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A careful review of the four major papers presented here reveals several themes that are relevant to campus alcohol abuse and other drug use. The first theme addresses the interaction of individual and organizational change strategies upon alcohol and other drug use. The second examines the importance of restructuring the campus environment and culture including policies, practices, and social norms of sub-environments in order to affect alcohol and other drug use. The third theme focuses on the evaluation of programs and, in particular, the need for a theoretical framework for conducting program evaluation as well as more sophistication in technique and data sampling.
Theme 1: Individual and Organizational Change
In addressing the first theme of individual and organizational change strategies, Gonzalez states it well when he says that a comprehensive effort must be more than a conglomeration of different activities. It should have an empirically tested framework and have activities that are carefully planned to complement each other. On too many campuses, there is a fragmentation of efforts with no unifying theme to draw together all of the various programs.
Additional support for this point of view is provided by Gilchrist's research, which suggests that a comprehensive approach is an integration of organizational change strategies in conjunction with individual change strategies. In her paper, Gilchrist comments on a person-in-environment model that blends theories of individual behavioral change with organizational change to achieve a more enduring effect. As in Gonzalez' ITMADP model, Gilchrist suggests a focus on the dynamic interaction between the person and the environment. Such an interaction is seen as crucial to developing and maintaining the behaviors that enhance health and reduce drug use. The goal is to have a social environment that supports and sustains individual behavioral change.
Gonzalez proposes that before individuals can engage in health-enhancing behaviors they need appropriate skills (e.g., assertiveness, stress management, interpersonal communication) to resist negative pressures from the environment as well as to engage in positive interactions with that environment. However, strategies such as affective education, values clarification and knowledge-attitude-behavior models that focus exclusively on the individual person are not seen as effective. Intervention strategies that include multiple component systems (peer group, family, schools, media, and community organizations) and aspects of a wide variety of approaches (e.g., providing accurate information on drug use in combination with teaching social resistance skills, utilizing peer facilitators, and changing community policies and norms) are the most promising type of prevention strategies (OERI 1993).
Kuh likewise recognizes the importance of a long-term, comprehensive strategy that takes into consideration the host (student), agent (alcohol), and environment (setting and mores that shape the campus culture). An example of such a comprehensive intervention is provided by Gilchrist when she describes a program at the University of Massachusetts that was designed to address multiple factors (predisposing, enabling, and reinforcing) that affect drinking behavior. Results from this study support other findings which show that changes in drinking behavior can be achieved through intensive educational approaches presented in multiple sessions over a period of time.
Theme 2: Environment and Culture
In addressing the second theme regarding the need to restructure the campus environment, Kuh describes the behavior of some colleges and universities in the language of addictive systems: resistant to admit that alcohol is a problem (denial), resistant to develop new policies or relying on state laws for regulation (control), defensive about criticism (self-centered), and highly resistant to institutional change efforts (rigidity). However, in order to overcome this resistance, Gilchrist suggests that support must come from all levels of campus life. Sustained administrative support is of particular importance, and efforts are bound to fail without top-level endorsement. Once policy is set, it needs to be translated into action for individuals directly responsible for implementing the program. Kuh shares this perspective and adds that any efforts made on campus to develop policies to reduce the availability of alcohol should be designed to fit the campus culture. He goes on to say that the most promising way to influence college student drinking is cultural change, and that students will adopt alternative behaviors for themselves in environments where this is valued.
Both Gilchrist and Kuh discuss the importance of examining the policies, practices, and social norms of self-contained or subenvironments on campus such as housing units, athletic teams, and fraternities to ensure that they will reflect the philosophy of the institution and are organized around the principles of sobriety, care, and concern. Other important subpopulations are ethnic minorities, nontraditional students, abstainers, and those in high-risk categories. Kuh believes collegiate environments that have a health-enhancing philosophy, whether they affect the entire campus or certain subpopulation groups, should be studied for adoption on other campuses.
Theme 3: Theory and Evaluation of Programs
The third and final theme regarding the need for theory-driven models and program evaluation is addressed by Gonzalez and Berkowitz. They point out that the lack of a theoretical framework for college programs has made it difficult to conduct evaluations and answer the question "what works." Berkowitz emphasizes that attention needs to be given to examining the relationship of theory to assessment and programming. He argues that questionnaires which incorporate theory-based items are needed. Berkowitz goes on to say that what is learned from surveys and effective prevention programs should be used to adapt and modify the theories upon which they are based. Moreover, he claims that surveys need to incorporate questions assessing use pattern, pre-disposing motivations and negative consequences of alcohol and other drug use in order to correct misperceptions about campus use and abuse patterns. Misperceptions have been shown to impact students. Finally, as it relates to sophistication, both Gonzalez and Berkowitz agree that a lack of standardization among survey instruments has created numerous problems for practitioners and researchers trying to compare data across institutions in order to assess the severity of the problem and find adequate solutions.
In summary, there are three themes that run through this document worth further consideration and deliberation for program development on campus. Taking into consideration both individual and environmental factors, restructuring units or subunits of the campus to encourage and enable more health-enhancing behaviors, and developing a theoretical framework for program development as well as evaluation are all essential elements in a comprehensive campus-based prevention effort.
References
U.S. Department of Education, Office of Educational Research and Improvement (1993). Reaching the goals: Goal 6: Safe, disciplined and drug-free schools. Washington, DC.
Responses to the Four Articles
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