The Influence of College Environments on Student Drinking
Introduction
During the last 30 years, the amount of research and theory related to the prevention of alcohol and other drug use has increased substantially. As noted by Gonzalez in section III, this increase in attention has not always been well focused or systematic. Most alcohol and drug-related studies have simply described current rates and patterns of use. A second category of studies has focused on identifying precursors and predictors of adolescents' drinking and drug use. These etiological studies, for the most part, have been fragmented and atheoretical. In general, this research has not provided practitioners with consistent direction to design effective alcohol and other drug prevention programs. Thus, the development of preventive interventions has proceeded somewhat separately from that of descriptive etiological research.
At the national level, the most comprehensive and influential prevention research to date has addressed cigarette smoking among junior and senior high school students. Despite the fact that alcohol is consumed and abused by more students than any other substance (Johnston, O'Malley & Bachman 1989), prevention of alcohol use among youth has received considerably less systematic study. This dearth of studies may be due to a cultural bias that does not define alcohol as a drug but rather views alcohol consumption as an accepted aspect of social behavior (instead of a significant health hazard). Studies over the past 20 years reveal that, regardless of structure or approach, preventive interventions to date have been least effective in modifying rates of alcohol use (Moskowitz 1989; Rundall & Bruvold 1988).
This article reviews the development of current approaches to alcohol and other drug prevention; what has been learned in the last 30 years about the effectiveness of these programs; current directions in the prevention of alcohol and other drug use; and critical elements in building effective prevention programs for the future as suggested by theory, research, and practical experience.
The Development of Current Prevention Strategies
Whether explicit or implicit, a progression of different assumptions can be detected underpinning strategies developed in the last 30 years to reduce or eliminate alcohol and other drug use among young people (Jones 1990). Each of the general strategies described below encompasses its predecessor. Each strategy is still in use. The strategies grow increasingly complex as prevention researchers recognize and attempt to address the increasingly broad range of influences that are shown to affect alcohol and other drug use.
Overview of Existing Prevention Strategies
The earliest preventive interventions were based on an atheoretical and somewhat simplistic faith in human rationality. These programs were based on an assumption that if individuals were given accurate facts about the harmful effects of alcohol and other drugs, those individuals-regardless of their circumstances-would reduce or avoid drug use because it was in their own best interest to do so. Research has not supported this straightforward idea of rational self-interest. Evaluations of this generic information-only or awareness model have led to one of the very few universally agreed-upon facts in the prevention field. That is, for the vast majority of individuals, simple awareness through passive receipt of health information is not enough to lead them to alter their present behavior or reduce their present or future use of drugs (Goodstadt 1986; Polich, Ellickson, Reuter & Kahan 1984; Rundall & Bruvold 1988; Tobler 1986).
Another early strategy for alcohol and drug prevention was based on the individual deficiencies model (also called the attitude change model). This model is based on an assumption that individuals use alcohol and other drugs primarily to compensate for lack of self-esteem, lack of effective decision-making skills, or lack of positive personal values. Prevention programming, therefore, focuses on addressing these psychological deficits. Affective education is one name often given to this preventive strategy. The content of such programs includes information about the effects of alcohol and drugs but focuses primarily on activities to build self-confidence, self-reliance, and a positive self-image. Values clarification is a frequent focus. Exercises focus on making "good" (that is, drug-free) decisions about future personal behavior. The goal of such efforts is to change the attitude of the individual toward himself or herself and toward drug use. It is assumed that, with the protection of anti-drug attitudes, drug-free behavior will naturally follow.
Although this rationale is appealing, evaluations of programs based on affective education, values clarification, attitude change, and decision making have not provided much support for the effectiveness of this approach (Mauss, Hopkins, Weisheit & Kearney 1988; Schaps, DiBartolo, Moskowitz, Palley & Churgin 1981; Tobler 1986). First, attitudes have proven to be extremely resistant to change (Rundall & Bruvold 1988). Second, a great deal of research has shown that attitudes do not have a predictable relationship-and sometimes have no relationship at all-to behavior (Wiker 1969). Two persuasive studies in the 1980s showed that significant positive changes in alcohol and other drug use behavior can occur with no detectable change in adolescents' attitudes (Resnick 1983; Tobler 1986). Particularly for still-developing youth and adolescents, attitudes are not the most powerful influences that shape or control behavior. A recent paper on adolescent behavior suggests why values clarification and decision-making training alone may not benefit many youth.
