National Institute on Alcohol Abuse and Alcoholism’s College Alcohol Intervention Matrix 3 of 5

Jason Kilmer, Ph.D. and Toben Nelson Sc.D. Author

08/04/2017 Added

65 Plays

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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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[00:00:01.000]Jason is one of the most dynamic speakers
[00:00:02.780]we have in our field.
[00:00:04.010]So following him is a tall order.
[00:00:06.800]He built up your expectations.
[00:00:08.440]I'd like to lower them down just a little bit,
[00:00:11.870]or maybe a lot.
[00:00:14.330]I tend to be pretty boring when I talk about this stuff.
[00:00:17.480]And the stuff I talk about is stuff
[00:00:19.480]that people don't want to hear about.
[00:00:22.345]It's stuff that people would like rather maybe ignore.
[00:00:27.560]There's a lot of evidence, including work that we've done
[00:00:30.381]that suggests that people prefer to ignore
[00:00:33.370]some of this stuff.
[00:00:34.830]I'm here to poke you a little bit with it more.
[00:00:39.870]But before I get into that, I do wanna say
[00:00:42.540]I'm really delighted to be back in Lincoln, Nebraska,
[00:00:46.677]professionally and personally.
[00:00:49.270]This is a great place for me.
[00:00:50.860]Actually, my in-laws went to school here at Nebraska.
[00:00:55.650]My father-in-law got his PhD in agronomy,
[00:00:59.300]as a matter of fact.
[00:01:01.040]My wife was born here.
[00:01:03.420]And we have had some great family events
[00:01:05.900]coming back to Lincoln.
[00:01:07.740]So it really is terrific to be back here.
[00:01:10.950]And then professionally, I have to say,
[00:01:14.278]University of Nebraska at Lincoln and the staff here,
[00:01:17.970]particularly Linda Major in Newman,
[00:01:21.091]really is a model nationally.
[00:01:23.210]And you guys are very, very fortunate to have
[00:01:26.138]those resources here.
[00:01:28.520]And I think the consortium that's available
[00:01:31.960]that you guys are participating in is really a model
[00:01:35.120]for other states nationally.
[00:01:38.510]It's a terrific, terrific resource,
[00:01:41.070]and you're very, very fortunate to have that.
[00:01:43.760]And it's great for us to come and talk about this stuff
[00:01:48.500]with a group like you because you already have
[00:01:51.497]that network set up,
[00:01:54.520]and the ability to relate to each other pretty directly
[00:01:59.520]through forums like this and other resources
[00:02:04.230]to connect with colleagues on other campuses.
[00:02:06.890]One of the things that I've noticed in the 20 or so years
[00:02:09.603]that I've been working in this area is people
[00:02:13.100]on individual campuses very often feel isolated,
[00:02:17.310]feel like they're right up against dealing with
[00:02:21.370]these very, very difficult issues,
[00:02:24.720]tragic, heartbreaking issues.
[00:02:26.810]And we keep seeing them over and over again.
[00:02:30.270]But the responsibility for addressing those issues
[00:02:34.897]gets put on the people who are in your positions
[00:02:38.790]at universities.
[00:02:40.640]It's a difficult thing to do.
[00:02:41.940]So please do take advantage of the opportunities
[00:02:46.200]you have to share with each other, support each other
[00:02:49.740]in doing this very, very difficult work,
[00:02:52.600]and often thankless work.
[00:02:55.510]Who's been involved in
[00:02:59.320]work on alcohol and drug prevention for less than a year
[00:03:05.070]in this crowd?
[00:03:07.760]Welcome, thanks for being willing to admit that.
[00:03:13.581]Welcome to our field.
[00:03:17.220]It's always good for me to get a little flavor
[00:03:22.083]of who's in the audience.
[00:03:23.010]How about folks more than a year?
[00:03:26.350]The rest of you, there's two choices.
[00:03:29.270]It's less than a year or more than a year.
[00:03:31.070]If you have been working exactly a year,
[00:03:33.480]go with more than a year, more than a year.
[00:03:36.580]More than five years, keep your hand up.
[00:03:40.286]More than 10?
[00:03:42.690]Okay, so we've got some veterans in the crowd as well,
[00:03:46.210]which is terrific.
[00:03:50.986]I wanna acknowledge our team.
[00:03:53.616]Jason mentioned our group at Minnesota.
[00:03:58.808]If Jason was sixth, and I'm probably vying with him
[00:04:02.700]for that sixth place, maybe we're 5.5. with each other.
[00:04:09.350]Tracy Toomey who's, oh (mumbles)
[00:04:13.890]right up there in the left-hand corner,
[00:04:15.970]Tracy's really been a driver in this area
[00:04:20.410]since she's been even an undergraduate
[00:04:22.370]at the University of Minnesota.
[00:04:24.100]She's the director of our Alcohol Epidemiology Program
[00:04:26.490]at Minnesota.
[00:04:28.632]And the true worker who has done most everything
[00:04:31.970]from our team is Kathleen Lenk.
[00:04:34.670]Kath has maintained a database of studies.
[00:04:39.090]She has everything at her fingertips.
[00:04:42.070]She really knows the literature inside and out.
[00:04:45.300]She's sitting up there on the top of the table.
[00:04:49.840]This is our group when we have our research meetings,
[00:04:51.960]our team meetings at the University of Minnesota.
[00:04:55.960]And Kath really
[00:04:59.166]is the glue that holds our group together.
[00:05:01.410]She's terrific, amazing, incredibly humble
[00:05:06.330]and a great hard worker.
[00:05:08.580]She gets very little credit for all of this stuff.
[00:05:11.390]She doesn't wanna come out and give talks like this.
[00:05:14.930]But she's really the one who's done the work.
[00:05:18.230]I've been at Minnesota since 2007.
[00:05:21.440]The rest of this group has been there longer than that.
[00:05:24.280]I'm not gonna take credit for the resources
[00:05:26.620]that are available
[00:05:27.453]on the Alcohol Epidemiology Program homepage,
[00:05:30.670]but there's an incredible amount of resources available
[00:05:34.540]on some of things that we're gonna be talking about today,
[00:05:37.260]as well as some other things
[00:05:41.150]you may have some interest in going on there.
[00:05:43.430]One of the things that we've learned
[00:05:46.040]in doing the work that we do,
[00:05:48.080]and I think part of that is reflected
[00:05:49.670]in how the matrix has evolved,
[00:05:54.520]is it's easy to say what to do.
[00:05:59.390]It's easy to say here's the evidence for doing that stuff.
[00:06:05.270]The how is a much different question.
[00:06:07.600]And that's kind of the theme, I think,
[00:06:09.620]of what we're trying to get toward with the matrix.
[00:06:14.933]And so we have some resources on that topic as well.
[00:06:19.960]Here's the few things I'm gonna talk about today.
[00:06:24.130]I'm gonna talk about a population perspective
[00:06:27.000]on excessive alcohol use among college students.
[00:06:30.180]We'll do an activity, we'll see how that goes.
[00:06:34.793]And then I'll talk about the CollegeAIMs,
[00:06:37.410]very specifically in the environmental strategies.
[00:06:40.489]And then start moving toward
[00:06:45.014]some of the how.
[00:06:46.550]So we'll talk about what to do
[00:06:48.660]and why we might want to do that.
[00:06:50.800]But the how is really important as well.
[00:06:52.850]And I think those are skills that we don't talk much about
[00:06:58.390]as researchers, from my perspective,
[00:07:02.520]but recognizing how important those kinds of things are.
[00:07:05.650]So we'll talk a little bit about that
[00:07:09.270]and some of my suggestions.
[00:07:11.950]And some of this comes from a course
[00:07:13.430]that Tracy Toomey and I teach on policy
[00:07:18.030]as a prevention strategy in public health.
[00:07:25.300]What we're concerned about
[00:07:28.410]on this topic is the excessive use of alcohol,
[00:07:34.080]in this case by college students.
[00:07:37.596]And the thing that most often gets brought up,
[00:07:41.840]and I wanna make a point about this, is
[00:07:46.630]we've been very concerned about motor vehicle crashes.
[00:07:51.230]This is a result of a lot of work.
[00:07:54.640]Well, first of all, it's the result of an enormous carnage
[00:07:58.800]on the roads
[00:08:01.980]regarding alcohol-involved motor vehicle crashes.
[00:08:06.430]And there's been a lot of concern about this
[00:08:09.230]as an outcome.
[00:08:11.010]But I think we've been a victim of our own success
[00:08:13.920]in some ways on this topic.
[00:08:16.260]We talk about preventing motor vehicle crashes,
[00:08:19.860]and we talk about the alcohol issue,
[00:08:21.960]even with college students as,
[00:08:24.740]well, it's okay if there's a lot of drinking going on,
[00:08:28.730]as long as they don't drive.
[00:08:31.820]And that's a fine approach,
[00:08:35.060]but I think it undermines us in some ways
[00:08:37.970]around a lot of the other consequences that happen
[00:08:41.730]as a result of excessive alcohol use.
[00:08:44.590]And the data suggests that college students,
[00:08:48.740]the deaths among college students
[00:08:50.000]are most commonly motor vehicle-related crashes.
[00:08:54.320]But there's also a wide range of not only deaths,
[00:08:57.470]but injuries, long-term social and health consequences.
[00:09:03.990]Some of these are long-term.
[00:09:06.335]That probably won't show up in a college population,
[00:09:10.220]but may be getting started when a person is in college,
[00:09:14.701]and expanding as people get older.
[00:09:18.100]But some of these are acute effects
[00:09:19.670]that college students most certainly experience.
[00:09:23.050]So trying to frame this,
[00:09:25.040]not just narrowly within the context of it's okay,
[00:09:29.540]as long as they don't drive,
[00:09:31.340]to thinking much more broadly
[00:09:33.650]about the consequences of heavy alcohol use.
[00:09:38.900]And as a researcher myself, not necessarily concerned
[00:09:43.830]about excessive alcohol use, I'm very concerned
[00:09:48.200]about a variety of different consequences,
[00:09:51.850]health and social, and the fact,
[00:09:55.490]and there's well-documented,
[00:09:57.290]that excessive alcohol use leads to those things.
[00:10:01.240]Preventing excessive alcohol use reduces those bad outcomes.
[00:10:05.680]So that's the perspective that I wanna take.
[00:10:07.790]I wanna circle back to that notion a little bit later
[00:10:10.830]in the talk.
[00:10:13.590]Jason mentioned the NIAAA College Drinking Task Force.
[00:10:19.420]This really was a major splash when it came out in 2002.
[00:10:24.800]One of the big conclusions, from my perspective,
[00:10:28.060]was this acknowledgement that the tradition of drinking
[00:10:32.002]is entrenched at every level
[00:10:35.020]of the college student environment,
[00:10:37.949]and that student drinking consequences affect everyone,
[00:10:43.510]not just the drinker.
[00:10:45.720]The notion that there were secondhand effects of alcohol
[00:10:50.620]was critically important to trying to move the dial
[00:10:55.500]and recognizing that this wasn't just,
[00:10:58.790]well, students, if they choose to drink,
[00:11:00.830]they're going to have to suffer the consequences
[00:11:02.790]of their own decisions, but that student drinking
[00:11:07.300]affects everybody else around them as well.
[00:11:11.010]So other students, perhaps their roommates,
[00:11:14.070]people they share a floor with,
[00:11:16.620]but also neighbors in the surrounding communities
[00:11:20.480]around universities.
