Campus and Community Environmental Scan and Assessment of Alcohol Programming and Services , James Madison University, Final Report, November 2007

Of the documents that I requested from JMU under the Virginia Freedom of Information Act, this report is the most significant. I received a copy of the report on October 22, 2010.  The Environmental Scan report is the result of JMU hiring an independent consultant in 2007 to look at the alcohol problem at JMU.   The observations the consultants make are very similar to the concerns I have raised in my post.  To a very large extent it seems to me that JMU has not followed the recommendations of the consultant. Not following the recommendations also speaks to the need for an external entity with the power to compel  JMU to change its policy.  JMU had the data from the consultant since 2007 and have done little to implement change.  As the conclusion of the report states "There is no indication, without a seismic change in the current drinking policies, that the current resources will be effective in reducing alcohol related incidences." There has been no" seismic" change in alcohol policies at JMU.

Some of the highlights of the report for me are:

• It is our belief that the students' behavior regarding the use of alcohol at JMU are very risky and are approaching dangerously high levels.  Data collected from the NCHA and Core Alcohol and Drug Survey reflect these risky patterns and related consequences. The most striking and consistent result of the environmental scan is because of its availability, lack of enforcement and social acceptance, alcohol is easy for JMU students to abuse.  This creates a "campus environment" that encourages excessive drinking. (page1)
• There is a perception among many administrators, faculty, staff and community members that there is not a problem with student's use of alcohol.  From what we understand from NCHA, Core Alcohol and Drug Study and interviews conducted these perceptions are incorrect.  There are considerable "town-gown" opportunities for positioning JMU to address and educate the community about the effects alcohol is having on its campus. (B on page 4)
• During our interviews with staff and senior leadership it became apparent that communication and understanding of the alcohol culture at JMU voids are prevalent and undermine JMU's ability to work seamlessly to implement creative policies to address the alcohol culture. There appears to be many "rumors" and "jokes" about the alcohol culture at JMU and this creates a dysfunctional relationship among some university staff and community members. (D on page 4)
• There are no clearly defined policies and enforcement regarding the use and abuse of alcohol.  The ambiguities inherent in JMU's judicial and legal policies and procedures regarding alcohol have led to tension among community police, campus police and city officials and students.  As a consequence, students do not fear being fined or prosecuted for alcohol violations and contribute to the ongoing abuse. (F on page 4) 
• During our visit, we heard multiple examples of inconsistent enforcement of alcohol related policies.  Interviewees reported that more times than not, students were not cited with an alcohol violation although strong evidence existed. Students also believed that the alcohol judicial and police processes allowed them to deny violating policies and that students "took turns taking a strike," to avoid further sanctions.  Several interviewees believed the use of preponderance and the "strike" policy created a culture that promoted and rewarded dishonesty.  In addition, several believed that the lack of consistent and stringent enforcement created an environment that promoted alcohol abuse. (H page 5) 
• It is believed by numerous interviewees that campus administration is afraid to implement and enforce strict policies on alcohol use which may have a negative impact on satisfaction rates and potential financial contributions.  The unresolved perceptions of JMU's alcohol related incidences and the University's desire to maintain a high level of student, alumni and parental satisfaction raise serious questions about the preparedness of JMU to adopt a long-term plan that will address alcohol abuse issues (L page 5)
• "...It is clear from our brief visit to JMU that current data recording practices are quiet inadequate to enable the nature and scale of alcohol related incidences to be assessed with any degree of accuracy.  This lack of reliable and valid data makes objective evaluation of initiatives aimed at the reduction of alcohol related problems very difficult.." (N page 6) 

RECOMMENDATIONS:

• Research and Conduct Comprehensive Study: "...Recommend that JMU research and conduct an extensive study to clearly define and determine the effects of alcohol related incidences on and off campus.  This study should include a complete inventory of existing alcohol programming and intervention strategies.  
• Develop Systematic and Consistent Methods for Defining, Recording, Analyzing and Collection of Data for Alcohol Related Incidences. "...It is clear from our visit that enhancements to the present data collection are required if more meaningful conclusions concerning alcohol's negative impact on JMU's campus can be drawn.  
• Develop an Inclusive Alcohol Prevention and Research Center: "JMU should consider developing an inclusive Alcohol Prevention and Research Center that has one organizational unit that will plan and guide a comprehensive alcohol abuse program. 
• Review, Revise and Assess Police and Judicial Processes: "JMU should review and assess its police and judicial processes including establishing more stringent policies and sanctions regarding alcohol use and abuse. It is highly recommended that these policies be consistently and strongly enforced to create a culture where students understand there are consequences to their illegal use and abuse of alcohol." (page 14, 15 and 16)

Below is the main body of the report including the recommendations.( I left out the literature review part of the report).

