CollegeAIM
[00:13:49.100]can use their interactive strategy planning worksheet
[00:13:51.620]to select a combination of what's out there
[00:13:53.770]based on needs for the campus and budget.
[00:13:56.910]So when you look at how CollegeAIM
[00:13:59.680]fits into the planning process,
[00:14:00.960]you're gonna see these four components multiple times today,
[00:14:04.920]and that's okay, because the intent is to consider,
[00:14:07.890]first, what's going on on campus,
[00:14:10.710]and if you are off campus,
[00:14:12.730]and you're looking at community issues,
[00:14:14.391]what are the behaviors at play,
[00:14:16.770]what are the priorities?
[00:14:18.115]Once you've done that, select strategies,
[00:14:20.584]after exploring what's out there.
[00:14:22.890]So here are needs, here's what we think
[00:14:25.840]could be used to address these.
[00:14:27.010]Let's take a look at what our options are.
[00:14:29.610]Plan, then, how to carry out strategies and measure results.
[00:14:33.050]And then implement the chosen strategies,
[00:14:35.030]evaluate them, and refine the program.
[00:14:39.455]My favorite single sentence from CollegeAIM is this one.
[00:14:43.297]"A mix of strategies is best",
[00:14:45.440]because we've, I've overused the image for years,
[00:14:47.980]that anything we do is a piece of a puzzle.
[00:14:49.960]I hear people talk about one piece of the strategic plan,
[00:14:52.970]but it really is highlighting this idea of a mix.
[00:14:55.660]The very first time I presented on this,
[00:14:57.220]on behalf NIAAA, they said if you can really hammer home
[00:14:59.790]to people the idea that a mix of strategies is best,
[00:15:02.670]that would be ideal.
[00:15:04.028]So I was like, well how can I do that,
[00:15:07.210]in slides that I would later
[00:15:08.170]be sending the federal government?
[00:15:09.780]So I came up with this to clarify a mix of strategies.
[00:15:12.540]This is Chex Mix.
[00:15:14.730]This is trail mix.
[00:15:16.700]This is Sir Mix-a-Lot,
[00:15:18.320]and this, of course, is a mix of strategies.
[00:15:24.130]I gotta tell you, at 8:00 in the morning, that's hilarious.
[00:15:28.080]So it really is this package deal.
[00:15:30.670]Part, again, if you had to pick a page of CollegeAIM
[00:15:34.140]that to me, is the best part, it's this sheet,
[00:15:37.180]and it's literally meant as a shopping list.
[00:15:39.080]It's take stock, and then go shopping,
[00:15:41.820]and we did this as a team, at the University of Washington
[00:15:45.320]on the student life side of what I do,
[00:15:46.837]and it was cool to look at.
[00:15:48.310]What do we think we have in place?
[00:15:50.350]Do we even have agreement of what we're offering?
[00:15:52.830]Do I know about programs that my colleagues didn't,
[00:15:55.590]or vice versa?
[00:15:56.595]So the first part is to look at current strategies,
[00:15:59.560]identify the strategy, and then identify,
[00:16:02.230]is this individual, is this environmental?
[00:16:04.360]Can we even agree?
[00:16:06.250]What does CollegeAIM say about its effectiveness,
[00:16:08.660]what's the relative cost, what are the barriers,
[00:16:11.590]what's the reach,
[00:16:12.610]but then there's a notes and next steps version.
[00:16:14.900]Do we need to keep it as it is,
[00:16:16.370]do we have to tweak it to boost effectiveness,
[00:16:18.660]do we have to add a strategy to complement this,
[00:16:21.113]or should we be doing something different?
[00:16:23.490]Should we be shifting to more effective options?
[00:16:26.410]Then you look at possible new strategies.
[00:16:28.677]What's the strategy name?
[00:16:30.540]Again, is it individual, environmental?
[00:16:32.660]What are the ratings?
[00:16:33.610]And then considering what do we need to do this?
[00:16:36.100]What's the staff training needs?
[00:16:37.720]What are the resources?
[00:16:39.380]Does this require a plan for conducting outcome?
[00:16:43.020]What I love about what CollegeAIM made clear
[00:16:44.740]is this does not mean to squash innovation.
[00:16:47.500]This does not mean if you've got something
[00:16:49.270]that you're convinced is the next best thing,
[00:16:51.697]certainly, complement it with what's already effective,
[00:16:55.570]but evaluate what you're doing,
[00:16:57.230]'cause you have the potential to add to the science.