[00:11:22.360]And a lot of universities, the neighborhoods around them
[00:11:26.280]have become areas where community members
[00:11:30.550]don't want to live,
[00:11:32.960]because of the consequences that they experience
[00:11:37.770]from student drinking,
[00:11:39.960]the peeing in their yard, vomiting in their yard,
[00:11:42.040]noise complaints, and those are relatively minor.
[00:11:46.200]My in-laws, who I mentioned earlier,
[00:11:49.860]he's now a professor at North Dakota State University,
[00:11:52.960]and they live right across the street from campus.
[00:11:55.870]And they've lived there for, I wanna say 25 years.
[00:12:01.567]Their neighborhood has changed really dramatically.
[00:12:04.420]And now they routinely have renters
[00:12:08.910]who they share a driveway with.
[00:12:11.586]And they've got students that are having parties
[00:12:15.770]all the time next door to them.
[00:12:20.640]One of the interesting parts of that is they called
[00:12:23.450]and tried to figure out a number of years ago
[00:12:25.284]who's the landlord of this.
[00:12:27.030]Can we really crack down on who the landlord is?
[00:12:30.300]It turns out it's the university.
[00:12:33.042](laughing)
[00:12:35.200]And they haven't done much to address
[00:12:37.700]some of those student issues.
[00:12:43.000]I think another important point here,
[00:12:46.000]if we think back historically to the 1980s,
[00:12:51.620]and we've got some really good data
[00:12:53.340]going back to that point from Monitoring the Future study,
[00:12:55.990]which is done at the University of Michigan,
[00:12:58.390]these data are readily available to you.
[00:13:01.380]You should be familiar with that resource
[00:13:03.790]if you're working in this area, in my opinion.
[00:13:06.540]This is just one set of data looking at alcohol use,
[00:13:11.368]a measure of five or more drinks.
[00:13:13.240]Back in the 1980s, pretty high rates of heavy drinking.
[00:13:18.984]Some of the things that have happened since then,
[00:13:21.968]a change in drinking age,
[00:13:24.010]and a change in enforcement of drinking age laws,
[00:13:27.890]pretty dramatically reduced the drinking among 12th graders,
[00:13:33.180]high school students in the United States.
[00:13:37.255]That's the blue line here.
[00:13:40.386]Unfortunately, we haven't seen that same level of decline
[00:13:44.810]among college students.
[00:13:46.510]So there's now a really big gap.
[00:13:49.320]So you've got high school students who,
[00:13:51.828]because our prevention, because our policies
[00:13:55.700]have been very effective, in my opinion,
[00:13:58.230]at reducing the level of drinking among high school students
[00:14:02.550]we now have a big shift when students go
[00:14:07.060]from high school into college.
[00:14:09.560]And that's been a subject of a lot of research.
[00:14:13.410]It's been the subject of a phrase
[00:14:16.320]that's coined as the College Effect.
[00:14:18.790]And a lot of you probably recognize
[00:14:21.780]and experienced that shift when students go
[00:14:24.840]from high school into college.
[00:14:27.707]You know, students who haven't had a lot of experience
[00:14:30.360]with heavy drinking.
[00:14:36.630]Another piece of research that I was involved with
[00:14:39.510]at the Harvard School of Public Health
[00:14:41.680]that I think there's a lot of important findings
[00:14:44.160]that have come out of that study,
[00:14:46.860]to me, the most important finding was
[00:14:50.680]this one exemplified in this graph here.
[00:14:54.319]And this just shows drinking rates by college.
[00:14:59.490]And the point here is that there's really wide variation
[00:15:04.650]in the drinking rates by different colleges.
[00:15:09.150]So you've got some schools at the bottom
[00:15:11.470]where hardly any students drink to excess.
[00:15:14.840]And you've got some schools at the top,
[00:15:16.980]on the right-hand side, where almost everybody,
[00:15:21.489]three out of four students, are drinking to excess
[00:15:26.420]on a pretty regular basis,
[00:15:31.220]and wide variation in between.
[00:15:34.250]The most important part of this to me was
[00:15:36.820]when we surveyed students, whole new groups of students,
[00:15:40.300]years later, up to 12 years later,
[00:15:43.530]at these very same colleges,
[00:15:45.660]that same distribution remained.
[00:15:48.140]So schools here on the far right
[00:15:51.770]that were heavy drinking schools
[00:15:53.997]remained heavy drinking schools many years later.
[00:15:58.370]And that suggests a couple things to me.
[00:16:00.170]Maybe they're recruiting the same kinds of students.
[00:16:03.470]But also the environment where these schools are located
[00:16:07.650]may be playing a really important role.
[00:16:09.970]And so we looked at,
[00:16:13.180]took advantage of the research design that we had
[00:16:15.730]to look at what are some of the factors
[00:16:18.570]associated with being a heavy drinking college.
[00:16:24.760]More likely to focus on intercollegiate athletics
[00:16:28.090]and fraternity and sorority life.
[00:16:30.720]Those are settings for socializing
[00:16:32.950]and heavy drinking at colleges.
[00:16:36.130]They tend to have a large number of outlets
[00:16:39.300]where they sell and provide alcohol nearby the campus.
[00:16:44.440]And we haven't done a randomized trial of inserting,
[00:16:48.690]or maybe even taking away alcohol outlets near campuses.
[00:16:52.550]But the cross-sectional evidence on this
[00:16:55.600]in college communities, as well as just communities out,
[00:17:01.090]just regular communities out in the real world,
[00:17:03.850]is really very strong evidence here.
[00:17:08.860]There's heavy marketing of alcohol.
[00:17:12.300]And they tend to have lax policies
[00:17:13.982]and enforcement of those policies,
[00:17:16.610]at the college level, in the local community,
[00:17:19.240]and at the state level.
[00:17:21.690]So those are some of the commonalities
[00:17:23.540]that help distinguish schools
[00:17:26.250]that fit on both ends of that distribution.
[00:17:34.320]I also wanna point out, because I do work
[00:17:36.876]beyond college students, that student drinking is part
[00:17:42.660]of a larger societal problem we have with alcohol.
[00:17:47.330]We often look to underage drinking as a big issue.
[00:17:51.480]We often look to college student drinking as a big issue.
[00:17:55.560]But, you know, as if it's over here and not us adults
[00:18:02.130]or not us as a society.
[00:18:04.270]And that's simply not the case.
[00:18:07.460]Alcohol, it contributes to the third leading cause
[00:18:10.580]of preventable death in the US.
[00:18:13.190]Our best estimates, their estimates,
[00:18:16.600]about 1,800 college students every year die
[00:18:20.070]as a result of their alcohol use.
[00:18:22.951]Almost 80,000 adults in the US.
[00:18:25.900]So college students are a tiny drop in that overall number
[00:18:32.010]of deaths that happen in the US.
[00:18:34.610]And that rate of mortality has been very stable over time.
[00:18:44.470]We did some work that looked at comparing drinking
[00:18:48.147]among college students and drinking among adults
[00:18:53.150]in the states where those colleges are located
[00:18:55.610]and found really strong correlations.
[00:18:58.570]Youth tend to drink like the adults around them.
[00:19:05.708]In my opinion the causes of those things are the same.
[00:19:08.890]I also suggest that the solutions to addressing
[00:19:11.900]those issues are the same as well.
[00:19:14.650]And that leads into what some of the environmental,
[00:19:19.120]the evidence around some of the environmental strategies
[00:19:21.800]that we're gonna recommend are as well.
[00:19:25.510]And it's also one of the big challenges,
[00:19:27.270]which I'll get into.
[00:19:30.770]At the University of Minnesota,
[00:19:31.810]our Alcohol Epidemiology Program group
[00:19:36.710]is big on developing frameworks,
[00:19:39.430]helping organize our thinking about some of these issues.
[00:19:42.430]I hope that some of these models will be helpful
[00:19:46.970]for you in your work.
[00:19:48.520]I feel like they've been very helpful in my own work.
[00:19:51.640]It's important to think about how students
[00:19:54.995]exist across a lot of different systems.
[00:19:58.870]And this is sort of a typical college student.
[00:20:02.590]I've been doing more work lately
[00:20:04.450]with fraternity and sorority members.
[00:20:07.220]And the picture of college systems is even more complicated
[00:20:11.870]for that group.
[00:20:12.703]There's a lot of intersecting systems
[00:20:15.770]and spheres of influence on groups like that,
[00:20:19.510]as well as on collegiate athletes
[00:20:23.680]that I think are important to pay attention to.
[00:20:26.390]But just the basic model here, students at the center.
[00:20:29.650]And this is developed off of
[00:20:31.700]a model in developmental psychology
[00:20:35.390]by Urie Bronfenbrenner.
[00:20:37.350]The students placed in the middle here,
[00:20:40.840]they have a lot of spheres of influence
[00:20:43.220]that are operating on them.
[00:20:45.983]So things that can impact them include individual level
[00:20:52.040]kinds of interventions that Jason will spend
[00:20:53.940]some time talking about,
[00:20:55.740]some things happening at the college level.
[00:20:58.130]And I think it's really important to think about
[00:21:01.250]not only the kinds of interventions that Jason
[00:21:04.730]is going to talk about, but also putting systems in place
[00:21:09.740]at the college level, in the community level,
[00:21:12.640]to think about how do we make sure we are doing,
[00:21:17.210]as Jason mentions, delivering effective interventions,
[00:21:21.624]especially at the individual level,
[00:21:23.546]and can we manage those from a systems perspective,
[00:21:27.010]from an organizational perspective.
[00:21:29.980]There's also factors happening in the community
[00:21:33.536]that are most certainly influencing student drinking,
[00:21:39.070]and settings where student drinking is occurring.
[00:21:44.340]And we provided a couple of examples here.
[00:21:48.130]Another model that I think is really useful
[00:21:51.090]from an environmental perspective is this one.
[00:21:54.150]It's called the integrated theory of drinking behavior,
[00:21:57.470]developed by Alex Wagenaar, who was the original director
[00:22:00.910]of the Alcohol Epidemiology Program at Minnesota.
[00:22:03.470]And his colleague Cheryl Perry does a lot of work
[00:22:05.830]in tobacco use.
[00:22:08.200]The thing we care about from a public health perspective,
[00:22:12.070]and probably from an individual's perspective as well,
[00:22:15.793]are the alcohol-related problems at the end.
[00:22:18.850]How do we disrupt, how do we change the rate of problems,
[00:22:24.200]the likelihood of problems?
[00:22:26.220]Well, one big impact on those is drinking behavior.
[00:22:30.582]What influences drinking behavior?
[00:22:33.270]A lot of really important individual level factors.
[00:22:38.150]Some of them are mutable, changeable.
[00:22:40.980]Some of them may not be.
[00:22:43.380]But it also locates individuals within this larger context,
[00:22:48.800]which is what I think is important
[00:22:50.190]about this particular model.
[00:22:52.860]How legally available is alcohol to that individual.
[00:22:58.120]What are the social controls that exist for alcohol
[00:23:02.704]for that individual to access alcohol?
[00:23:05.830]How available economically?
[00:23:08.210]Is it really, really cheap,
[00:23:10.270]and there's large quantities of alcohol available?
[00:23:14.770]Or is it expensive and harder to get?
[00:23:19.000]That influences how much an individual may drink.