 

"Tailgates go off without a hitch" 10/18/2010

This is the headline in "The Breeze" JMU's newspaper. (can be found at : http://issuu.com/thebreezenewspaper/docs/combined10.18.10) The article notes that "Police presence seemed minimal compared to previous games this year in both student and alumni lots"  and "Despite the rumors circling about a police crackdown in the student lots, alumni who tailgated frequently said they noticed little change from last year" 
  The impression one gets form the article is that life at JMU is back to "normal" and that would mean the JMU Negative Alcohol Culture is alive and well. "The police gave out 12 drunk in public citations and seven underage possession citations on-campus from 7 a.m. Saturday to 7 a.m. Sunday, up from 15 total alcohol citation on Saturday of last year's Homecoming game"

  The Breeze also had an article "Redefining party: New Greek life policies address alcohol at recognized events" which highlighted new Greek policies. Some of the new policies are:

• The definition of a party is any fraternity or sorority event that is registered with the university and Harrisonburg Police Department where alcohol is present.
• If there are discrepancies between a chapter's national policies and the JMU policy, the stricter policy will apply
• A minimum of six sober members per sponsoring organization must be present at teh event where alcohol is served.
• Sorority parties shall not exceed the size of the sorority plus three guest per sister.
• Fraternity parties shall not exceed more than 250 registered guest and 30 unannounced guest.
• Chapters must maintain a collective 2.7 GPA.

Hopefully the new policies will have some positive impact.

  Most observers acknowledge that Transforming the Negative Alcohol Culture at JMU will take time and the smooth start to this fall semester does not mean the problem is solved. It is discouraging to see that only halfway into the semester the students feel things are back to"normal." 

Stages of Change Model

Readiness to Change/Stages of Change

The field of health psychology has long recognized the fact that individuals who are engaged in voluntary behavior change generally progress through a recognizable process. The Stages of Change model (DiClemente and Prochaska, 1998; Prochaska et al., 1992) has proven utility when applied to a wide range of health promotion behaviors including smoking cessation, dieting, initiating exercise programs, adopting safe sex practices, reducing intimate partner violence, and overcoming substance abuse problems (Begun et al., in press; Carney and Kivlahan, 1995; Prochaska et al., 1994; Willoughby and Edens, 1996).

Research indicates that individuals typically progress through a predictable, but non-linear sequence of stages when modifying a specific problematic behavior. Each stage is characterized by a set of attitudes, intentions, and behaviors related to the change process itself, as well as to the specific target behavior. People progress through these stages whether or not the change process is being facilitated by formal treatment interventions. Individuals differ markedly in the amount of time and degree of effort exerted in each stage, but the sequence is remarkably similar for everyone.

Stages of Change - Precontemplation - Contemplation - Preparation - Action - Maintenance

The first stage in the change process, Precontemplation, is characterized by a lack of intent to change the behavior because it is not viewed as being problematic (lack of awareness), the pros outweigh the cons (decisional balance), or the person is discouraged and demoralized by past failed attempts to change (self-efficacy). It is not uncommon for these individuals to appear in a treatment setting, but they are seldom there without pressure from family, job, or the law (Connors, Donovan, & DiClemente, 2001). A sub-group of individuals, who may be transitioning from this to the next stage, appear highly ambivalent about making change. They score high on precontemplation measures, but average on later stages.

The second stage is Contemplation. This stage is characterized by the individual considering making a change, seeking information related to the problem, and evaluating the pros and cons of changing-however, no overt change effort has begun. An individual who enters treatment may not be ready to take action (see later stages), but is seeking a means of reinforcing and continuing their contemplation processes (Connors et al, 2001).

Subsequent to this stage, individuals enter into the Preparation stage. Here a person solidifies the gains in Contemplation and begins to develop a concrete and upcoming (within one month) plan of action. The individual shows determination and may even begin some tentative changes and increase self-regulation. Furthermore, individuals at this stage are often able to recite valuable lessons learned from past failed attempts. This stage did not appear in early discussions of the model because it initially appeared as a blend of high Contemplation and Action processes, rather than as a distinct stage itself.