The [student] who learns systematic decision making may make a health decision but be unable to later carry it out under environmental pressure. Learning how rational decisions are made (i.e., "I have decided not to sleep with anyone until I am married") may be easily achieved in a classroom setting. Subsequent ability to behaviorally resist the passionate pressure to sleep with a boyfriend or girlfriend may be, however, much more difficult (Duryea, Ransom & English 1990, p. 176).
Although the example here concerns sexual behavior, it is clear that alcohol and drug use, too, are strongly affected by social context, biological and emotional needs, and both real and imaginary pressure from peers and others. Interventions aimed solely at developing healthy attitudes do not take such environmental pressures into account.
The best articulated, best tested, and most elegant theory now available to drug prevention programmers is Bandura's social learning theory. This theory shows clearly why changing an individual student's attitudes is not enough to bring about effective and lasting avoidance of alcohol and other drug use (Bandura 1986; 1989). Social cognitive theory is based on the idea that human behavior is the result of a complex and reciprocal interaction between both personal and environmental factors. According to this theory, a person's beliefs, thinking processes (cognition), and emotions-which taken together are what we call attitudes-both result from and influence his or her external environment. A given behavior results from the combined effects of the environment and an individual's attitudes. Thus, even when an individual's attitudes remain stable (and they rarely do, particularly when the individual is still growing and developing), different environments and different situations can result in very different behavior from that same individual.
In the mid-1970s, prevention as a field of scholarly study entered a period of rapid development. For the first time, relatively sophisticated theory and findings from research in social and cognitive psychology, including the work of Bandura, and from persuasion and communications theory were used to plan new approaches to alcohol and drug prevention. Interest in using tested theories about human behavior in designing prevention programs grew from an expanding appreciation of the complexity of factors that influence human behavior. Developmental research shows that normal development leads children to turn increasingly to peers as they grow into adolescence. In addition, survey data clearly show that youths' alcohol and other drug use is unmistakably and strongly associated with the alcohol and other drug use occurring among friends and peers in social settings.
The prevention approach that developed in the late 1970s and early 1980s is based on a social influences model. The underlying assumption is that alcohol and other drug use for young people is primarily a social behavior strongly influenced by social motives, including both overt and covert pressure from friends and others to conform to group norms. The need to fit in and be accepted by peers is strong in adolescence. As social contexts change, all youth-not simply those who lack self-esteem or decision-making skills-are susceptible to being influenced (or pressured through actual or imagined social norms) into using alcohol and other drugs regardless of those youths' previous attitudes towards these substances. The work of McGuire (1961), Bandura (1977), and followers of B. F. Skinner and behavior modification researchers (Kazdin 1975) all contributed to the design of this new preventive approach to address the effects of social pressure.
In general, the preventive strategy developed from the social influences model is to "inoculate" youth against the effects of social pressure by equipping them with the cognitive and behavioral skills to recognize and resist such pressure. Although specific inoculation programs vary in emphasis, interventions based on this strategy have had five core components:
Most tests of the inoculation strategy used in alcohol and other drug prevention efforts have occurred in junior and senior high school classrooms. This preventive approach of incorporating direct cognitive and behavioral skills training and behavioral skills practice can achieve at least short-term success in reducing the overall rates of cigarette, alcohol, and marijuana use among school-attending youth who are not already heavy users of these substances (Battjes 1985; Bell & Battjes 1985). One important criticism of the inoculation strategy raised by evaluation researchers is that inoculation interventions by themselves often seem to produce only short-lived or temporary effects. Without regular refresher programs or boosters, effects of successful school-based inoculation training programs have been found to disappear after 1 to 2 years (Flay 1985; Iverson & Kolbe 1983; Walter, Hofman & Connelly et al. 1985).
Finally, although programs using the social inoculation strategy have produced unmistakably positive effects in reducing high school students' use of cigarettes and marijuana, the success of the strategy in reducing alcohol use is less clear. It is agreed that social inoculation programs can successfully correct misinformation about the prevalence of drinking among same-age peers, can teach youth to recognize social pressure, and can teach the cognitive and behavioral skills necessary to resist the pressure to drink. However, critics state that correcting this misinformation does not reduce students' drinking (Mauss et al. 1988; Moskowitz 1989). As one of the most critical research groups concluded, these variables make such a small independent contribution to drinking behavior that it is unlikely [that] even a highly successful classroom intervention directed at these variables would do much to prevent alcohol use or abuse by youth (Mauss et al. 1989, p. 51).