[00:23:23.770]And is it physically available?
[00:23:26.020]Can I go right next door?
[00:23:28.130]Do I have a tap on a refrigerator in my garage?
[00:23:33.947]If you have that, you're much more likely
[00:23:36.650]to be drinking regularly, heavily.
[00:23:39.980]And some student apartments, some fraternity houses,
[00:23:45.140]have alcohol that easily accessible.
[00:23:49.000]No wonder there's so much drinking.
[00:23:53.053]And all of those factors,
[00:23:54.420]and this is a gross over-simplification of it,
[00:23:57.840]can be changed, can be addressed, through public policy
[00:24:04.370]and institutional policies and structures.
[00:24:08.720]That's where policy fits in here.
[00:24:11.130]And there's a lot of policy-level kinds of strategies
[00:24:14.920]and interventions that we'll be talking about
[00:24:17.920]within the college matrix.
[00:24:19.520]And policy, here's where it gets boring,
[00:24:22.850]policy is one of those things that people don't want
[00:24:25.720]to talk about.
[00:24:26.990]They don't want their behavior restricted in certain ways.
[00:24:31.190]They don't want someone else, particularly college,
[00:24:33.580]I don't know if you guys have worked with college students.
[00:24:36.600]They don't tend to like you to tell them what to do.
[00:24:40.340]And that's what policy is.
[00:24:43.090]And people who sell alcohol commercially
[00:24:45.730]don't like you to tell them what to do
[00:24:48.140]or how to operate their business.
[00:24:52.820]And I want to locate the individual within this larger
[00:24:57.290]framework as well.
[00:24:58.560]I do a lot of work with Ken Winters, who,
[00:25:01.410]like Jason is a clinical psychologist,
[00:25:03.760]has done a lot of work on drug and alcohol use
[00:25:06.330]among adolescents, from an individual perspective.
[00:25:11.486]There are important range of intervention points
[00:25:15.710]for student alcohol use,
[00:25:18.040]from students who are abstinent,
[00:25:21.120]who drink maybe a little bit
[00:25:23.080]to getting in the range of more heavy and abusive
[00:25:26.010]on alcohol use, and for clinically relevant,
[00:25:30.280]may be dependent on alcohol.
[00:25:33.170]There's a lot of different points of intervention
[00:25:36.030]that happen here.
[00:25:37.700]Brief intervention is very appropriate
[00:25:39.890]at this level for individuals.
[00:25:41.950]Treatment is very appropriate for this level.
[00:25:45.998]Policy, enforcement, educational approaches
[00:25:49.730]are appropriate across the spectrum.
[00:25:53.270]And I think it's critically important to think
[00:25:55.670]about that approach from a population perspective.
[00:26:04.810]Where has most of our effort been
[00:26:08.930]at addressing student alcohol use?
[00:26:15.700]What does this mean?
[00:26:17.094]Far end. At the far end?
[00:26:19.808]This end? Yeah.
[00:26:23.874]I think a lot of that work that's been done
[00:26:25.870]really has focused in these areas.
[00:26:30.550]Less, but the problems that stem from alcohol use
[00:26:34.980]are primarily in a population, in a community,
[00:26:38.240]at a school, primarily a function of various aspects
[00:26:43.010]of the availability of alcohol.
[00:26:47.080]It suggests that we might want to be
[00:26:50.240]focusing here as well.
[00:26:53.320]And I think unfortunately, and Jason knows this as well,
[00:26:58.210]unfortunately, sort of the individual and the environmental
[00:27:01.414]strategies get played off against one another.
[00:27:05.850]And there's certainly a preference for operating
[00:27:10.350]at the individual level,
[00:27:12.023]and sometimes it's seen as we're in competition
[00:27:15.358]for getting resources, attention,
[00:27:20.160]implementation of different strategies.
[00:27:24.160]But they're really the same part of the issue
[00:27:27.880]that's part of a comprehensive approach.
[00:27:29.850]And I think this slide helps illustrate that
[00:27:34.210]to some extent.
[00:27:36.180]And the point that I like to make here is
[00:27:40.270]you can have the greatest individual level intervention,
[00:27:44.760]the most effective thing, send a student through that
[00:27:49.100]and have them come out the other side better,
[00:27:53.410]not drinking so much.
[00:27:55.820]Then we send them back into this very same,
[00:27:58.450]toxic environment that created that situation
[00:28:02.980]in the first place.
[00:28:04.340]So we have to be working on both sides of this,
[00:28:07.990]doing individual and environmental kinds of interventions.
[00:28:12.920]Another model that I liked,
[00:28:15.310]we've tortured Linda and other colleagues
[00:28:18.814]in previous projects about this particular model.
[00:28:23.350]But I happen to like it a lot,
[00:28:25.781]and I think it's really useful in terms of thinking
[00:28:27.930]about what you would want to do,
[00:28:30.830]how you would want to address the situation,
[00:28:33.220]because I think it describes it very well.
[00:28:35.970]We have drug-related problems,
[00:28:37.680]in this case alcohol in the middle.
[00:28:40.450]We've got features of students, people,
[00:28:43.930]what they know about alcohol, their attitudes toward it,
[00:28:46.880]their intentions about using it,
[00:28:48.940]and maybe their skills, even, in terms of resisting
[00:28:52.060]or engaging with alcohol use.
[00:28:55.240]And a lot of the work historically,
[00:28:57.520]in college drinking prevention programs has focused there.
[00:29:05.000]I want to encourage continued and continued use
[00:29:08.660]of those kinds of interventions,
[00:29:10.270]systematizing those kinds of interventions,
[00:29:12.782]because they're critically important,
[00:29:14.220]but also adding things in the environment.
[00:29:17.889]So in this model of things that fall in the environment,
[00:29:22.360]advertising and promotion of alcohol.
[00:29:24.570]How available is it?
[00:29:26.220]What are the legal sanctions?
[00:29:28.080]What are the institutional systems and protocols
[00:29:31.370]and rules for dealing with alcohol-related issues?
[00:29:35.770]But also features of the alcohol itself.
[00:29:39.770]How expensive is it?
[00:29:41.674]What's it composed of?
[00:29:45.720]The big craft brew,
[00:29:47.030]I've noticed that it has hit here in Lincoln.
[00:29:49.810]Maybe it's hit in your area as well.
[00:29:52.250]Craft beer is viewed as an economic boon.
[00:29:56.990]But the percent alcohol in craft beer
[00:30:00.610]is really, really high.
[00:30:03.760]So paying attention to that.
[00:30:06.040]I mean, you think about an intervention where
[00:30:08.960]you would serve light beer compared with a craft beer.
[00:30:15.740]People may be not getting as intoxicated
[00:30:18.300]if we're drinking light beer.
[00:30:20.610]Less alcohol content.
[00:30:23.410]Labeling, how is it packaged.
[00:30:26.360]So those are the different kinds of things,
[00:30:30.080]I think this is a helpful orienting framework.
[00:30:33.540]I know when I present stuff like this with the dates of 1986
[00:30:36.960]to my students in class, they think that's ancient history.
[00:30:42.820]Surely there had to have been much better ideas
[00:30:45.340]happening since then.
[00:30:48.050]There are some useful ideas.
[00:30:49.330]I still think this one's pretty useful.
[00:30:52.320]I want to pause here for a few minutes
[00:30:56.090]and engage you a little bit.
[00:30:59.280]I didn't bring pencils, I didn't bring paper.
[00:31:02.240]But I'd like you to take a few minutes,
[00:31:04.280]by yourself or with the colleagues that you're sitting with,
[00:31:08.430]take a few minutes.
[00:31:10.460]Use the Torjman Model, and I'll put it back up there
[00:31:13.330]in a second, to identify your current performance,
[00:31:18.678]where you are where you're working.
[00:31:20.980]What are the kinds of things that you're doing
[00:31:24.140]in your community on your campus,
[00:31:27.110]and where do they fit within this model.
[00:31:29.890]And then let's take a look at that
[00:31:31.850]and identify some strengths of what your program is
[00:31:36.580]and perhaps some weaknesses.
[00:31:40.830]You guys thought you were just gonna be able
[00:31:42.624]to sit there all day.
[00:31:44.135]You're gonna have to do something.
[00:31:44.968]And then somebody's gonna have to talk.
[00:31:46.690]So I'll show this model.
[00:31:50.698]And I'll also have some of these definitions
[00:31:52.859]available to you.
[00:31:55.020]So what do we mean by knowledge?
[00:31:57.610]What do we mean by skills?
[00:32:00.010]And I'll be happy to flip back and forth.
[00:32:01.900]But I'm gonna show that model up here for a minute.
[00:32:05.010]And it's very hard for me, but I'm gonna stop talking
[00:32:07.460]and you're gonna go to work for five minutes.
[00:32:10.050]If you'd like me to flash to the definitions
[00:32:13.520]or back to the model, I'm delighted to do that.
[00:32:21.400]Ah, come on!
[00:32:23.770]Too far away.
[00:32:26.350]Don't worry, don't worry.
[00:32:31.060]Oh, you gotta worry.
[00:32:33.270]Come back here, all right.
[00:32:34.870]So take five minutes.
[00:32:36.930]Take five minutes.
[00:32:38.670]Write down on a piece of paper.
[00:32:41.699]If you don't have a piece of paper,
[00:32:43.080]people with pads nearby will share with you.
[00:32:45.920]Talk with your colleagues.
[00:32:47.991]On your marks, get set, go.
[00:32:53.150]All right people, five minutes is up.
[00:32:56.120]Others, thoughts?
[00:33:00.520]Yeah?
[00:33:03.450]He's gonna want you to be on the microphone, thank you.
[00:33:07.180]We all deal with, I think,
[00:33:09.550]relatively small communities with our universities.
[00:33:12.820]Even here in Lincoln it's relatively small
[00:33:15.060]with the accessibility to alcohol in general,
[00:33:18.110]whether that's a liquor store or the bars or whatever.
[00:33:22.250]We were talking about how easy it is for our students
[00:33:25.450]to walk right across the campus.
[00:33:27.860]There's a gas station that sells alcohol there.
[00:33:31.380]There's also a liquor store right across from campus
[00:33:33.360]that sells alcohol.
[00:33:35.019]And then it's not more than five blocks to get down
[00:33:38.300]to our kind of downtown where all the bars
[00:33:40.560]and another liquor store is.
[00:33:42.060]And so it's relatively easy to be accessible
[00:33:46.923]to our students, even if they don't have a car,
[00:33:50.010]or they are walking and stuff like that.
[00:33:51.920]So that brings in other concerns.
[00:33:54.220]One thing that we've done through our Peer Health
[00:33:57.160]Education Office is we've actually partnered,
[00:33:59.500]and now it's rolled through our student fees is we fund
[00:34:03.260]what's called The Safe Ride Program,
[00:34:05.390]where our students can work with the local cab company,
[00:34:08.490]show their student ID, and they can get a ride
[00:34:10.540]from either the bar, or if they are at a house party,
[00:34:13.719]back to their residence.
[00:34:15.530]They will not take them from a party to a party
[00:34:17.750]or a bar to a bar.
[00:34:19.084]But then it's a free cab ride for them
[00:34:23.520]that we offset the cost of that through the student fees.
[00:34:27.990]Yeah, I think that's a great example.
[00:34:30.270]It's not one that shows up in the environmental strategies
[00:34:34.060]of the CollegeAIM.