The most overtly obvious stage is Action. Behavior change has clearly begun as individuals acquire and practice skills and strategies needed to implement the change. They work to modify both their own behaviors and the environmental contexts of their behaviors (reducing and avoiding temptation experiences). These individuals also become aware of 'traps' that might work against their change efforts. The transtheoretical aspect of the Stages of Change model is most evident through this stage. Diverse intervention approaches seem effective in this stage even though many are ineffective for people in precontemplation or contemplation stages. Most of the treatment evaluation research explores interventions designed for people in this stage of the change cycle. The Action stage typically lasts an average of six months in the change of substance abuse behavior (Prochaska and DiClemente, 1992).

Finally, individuals may achieve the Maintenance stage. Individuals at this stage continue working to sustain the change gains made during the prior stages. They also actively work to avoid and prevent relapse (recurrences of the problem behavior). Termination of the change process does not occur until the person is fully confident and secure in the maintenance of change. This is the ultimate goal of the change process-to move through the spiral of stages, exiting through maintenance to termination.
Most people undergo several cycles of the stages of change process before achieving their ultimate change goals. It may take an average of 5-7 serious attempts (Prochaska, DiClemente, & Norcross, 1992).

The above is from the National Institute on Alcohol Abuse and Alcoholism, of the National Institutes of Health, "Social Work Education for the Prevention and Treatment of Alcohol Use Disorders" , Module 5: Diagnosis and Assessment of Alcohol Use Disorder available at the NIAAA web site http://www.niaaa.nih.gov/Pages/default.aspx
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The Stages of Change Model is important to consider since the goal is to Transform the Alcohol Culture at JMU.  In order for people to get to the "Action" stage there are usually both internal and external motivating factors.  Students report experiencing many negative consequences related to alcohol use at JMU. The education sanctions imposed by the Judicial Affairs office on students are helping students through the stages of change.  There are many situations where a person did not consider their drinking to be a problem until the consequences became severe enough to them that they began to identify themselves as having a problem. For some people a DUI is the wake up call, for others relationship dysfunction or other losses served as their wake up call.  Suspension from JMU could be the wake up call for students that their drinking was a problem and help move the student to the "Action" stage of change.  JMU needs to see suspension as a helpful tool for students individually and also for transforming the JMU negative alcohol culture .

How many students have had "three strikes"? and How many of those students were suspended?

I asked JMU for data on the effectiveness of the "three strikes" policy. The Judicial Affairs office reported that in their data base covering ten years (2000-2010) there have been a total of 212 "three strikes" and of those who have had "three strikes" 78 have been suspended.  Judicial Affairs notes " As you can see in the end there are very few students who receive three strikes for alcohol violations."
  Again the data demonstrates that suspension is an infrequently used sanction. Judicial Affairs has wide discretion in dealing with student misconduct.  In their response Judaical Affairs noted" If there is  violence, drug dealing, or drinking and driving, or other behaviors that negatively affect the community that goes along with "a strike" a student can and often is suspended on a first or second violation."  I  appreciate that each case has individual circumstances that must be addressed but there seems to be a need for some standardized criteria like courts have "sentencing guidelines" that direct the consequences implemented for violations.  I contend that increasing the number of suspensions will have the most impact on changing the negative alcohol culture at JMU.  I see suspension as a way to increase accountability for student alcohol behavior misconduct.  I believe JMU needs to increase the balance of "accountability" versus "education" and this may mean a paradigm shift in the Judicial Affairs office. The current mission of Judicial affairs is

• " We are committed to promoting student learning, civic responsibility and, through partnerships, developing the community necessary for the university to achieve its mission."

Developing civic responsibility needs to include being accountable for one's behavior. Suspension is a sanction that holds students accountable.  The fact that this sanction has only been used 78 times in ten years speaks to the previous post (Restoring Responsibility in the JMU Community: Alcohol and the Quest for Excellence, Integrity and Mutual Respect)  "what we are willing to tolerate" thinking and this thinking needs to change if JMU is to accomplish the goal of Transforming the Alcohol Culture.

"Alcohol culture on campus in unchangeable" and "Alcohol is a permanent feature of college life and is a rite of passage"

      These are two assumptions that courts made in the 1970's in regard to Higher education Law, according to Peter Lake, "Law and Prevention" Prevention File (spring 2003).  Many people may still believe these assumptions.  However Lake explains that "By the 1990s courts had begun to fully main-stream colleges into a tort system that viewed the solution to complex risk phenomena as one of "shared responsibility." Further Lake states "Courts have sent the following messages in key cases around the country.