In summarizing the historical development of alcohol and other drug prevention approaches, it is apparent that the information-only, individual deficiencies/attitude change, and social inoculation methods have relied heavily on theories from clinical, social, and educational psychology. The net effect has been that these prevention models and the preventive intervention strategies emerging from them have aimed at influencing only individuals and individual behavior and not the wider environment or the social context in which behavior occurs. Although positive effects from these models, particularly the inoculation model, have been documented, these prevention strategies have been open to the criticism that they are only effective with some youth-usually those at lowest risk for problem substance use-and that the effectiveness is often short lived.
Current Directions in Prevention Theory
The most recent developments in prevention theory and program development involve recognition of the critical importance of the environment in shaping and maintaining individuals' behavior. This emerging preventive approach might be called the ecological or person-in-environment model. Interventions based on this model have multiple components and are designed to address both individuals and the policies, practices, and social norms that affect them on campus or in the community. The following activities are conducted to influence as many components of the individual's environment as possible: dissemination of drug information; cognitive and behavioral skills training for youth, parents, and professionals; mass media programming; development of grass-roots citizen interest groups; leadership training for key organization and community officials; policy analysis and reformulation; and many other activities. These events are incorporated in different ways with varying target groups at different times in a comprehensive, communitywide prevention campaign. College campuses may be uniquely suited to the person-in-environment approach because they are relatively self-contained environments. In many instances, students live on campus, work on campus (either studying or in paid employment or both), and socialize on campus. There are few other environments that encompass (and thus may address) so many important aspects of an individual's life concurrently.
Prevention activities based on the comprehensive, person-in-environment model incorporate a broad range of theories. Although the social influences/social inoculation model draws heavily on the field of psychology (with its emphasis on individual behavior), the person-in-environment approach draws heavily on public health and organizational change theory. The approach draws from social marketing theory, organizational development theory, community organization theory, and diffusion-of-innovations theory (Bracht 1990; Glanz, Lewis & Rimer 1990; Green & McAlister 1984; Lefebvre & Flora 1988; Parcel, Simons-Morton & Kolbe 1988; Rogers 1983).
A review of prevention programs from the past 30 years shows that no single approach has been found that works in all environments and with all populations. The current thinking is that the best approach is to combine a variety of theories and methods to achieve the desired goal (see, for example, Gonzalez' ITMADP model discussed in section III). The person-in-environment model blends theories of individual behavioral change with theories of organizational change to accomplish broad-scale, and potentially more enduring, effects (Gilchrist, in press). The aims of these programs are to bring about and sustain individual behavioral change with changes in the social or organizational environment. Thus, these preventive approaches incorporate interventions that are long term and sustained, rather than short term and time limited. In addition, rather than relying on a single set of prescribed procedures and materials, these programs make use of a phased menu of different intervention options that can be combined or tailored to fit specific locales and circumstances (Bracht 1990; Glynn, Boyd & Gruman 1990).
The development of person-in-environment alcohol and other drug prevention programs are but one segment of a rapidly expanding field of comprehensive health promotion and disease prevention. Experts in this field, as well as drug prevention specialists, have become increasingly concerned with human ecology (the influence of the social environment on behaviors) and with the validity of programs designed to change human behavior. As illustrated in the discussion on the person-in-environment approach, the ecological perspective "assumes that appropriate changes in the social environment will produce changes in individuals, and that the support of individuals in the population is essential for implementing environmental changes" (McLeroy, Bibeau, Steckler, & Glanz 1988, p. 351). Ecological views of campus environments are highlighted by Kuh in section IV.
As noted by Glanz et al. (1990), five distinct sets of factors interact in complementary ways in the ecological perspective:
If one could create a social environment where positive social influences regarding alcohol use predominated, then there would be little need to attempt the difficult task of trying to train the ultimate social animal to resist social influences as is currently in vogue in many "just say no"-type prevention programs (Moskowitz 1989, p. 78).