[00:34:35.186]That's an intervention that's not been evaluated properly.
[00:34:41.280]And there's also some risk, perhaps, in, okay,
[00:34:45.940]you have a free ride to a bar, you know,
[00:34:47.800]and increasing availability and increasing access
[00:34:50.760]to students as well.
[00:34:52.700]It's a challenging one, but I think it's probably
[00:34:55.530]really important to make sure that students have
[00:34:59.670]safe access to get from place to place.
[00:35:03.610]And certainly students are willing to step up
[00:35:07.530]and pay for that.
[00:35:09.280]And it's not, you can't get a ride to the bars.
[00:35:12.860]It's actually if you've been-- If you've been there.
[00:35:15.260]Yeah, and they won't take you to parties and stuff.
[00:35:18.260]It's just to your residence.
[00:35:21.245]What other example of what some things that are being
[00:35:25.890]worked on in your communities?
[00:35:27.920]I'm gonna stand on this side, I've been ignoring this side.
[00:35:33.150]Somebody, yeah?
[00:35:35.199]I want to touch on everything you said
[00:35:38.736](muffled speaking)
[00:35:43.060]Just last night we had one of the residence halls
[00:35:46.421](muffled speaking)
[00:35:52.639]They're only having a drink (muffled speaking).
[00:35:57.840]It was amazing how many of the students that participated
[00:36:00.150]in the drink pouring activity poured way more
[00:36:03.060]than one ounce into that Solo cup.
[00:36:06.173]And when the wellness advocates were doing
[00:36:08.070]the peer-to-peer education and poured it back
[00:36:09.810]into a measuring cup, they were like, "Oh my goodness!"
[00:36:13.720]So the next time they go out to a party,
[00:36:15.290]they might be shocked at their lack of buzz,
[00:36:17.960]but hopefully their tolerance level will adjust.
[00:36:19.990]And it was a good way to increase the knowledge.
[00:36:22.340]So one interesting thing about those red Solo cups,
[00:36:25.270]by the way, you people notice they have ridges on them?
[00:36:29.380]Those are actually measured in standard drink sizes.
[00:36:34.330]And I didn't know that until we started getting into
[00:36:38.580]this research area with Greek students.
[00:36:42.770]And most students are not aware of that.
[00:36:45.810]So an intervention to educate them about standard
[00:36:51.340]drink sizes and maybe not overpouring might be useful.
[00:36:57.200]So overall,
[00:37:00.260]where's the focus
[00:37:03.790]on your campuses within this model?
[00:37:09.829]Knowledge.
[00:37:11.124]Knowledge.
[00:37:17.560]Lot of focus on person.
[00:37:20.870]Lot of focus in this box.
[00:37:23.120]This is why I like this model.
[00:37:25.290]It helps encourage thinking on some of these other kinds
[00:37:29.380]of strategies that are influencing alcohol use.
[00:37:33.520]So those are really important strategies.
[00:37:37.580]And we're all in higher education,
[00:37:39.910]and it's critically important to educate
[00:37:41.760]the young people of tomorrow.
[00:37:43.730]And we want to do that and we want to continue to do that.
[00:37:47.860]But moving beyond adding some other kinds of strategies
[00:37:52.730]as well is what I think this model really does encourage.
[00:37:58.660]And I will tell you, and we'll get into this
[00:38:00.700]in a little bit, the alcohol industry spends a lot of time
[00:38:05.410]on all of these things, trying to make it easier
[00:38:09.420]for their customers to get alcohol.
[00:38:18.050]Successful interventions are ones that work.
[00:38:23.470]And that's what we're gonna talk about
[00:38:24.740]with the CollegeAIM matrix.
[00:38:29.380]The CollegeAIM, M stands for matrix,
[00:38:30.640]as Jason pointed out to me.
[00:38:33.370]We wanna use effective interventions, ones that work.
[00:38:39.180]We also want to have interventions that reach
[00:38:41.860]a broad range of potential students.
[00:38:45.950]That's the impact, that's prevention.
[00:38:49.410]That's where the rubber meets the road
[00:38:51.972]in the kinds of work that you're doing.
[00:38:54.790]So we can have effective interventions.
[00:38:58.050]And one of the things that we do
[00:39:00.050]on University of Minnesota campus is the Basics Program.
[00:39:05.690]Very well-documented effectiveness of that program.
[00:39:11.250]We have a campus of 45,000 students
[00:39:14.310]at the University of Minnesota.
[00:39:17.030]Basics was run with
[00:39:20.910]15 students a year ago in the fall.
[00:39:25.950]It's not reaching a lot of students.
[00:39:29.350]We need better systems in place to get
[00:39:33.510]a very effective intervention out to a broader range
[00:39:37.330]of students where it can have that impact.
[00:39:42.970]We talked a little bit about the NIAAA
[00:39:47.890]College Drinking Task Force report.
[00:39:50.630]It came out with some pretty clear recommendations
[00:39:53.371]at the time in 2002.
[00:39:57.430]A lot of really good individual level interventions,
[00:40:01.170]including norms clarification,
[00:40:03.120]cognitive behavioral skills training,
[00:40:05.270]motivational interviewing,
[00:40:07.150]all a broad, empirical base.
[00:40:10.440]The base on those has continued to grow
[00:40:13.860]and expand since 2002.
[00:40:18.190]And those are useful things to be doing on your campus.
[00:40:22.250]Restricting alcohol outlets, even way back in 2002,
[00:40:25.930]very strong evidence.
[00:40:28.400]Increasing prices and taxes on alcohol,
[00:40:32.680]probably the most effective, in my opinion.
[00:40:36.640]Responsible beverage service policies.
[00:40:39.870]Maintaining and enforcing the 21 drinking age
[00:40:42.200]and impaired driving laws.
[00:40:44.650]And when, in 2007, Jason mentioned this,
[00:40:49.060]there was a re-look at the evidence.
[00:40:51.920]And the evidence for these, again, continued to grow
[00:40:54.830]and build at that time.
[00:40:56.940]They also found that compliance checks in bars,
[00:41:00.300]there were enough studies at that point
[00:41:02.350]that there was strong evidence for doing those kinds
[00:41:05.800]of interventions.
[00:41:07.090]So in 2002, NIAAA said, here's what to do.
[00:41:14.040]Good luck with that.
[00:41:17.410]How many people in here are familiar
[00:41:20.010]with the College Drinking Task Force recommendations?
[00:41:24.790]Familiar?
[00:41:27.830]Be more familiar with those.
[00:41:30.080]How many have read the full report?
[00:41:32.630]It's very exciting.
[00:41:39.250]How many have implemented all of those things?
[00:41:45.030]You're in good company.
[00:41:47.160]In 2008, our group at Minnesota did a study
[00:41:51.030]looking at whether those recommendations were implemented
[00:41:56.240]in a representative sample of 300 colleges,
[00:41:59.910]more than 300 college around the country
[00:42:02.231]and asked the question, how are colleges doing?
[00:42:06.726]How do you think colleges were doing?
[00:42:12.310]Kind of like you guys, not too good.
[00:42:16.550]What we found,
[00:42:19.690]so why aren't colleges implementing
[00:42:22.480]these recommended interventions?
[00:42:24.470]And we have specific data on who was doing what
[00:42:27.237]and what kinds of schools were doing it.
[00:42:28.930]It doesn't necessarily matter.
[00:42:30.680]Those environmental interventions, in particular,
[00:42:33.440]did not have a tremendous amount of uptake.
[00:42:36.160]And the most effective thing, virtually no one was doing.
[00:42:41.110]Why aren't colleges implementing
[00:42:43.020]these recommended interventions?
[00:42:45.987]Money. Partially, okay.
[00:42:49.580]So we've told them what to do.
[00:42:53.070]How do you do it?
[00:42:54.660]How do you do it?
[00:42:55.940]People who are coming into the field, new,
[00:42:58.390]less than a year working on these issues,
[00:43:01.740]probably haven't been trained on how to do this stuff.
[00:43:06.010]We haven't done a very good job of helping schools
[00:43:11.120]with the how question.
[00:43:15.948]In my opinion, a lot of college-based interventions
[00:43:20.127]are focusing almost exclusively on individual students.
[00:43:26.170]And we've heard a little bit from you about that.
[00:43:29.600]They are seeing the trees, but missing the forest.
[00:43:34.560]We spend a lot of time on education.
[00:43:39.000]Virtually every college, every time we've done this,
[00:43:42.150]and we've done a number of surveys,
[00:43:44.620]asking schools what they're doing.
[00:43:46.620]Virtually every college spends some amount of effort
[00:43:50.130]and quite a bit of money educating students
[00:43:52.720]about the risks of alcohol use.
[00:43:54.550]They know it already.
[00:43:57.980]And point in fact, and probably because they already know
[00:44:01.470]a lot of these things, the College Drinking Task Force
[00:44:05.590]has found that these approaches,
[00:44:09.160]at least by themselves, don't work.
[00:44:12.360]They're not effective.
[00:44:13.970]But every school, virtually every school does it.
[00:44:19.690]We spend a lot of time and focus treating
[00:44:23.980]and/or punishing the heaviest drinkers,
[00:44:29.920]the ones who are down that spectrum.
[00:44:32.500]And surely treatment is appropriate.
[00:44:34.890]And when people violate the rules
[00:44:36.870]and the expectations that we have,
[00:44:39.450]surely they should have certain consequences
[00:44:43.590]associated with them.
[00:44:45.540]So we're spending a lot of times focusing
[00:44:47.780]on the heaviest drinkers, the bad apples.
[00:44:54.410]Colleges are doing all kinds of these kinds of things.
[00:44:59.010]Some of you mentioned some of these already.
[00:45:02.970]That's what a lot of colleges are doing
[00:45:04.920]when I go around the country, talk to folks,
[00:45:07.220]these are the standard kinds of interventions
[00:45:10.350]that folks are doing.
[00:45:12.930]Where were these in the College Drinking Task Force report?
[00:45:19.660]There's just not a ton of evidence.
[00:45:21.600]So great things to be doing.
[00:45:25.050]And as Jason mentioned, we want to encourage innovation.
[00:45:27.880]We want to encourage schools to be doing stuff that works.
[00:45:32.660]But we need more evidence around a lot of these things.
[00:45:40.930]Oh, that's painfully slow, isn't it?
[00:45:43.842](laughing)
[00:45:46.430]My favorite part of giving talks is doing
[00:45:49.060]the animations on slides.
[00:45:53.480]So here's the,
[00:45:55.430]these are the recommendations.
[00:46:02.050]Part of the reason, in addition to resources,
[00:46:05.650]is a lot of the systems on campuses
[00:46:09.130]are fractured or siloed.
[00:46:12.150]Siloed is one of those new buzzwords in corporate America
[00:46:16.760]and organizations.
[00:46:18.840]But people end up working just in isolation,
[00:46:23.190]not talking to other systems that may be influencing
[00:46:28.620]the topic that you may care about,
[00:46:31.360]regardless of what it might be.
[00:46:33.750]There are some structures in universities that help
[00:46:37.690]reinforce that siloing.
[00:46:40.703]When we started working with University of Nebraska
[00:46:44.640]and Linda back in the '90s,
[00:46:47.500]not necessarily here, but at a lot of other campuses
[00:46:50.770]we were working with in the Matter of Degree program,
[00:46:55.110]one of the biggest issues was relationships,
[00:46:59.100]especially relationships between campus and community.
