University of Tennessee

The Problem

In 2002, the Princeton Review identified the University of Tennessee (UT) as the number one party school in America. While this designation was not determined by research-based methods, it did correspond with concerns on campus. In response to this report, the university implemented the Fall Prevalence Survey in 2004 to assess the campus’s drinking culture. At the time of the survey, UT had a heavy-drinking rate of 48 percent, and a frequent heavy-drinking rate of 27 percent. Additionally, students reported a host of negative experiences including 33 percent missed classes, 36 percent had memory loss, 57 percent vomited, 26 percent performed poorly on a test, and 59 percent had a hangover.

While drinking behaviors at UT were elevated compared to regional rates, students’ perceptions of the environment were even more exaggerated. Ninety-six percent of students believed that students consumed alcohol once a week or more and they also believed the typical student consumed eight drinks per occasion. The survey also indicated that the environment was conducive to alcohol misuse. Sixty-six percent “did not know if the campus had an alcohol prevention program,” 48 percent reported that they “did not abide by the university alcohol policy,” and 61 percent reported “the alcohol policy was not consistently enforced.” After accepting these alarming indicators, the university acknowledged the nature and scope of the alcohol problem and sought ways to address it by organizing the Safety, Environment, and Education (SEE) Committee.

New Structure to Address the Problem

The committee found that the university lacked an organized, coherent, and focused effort to address alcohol abuse prevention. Through attendance at national meetings and consultation with leaders in the field, committee representatives identified that many campus-based prevention programs struggled with elements of program design. Prevention specialists were often buried in university hierarchy, limiting program implementation and decreasing effectiveness. In this approach, a particular office on campus was responsible for prevention.

The SEE Committee chose to challenge this model by proposing a new approach to the campus’s prevention infrastructure. Under the SEE model, the center director would serve on the vice president for student affairs’ directors team, report directly to the vice president, communicate laterally with other directors such as counseling services and health services, and provide information, education, and services down to coordinators. This model would allow for more direct collaboration within student affairs and emphasize that prevention efforts are the responsibility of the entire university.

The SEE Committee presented this model to the chancellor and gained support to fund the Safety, Environment, and Education (SEE) Center. One clear advantage of initiating the new program was the opportunity to implement evidence-based programs based on the tiers of effectiveness identified in A Call to Action: Changing the Culture of Drinking at U.S. Colleges (National Institute on Alcohol Abuse and Alcoholism, 2002).

Strategic Planning

The strategic plan began with a thorough needs assessment and problem analysis in order to understand the university’s issues and identify the most appropriate strategies to address the campus’s needs. Since SEE was a new program, it chose to be very deliberate in setting prevention goals and selecting interventions. The strategy would be to “do a few things very well” rather than initiate more programs than could be implemented with fidelity.

The assessment found that many students (60 percent) consumed alcohol in their residence halls and that different residence halls had various patterns of policy violations. Some halls had as few as 20 policy violations per year while other halls had more than 300. The consistency of policy enforcement was not random, but coincided with particular residence hall reputations. There appeared to be two patterns of policy enforcement. The first pattern consisted of large amounts of policy violations in the fall semesters followed by fewer policy violations during the spring semesters. Students viewed these halls as “safe” and “mild” environments and they felt policy was enforced. A different pattern emerged from the second group of halls. In these halls, there were few violations during the fall and many policy violations in the spring. Students viewed these halls as “unsafe” and “wild” environments, with the perception that staff were not consistently enforcing policy. Recognizing this strong undercurrent of inconsistent policy enforcement, it was not surprising that 48 percent of students reported that they “did not abide by the university alcohol policy” and 61 percent reported, “the alcohol policy was not consistently enforced.”

Interventions

The SEE strategic planning sessions resulted in the initiation of two distinct interventions: enhanced training of UT residence hall staffs and a five-component social norms media campaign.

Residence Hall Staff Training

Surprisingly, the enhanced training of residence hall staff was rather simple. It utilized the common practice of hall director (HD) and resident assistant (RA) trainings. Previous trainings of residential staff consisted of providing information on how to care for intoxicated students.

The SEE Committee chose to take a different approach. It informed the HDs and RAs of the patterns of policy enforcement and the subsequent outcomes. It emphasized that consistency of enforcement early in the year set a tone on campus and predicted better community outcomes throughout the year. Conversely, inconsistent enforcement during the fall semester led to more policy violations and lower satisfaction by HDs, RAs, and residents.