[00:17:00.120]We've already gotten the email about Matrix 2.0,
[00:17:03.290]about the fact that because of a growing literature,
[00:17:06.030]this is meant to be a living document,
[00:17:07.620]that we can actually add to, switch around
[00:17:09.730]as more evidence comes out.
[00:17:12.910]So once you've done that worksheet,
[00:17:14.350]consult CollegeAIM to figure out where to go next.
[00:17:17.440]The question is, what does the Matrix look like?
[00:17:20.450]If you've seen the movie, you know it looks like this,
[00:17:22.450]but that's not what it is.
[00:17:25.797]We are talking about the fact,
[00:17:26.630]we didn't know they were gonna call it CollegeAIM
[00:17:27.680]until right before it came out.
[00:17:28.730]We agreed that the Matrix just sounded pretty cool.
[00:17:32.350]But what does it look like?
[00:17:33.670]There's actually two:
[00:17:35.335]one for individually focused approaches,
[00:17:37.720]one for environmental level approaches.
[00:17:40.070]Purely as screenshots, and you're gonna learn
[00:17:41.810]a lot more from Toben about the environmental.
[00:17:44.070]I'll talk about individual.
[00:17:45.910]But you can notice these columns and rows,
[00:17:47.860]and the columns are sorted by relative cost,
[00:17:50.064]and then the rows are sorted by amount of effectiveness,
[00:17:53.643]and you can see the higher, moderate, lower,
[00:17:56.480]not effective and the ones that are too few.
[00:17:59.300]The one group of studies that were not rated
[00:18:04.230]in these domains is right above the legend,
[00:18:06.730]and these are ones where there's such evidence,
[00:18:09.090]and it's such a recommended strategy federally,
[00:18:11.286]but it varies in terms of cost,
[00:18:13.395]based on what a college campus is able to do.
[00:18:16.020]It has to do with screening and brief interview
[00:18:18.490]with referral to treatment.
[00:18:19.860]If a campus doesn't have a health center
[00:18:21.650]or a counseling center,
[00:18:22.800]that would be a pretty cost-prohibitive step to take,
[00:18:26.780]but certainly, there are very large and very successful
[00:18:29.812]screening and brief intervention efforts on college campuses
[00:18:33.071]that I'll talk more about after lunch.
[00:18:35.930]The environmental matrix looks like this,
[00:18:37.740]similarly rated by relative cost,
[00:18:40.050]similarly rated by amount of effectiveness.
[00:18:45.120]You can then, in CollegeAIM,
[00:18:47.460]if that grid in and of itself is a lot to digest,
[00:18:49.980]which it is, they organize every individual level strategy,
[00:18:54.270]and you can look at, notice for example,
[00:18:55.890]this one's coded as IND-3.
[00:18:58.000]You can then go look, and find where IND-3 exists,
[00:19:00.440]and in this case, it's on the upper left.
[00:19:02.530]That's something that is effective, and pretty low cost.
[00:19:05.739]That's if you look at it from the pdf standpoint.
[00:19:09.150]You can do thee same with the environmental.
[00:19:11.402]But if you go to the HTML version,
[00:19:14.115]you can actually comparison shop.
[00:19:17.110]You can click all of the strategies you're interested in,
[00:19:19.980]and then where it says Print Preview Strategies,
[00:19:22.290]click on that, and it'll bring up a summary.
[00:19:25.644]From the where was this
[00:19:27.000]when I was in graduate school category,
[00:19:30.200]the area that says references,
[00:19:31.640]you click on references, and it shows you all the studies
[00:19:34.260]that went into declaring that intervention effective or not.
[00:19:38.510]If you're like, wait, what?
[00:19:39.830]I've never seen that article,
[00:19:41.230]you click on the title, and it gives you the article,
[00:19:43.680]and so the ability to access the science
[00:19:46.660]without sounding like an infomercial has never been easier.
[00:19:49.663]That did sound like an infomercial,
[00:19:51.849]but it lets you see the ratings,
[00:19:54.130]it lets you see the references.
[00:19:55.670]It even lets you see the potential resources
[00:19:57.640]for what do we need to do to make this happen?
[00:20:00.520]That's new, and that's way different
[00:20:02.570]than what we had with the Call to Action Taskforce Report.
[00:20:06.410]Again, you click on Strategies
[00:20:07.960]to print the reference or discussion section.