[00:47:04.000]There were groups that just simply
[00:47:07.640]hadn't talked to each other, in some cases ever,
[00:47:11.230]but were working on basically the same kinds of issues.
[00:47:14.960]Relationships are critically important in doing this work.
[00:47:21.800]You have to get out of your office and go meet with people
[00:47:25.550]and develop those relationships.
[00:47:30.290]I can say that 'cause I'm a retired guy
[00:47:32.870]who sits in his office and only works on his computer,
[00:47:36.300]comes out and does this once in a while
[00:47:38.664]when they let me out of my cage.
[00:47:40.200]I recognize I'm no good at that.
[00:47:44.240]But having people in the positions of alcohol
[00:47:49.286]and other drug prevention need to have those skills,
[00:47:52.000]need to be able to develop those relationships.
[00:47:54.580]Critically, critically important.
[00:47:57.020]Another reason is environmental strategy implementation
[00:48:01.030]is really hard.
[00:48:03.550]It's partly why people don't like me when I come out
[00:48:06.770]and talk about these things.
[00:48:08.903]I keep encouraging, you know,
[00:48:10.200]here's what you should be doing,
[00:48:12.310]the things that are recommended,
[00:48:13.500]the things that have an empirical basis.
[00:48:16.440]But they're really hard to implement
[00:48:19.890]for a variety of reasons.
[00:48:22.240]A lot of the policies and strategies that work,
[00:48:27.460]you can't just simply snap your fingers on campus,
[00:48:30.860]and I know that's not how it works,
[00:48:33.620]to make a policy that influences the off-campus area.
[00:48:39.390]It's challenging, it's difficult.
[00:48:40.900]You have to work with people outside of your organization.
[00:48:46.660]There are lots of barriers to making that happen.
[00:48:50.990]Having good relationships is one way to start breaking down
[00:48:54.670]some of those barriers.
[00:48:56.590]But one will still run into all kinds of barriers
[00:49:00.411]to implementing environmental strategies.
[00:49:06.040]There's often a lot of negative reaction.
[00:49:08.670]You read the newspaper, any time one of these effective
[00:49:12.530]interventions is proposed, it's so easy for reporters
[00:49:16.360]to go find a student who will say, oh, that will never work.
[00:49:21.970]So you have a mountain of scientific evidence
[00:49:24.160]on this side, and then you've got one student
[00:49:27.040]that a reporter stumbled across that is saying,
[00:49:30.600]oh, that'll never work.
[00:49:31.460]That wouldn't change my behavior.
[00:49:33.880]Wouldn't change the behavior of my friends.
[00:49:37.630]And we often accept that.
[00:49:42.210]There's this notion of equating policy with punishment.
[00:49:46.500]And nobody wants to be the fun police.
[00:49:50.730]But sometimes you might feel like that.
[00:49:54.840]Anybody nodding their heads.
[00:49:59.630]And sometimes, we haven't recognized
[00:50:02.080]that there are a specific set of skills
[00:50:05.370]that college alcohol prevention staff need to have,
[00:50:08.950]including this ability to develop relationships,
[00:50:11.800]including the ability to advocate for strategies that work.
[00:50:18.940]I think historically, back when I started this work, anyway,
[00:50:22.840]I think it's evolved quite a bit from there.
[00:50:25.390]But you know, it used to be the office
[00:50:27.270]where you had a lot of pamphlets,
[00:50:30.224]and ordering pamphlets and keeping those up-to-date
[00:50:32.070]and going out and talking to student groups
[00:50:34.750]was the main function of alcohol prevention staff
[00:50:38.544]on college campuses.
[00:50:40.310]And we've moved away from that.
[00:50:42.930]It's still a part of folks' job,
[00:50:44.620]and I think probably still useful and important part.
[00:50:47.330]But there's a lot of other dimensions that I think
[00:50:49.300]are gonna be much more effective.
[00:50:56.660]From my perspective, I think it's important to acknowledge
[00:51:02.650]the role of alcohol industries.
[00:51:06.270]In some ways, we are directly competing for valuing health,
[00:51:12.900]valuing prevention, valuing safety
[00:51:17.790]in competition with people making money
[00:51:21.730]off of a very lucrative product that people,
[00:51:26.430]particularly our students, like a lot.
[00:51:31.170]And one of the issues with dealing with the industry is
[00:51:37.288]we have to be faced with these choices
[00:51:41.400]in terms of the strategies.
[00:51:44.153]There's this axiom in alcohol policy work that
[00:51:48.960]popular strategies tend to be ineffective.
[00:51:54.030]The stuff that everybody tends to do,
[00:51:56.310]they tend not to work very well.
[00:51:58.210]The more effective strategies tend to be very unpopular.
[00:52:03.380]That's why no one likes me when I come
[00:52:05.010]and talk about this stuff.
[00:52:07.590]But I think it's the truth.
[00:52:13.900]And again,
[00:52:16.270]the alcohol industry is working
[00:52:18.630]on every one of these levels.
[00:52:24.950]And we need to be in there,
[00:52:27.510]talking about the value of health,
[00:52:31.550]the value of safety,
[00:52:33.700]the value of moderate drinking
[00:52:40.710]in these different domains.
[00:52:44.900]So how do you implement effective prevention?
[00:52:49.090]How do you implement these strategies?
[00:52:56.060]One I think is having a broader population level perspective
[00:53:01.640]on some of these issues.
[00:53:02.940]And those are some of the things
[00:53:03.840]I've been talking about so far.
[00:53:06.790]Focusing on those public health considerations.
[00:53:11.330]When you go out and advocate and place a value on health,
[00:53:18.160]and place a value on safety, and student well-being,
[00:53:24.010]it's hard to argue against those things.
[00:53:27.270]And alcohol is a major threat,
[00:53:31.060]probably the biggest threat to those things.
[00:53:37.010]Talking early and often about the value we wanna place
[00:53:41.870]on student health, safety, and well-being.
[00:53:46.080]Focus on those public health considerations.
[00:53:48.780]And the evidence for alcohol undermining those things
[00:53:52.930]is very, very strong.
[00:53:58.630]Drawing attention to the upstream sources of the damage,
[00:54:04.680]not just the bad seeds that are causing problems,
[00:54:09.190]you know, the misbehaving students.
[00:54:12.530]They're part of a larger context.
[00:54:15.670]They're part of a larger environment.
[00:54:19.260]That is bringing about those behaviors,
[00:54:23.640]those negative consequences.
[00:54:25.890]And you can cycle through different students
[00:54:29.710]in different years.
[00:54:31.850]The context, the source of the problems remains the same.
[00:54:37.410]Focusing on those upstream sources, I think,
[00:54:40.860]is a critical part of reframing these issues
[00:54:44.560]and moving toward effective prevention.
[00:54:50.050]And as I mentioned, embrace the fact in a lot of,
[00:54:55.820]this is where people feel like they're out on their skis
[00:54:58.910]a little bit.
[00:54:59.950]They feel like they're gonna be in trouble.
[00:55:02.930]They feel like no one's gonna support them.
[00:55:06.700]Embracing the fact that we are advocating
[00:55:09.870]and competing against some very powerful
[00:55:15.930]economic interests with the alcohol industry.
[00:55:21.340]And I won't get into this.
[00:55:23.233]Linda's been a strong advocate of this position
[00:55:26.620]for a long time.
[00:55:28.230]The industry is not just one thing.
[00:55:30.970]The industry is a lot of different things.
[00:55:33.060]And they have different, and sometimes within the industry,
[00:55:36.760]competing self-interests.
[00:55:39.150]Understand what the industry's self-interest is.
[00:55:43.040]It is critically important.
[00:55:44.850]From the big producers who may not have a direct impact
[00:55:51.620]in your community, to the distributors
[00:55:55.680]who may be in your community, to the retailers,
[00:55:59.120]who may be active in your community,
[00:56:01.940]or actively undermining you, or working against
[00:56:04.800]what you're trying to do on your campus.
[00:56:08.640]Go develop relationships with them.
[00:56:10.780]Understand what their self-interest is
[00:56:13.140]and start figuring out,
[00:56:14.850]you won't align with them directly.
[00:56:16.860]But start figuring out where you might align with them
[00:56:20.090]in some ways.
[00:56:22.100]And get them to understand where you're coming from
[00:56:25.090]in valuing health and safety and well-being.
[00:56:29.770]'Cause they value those things, too.
[00:56:36.100]Use existing tools.
[00:56:38.605]We've been thinking about this for a long time,
[00:56:41.550]trying to address the how question.
[00:56:44.020]So you know, what, here's go do these things.
[00:56:47.300]Nobody tells us how.
[00:56:49.930]That's the spirit of the CollegeAIM.
[00:56:54.510]And what we're moving toward in terms of focusing
[00:56:58.900]those efforts on how to make these interventions happen
[00:57:04.528]at colleges and college communities.
[00:57:09.450]The environmental strategies, the stuff that I worked on,
[00:57:12.960]provides a menu of different strategies.
[00:57:16.080]And Jason's point is critically important.
[00:57:18.470]There does need to be a mix of things.
[00:57:23.110]The strategies, these are all rated
[00:57:25.872]across a number of different dimensions
[00:57:27.860]that we thought were really important.
[00:57:30.610]The relative effectiveness,
[00:57:32.460]in other words, how well does it work?
[00:57:36.090]That's useful to know.
[00:57:37.460]If it doesn't work, maybe we shouldn't be using it.
[00:57:41.720]Or maybe not prioritizing it as much.
[00:57:45.650]Public health reach, how many students does it address?
[00:57:51.920]The public health reach, and this is where we run
[00:57:55.450]into some challenges with environmental strategies.
[00:57:58.360]Something that's really effective that was recommended
[00:58:01.360]by the college drinking task force, raising taxes.
[00:58:06.300]Is that a popular platform?
[00:58:07.910]Anybody wanna run for political office on that platform?
[00:58:11.290]Probably not.
[00:58:12.780]But it works, and it's happened.
[00:58:15.760]And we've been extremely successful in public health
[00:58:19.950]in raising taxes and reducing tobacco use.
[00:58:26.110]It can happen, it has happened, probably in this state.
[00:58:32.070]You can use the same thing for alcohol.
[00:58:34.930]Challenging work, though.
[00:58:37.510]There are costs associated with these things.
[00:58:40.340]We probably want to use things that are less costly,
[00:58:44.120]rather than more costly.
[00:58:45.760]And there are important barriers to implementation
[00:58:47.640]of all of these.
[00:58:48.473]So understanding what some of those are,
[00:58:50.880]and developing strategies, so it's not that the barriers
[00:58:54.680]are dissuading us from pursuing strategies,
[00:58:58.630]but understanding what those barriers are,
[00:59:01.410]and having a strategy and tactics to address those barriers
[00:59:05.370]and break through those barriers.
[00:59:09.490]The CollegeAIM recommends an approach of assessing,
[00:59:15.320]selecting interventions, planning for them,
[00:59:19.140]planning how to implement them,
[00:59:20.640]and then going out and doing them,
[00:59:22.970]and providing resources for addressing all of those things.
[00:59:26.840]And I'd like to add, as well,
[00:59:31.030]continually evaluating what the success
[00:59:35.420]of those strategies are.
[00:59:39.250]One of the things that we've learned is that,
[00:59:42.360]when you pass a policy,
[00:59:44.490]that's not the end of the story.