• First, the fortunes of the Greek community in litigation are tied to colleges: A fraternity injury is a college student injury.
• Second, the duty of college is not to observe student life from a distance, but to use reasonable care to prevent foreseeable danger in the college community.
• Third, responsibility of colleges is not limited to the campus landscape, but extends into student life and academics (what I cal a riskscape).
• Fourth, scientific evaluation is what reasonable business do. Evaluation shows reasonable care.For example using the new NIAAA report's recommendations is a good way to defend a university's approach to high-risk alcohol culture.
• Fifth, colleges share responsibility with students, and other entities on and off campus, and should actively work with all individuals and groups who can facilitate campus safety.
• Sixth, high-risk alcohol culture must be approached proactively to prevent injury, instead of reactively to win legal cases at the cost of student safety.  The casebooks are filled with instances where actors acted simply to avoid legal liability, but not reasonably in the face of danger."

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  I look at Lake's message as one that would apply to the JMU situation.  JMU shares the responsibility with students to reduce risk and provide a safe environment.  Given the data that JMU has collected, there are foreseeable risk to student safety caused by the negative alcohol culture. JMU's comprehensive plan is heavily focused on educational efforts.  The accountability side of the equation is not being met.  There needs to be a balancing of education and accountability for behavior change.  Again I wonder, will it take a lawsuit (an external influence) to help JMU to hold students accountable for their negative alcohol behavior?

Restoring Responsibility in the JMU Community: Alcohol and the Quest for Excellence, Integrity and Mutual Respect

One of the documents JMU provided in response to my Virginia Freedom of Information Act request was "Restoring Responsibility in the JMU Community: Alcohol and the Quest for Excellence, Integrity and Mutual Respect" (revised 5/27/10).  In the body of the text it identifies this document as a "plan" and the areas which will be addressed across the university.  Below is the 9 page document which is also referred to as "JMU Foundation Plan 5 2010"

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In the "Law and Policy Enforcement" section of the plan, the introductory paragraph notes "..In addition, we need to determine if our consequences are adequate and what we are willing to tolerate with respect to prosecution, suspension ,etc..."   I found this an interesting phrasing.  Maybe what JMU is willing to tolerate is part what limits JMU's view of solutions to the negative alcohol culture.  An examination of policy from external to JMU might give some fresh views about what should be tolerated in regard to prosecution and suspension.  I think the ongoing and escalating negative alcohol culture as reflected in the Core Alcohol and Drug Surveys are testimony that the law and policy enforcement response  is not adequate in terms of causing behavior change at JMU. 

JMU Core Alcohol and Drug Survey April 2008

One of the documents that I requested under the Virginia Freedom of Information Act was the JMU Core Alcohol and Drug Survey April 2008.  Below are pages from that Survey that can be compared to the earlier post "JMU Core Alcohol and Drug Survey April 2010".  This is one of the outcome measures that was identified in the JMU Student Affairs and University Planning Vision and Strategic Plan 2014 (see earlier post).

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The data from this 2008 Survey needs to be compared to the data from the 2010 Survey.  As noted in the 2010 Survey results- most JMU students saw drinking as "central in the social life" of most JMU students.

 Table 3 " Problematic Experiences looks very similar from 2008 to 2010.  The average number of drinks consumed per week at JMU was 8 drinks in 2008 and 8.6 in 2010.  This compares to a national average of 5.5 in 2008 and 5.5 in 2010. The percentage of students who report having binged in the last two weeks at JMU was 62.2% in 2008 as compared to a national average of 46.7% in 2008.  The percentage of students who report having binged in the last two weeks at JMU is 60.5% as compared to the national average of 46.7% in 2010.  JMU was well above the national average in binge drinking in both 2008 and 2010.  The differences in the two reports do not look very significant to me- So far I do not see the JMU comprehensive alcohol plan showing that "students will report a decrease in the negative behaviors associated with alcohol use"- the outcome measure identified in the SAUP plan under Performance Indicators 1.3.

JMU Comprehensive Alcohol Plan?

I requested several documents from JMU under the Virginia Freedom of Information Act. One of these was the JMU "Comprehensive Alcohol Plan" or "Comprehensive Plan for Substance Abuse Prevention" that is referred to in several JMU documents( see Student Affairs and University Planning Vision and Strategic Plan 2014 at the JMU web site). I received a number of documents but none with the title "Comprehensive Alcohol Plan," or "Comprehensive Plan for Substance Abuse Prevention" so I sent an e-mail asking for clarification. The response was that all of the documents sent to me comprised the JMU Comprehensive Alcohol Plan, that there is no separate document. Below is a list of the documents sent to me I have posted parts of the documents in other post but provide a listing of the documents below.