[00:20:09.830]So here's one example.
[00:20:11.410]Everywhere you see a blue title,
[00:20:13.100]you can click on it,
[00:20:13.933]and it'll bring you the article right there.
[00:20:16.727]They also have, and this, since it was released,
[00:20:20.130]we already have made some updates, to it.
[00:20:22.030]There's a frequently asked questions category
[00:20:24.820]It's everything from frequently asked questions
[00:20:27.540]You know, I keep hearing parents say,
[00:20:29.670]well, I drank when I was in college and I'm okay,
[00:20:31.730]or why don't we just lower the drinking age?
[00:20:33.600]Wouldn't that take care of it,
[00:20:34.880]and they provide science-based answers.
[00:20:36.780]There's even links to articles in the FAQ section,
[00:20:41.050]and so this tries to anticipate up front
[00:20:43.400]what might those of us who work in student life,
[00:20:45.430]I mean, I have a foot in both worlds,
[00:20:46.650]but what might those of us in student life be encountering,
[00:20:49.160]what might administrators be encountering, and so on.
[00:20:52.363](audience member coughing)
[00:20:53.196]So as a case example,
[00:20:54.170]keeping the Matrix example going further,
[00:20:56.520]so you've got Neo, who's at a school
[00:20:58.670]that's targeting driving under the influence,
[00:21:00.440]with a wrecked car display.
[00:21:02.270]His school is considering adding
[00:21:04.170]either a beer goggles simulation,
[00:21:06.800]one of the fatal vision kind of things,
[00:21:08.440]or a bystander intervention program.
[00:21:10.580]So do they start with individually focused
[00:21:13.010]or environmental level approaches?
[00:21:16.350]Milking the movie one last time,
[00:21:17.800]there's the individually focused or environment level.
[00:21:21.050]There's the awesome view
[00:21:21.883]from Laurence Fishburne's sunglasses.
[00:21:24.411]And so if he says, this turned out formatted differently
[00:21:28.220]on this than on my computer,
[00:21:29.340]so sorry about some of the formatting,
[00:21:30.670]but the wrecked car display, that's not actually rated,
[00:21:33.780]and that's not something that has a lot of science behind it
[00:21:36.470]and it can actually be potentially pricey.
[00:21:39.110]The beer goggles program, that's not actually rated either.
[00:21:42.790]So when they look at the idea of bystander,
[00:21:46.170]they do see that bystander interventions
[00:21:47.930]are one where there's few studies,
[00:21:49.860]but it's still on this list,
[00:21:52.170]and so perhaps, they decide to go with a bystander approach.
[00:21:55.610]That's how this is done.
[00:21:56.760]It's a chance to say, what are we doing?
[00:21:59.050]What could we be adding?
[00:22:00.340]And what might we need to replace?
[00:22:02.940]So the other thing is to use CollegeAIM to consider
[00:22:05.835]how students are even getting connected to strategies.
[00:22:08.710]What if you've got all these effective things in place,
[00:22:10.944]but students aren't properly getting funneled
[00:22:13.320]to them or through them?
[00:22:15.030]We were at dinner last night,
[00:22:16.610]and I made the comment that I found this quote
[00:22:19.180]when reviewing literature for a different presentation
[00:22:22.490]last year that I think is really great.
[00:22:25.060]It says, "The use of effective interventions
[00:22:26.857]"without implementation strategies
[00:22:28.617]"is like serum without a syringe;
[00:22:30.437]"the cure is available, but the delivery system is not."
[00:22:33.289](audience member sneezing)
[00:22:34.955]Part of it is how do we find these delivery systems?
[00:22:36.800]If you've got a list of here's what we wanna do,
[00:22:39.370]how are we gonna bring that to the population
[00:22:41.310]that we're working with?
[00:22:42.550]And so part of what campus team can do,
[00:22:45.390]a community coalition can do is consider
[00:22:47.109]what are those strategies going to be,
[00:22:49.923]how are gonna make sure
[00:22:51.450]people are getting connected to these approaches?
[00:22:54.220]So this came out September 22nd, 2015.
[00:22:58.019]To my knowledge, you're the first state/regional group
[00:23:02.010]to do something like this, and I applaud you for that,
[00:23:04.580]but you know what has been the early feedback thus far?
[00:23:08.155]The feedback we have heard for sure
[00:23:10.370]is that people are really into
[00:23:12.180]the direct access to articles.