[00:59:46.870]You gotta keep making sure that it's doing
[00:59:49.610]what it's intended to do.
[00:59:52.130]And you have to keep evaluating that
[00:59:55.040]and monitoring that over time.
[00:59:57.550]And what often happens is the policy, or the strategy,
[01:00:03.360]needs to be tweaked based on the feedback you're getting.
[01:00:06.830]So if you don't have a mechanism for evaluating
[01:00:10.112]what you're doing, you have no ability to go back
[01:00:14.590]and tweak and make it better and more effective.
[01:00:20.150]Jason mentioned the planning worksheet.
[01:00:24.290]I think this is a really useful part of the tool.
[01:00:28.340]We took five minutes and talked a little bit
[01:00:30.170]about what kinds of things you're doing on your campus.
[01:00:33.520]I would strongly recommend using this worksheet
[01:00:38.070]and going through very systematically,
[01:00:40.890]and spending more than five minutes,
[01:00:43.080]assessing what you're doing on your campus.
[01:00:46.890]And to me, one of the most important parts of this worksheet
[01:00:51.158]is the notes and next steps,
[01:00:54.370]because it asks some critically important questions about,
[01:00:58.560]especially the things that you're already doing.
[01:01:02.070]How can you continue to monitor and make that stuff better?
[01:01:06.600]So it's not just we did it and it's done
[01:01:09.270]and the box is checked.
[01:01:11.650]But you're using those strategies
[01:01:15.769]and implementing them effectively.
[01:01:18.880]And then once you've taken a look
[01:01:20.200]at what you're currently doing, I think a useful
[01:01:28.210]assessment is looking at the CollegeAIM,
[01:01:32.400]seeing what other kinds of things
[01:01:34.010]you might be able to implement,
[01:01:36.000]what makes sense on your campus
[01:01:38.296]and fill out that bottom part in terms of new strategies.
[01:01:45.360]So I think this is moving toward not just,
[01:01:48.850]here's a bunch of recommendations, good luck with those,
[01:01:53.570]toward making them happen on your campus.
[01:01:59.110]And again, I think this Torjman model is really helpful
[01:02:03.860]in thinking about what kinds of things you can be doing,
[01:02:07.320]and where maybe you're focused and doing a lot of stuff,
[01:02:11.840]and where maybe you're not spending
[01:02:14.580]a lot of time and effort.
[01:02:16.630]That is likely influencing the drinking that's happening
[01:02:19.710]among your students, and the negative consequences.
[01:02:25.650]This is the overall look
[01:02:28.975]at the environmental level strategies.
[01:02:32.460]We've got, these are rated by here cost,
[01:02:37.960]and by effectiveness.
[01:02:43.042]And that was done pretty intentionally.
[01:02:46.120]I'd like to highlight this stuff,
[01:02:52.070]thinking about picking strategies
[01:02:55.370]and reinforcing existing strategies
[01:02:58.100]that are effective,
[01:03:01.740]that they actually work, and they tend to be low-cost.
[01:03:06.460]Now one of the exercises for us was to,
[01:03:09.890]when we were developing this,
[01:03:11.410]was to do an assessment of cost.
[01:03:15.440]And that's not super straightforward.
[01:03:18.150]And one could certainly quibble with where
[01:03:21.290]some of these interventions ended up,
[01:03:23.290]particularly on the environmental side,
[01:03:26.350]because they require a lot of public resources.
[01:03:29.896]They require efforts by maybe law enforcement
[01:03:34.120]to enforce some of these things,
[01:03:36.130]at other state agencies, including Liquor Control,
[01:03:39.720]your local licensing board,
[01:03:43.119]an effort that may not be happening.
[01:03:45.690]So these maybe are low-cost from one perspective,
[01:03:49.330]but high-cost in terms of public resources
[01:03:52.230]from another perspective.
[01:03:53.730]And understanding what those are is useful.
[01:03:56.810]But again, I think you should be looking
[01:04:00.850]toward these upper boxes and identifying one or two or five
[01:04:07.220]of these strategies when you're thinking
[01:04:09.970]of implementing a new strategy on your campus,
[01:04:13.870]because these are the things that actually work.
[01:04:18.200]Those include
[01:04:20.690]tough stuff.
[01:04:22.650]Restricting happy hour and prices.
[01:04:26.820]Banning Sunday sales.
[01:04:29.320]In cases where that,
[01:04:33.036]do we have a restriction on days of sale in Nebraska?
[01:04:35.520]No? Not anymore.
[01:04:37.552]Not anymore, how did that go?
[01:04:40.440]You like that law?
[01:04:41.980]We're talking about it in Minnesota right now, actually.
[01:04:44.580]We have a Sunday sales restriction,
[01:04:46.670]and it's an interesting conversation.
[01:04:53.680]Retaining the 21 drinking age.
[01:04:55.620]This has been an ongoing conversation
[01:04:57.530]for the last 10 years.
[01:04:59.170]And you may have run into people who tell you,
[01:05:03.140]well, why don't we just lower the drinking age?
[01:05:04.770]That will solve all of our problems.
[01:05:08.632]Don't buy it.
[01:05:11.840]Enforcing the drinking age.
[01:05:13.998]We've come from a place where the drinking age
[01:05:17.430]has not been enforced to a place
[01:05:20.250]where it's more consistently enforced.
[01:05:23.880]That's a very effective strategy
[01:05:26.330]that has led to some of the decline,
[01:05:27.860]particularly among high school students
[01:05:30.010]in not only in consumption rates,
[01:05:32.500]but a big decline overall in bad outcomes,
[01:05:39.150]like deaths from alcohol-involved motor vehicle crashes.
[01:05:43.680]Increasing alcohol tax.
[01:05:46.000]I didn't see anybody jumping up and down
[01:05:47.590]or running for political office on this platform.
[01:05:51.490]But a very, probably the most effective thing you can do.
[01:05:59.740]Other things, in the environmental strategies,
[01:06:03.910]restrictions on hours of sale.
[01:06:06.450]Most places, most communities in the US
[01:06:09.280]are going the opposite direction.
[01:06:11.250]So a lot of the evidence for this is the counter-evidence.
[01:06:16.540]Work hard to retain your hours of sale restrictions.
[01:06:20.830]Social host is actually one where there's a big increase.
[01:06:24.280]Anybody have social host, is it statewide?
[01:06:27.160]No, not statewide?
[01:06:28.400]Anybody, social host in their community?
[01:06:30.990]Okay.
[01:06:33.160]We just have this in the last three years in Minneapolis.
[01:06:37.850]The police really love this.
[01:06:39.600]It helps them enforce and deal
[01:06:42.690]with some of the unruly houses,
[01:06:45.000]near our campus, in particular.
[01:06:48.750]Dram shop liability.
[01:06:50.630]Alcohol outlet density, there's another one where it tends
[01:06:53.470]to go in the opposite direction in the name
[01:06:56.090]of economic development.
[01:06:58.340]Staying in a hotel down in the Haymarket area.
[01:07:00.817]The first time I was here in Lincoln, it was late '90s.
[01:07:05.140]There was nothing going on down there.
[01:07:07.266]Now it's booming and exciting,
[01:07:10.240]and a lot of it is fueled by alcohol
[01:07:13.384]and the alcohol outlets that are there.
[01:07:18.260]But it also, my understanding, it's led to
[01:07:20.610]a number of problems in addition.
[01:07:23.630]Limiting density of alcohol establishments
[01:07:25.750]is incredibly useful, a very, very difficult one
[01:07:30.100]to try to intervene on.
[01:07:33.480]Enacting RBS training laws.
[01:07:36.090]That's one that's a little bit more low-hanging fruit,
[01:07:39.970]really useful.
[01:07:41.210]I know that here in Nebraska, Linda has worked really hard
[01:07:46.210]on developing online training and packaging that
[01:07:50.240]so it can be delivered effectively to people
[01:07:53.610]who are in the service industry.
[01:07:55.780]If you're not using that program, talk to Linda,
[01:07:59.292]and start making use of that in your community.
[01:08:05.100]Very useful.
[01:08:09.880]So just as an aside, 'cause I have to put in
[01:08:11.640]some of my own work and plug what we're doing,
[01:08:15.420]I work with a group of colleagues
[01:08:19.130]who are expert in alcohol policies,
[01:08:22.080]and evaluated the efficacy and strength
[01:08:24.960]of alcohol policies in the United States.
[01:08:27.950]This was targeting general population,
[01:08:30.910]not just college students.
[01:08:34.750]And we rated about 50 different policies.
[01:08:39.740]The things that we determined were most effective,
[01:08:42.610]and I'm going to the methodology here,
[01:08:45.430]but I'm happy to share that resource with you,
[01:08:49.560]things that are also going to be very effective
[01:08:52.150]for college students.
[01:08:54.586]And partly why I'm bringing this up is there's a lot
[01:08:58.360]of consistency in the evidence and the ratings
[01:09:01.580]of the evidence about what works.
[01:09:04.520]So across this rating,
[01:09:06.520]across the Centers for Disease Control Community Guide,
[01:09:12.870]that's an incredibly useful resource,
[01:09:15.290]and some of the matrix materials
[01:09:18.740]point to resources in there.
[01:09:20.560]If you're not familiar with the Community Guide,
[01:09:23.340]there are two directly relevant pieces
[01:09:26.770]that are available to you as resources.
[01:09:31.810]There's one on excessive alcohol consumption
[01:09:34.430]and there's one on impaired driving.
[01:09:37.380]Both very useful and provide not only the whats
[01:09:41.070]and the summary of the evidence,
[01:09:42.740]but also guidance on how to implement those.
[01:09:46.740]So Google the Community Guide and you will find it.
[01:09:52.750]And similarly, we often think about the youth population,
[01:09:57.760]which many of your college students are falling
[01:10:00.940]into that category.
[01:10:03.160]We have to think of the interventions that we're doing
[01:10:05.220]to prevent underage and youthful alcohol consumption
[01:10:10.087]really differently.
[01:10:12.090]And there are a few strategies that are more particular,
[01:10:17.210]more exclusive to youth, including the drinking age laws.
[01:10:22.070]But by and large, the same kinds of things that prevent
[01:10:25.879]drinking among adults also address youth drinking.
[01:10:29.900]And that gets back to my earlier point about young people
[01:10:33.640]tend to drink like the adults around them.
[01:10:36.200]It's because they're in the same environment
[01:10:38.577]where the same restrictions or lack of restrictions
[01:10:42.690]exists on their consumption.
[01:10:49.100]Let's see.
[01:10:50.590]The other thing is there are things here in this,
[01:10:55.780]high cost, low effectiveness,
[01:10:58.010]or ineffective group of strategies.
[01:11:02.290]Take a look at what those things are,
[01:11:05.210]and maybe start pruning out some of the things
[01:11:08.620]that maybe you're spending a lot of time on,
[01:11:11.540]maybe spending a lot of resources on.
[01:11:14.260]And maybe refocus those on things
[01:11:17.013]that are higher effectiveness.
[01:11:24.030]I talked about developing relationships.
[01:11:28.436]And it's critically important.
[01:11:30.040]One of the things I think that can get us toward
[01:11:33.529]successful implementation of environmental strategies
[01:11:37.370]are knowing who else has some skin in the game,
[01:11:41.220]knowing who else has some self-interest
[01:11:44.020]around the things that you would like to see change,
[01:11:47.722]and understand where they're coming from.