This simple intervention led to dramatic outcomes. With increased consistency of enforcement, significant changes occurred with the student perceptions of the campus climate. According to the 2004 survey, when asked if the campus had alcohol policies only 29 percent of students who responded reported that they were aware of the policies in 2004, but this number jumped to 93 percent in 2005 and 99 percent in 2006 after the staff training sessions. Likewise, student perception of policy enforcement increased to 73 percent in 2006 up from 52 percent in 2004 and 54 percent in 2005.

Social Norms Media Campaign

To address UT students’ misperceptions of alcohol use, the SEE Center implemented a five-component social norms media campaign. The campaign’s goal was to decrease exposure to messages that reinforced unhealthy perceptions regarding college alcohol use and to increase exposure to messages that corrected these beliefs with five distinct components.

The first component consisted of efforts to reduce exposure to negative messages. The UT’s student newspaper had a history of selling ads from area bars catering to college students. Many of these ads encouraged high-risk drink specials promoting large amounts of alcohol for a minimal price. SEE Center staff had several meetings with the newspaper’s board of advisers to express concerns about the effect that these advertisements could have on student perceptions and subsequent behaviors. In addition to collaborative discussions, SEE Center staff informed the newspaper advisers that they would continue to monitor the percentage and severity of the alcohol advertising. The result was a significant reduction in the severity and frequency of these types of ads. The percentage of alcohol-related ads decreased from 16 percent in the summer of 2005 to 11 percent in the fall of 2005 to 6 percent in the spring of 2006.

After successfully reducing the amount and severity of negative information that reinforced unhealthy norms, the SEE Committee began to craft media campaigns to reinforce healthy norms. The second component added a health and safety session during orientation in 2005. The focus of the presentation was to provide new students with accurate information regarding the healthy norms of UT’s students. The third component consisted of placing a poster highlighting normative healthy drinking behavior in each residence hall room upon the students’ arrival on campus. The SEE Committee identified a common experience as its fourth opportunity to provide accurate normative information to impressionable incoming students. Approximately 50 percent of UT’s students participate in a first-year studies course. During the first-year studies course, students were required to complete an online alcohol and drug education assignment, which included normative information and individualized feedback. The fifth component consisted of utilizing the campus newspaper by placing healthy ads that countered the advertisements by the bars and restaurants. Two advertisements were placed in the newspaper each week highlighting the healthy behaviors of the majority of students.

Through the implementation of the social norms media campaign, the SEE Committee observed significant reductions in UT students’ perceptions of drinking behaviors on campus. The average number of drinks students perceived the typical student to drink in a week decreased from eight in 2004 and 2005 to five drinks in 2006.

Evaluation and Outcomes

UT has conducted annual prevalence surveys since 2004. Using e-mail solicitation to a Web-based survey, the surveys gets close to 1,000 responses per year. The method included incentives upon completion of the survey and random drawings. The survey consists of nationally comparable items including high-risk drinking, frequent high-risk drinking, perceptions, and negative consequence scales.

Significant Improvements After Two Years

While the 2005 alcohol use prevalence rates were consistent with the previous year, something interesting happened in 2006. After two full years of enhanced residence hall staff training and a full year of the five-component social norms media campaign, there were significant reductions in both heavy-drinking rates and frequent heavy-drinking rates. Heavy-drinking rates decreased by 27 percent and frequent heavy-drinking rates decreased by 44 percent. These trends continued in 2007 resulting in total reductions since program implementation of 35 percent (heavy drinking) and 53 percent (frequent heavy drinking).

Keys to Success

During strategic planning, the SEE Committee identified variables that shaped UT’s culture, but may be difficult to influence. For example, while the bar scene and football tailgating contributed to risk in the UT environment, these issues might not be “malleable.” The SEE Committee used the term “malleable” to mean situations that were likely to be positively influenced by interventions at this time. These issues were too large and complex for the SEE Center to intervene with successfully. Staff identified these issues in the long-term plan, but determined that applying limited resources to these concerns now would detract from the resources that could be appropriated to the selected interventions.

The SEE Committee was very deliberate in the strategic planning process to identify evidence-based strategies to achieve their specific goals. That process allowed the committee to implement “a few things very well” rather than a plethora of interventions marginally. The committee was deliberate in the implementation of “malleable” variables. The strategic plan intentionally identified a small number of “selected” interventions based on the campus-specific assessment. The SEE Committee based the selection of “selected-malleable” interventions on these three criteria:

• met campus specific need;
• had current capacity to influence the topic area; and
• harmful behavior or negative consequences could be reduced through successful implementation.

Inherent in this approach is the commitment to stop doing things that marginalize efforts and resources toward the selected interventions. A necessary aspect of this system of prevention is to say no to external requests for prevention resources and time to projects outside of identified interventions. Another important component is to establish stakeholder buy-in to selected interventions so their actions or requests do not impede the prevention programs.