[00:23:13.995]If you don't work in research,
[00:23:15.965]access to and even conducting those lit reviews
[00:23:18.780]can be time intensive and actually,
[00:23:20.940]depending on keywords, make that fairly challenging.
[00:23:24.110]The worksheet, everyone's in agreement,
[00:23:26.327]if you take one page that you do as an exercise,
[00:23:30.991]People really like the FAQ page.
[00:23:32.954]The pdf and the print version has been ordered
[00:23:36.010]by a ton of people.
[00:23:37.340]The HTML version, again,
[00:23:38.803]really brings it to life in a different way.
[00:23:41.100]So much like the individual and environment,
[00:23:43.550]it's not do we pick one or the other?
[00:23:45.730]You might find that both serve
[00:23:47.510]very different values for you.
[00:23:49.490]I do know that it's helpful in prioritizing
[00:23:52.210]in a tough budget climate.
[00:23:53.850]And what I heard at NASPA's conference just in January
[00:23:57.380]was people asked, where's this for other drugs?
[00:24:01.090]Where's this for other behaviors?
[00:24:02.500]And we're not there yet.
[00:24:03.450]I mean, again, this has been decades
[00:24:05.340]of research for alcohol,
[00:24:06.240]but people have said, I wish there was a similar tool
[00:24:08.730]for marijuana prevention and intervention,
[00:24:10.680]or for sexual assault prevention efforts.
[00:24:14.740]For coalitions, I mean, certainly do with this as you wish,
[00:24:17.610]but I think that what coalition can do
[00:24:19.850]is to bring key stakeholders
[00:24:21.570]both on and off campus to the table.
[00:24:23.810]If you fill out that worksheet as a group,
[00:24:25.800]if it's not a group that's too huge,
[00:24:27.490]you know, within reason,
[00:24:28.699]the various stakeholders that can impact
[00:24:31.750]on and off campus might be right there,
[00:24:33.840]and truthfully, many of the environment strategies
[00:24:36.560]Toben's gonna talk to you about requires the involvement
[00:24:38.910]of off campus partners.
[00:24:40.660]I really think you can reduce barriers to disseminating
[00:24:42.860]best practices by raising awareness of what works,
[00:24:45.960]and I'm gonna talk, in my presentation,
[00:24:47.808]about some of the barriers that are out there,
[00:24:50.520]and ways to overcome those,
[00:24:52.050]and then since I mentioned it earlier,
[00:24:54.223]despite the mix of--
[00:24:55.359](audience member sneezing)
[00:24:57.025]Despite the mix of strategies being key,
[00:24:58.020]it is that reminder that any one thing we do
[00:25:00.400]is part of an overall puzzle.
[00:25:02.060]It really is highlighting this idea
[00:25:03.930]that everything on both sides of the Matrix
[00:25:06.050]should be packaged.
[00:25:07.723]So to end perfectly on time,
[00:25:10.640]to tag over to Toben,
[00:25:12.090]I've heard some people go, wait!
[00:25:14.020]So we're done, right?
[00:25:14.853]It's like, of course not.
[00:25:15.686]I mean, we've come a long way, in the 70+ years
[00:25:19.770]since Fry's article in 1945,
[00:25:22.120]but a lot more research is needed.
[00:25:24.100]The ones that are insufficient research
[00:25:26.370]or not enough to rate, we need to do more research on those.
[00:25:30.030]Can we move them to a different category?
[00:25:32.262]Best practices in training and implementation.
[00:25:35.990]I was trained in the lab that BASICS,
[00:25:38.140]which is one of the gold standards in our field
[00:25:40.030]was developed, and people say to me,
[00:25:42.437]"What's the best practice in BASICS training?"
[00:25:45.390]That's a great question.
[00:25:46.980]I mean, we've submitted that as a grant
[00:25:48.670]that was not yet funded,
[00:25:51.660]but that's a research question.
[00:25:53.940]So I talk someone that's like, I got BASICS certified.
[00:25:56.140]I'm like, wow, that's not a thing, actually.
[00:25:59.907]So I don't know, I'm not sure who certified you.
[00:26:02.700]But we need to know what those best practices are.
[00:26:05.140]What's the best package?
[00:26:06.480]I mean, is that even an answer?
[00:26:07.940]But if we're looking at packaging individual
[00:26:10.000]and environmental approaches,
[00:26:11.330]what is that best package?