[01:11:51.780]Identify who are people who are allies.
[01:11:56.320]And you're not gonna find maybe anybody
[01:11:59.020]who's always on your side in terms of what kinds
[01:12:03.430]of strategies you might like to implement.
[01:12:06.160]But you'll also find that you may have,
[01:12:09.770]you know, strange bedfellows in some of these areas,
[01:12:14.080]where for example, alcohol outlet owners,
[01:12:19.700]alcohol establishment owners may have vested interest
[01:12:23.350]in helping reduce and keep a lid on
[01:12:27.030]alcohol outlet density, for example.
[01:12:30.120]So develop those relationships.
[01:12:32.890]And you, they have to compete in that environment.
[01:12:37.240]When they are in an environment where there's more outlets,
[01:12:40.380]often what happens is they have to compete with each other,
[01:12:45.301]and it ends up competing on low price and high volume.
[01:12:51.910]Is that a recipe for health and safety
[01:12:54.980]and well-being of your students?
[01:12:59.630]So understand where your allies are,
[01:13:03.130]and who might be opposing you.
[01:13:06.320]So I wanna take another five minutes, very briefly,
[01:13:11.036]and start coming up with a list of allies,
[01:13:15.890]or stakeholders on your campus in your community
[01:13:19.680]who might have an interest in student drinking issues.
[01:13:24.306]Let's start with one.
[01:13:26.670]Identify what you think their self-interests, sorry,
[01:13:30.940]might be, and identify some barriers to engaging them
[01:13:36.210]or taking steps to address student drinking.
[01:13:40.360]So let's take another five minutes.
[01:13:42.730]Start thinking about an intervention maybe you would like
[01:13:46.190]to try and implement,
[01:13:50.502]and who is a stakeholder in that,
[01:13:55.040]has an interest in that strategy.
[01:14:06.020]All right, in the interest of time,
[01:14:08.037]and I understand that I am the person who is standing
[01:14:11.350]in between you and lunch happening at noon.
[01:14:15.730]I do wanna get a few comments, though,
[01:14:20.600]on some stakeholders who you're thinking about.
[01:14:25.480]Anybody have a stakeholder identified
[01:14:29.240]that they want to share with the group?
[01:14:31.530]Yeah, go ahead.
[01:14:32.770]Let Jason get the mic to you, because.
[01:14:36.232]Oh hello, let's go ahead, let's head over here.
[01:14:39.140]Phil.
[01:14:42.350]I'm Derek McConnell
[01:14:43.630]from University of Nebraska-Lincoln here.
[01:14:45.380]Thank you.
[01:14:46.480]One of the groups, or one of the stakeholders
[01:14:48.540]that we've actually worked with and has been very helpful
[01:14:50.740]with us is actually Adam Morfeld, who's a state senator.
[01:14:54.520]So as we were looking at things we could do
[01:14:57.340]possibly with taxes, or along those lines,
[01:14:59.910]nobody, as you said, is going to shout and jump
[01:15:02.220]on that platform.
[01:15:03.280]But he's somebody who we thought we could at least
[01:15:05.560]possibly approach as an idea,
[01:15:07.830]as well as the liquor selling laws.
[01:15:10.210]And we found out those vary by county here in Nebraska,
[01:15:13.520]and how that works.
[01:15:15.500]And tell us a little bit about what,
[01:15:18.010]hang on the mic.
[01:15:19.850]Tell us a little bit about
[01:15:20.683]what the senator's self-interest is.
[01:15:25.230]So the senator is actually a former student
[01:15:27.640]here at the University of Nebraska.
[01:15:29.220]And he's actually done a really good job having us do
[01:15:32.140]the Good Samaritan policy,
[01:15:34.360]which helps people call for help,
[01:15:36.740]even if they are intoxicated themselves,
[01:15:40.230]to get out of like minor possession and whatnot.
[01:15:42.340]And he's actually looking to move that
[01:15:43.800]towards drugs as well.
[01:15:45.510]But he's been really helpful in looking at the policies
[01:15:49.470]that we have.
[01:15:50.303]And he's actually the senator that represents the district
[01:15:53.280]that our campus lies in.
[01:15:56.694]Terrific.
[01:15:59.056]So I mean, you're a constituent.
[01:16:01.770]That's part of the self-interest, most assuredly.
[01:16:05.696]Understand who your government representatives are
[01:16:10.470]and try to figure out if there's an alignment there.
[01:16:14.020]You can make a lot of things happen with relationships
[01:16:17.370]with government officials.
[01:16:19.180]That's their job.
[01:16:21.610]Other, anybody, I picked on this side,
[01:16:24.370]I'll pick on this side.
[01:16:25.840]Yeah, go ahead.
[01:16:27.590]No, right here Jason.
[01:16:29.240]Down one more, down one more.
[01:16:30.910]Like the enthusiasm.
[01:16:33.703]For those not watching at home,
[01:16:35.405]this is a very enthusiastic hand-off.
[01:16:38.542]I'm Geri Cotter,
[01:16:40.460]and I'm with Nebraska Wesleyan University.
[01:16:42.380]So we're located in Lincoln, as well,
[01:16:44.860]where our campus is in more of a residential area.
[01:16:49.080]So our obvious ones are our neighborhood
[01:16:53.070]and business association.
[01:16:55.130]And I would say their self-interest is
[01:16:59.440]their own property values.
[01:17:01.990]So I was thinking of you when you mentioned
[01:17:04.910]your father-in-law in North Dakota.
[01:17:07.680]His house is not worth much.
[01:17:11.610]Yeah, so I think that for us,
[01:17:13.560]those are our stakeholders that we need to work with.
[01:17:17.000]But the business, too.
[01:17:17.833]We have a small business community near us.
[01:17:20.270]Not large, but nevertheless, they also have an interest
[01:17:23.660]in making sure.
[01:17:25.920]Yeah, yeah they sure do, thank you.
[01:17:29.610]One more, this side, somebody.
[01:17:36.085]Somebody who hasn't gone yet.
[01:17:40.590]What were you talking about these last five minutes?
[01:17:45.030]Yeah, go ahead, thank you.
[01:17:51.503]So I think one of the things that we talked about
[01:17:53.080]was the Century Link and really it being
[01:17:56.500]kind of the house for our big
[01:18:00.690]athletic, obviously basketball,
[01:18:03.517]and it being just kind of a pain point for us
[01:18:06.240]because Budweiser is our sponsor.
[01:18:08.800]And I don't think we've ever had the conversation
[01:18:11.580]of yeah, we're probably not gonna stop that sponsorship.
[01:18:16.120]But we've never had the conversation
[01:18:17.770]of how do we do that differently,
[01:18:19.716]because the first thing,
[01:18:21.260]and I don't know if you guys have been to a game there,
[01:18:23.610]first thing right off the bat is the horses,
[01:18:26.260]and you know, the sides kind of like
[01:18:28.990]are filling beer glasses.
[01:18:30.350]So it's just, I think we could have the conversation
[01:18:34.040]hopefully how do we do that differently
[01:18:35.900]and the impact that that has on our students,
[01:18:38.470]but also that social impact.
[01:18:40.930]Yeah, so has the question been raised in your community,
[01:18:45.056]is that an appropriate sponsor for collegiate athletics?
[01:18:50.750]Well, in Student Affairs land, we would say no.
[01:18:53.610]In Athletics land, they would say yes.
[01:18:57.970]So I think that it's just,
[01:19:00.080]I mean it's just this battle of we know that it brings
[01:19:03.530]a lot of money into our world.
[01:19:07.187]But where does that partnership kind of tail off
[01:19:11.460]and how do we work together better?
[01:19:13.170]And we've never been able to sit down at the table
[01:19:15.660]and have a conversation about that.
[01:19:17.590]So I think maybe even posing the question
[01:19:21.220]of how do we do this differently
[01:19:22.930]with our athletics marketing and with Budweiser,
[01:19:26.280]I think is important.
[01:19:28.070]So hang onto that mic for just one second.
[01:19:30.070]You jumped in, I'm gonna keep asking you questions.
[01:19:33.300]So what's the Athletic Department's self-interest there?
[01:19:37.687]And maybe it's obvious.
[01:19:40.870]What's their self-interest.
[01:19:43.620]I think it's both sponsorship,
[01:19:46.210]but it's also pulling people in.
[01:19:48.800]It's the audience and knowing that the Century Link,
[01:19:54.590]we don't own that, and that's not something
[01:19:57.020]that we necessarily can say,
[01:19:59.390]I mean maybe we could.
[01:20:00.430]But we can't say like out of all collegiate events,
[01:20:03.890]does the beer sales, or you know, the spirit sales,
[01:20:08.830]does that shut off?
[01:20:10.870]I don't know if that question has ever been posted.
[01:20:14.660]Big-time collegiate athletics,
[01:20:17.499]they are under enormous pressure to raise money.
[01:20:23.340]And they don't necessarily take some of these issues
[01:20:27.920]into consideration when they're going out
[01:20:29.980]and developing sponsorship relationships.
[01:20:33.020]I actually am neighbors with the guy who does that work
[01:20:38.950]for the University of Minnesota.
[01:20:40.510]And they have, in my opinion,
[01:20:43.530]some questionable relationships with sponsors.
[01:20:46.800]So how do you even raise that question and say,
[01:20:51.022]hey Greg, is that an appropriate sponsor
[01:20:53.450]for University of Minnesota athletics?
[01:20:56.990]And that's a place where we can start.
[01:20:59.750]And I think the answer to that question will depend a lot,
[01:21:05.890]and vary a lot, depending on what your perspective is,
[01:21:11.010]and where you're coming from.
[01:21:14.642]That would also, I think, impact the culture
[01:21:18.368]and tradition on campus, which I think is a whole
[01:21:20.991]different and separate conversation.
[01:21:25.892]You wanna try to make a major change on a campus
[01:21:29.647]as if that (words drowned out by coughing) on campus.
[01:21:35.510]You might as well have an act of God.
[01:21:40.296]Could you repeat the comment for the--
[01:21:41.129]Yeah, so the comment is that situation
[01:21:45.220]and that relationship for a university,
[01:21:47.610]correct me if I'm wrong, mischaracterizing you.
[01:21:50.260]That really helps set a culture in a community
[01:21:55.180]among fans of collegiate athletics,
[01:21:58.390]among students and student fans and student athletes.
[01:22:04.290]What's Budweiser's self-interest in that relationship?
[01:22:10.220]Anheuser-Busch.
[01:22:13.680]They wanna promote that culture.
[01:22:16.890]They have a fine line to walk in terms of what's responsible
[01:22:20.357]and what's acceptable for public opinion and what's not.
[01:22:24.763]But that's their self-interest.
[01:22:27.360]And it's not a static relationship.
[01:22:30.320]That culture exists and it's the same over time.
[01:22:37.460]The reason that Anheuser-Busch is involved
[01:22:41.170]in that relationship is that they're trying to push
[01:22:43.662]the culture of drinking, the culture of acceptance,
[01:22:46.980]the normative culture around purchasing
[01:22:50.870]and consuming their product in the other direction.
[01:22:55.130]And that's dangerous for the health and safety
[01:22:58.530]of our communities.
[01:22:59.610]That's the balance.
[01:23:01.480]So inserting health, inserting safety
[01:23:04.920]into that conversation.