1. JMU Prevention Summary
2. 2009-2010 BASICS Analyses
3. 2007 Environmental Scan
4. 2010 "Your Call" Marketing Award Announcement
5. CORE 2008 and 2010 -CORE Health Behavior Surveys
6. Strategies Doc- support for SAUP Performance Indicator 1.3
7. JMU Foundational Plan- support for SAUP 2014 Strategic Plan, performance indicator 1.3
8. Dukes in Recovery- see http://www.jmu.edu/healthctr/sap/DIR.shtml
9. The Faculty interest Group " The Perfect Storm", evolved into the Madison Teaching Fellows small groups, one of which is called "Alcohol and Academic Culture"- this group will examine and suggest means by which instructional faculty can cultivate rigorous learning experiences that both challenge and mitigate students' extracurricular use of alcohol. see http://www.jmu.edu/cfi/programs/10-11/alcohol/index.html
10. Alcohol-Free Program Funding



The Student Affairs and University Planning Vision and Strategic Plan 2014 Goal 1, objective 1.3 is below.

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When I read "Comprehensive Alcohol Plan" or "Comprehensive Substance Abuse Prevention Plan", I was expecting a unifying document that identified the mission, goals, objectives and outcome measures for accomplishing the goals.  I have to say I am a bit disappointed in the response that there is no document with the title noted in the JMU material.   The SAUP Vision and Strategic Plan comes closest to what I was expecting. The performance indicator 1.3 gives some objective outcome measures, especially the CORE surveys of 2008 and 2010.  This provides some objective measures of progress towards Goal 1 in that it identifies a specific measure that "students will report a decrease in negative behavior associated with alcohol use as reported by the Core Alcohol and Drug Survey..."

 GOAL 1 states: "We will create and maintain campus environments that increase students' ability to make healthy choices in their lives" More specific to the alcohol issue is:

"Objective 1.3 We will refocus and improve alcohol education and behavior management programs

The SAUP division will engage in a comprehensive review of alcohol education and behavior management resulting in: 

                   *adoption of a comprehensive plan for substance abuse prevention..."

You can see where I got the impression that an actual document called the Comprehensive Plan for Substance Abuse Prevention would be developed in order to be adopted by JMU. My next post will be the 2008 Core Alcohol Data Survey so you can compare it to the 2010 data.

JMU Prevention Summary

I have asked JMU for a number of documents under the Virginia Freedom of Information Act. One of the documents I received is "JMU Prevention Summary".  I have included the four page report below.
(If you click on the page and then click again it will enlarge so you can read the details)

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The JMU Prevention Summary presents a large number of prevention efforts.  The model of Universal, Targeted and Indicated Prevention programs address prevention efforts at a variety of levels. The Environmental Prevention & Early Intervention Policies include the "Three Strikes" policy which I view as a major flaw in the prevention effort.  The prevention efforts are heavily focused on education and increased knowledge and awareness about alcohol, it's negative impact on students, the social norms information and general health information.  There is an unstated underlying assumption that the JMU negative alcohol culture is caused by students lack of knowledge about alcohol. I have a large question about this unstated assumption.  I think today's JMU students arrive at JMU with a better knowledge base about alcohol than any previous group of JMU freshman.  What I see as lacking is JMU students experiencing meaningful consequences for their alcohol violations and misconduct.  I see JMU as reluctant to offend alumni, parents and students by using the power of suspension.   I think JMU will need support from outside of JMU to implement meaningful change that goes beyond education and moves to accountability for alcohol misconduct by making dramatic changes in JMU Judicial Affairs policies.  I think the JMU "Your Call" marketing campaign referred to in President Rose's letter to the students, is reflective of the "bystander" era of legal liability rather than the "duty" era (see earlier post:"The Rights and Responsibilities of the Modern University: Who Assumes the Risk of College Life?"  ) of legal liability of universities.  I think on the JMU "Your Call Marking campaign" web page the message of the university as "bystander" is reflected by the following statement:

".The "Your Call" brand identity and corresponding marketing materials reinforce to students that the University Health Center's Substance Abuse Prevention will provide them with various tools and educational resources, but as young adult, the decision is ultimately "their call."

  To me the end of the statement attempts to distance JMU's duty to provide a safe environment for students and share the legal responsibility for the health, safety and welfare of JMU students. The marketing campaign started in 2008 and the riots occur in 2010. Makes me wonder if the marketing campaign was effective and how was the effectiveness of the campaign measured.

JMU Core Alcohol and Drug Survey , April 2010

I requested several reports from JMU under the Virginia Freedom of Information Act. One of these was the JMU Core Alcohol and Drug Survey , April 2010. This is one of the outcome measures that was identified in the JMU Student Affairs and University Planning Vision and Strategic Plan 2014.  Below are some of the pages from that report.