In fact, several research groups have noted that regardless of the prevention model ostensibly being tested, all successful drug prevention programs may have been aided by the growing, societywide disapproval of drug use, particularly cigarette and marijuana use (McAlister, Perry & Maccoby 1979; Pentz et al. 1989). Data from a recent national school-based sample of adolescents strongly suggest that news media and national events do affect youths' perceptions of the personal risks involved in cocaine and marijuana use and their recognition of social disapproval for using these substances. These changed perceptions have led to a steady decline in national use rates of cocaine, marijuana, and cigarettes among adolescents (Bachman, Johnston, O'Malley & Humphreys 1988; Bachman, Johnston & O'Malley, in press). These authors state:
Recent evidence suggests that large proportions of youth and young adults do pay attention to new information about drugs, especially about the risks involved, and they moderate their behavior accordingly (Bachman, Johnston & O'Malley, in press, p. 21).
In one of the few studies providing information about older students' perceptions of risk from alcohol, Gonzalez and Haney (1990) found a strong relationship between college students' perceptions of personal risk of harm from alcohol and lower alcohol use. Recent, well-designed studies show that providing realistic information about risks and consequences of alcohol and other drugs as an important ingredient in changing social (or local community) opinion and thus the social environment in which personal behavior (such as alcohol and other drug use) takes place (Gonzalez 1989, 1990; Lorig & Laurin 1985).
Research Support for the Ecological Model
To date, the most ambitious and best known demonstration of a person-in- environment approach to drug prevention is the ongoing Midwestern Prevention Project (Johnson et al., in press; Pentz et al. 1989). Referred to locally as Project STAR (Students Taught Awareness and Resistance), the aim is to influence several layers of a community at once to build widespread environmental change. This project, launched with both federal and local private foundation funding in neighborhoods in Kansas City and Indianapolis, combines mass media programming, teacher training, school-based cognitive and behavioral skills training for children, parent education, community organizing activities (including training key community leaders in drug-prevention strategies and methods), and community health policy analysis and change activities. At its 3-year evaluation, organizers of the project reported sustained and apparently stable reductions in high school students' use of cigarettes and marijuana (Pentz et al. 1989). Program effects on alcohol use were less clear. In response to these mid-program evaluation results, the prevention programming now includes "enhanced alcohol content designed especially to deal with the relative normative nature of alcohol use in the general society" (Johnson et al., in press). The success of the Midwestern Prevention Program to date has been attributed to its ability to orchestrate simultaneous changes in several important channels of influence on youths' behavior (e.g., school, parents, media, community norms; Johnson et al., in press). Each channel is assumed to trigger and to reward skills and other learning related to drug-free behavior acquired through it or some other channel.
One of the few college-based ecological programs in prevention literature is described in Kraft (1984). The overall goal of this University of Massachusetts program was "to create a campus environment that encouraged responsible use of beverage alcohol and discouraged irresponsible drinking behaviors" (p. 328). The program was planned to address the following three kinds of factors that influence drinking behavior:
After 4 years, results showed that only those intensive educational approaches in which students received direct training in multiple sessions over time resulted in actual changes in drinking behaviors. The program planners concluded that particular attention to enabling and reinforcing factors (as opposed to emphasis on predisposing knowledge, attitudes, beliefs, and values) was critical, and that a combined and phased use of educational and regulatory (i.e., policy) approaches were useful to initiate and sustain behavioral change. The planners' original assumption that intensive educational activities with a 5-10 percent cross-section of the students each year would spread out to produce campuswide effects proved false. They concluded that more multi-session, intensive efforts were needed that were specially tailored to the high-risk (that is, heavier drinking) groups. These high-risk groups included fraternity members, all-male dormitory residents, first-year student dormitory residents, and residents of high-rise dormitories.
Issues in Designing Effective Prevention Programs
Scholarly work in the last decade has increasingly supported the notion that alcohol and drug prevention planners cannot expect to rely on a single "canned" prevention curriculum. Many factors affect a prevention program's success. A program developed in one locale or environment may not translate well to another. Scholars' response to this problem of limited transferability has been to derive general principles that appear essential to initiating successful prevention programs regardless of setting or environment. Increasingly, studies identify general principles that underlie conditions promoting a design that results in enduring, desired changes at both the organizational and the individual behavior levels. This work strongly suggests that integrating organizational change strategies with individual change strategies is critical for a focused, sustained, and effective prevention effort. The remainder of this section describes what is currently known about such integration efforts and about one final, but often neglected, principle-that of gaining clarity about a prevention program's mission and goals.