[01:23:07.200]And where the rubber meets the road here
[01:23:08.960]is in the Athletics Department, but in this particular case,
[01:23:13.550]it's a challenging, challenging issue.
[01:23:16.530]But starting by raising the question, I think,
[01:23:18.740]is a good place to go.
[01:23:24.962]I'm talking a little bit about how I tend to frame
[01:23:27.910]environmental strategies coming from a public health
[01:23:31.010]perspective, a population perspective.
[01:23:34.850]I think it's critically important to re-frame
[01:23:39.011]environmental strategies.
[01:23:40.987]That's something that, oh, that's impossible.
[01:23:44.210]Or oh, I don't wanna go there.
[01:23:45.680]Or oh, it'd be much easier to do the things
[01:23:49.960]that we've been doing,
[01:23:52.412]to a point where we're talking about these strategies
[01:23:56.460]in a real and different way.
[01:24:01.010]One of the ways that I talk about implementing policies,
[01:24:05.570]which are a lot of the environmental strategies,
[01:24:09.300]is that our policies are our community standards.
[01:24:14.660]These are the behaviors, the ways of operating
[01:24:18.880]that we expect in our community.
[01:24:25.390]The drinking behaviors that cause problems
[01:24:29.430]are not generally acceptable to most people
[01:24:32.680]in your community.
[01:24:36.360]Bringing them out into the light of day is useful.
[01:24:41.370]One of the amazing images that I remember
[01:24:46.130]from here in Lincoln was
[01:24:51.050]the video from the street posts of bar closing time
[01:24:55.687]and the streets in downtown Lincoln
[01:24:58.510]and what that scene looks like.
[01:25:02.020]And I know elected officials and neighbors
[01:25:05.940]and administrators at this university were horrified
[01:25:10.930]by what was going on at that time.
[01:25:13.670]But nobody really knew.
[01:25:16.210]Bringing stakeholders along on a police ride-along
[01:25:21.290]is a very eye-opening experience.
[01:25:25.370]Understanding what's happening
[01:25:28.140]and saying, this is not
[01:25:32.280]acceptable, it doesn't meet our standards in our community.
[01:25:41.700]Making your approach align
[01:25:43.730]with your university's mission statement.
[01:25:49.270]Generally there's some language in there,
[01:25:51.270]most universities, about learning,
[01:25:54.970]and performance and growing and development.
[01:25:58.520]Alcohol is a major impediment
[01:26:02.280]to reaching those and addressing those missions
[01:26:07.550]of your universities.
[01:26:10.370]Aligning that and talking about your approach
[01:26:13.880]to dealing with alcohol as consistent
[01:26:17.370]and a part of your university's mission statement,
[01:26:20.740]whatever it may be.
[01:26:22.310]Surely many of the strategies that you'd like to take
[01:26:27.580]that are effective, that work,
[01:26:29.760]are going to align really directly
[01:26:32.440]with your university's mission statement.
[01:26:34.880]It makes it harder for people to argue against you,
[01:26:40.914]because those are about consistent and shared values.
[01:26:47.550]It's hard to say, well, we don't really care
[01:26:50.520]about learning here at this university.
[01:26:53.560]And therefore we don't really care about a major impediment
[01:26:57.120]to student learning and development.
[01:27:01.460]Start aligning how you talk about these issues
[01:27:04.650]with your university's mission statement.
[01:27:07.680]Talk about those standards early and often.
[01:27:10.340]And talk about them with student groups.
[01:27:14.800]Identify what student values are.
[01:27:17.980]Generally speaking, and there may be some exceptions,
[01:27:21.610]but students don't value necessarily opportunities
[01:27:26.710]to throw up.
[01:27:28.650]They don't value opportunities to get in a fistfight.
[01:27:33.260]They don't value opportunities to be vulnerable
[01:27:37.370]to sexual assault.
[01:27:40.330]They do value socializing.
[01:27:43.420]They do value learning.
[01:27:46.230]So talk with them about standards for behavior
[01:27:50.240]that help them get to what their goals are.
[01:27:56.870]And engage students in identifying what those standards are.
[01:28:01.060]Even students, by and large, will not say it's acceptable
[01:28:06.960]for large packs of roving students to be out
[01:28:11.860]and vomiting in neighbors' yards or peeing in their bushes.
[01:28:18.670]Most students don't think that's okay.
[01:28:20.690]Most students don't think it's okay to have
[01:28:23.790]the sink in their residence hall broken
[01:28:26.810]and mirrors smashed and vomit in their bathrooms.
[01:28:32.950]Those are standards to which we can all agree on.
[01:28:37.240]And how do you get to those standards?
[01:28:42.410]So if we think about policies as the standards to which
[01:28:45.500]we're holding ourselves, our community, our students to,
[01:28:49.320]enforcement is the piece that helps make them accountable
[01:28:53.550]to those community standards.
[01:28:56.480]Students often complain about being targeted by enforcement,
[01:29:01.520]by police.
[01:29:03.767]But there's a real disconnect between the enforcement
[01:29:08.090]activities by the appropriate law enforcement officials
[01:29:13.600]and making them accountable to what the standards are.
[01:29:19.400]And maybe even helping police reframe,
[01:29:22.080]law enforcement agents reframe their enforcement activities
[01:29:26.859]around community standards,
[01:29:29.180]what's acceptable, what's okay in our community.
[01:29:33.300]It's not okay that, you know, young woman are vulnerable
[01:29:37.890]to being sexually assaulted.
[01:29:42.380]So what do we do to make people accountable
[01:29:45.450]to those standards?
[01:29:49.740]There's both formal and informal mechanisms of enforcement.
[01:29:54.150]It's critically important to communicate
[01:29:56.500]about enforcement efforts.
[01:29:59.150]Very successful approach that's happened
[01:30:02.360]at the University of Nebraska-Lincoln campus has been
[01:30:06.930]early in the year,
[01:30:10.110]police patrols out in the neighborhoods,
[01:30:12.750]and letting students know that those are happening.
[01:30:16.310]And that tends to keep a lid on some of that activity.
[01:30:21.059]Makes it less blatant, less likely to be out in yards,
[01:30:25.950]out in the streets, drunkenness.
[01:30:31.320]Enforce those standards for people who supply alcohol,
[01:30:36.700]as well as people who are consuming it.
[01:30:40.250]Alcohol is no ordinary commodity.
[01:30:43.890]We have special regulations
[01:30:45.590]because it is a dangerous product.
[01:30:49.620]So enforcing the standards for people
[01:30:52.150]who are supplying alcohol,
[01:30:54.240]so they're not serving people who are already intoxicated,
[01:31:00.450]which is a challenging law to enforce.
[01:31:03.630]Making sure that they understand that they have a role
[01:31:06.840]in enforcing the standards of our communities.
[01:31:11.540]And moving away from this bad apples approach.
[01:31:18.720]Gonna skip over this.
[01:31:20.780]And, we have two minutes
[01:31:25.170]before lunch, so I don't want to get in the way of that.
[01:31:29.700]But I do think this is a critical activity.
[01:31:32.180]So I want you to think about this as you are
[01:31:37.050]moving toward lunch, and as you go back to your communities.
[01:31:41.240]Think about developing your pitch for
[01:31:45.850]an environmental strategy
[01:31:47.300]that you'd like to see implemented.
[01:31:53.470]And this is an important tactic
[01:31:55.590]for business school students, entrepreneurs,
[01:32:00.680]people who are trying to advocate for an idea.
[01:32:05.120]I think we can draw on some of those same kinds of skills.
[01:32:09.200]And this is something that we teach our students
[01:32:11.330]in our legislative advocacy courses for public health.
[01:32:16.820]Develop that elevator talk.
[01:32:18.630]So if you happen to run into your senator,
[01:32:22.250]your government official, and you have that minute
[01:32:25.680]and 30 seconds, maybe when you're riding the elevator
[01:32:28.260]with them, that's where the elevator pitch comes from,
[01:32:33.040]be ready for those opportunities to present themselves
[01:32:37.470]with the ability to advocate.
[01:32:40.130]And that's not a 10-minute diatribe.
[01:32:46.250]It's literally 60 seconds, 90 seconds.
[01:32:51.070]Hone it down and practice that.
[01:32:54.180]Practice it on your colleagues.
[01:32:57.100]Develop that pitch for why this is a good idea.
[01:33:00.660]'Cause you're gonna have to sell these ideas to people
[01:33:03.790]who aren't buying.
[01:33:06.800]And it's a tough sell.
[01:33:10.410]Here are the quick outlines of what we recommend
[01:33:13.160]in public health policy.
[01:33:15.620]Tell people who you are, what you want to accomplish,
[01:33:19.140]how your approach is different than what's being done.
[01:33:24.372]Uh oh.
[01:33:28.350]Why it might work, and what you want them to do.
[01:33:34.000]And I have this link up here.
[01:33:35.450]This is an online tool that was developed
[01:33:39.520]by the Harvard Business School for students
[01:33:42.380]to develop product pitches.
[01:33:46.220]And you can actually write a script and run it through that
[01:33:50.160]and get some feedback on what your pitch is
[01:33:55.190]to make it more effective.
[01:33:57.260]And I would strongly recommend you using that tool.
[01:34:01.360]We have our students at the University of Minnesota
[01:34:04.170]do exactly that for one of their assignments.
[01:34:07.220]And it's really hard.
[01:34:09.750]And it's hard for our students to go and talk to people
[01:34:13.956]and make a pitch, even for something
[01:34:17.610]they are desperately passionate about in public health.
[01:34:22.200]But it's a critically important skill
[01:34:24.440]and one that I strongly recommend to you.
[01:34:27.510]So I'm just gonna end on advocating for doing that.
[01:34:34.850]These resources are available to you in the slides.
[01:34:39.430]I'll be taking questions and comments later.
[01:34:42.560]And I do also have a couple of recommendations
[01:34:45.310]for resources for you that you can use to refer to
[01:34:50.070]when you go back home.
[01:34:51.150]In addition to the CollegeAIM environmental strategies,
[01:34:54.390]that worksheet, I strongly recommend you work through that.
[01:34:58.124]I recommend this book, Organizing for Social Change.
[01:35:02.770]A lot of very practical things to do.
[01:35:06.669]And you can purchase this book,
[01:35:09.310]I don't get any money for this,
[01:35:12.103]through this website.
[01:35:15.320]This is my book, I do get money for this
[01:35:19.039]on Preventing Binge Drinking on College Campuses.
[01:35:22.240]We tried to make this book really different,
[01:35:24.240]and this is working with my colleague Ken Winters,
[01:35:27.392]focusing on how do you make these environmental change,
[01:35:33.290]recommended environmental strategies happen,
[01:35:36.720]and connecting people with resources and examples
[01:35:40.870]of where people have effectively done this in the past.
[01:35:48.413]And some resources from the old place
[01:35:50.945]on the College Alcohol Study,
[01:35:52.840]and the Matter of Degree Evaluation,
[01:35:54.990]which University of Nebraska at Lincoln was part of,
[01:35:58.720]a critical leader within that program.
[01:36:02.460]There's some resources on that website as well.
[01:36:05.530]And with that, it's two minutes over, my apologies.
[01:36:11.150]And I think we have lunch.
[01:36:13.180]Do we have any instructions for lunch?

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National Institute on Alcohol Abuse and Alcoholism’s College Alcohol Intervention Matrix 3 of 5

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