 

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It is interesting that this report is published in April 2010 the same time as the JMU Springfest riot. It gives a good snapshot of the JMU negative alcohol culture right at the time of the riot. The data demonstrate that many students see alcohol as "central to social life" at JMU. Also it demonstrates that JMU is above the norm in terms of an average of 8.6 drinks per week versus 5.5 nationally and in terms of binge drinking (in the previous two weeks)  JMU= 60.5 % versus 46.7% nationally.  It is important to note this difference at JMU versus the national data.  JMU has a unique problem.  Again in my way of thinking with the data demonstrating that JMU is extreme in the level of alcohol problems, the solution for JMU needs to go beyond  the typical university interventions  in order to cause meaningful change in the negative alcohol culture.

JMU American College Health Association National College Health Assessment II,Spring 2009

I requested several reports from JMU under the Virginia Freedom of Information Act. One of the reports was the JMU American College Health Association National College Health Assessment II, Spring 2009.
"The ACHA-National College Health Assessment II (ACHA-NCHA II) is a national
research survey organized by the American College Health Association (ACHA) to
assist college health service providers, health educators, counselors, and administrators
in collecting data about their students' habits, behaviors, and perceptions on the most
prevalent health topics.
ACHA initiated the original ACHA-NCHA in 2000 and the instrument was used
nation wide through the spring 2008 data collection period. The ACHA-NCHA now
provides the largest known comprehensive data set on the health of college students,
providing the college health and higher education fields with a vast spectrum of
information on student health......
This Executive Summary highlights results of the ACHA-NCHA II Spring 2009 survey for James Madison University consisting of 461 respondents.  The overall response proportion was 15.5%"

Some Highlights:

2.6 % of college students reported driving after having 5 or more drinks in the last 30 days.*
22.5 % of college students reported driving after having any alcohol in the last 30 days

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The data demonstrates that binge drinking and negative consequences from drinking continue to be a problem at JMU.

BASICS- JMU data 2009-2010- a bit of a dissapointment

In Fall 2009, the University Health Center’s Substance Abuse Prevention started to formally evaluate the effectiveness of BASICS at JMU. The evaluation includes a pre-test, 1-month posttest, and 3-month posttest design.  I wrote to JMU and requested under the Virginia Freedom of Information Act a copy of their data evaluating the effectiveness of the BASICS program at JMU. I received the report and below are some highlights.

From the report here is a description of the BASICS program:

James Madison University’s (JMU) Health Center Substance Abuse Prevention program coordinates the Brief Alcohol Screening and Intervention for College Students (BASICS). BASICS is an evidence based, early intervention alcohol abuse program developed for a college student population (Dimeff, Baer, Kivlahan, & Marlatt, 1999). The intervention targets college students who drink heavily and have experienced or are at great risk for experiencing negative consequences as a result of their excessive alcohol consumption. The BASICS program consists of two fifty-minute interview sessions during which students engage in an empathetic, non-confrontational, and non-judgmental discussion with a BASICS program representative. During the first BASICS meeting session, students provide general information to the BASICS representative concerning their substance use by responding to and discussing a self-report instrument. The second BASICS meeting session allows the student and BASICS representative to engage in a feedback session that encourages students to evaluate their drinking behavior, potential risks or consequences associated with this behavior, and potential changes they may make in their behavior to reduce future substance abuse related issues.   JMU students may refer themselves to the BASICS program or be referred by JMU administrators, faculty/staff, coaches, friends. Students may also be mandated to participate inBASICS programming by JMU Judicial Affairs as a result of a JMU alcohol policy violation or a court mandate to complete substance abuse prevention hours. Students who participate in BASICS complete a mandatory pre-test, are encouraged to complete a 1-month post-test, and an additional 3-month post-test. Each assessment contains identical measures including the Daily Drinking Questionnaire (Collins, Parks, & Marlatt, 1985), the Alcohol Use Disorders Identification Test (AUDIT; Babor, Biddle-Higgins, Saunders, & Monteiro, 2001; Saunders, Aasland, Babor, de la Fuente, & Grant, 1993), the Rutgers Alcohol Problem Index (RAPI; White & Labouvie, 1989), and the Situational Temptations Scale – short form (Maddock, Laforge, & Rossi, 2000), and Student Make-Changes Ruler(modified from the Readiness Ruler; Center for Evidence-Based Practices, Case Western Reserve University, 2010).