[00:26:14.580]Art Bloom, who used to work with us down at Washington,
[00:26:16.930]and when he was down in Texas,
[00:26:18.820]looked at when we translate these approaches,
[00:26:22.120]not only on different cultures,
[00:26:23.470]but even different languages, what impact?
[00:26:25.220]He looked at the impact
[00:26:26.230]of an alcohol skills training program in Spanish,
[00:26:30.850]to Spanish-speaking students.
[00:26:32.578]I'm a trainer on a grant to Bonnie Duran,
[00:26:35.597]working with tribal colleges
[00:26:37.210]and universities across the country
[00:26:39.040]to look at what cultural adaptations to brief interventions
[00:26:42.180]need to be used on campus for those serving
[00:26:44.750]and working with Native American students.
[00:26:47.490]With all of the studies that have been done
[00:26:49.050]on an approach like BASICS,
[00:26:50.580]not a single one has been done with community college.
[00:26:52.950]Christine Lee is my friend and colleague
[00:26:54.730]at University of Washington.
[00:26:56.150]I'm an investigator on her project,
[00:26:57.810]looking at adaptations.
[00:26:59.370]Of these approaches, typically tested with four year schools
[00:27:02.230]to two year settings, both community and technical schools.
[00:27:05.740]Are there overlap of alcohol and other health issues?
[00:27:09.720]One of my good friends
[00:27:11.160]and also hero in this field, Laurie Davidson,
[00:27:13.920]on her work with the Suicide Prevention Resource Center,
[00:27:16.480]has said if campuses and communities really wanna look
[00:27:19.000]at suicide prevention, she says good alcohol prevention
[00:27:22.333]is good suicide prevention,
[00:27:24.660]because the more we can do
[00:27:25.820]to reduce the really high risk things around drinking,
[00:27:27.950]that will pay dividends around things like mental health.
[00:27:30.870]The overlap of alcohol and other substance use.
[00:27:33.660]You know, again, I'm in a state that has legalized marijuana
[00:27:36.170]for recreational reasons,
[00:27:37.580]and when we look at how polysubstance use,
[00:27:41.670]and even simultaneous use hangs or doesn't hang,
[00:27:44.800]that opens up its own prevention concerns.
[00:27:47.200]And finally, the use of technology to promote change.
[00:27:50.030]I will end on what I hope you'll find to be a humorous note.
[00:27:52.970]Sometimes, I have times where I'm sitting in staff meetings
[00:27:55.440]in our research lab, where I genuinely feel
[00:27:58.410]like the only reason I'm there
[00:27:59.260]is just to kinda make people laugh,
[00:28:00.810]and I have a colleague that is doing research on Twitter
[00:28:04.170]to look at what people tweet about drinking,
[00:28:06.210]and how that hangs with their actual behavior,
[00:28:08.430]and largely, to make her laugh,
[00:28:11.010]I sent this to her.
[00:28:12.700]I said if Twitter existed in the early days of psychology,
[00:28:15.800]it would've looked something like this.
[00:28:19.100]Pavlov: "So if anyone has any idea how to get dog saliva
[00:28:22.097]"out of a rug, I'd sure appreciate it.
[00:28:28.621]Pavlov's Dog: "You did this to me, bro.
[00:28:30.947]"What are you going to do?
[00:28:31.780]"Cry to your mom again?
[00:28:37.400]Freud: "Hey, did someone say mom?
[00:28:38.727]"Damn, sorry, my bad.
[00:28:42.754]So I like to think that Sigmund Freud's Twitter name
[00:28:45.350]would actually be BigSigFreud.
[00:28:48.223]So exactly at 10:15, again,
[00:28:51.784]acknowledging my colleagues UW that helped with this.
[00:28:55.450]Vivian Faden, who really kept us moving forward.
[00:28:57.620]I'll acknowledge Megan again, and truly that say
[00:29:01.053]it's fun for me to get to tag team with Toben.
[00:29:03.710]On top of a great guy and a huge contributor in this field,
[00:29:07.060]he really is on my list of favorite presenters,
[00:29:08.860]so I'm excited to hear from him
[00:29:10.560]and get to work with him today.
[00:29:11.730]So I hope, as a brief overview,
[00:29:13.620]this was useful in getting a sense of what this tool even is
[00:29:16.666]and how to talk about the environmental approaches.
[00:29:20.050]I will tag over to Toben.
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