Integrating Organizational and Individual Change Strategies
In the last 15 years, researchers have isolated predictable steps that characterize innovation and change within multilevel organizational or community systems (Argyris 1987; Bracht 1990; Charter et al. 1973; Goodman & Steckler 1990; Green & McAlister 1984; Kolbe 1986; Kraft 1984; Porras & Hoffer 1986; Rogers 1983). These studies provide evidence for a general model of change as it occurs in organizational systems. This model consists of becoming aware of a problem; analyzing current practices, resources, and options; adopting a strategy or plan for change; implementing the plan; and then examining the success of the original plan and its implementation. This section provides an illustration of how organizational change strategies can be applied to building organizational consensus, receptivity, and resources for learning activities to prevent substance abuse problems.
Successful social change of any type-whether drug related or not-rests on the inclusion of all concerned constituencies in both the planning and the implementation processes (Argyris 1987; Green 1986; Kettner, Daley & Nichols 1985; Rothman 1970). Parcel and his colleagues (Parcel et al. 1987; Parcel, Simon-Morton & Kolbe 1988; Simons-Morton et al., in press) used research on innovation and change in schools to create a model with four sequential phases. This model deliberately integrates several organizational change strategies with individual student learning strategies. The four phases are
Next, to create a realistic structure for carrying out effective prevention activities, various options for proceeding must be examined and accepted by people at all organizational levels being affected by the innovation. In the Parcel et al. (1988) research, two planning groups were formed. The policy planning group developed clarity about the values, goals, and purposes of the prevention program and addressed the concerns, reservations, and perceived "big picture" problems identified by the group. The group then wrote a policy incorporating a prevention goal and recommended that systemwide resources be set aside to implement the policy.
A second set of groups called practice planning groups was then convened to translate the policy into a set of concrete activities. The practice planning groups involved those individuals who would be directly responsible for implementing the program. Together with recognized prevention experts, they determined new practices or modifications of existing practices that were needed to address the prevention goals.
The third phase of organizational change addressed preparing specific individuals to implement and maintain the agreed-upon activities. School staff's roles and procedures were altered. Major steps in implementing these alterations included providing in-service training, providing technical assistance and resources, monitoring program implementation, and providing feedback.
The fourth and final phase was coordinating and launching the student learning activities. Staff were hired to model appropriate behavior, to teach cognitive and behavioral skills that fit students' interests and developmental levels, to help students write contracts to practice new skills in settings outside the classroom, and to deliver systemwide recognition of students' successful performance of desirable new behavior. As summarized earlier, other similar programs have provided a variety of ways to support student learning, including the use of media to model appropriate behavior and the distribution of cues or reminders (bookmarks, posters, ads, displays; Kraft 1984).
The Importance of Clearly Defined Goals
The goal for alcohol and other drug prevention programs may seem self-evident. However, many prevention efforts fail in the planning stage because the avowed goals appear unrealistic, unachievable, or unnecessary. An example, mentioned by Gonzalez in section III, is trying to keep college students from drinking when 90 percent or more of them have already been introduced to alcohol. Prevention can be defined with several very different goals in mind (Gilchrist, in press). The adoption of a goal has important philosophical and political ramifications that can positively or negatively affect acceptance of a program by either implementers or recipients.
Designers of a prevention program must concretely define the program's mission and boundaries, that is, what it is and is not expected to accomplish. Prevention literature reveals a range of intended accomplishments. Past alcohol and other drug prevention programs variously have aimed (1) to prevent all use of one or more substances (the abstinence goal); (2) to reduce the overall levels or amounts of use (the reduction-in-rates-of-use goal); (3) to reduce only dangerous use or progression of use into addiction (the reduction-of-abuse goal); or, finally, (4) to reduce the number of serious problems that are caused by the level of use (the insulation-from-harm goal).
The goal of many published prevention studies-that of preventing initiation of alcohol and other drug use-may be an appropriate goal for addressing the needs of children, who (usually) enter the program as nonusers. The prevention-of-initiation goal is less useful for groups such as college students, where the majority already have experience with one or more substances. Adoption (whether consciously or unconsciously) of the abstinence (no-use-at-all) goal, particularly for alcohol, may create both organizational and individual resistance because it appears naively unrealistic. When the target group is of legal drinking age, other ways to frame prevention goals may be more useful than prevention of initiation or achievement of abstinence (Gilchrist 1991; Jessor, 1984). One such frame is insulation from immediate and serious harm resulting from alcohol or other drug use. With this goal as a focus, intervention efforts emphasize awareness, skills, and policies related to specific, concrete circumstances when judgment impaired by alcohol or drugs can have undeniable and permanently harmful effects. Examples of such circumstances are (1) driving, (2) engaging in unprotected or unwanted sexual intercourse while high, or (3) drinking in settings where risk of injuries (for example, from falls) or interpersonal assault (fights, sexual abuse) is high.