The EXECUTIVE Summary notes:

Overall, students with complete pre-, 1-month post-test, and 3-month post-test data either maintained or decreased their levels of drinking, negative consequences associated with alcohol consumption, and level of temptation to drink excessive amounts of alcohol.
One-Way Repeated-Measure ANOVA and post hoc dependent t-test results indicated a significant decrease in student mean drink quantity, peak BAC, and meant total AUDIT scores. Although differences were non-significant, there were decreases in student mean drink frequency, mean total RAPI score, and mean total Situational Temptations Scale score from pre-, to post-test 1, and post-test 2. Descriptive statistics indicated that student self-reported binge drinking remained the same across pre-, post-test 1, and post-test 2. Furthermore, descriptive statistics indicated that student responses specifying their current pattern for cutting back or abstaining from drinking did differ across pre-, post-test 1, and post-test 2.

DETAILS IN REPORT

Table 1 presents the number of participants who completed the BASICS assessments across the three time points. A total of 59 participants completed the BASICS pre-test, post-test 1, post-test 3, or any combination of the three assessments. Note that only 19 participants had complete data for the pre- post-test 1, and post-test 2 items, thus these were the participants used in the analyses reported below. There seems to be a major issue with participants completing the entirety of the tests across the three test administrations. This could be an issue of program attrition, student failure to respond to all pre- and post-test assessment items, or incorrectly entering identification numbers across test administrations. Several participants were removed from the data set due to invalid and missing student identification numbers. However, the major issue seemed to be due to student ID mis-match across assessment administrations. This data merge issue indicates that students either entered their student ID numbers incorrectly or did not complete assessments at all three time periods. As the small sample size severely limits the analyses in this report, we strongly encourage BASICS administrators to take steps in the future to ensure that a larger proportion of participants complete the assessment at all three time points.

Table 1.
Sample Sizes for Pre-Test, Post-Test 1, and Post-Test 2.

Time Point                   Total Sample                 Complete Responses      Matched Pre and Post
Pre-Test                              65                                      56                                    N/A
Post-Test 1                         68                                       67                                     21
Post-Test 2                         59                                       59                                     19

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As I read this report it appears that of the 59 participants only 19 completed all three phases of the evaluation of effectiveness of the BASICS program.  Later in the report it emphasizes that:
     "As noted previously, the analyses are exploratory in nature and the results should be interpreted with       caution."
Using the data from the 2009-2010 Judicial Affairs report this would mean that out of the 3575 sanctions, only 59 led to referral to the BASICS program.  With complete data sets on only 19 of the 59, the effectiveness of JMU's BASICS program is really unknown at this time.  I found myself disappointed in the quality of this evaluative research.  Even if the evaluative research demonstrated valid data about the effectiveness of the JMU BASICS program, it provided services to only 59 students.  This is a very small number of students considering the number of sanctions and the size and scope of the negative alcohol culture at JMU.

How to Reduce High-Risk College Drinking: Use Proven Strategies, Fill research Gaps

How to Reduce High-Risk College Drinking: Use Proven Strategies, Fill Research Gaps, Final Report of the Panel on Prevention and Treatment, Task Force of the National Advisory Council on Alcohol Abuse and Alcoholism, National Institute of Health, U.S. Department of Health and Human Services, April 2002 www.collegedrinkingprevention.gov

This report outlines a review of research and identifies effective interventions dealing with high-risk college drinking.  Some highlights:
"....Prevention work in public health is often guided by a social ecological framework.  This approach recognizes that any health-related behavior, including college student drinking, is affected by multiple levels of influence such as intrapersonal (individual) factors, interpersonal (group) processes, institutional factors, community factors, and public policies (DeJong and Langford, 2002; Stokols, 1996) Health promotion research shows that a strategically planned approach with a range of interventions directed at multiple levels of influence increases the likelihood of success.  Appendix 2, "Typology: A Theoretical Framework for Alcohol Prevention Initiatives," provides an example of the varied types of strategies and activities that can be combined to provide multiple sources of support for reducing high risk drinking. ..." (p3)
"...Individual drinking behavior is influenced by myriad environmental factors such as public and institutional policies and practices, economic factors, messages in the media and social norms (Wagenaar and Perry, 1995).  Reductions in alcohol use and related problems may be achieved by changing such environmental factors (Edward et al., 1994, NIAA, 1997; Toomey et al., 1993; Toomey and Wagenaar, 2002)...."