Prevention efforts framed as protecting students from harm can be presented as having the goal of eliminating accidents and serious injuries. Success for such a program would be demonstrated by reductions in drunk driving citations, in alcohol-related accidents, and in alcohol-or drug-related assaults, but not necessarily in reductions in overall use of alcohol. The insulation-from-harm goal stresses the social responsibility that students-indeed all adults-have, not for abstaining from drinking, but for not causing harm to others. Prevention activities defined in this manner would focus not strictly on health issues, which many students may brush aside, but on strengthening a campuswide sense of community and mission.
Finally, all prevention programs have a political component or a rationale that sustains and supports (or occasionally undermines) them. Preventive interventions, to be successful, demand considerable energy and resources. Such efforts presumably are launched in response to some recognized demand for action. What is critical to the success of the preventive program is that its shape, focus, and rationale fit the community, teacher, and school administrator's [and parents'] definitions of appropriate action....The educational program is not only an effort to change adolescent drinking behavior, but is just as importantly a symbolic act which signals concerned interest groups that some action is being taken to deal with the problem....Enthusiasm for prevention programs can be maintained by their publics because they make political and philosophical sense, even though scientific support may be lacking (Weisheit 1984, pp. 75-76).
That scientific evidence may be ignored is regrettable. Nonetheless, the importance of a political and philosophical underpinning for a preventive intervention should not be underestimated. If prevention program planners and implementers cannot articulate the program's philosophical basis clearly, the program will be poorly accepted and will have limited impact.
Developing a context-sensitive rationale for the prevention activities is critical to program success, and yet this step is commonly ignored. Social marketing theory and methods have proven useful in conceptualizing the rationale and program definition step (Glanz, Lewis & Rimer 1990; Kotler 1982). The investigation of processes for defining goals and rationales is a useful direction for future research on preventing alcohol and other drug problems on college campuses.
Summary
Approaches to preventing alcohol and other drug use have become more sophisticated over the last 30 years. The most recent evolution stresses the importance of addressing both individuals and their environments to achieve lasting behavior change. Because campuses are self-contained environments, campus-based prevention programmers have the opportunity to address and potentially to affect a relatively comprehensive slice of students' lives. Theories of organizational change suggest that a campus alcohol and drug prevention coordinator should begin a prevention planning effort with support across all levels of campus life, from students themselves to the president, provost, or chancellor. This ambitious goal may not be as formidable as it sounds if some creative attention has been given to framing the prevention effort in clear, positive terms that bring different constituencies (e.g., resident hall assistants, students, faculty, staff, administration) together rather than setting one constituency (e.g., administration) against another (e.g., students). It is increasingly clear that "quick fix" approaches to alcohol and other drug prevention do not produce real and lasting effects. Another task for alcohol and drug coordinators is to help constituent groups resist quick fixes and to help them see the range and complexity of intervention activities that are actually required to influence students' behavior. The section by Kraft (1984) listed in the bibliography may be a helpful resource in this beginning phase.
Although a common expectation is that a campus alcohol and drug coordinator should be an expert who will design specialized prevention procedures, theories of organizational change demonstrate that involving a variety of people in designing a variety of preventive activities is more effective. The skills required for a successful campus prevention program may be those of community organizing rather than those related to an expertise in substance use and abuse. A review of past research on alcohol and other drug prevention shows that once a suitably supportive environment for prevention planning and implementation has been established, it is highly desirable to ensure repeated opportunities for students to acquire and practice skills for resisting influences to use alcohol and other drugs. These skills-building opportunities should be as specific and as realistic as possible and should involve a commitment from each student to practice resistance skills outside the training setting and to report successes and failures in future training sessions. An important role for the alcohol and drug coordinator is to enlist planning groups to tailor these skills-building opportunities to particular groups-for example, fraternity members, first-year students, and all-male dormitory residents-those groups identified by Kraft (1984) as using greater amounts of alcohol and other drugs and requiring more concentrated preventive attention than other groups.
Checklist on Prevention
Argyris, C. (1987). Reasoning, action strategies, and defensive routines. In R. W. Woodman & W.A. Pasmore (Eds.), Research in organizational change and development: Vol. 1. Greenwich, CT: JAI Press.
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Bachman, J.G., Johnston, L.D., O'Malley, P.M., & Humphreys, R.N. (1988, March). Explaining the recent decline in marijuana use: Differentiating the effects of perceived risks, disapproval, and general lifestyle factors. Journal of Health and Social Behavior, 29, 92-112.
Bachman, J.G., Johnston, L.D., & O'Malley, P.M. (in press). How changes in drug use are linked to perceived risks and disapproval: Evidence from national studies that youth and young adults respond to information about the consequences of drug use. In L. Donohew & H. Sypher (Eds.), Persuasive communication and drug abuse prevention. Hillsdale, NJ: Lawrence Erlbaum.
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191-215.
_______ (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.
_______ (1989, September). Human agency in social cognitive theory. American Psychologist, 1175-1184.
Battjes, R.J. (1985). Prevention of adolescent drug abuse. The International Journal of the Addictions, 20(6 & 7), 1113-1134.
Bell, C.S., & Battjes, R. (1985). Prevention research: Deterring drug abuse among children and adolescents (NIDA Research Monograph 63). Rockville, MD: National Institute on Drug Abuse.
Botvin, G.J., Baker, E., & Renick, N.L., Filazzola, A.D., & Botvin, E.M. (1984). A cognitive-behavioral approach to substance abuse prevention. Addictive Behavior, 9, 137-147.
Bracht, N. (1990). Health promotion at the community level. Sage Publications.
Charter, W.W., et al. (1973). The process of planned change at the school's instructional organization. Eugene, OR: University of Oregon, Center for the Advanced Study of Educational Administration.
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Flay, B.R., d'Avernas, J.R., Best, J.A., Kersell, M.W., & Ryan, K.B. (1983). Cigarette smoking: Why young people do it and ways of preventing it. In P.J. McGrath & P. Firestone (Eds.), Pediatric and adolescent behavioral medicine: Issues in treatment: Vol. 10: Spring series on behavior therapy & behavioral medicine (pp. 132-183). New York: Springer.
Gilchrist, L.D. (1991). Defining the intervention and the target population in Leukefeld, C.G & Bukowski, W.J. (Eds.). Drug abuse prevention intervention research: Methodological Issues (NIDA Research Monograph 107). Rockville, MD: National Institute on Drug Abuse.
Glanz, K., Lewis, F.M., & Rimer, B.K. (Eds.). (1990). Health behavior and health education: Theory, research, and practice. San Francisco: Jossey-Bass.
Glynn, T.J., Boyd, G.M., Gruman, J.C. (1990, Fall). Essential elements of self-help/minimal intervention strategies for smoking cessation. Health Education Quarterly, 17(3), 329-345.
Glynn, T.J., Leukefeld, C.G., & Ludford, J.P. (Eds.). (1983). Preventing adolescent drug abuse: Intervention strategies (NIDA Research Monograph 47). Rockville, MD: National Institute on Drug Abuse.
Gonzalez, G.M. (1989, November). An integrated theoretical model for alcohol and other drug abuse prevention on the college campus. Journal of College Student Development, 30, 492-503.
_______ (1990, March/April). Effects of a theory-based, peer-focused drug education course. Journal of Counseling & Development, 68, 446-449.
Gonzalez, G.M., & Haney, M.L. (1990, July). Perceptions of risk as predictors of alcohol, marijuana, and cocaine use among college students. Journal of College Student Development, 31, 313-318.
Goodman, R.M., & Steckler, A.B. (1990). Mobilizing organizations for health enhancement: Theories of organizational change. In K. Glanz, F.M. Lewis, & B.K. Rimer (Eds.), Health behavior and health education: Theory, research, and practice. San Francisco: Jossey-Bass.
Goodstadt, M.S. (1986). School-based drug education in North America: What is wrong? What can be done? Journal of School Health, 56(7), 278-281.
Green, L. (1986). The theory of participation: A qualitative analysis of its expression in national and international health politics. Advances in Health Education and Promotion, 1, 211-236.
Green, L.W., & McAlister, A.L. (1984, Fall). Macro-intervention to support health behavior: Some theoretical perspectives and practical reflections. Health Education Quarterly, 11(3), 322-339.
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Theories, Dominant Models, and the Need for Applied Research
The Influence of College Environments on Student Drinking
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