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I am concerned with the environmental factor of JMU's  "institutional policies and practices"- that is the "three strikes" policy.  I think this has created the impression in the students mind that there are no consequences until the third strike.  Again I think the feedback from the students is that they consider a real consequence to be suspension from the university for a semester.  Being put on probation and having to attend educational or assessment interventions are not viewed as "real" consequences by the students.  Why not a zero tolerance policy?  According to the Judicial affairs report for the last year there were 3575 sanctions but only 35 suspensions.  I think how many times does a student have to actually violate alcohol rules before they are caught and reported to judicial affairs? If you look at yourself and think how many times have I driven over the posted speed limit versus how many times have I received a speeding ticket- those are two very different numbers. I think we can assume that the JMU student who appears before the judicial affairs group has had multiple infractions that went under the radar.  In my thinking this means the one time you have the student before judicial affairs is your opportunity to intervene with a student that most likely has an ongoing pattern of alcohol misconduct and happened to get caught on this occasion. For the students and JMU's benefit we should take this opportunity to intervene. I think the recent Springfest gives a good example of the difficulty in getting convictions for alcohol misconduct. "According to the DNR (Daily News Record), five of at least 10 felony cases from the riot have been dropped( "The Breeze" Vol.87,No12, October 7, 2010). The riot is estimated to have had 8000 participants and only 10 felony arrest and as of today five of the ten  are dropped. 
    Going to a zero tolerance policy and suspending a student for a semester for their first alcohol violation is an extreme sanction, but are we not at the point at JMU where extreme- outside of the norm actions are required for the negative alcohol culture to change?  I am sure this would be a very unpopular policy change and this is one reason why I believe there needs to be an outside of JMU influence to create a dramatic change in the JMU negative alcohol culture.

Statistical Snapshot of College Drinking by NIAAA

National Institutes of health

National Institute on Alcohol Abuse and Alcoholism

 

Statistical Snapshot of College Drinking 

The consequences of excessive and underage drinking affect virtually all college campuses, college communities, and college students, whether they are younger or older than the minimum legal drinking age and whether or not they choose to drink.

• Alcohol Consumption and Binge Drinking are Common Among College Students (1)
    - Alcohol Consumption: About four in five of all college students drink, including nearly 60 percent             of students age 18 to 20.
- Binge Drinking: Approximately two of every five college students of all ages—more than 40 percent—have reported engaging in binge drinking at least once during the past 2 weeks. However, colleges vary widely in their binge drinking rates—from 1 percent to more than 70 percent (Wechsler et al., 1994, 1998, 2000b and NSDUH 2006).

• Excessive Drinking in College Leads to Many Adverse Outcomes (2)
- Deaths: It is estimated that 1,700 college students between the ages of 18 and 24 die each year from alcohol-related unintentional injuries, including motor vehicle crashes (about half among students under 21)
- Injuries: It is estimated that 599,000 students between the ages of 18 and 24 are unintentionally injured under the influence of alcohol each year (about half among students under 21)
- Assaults: It is estimated that more than 696,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking each year (430,000 of them by a college student under 21)
- Sexual Abuse: It is estimated that more than 97,000 students between the ages of 18 and 24 are victims of alcohol-related sexual assault or date rape each year (about half among students under 21)
- Unsafe Sex: It is estimated that more than 400,000 students between the ages of 18 and 24 had unprotected sex as a result of their drinking and more than 100,000 students between the ages of 18 and 24 report having been too intoxicated to know if they consented to having sex each year
- Academic Problems: It is estimated that about 25 percent of college students report academic consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and receiving lower grades overall
- Vandalism: About 11 percent of college student drinkers report that they have damaged property while under the influence of alcohol

For additional information about college drinking, go to NIAAA’s College Drinking Prevention Web site at: http://www.collegedrinkingprevention.gov/.

Notes/Additional Resources
1 Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE. Monitoring the Future National Survey Results on Drug Use, 1975–2007. Volume I: Secondary School Students (NIH Publication No. 08–6418A). Bethesda, MD: National Institute on Drug Abuse, 2008, p. 26.

2 Hingson R, Heeren T, Winter M, Wechsler H. Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18–24: Changes from 1998 to 2001. Annu Rev Public Health 26:259–279, 2005.

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The data clearly defines the problems that alcohol is causing on college campuses. JMU is just one example of a national issue. However not all colleges have Springfest riots. JMU is not within the norm.  Therefore the steps that JMU will need to take to change the negative alcohol culture may need to be beyond the norm.  What works at other universities may not be enough for the JMU situation. 

Texax A&M University "Bonfire" November 19,1999- Is Springfest JMU's version of Bonfire?

Below is from :
"Dying to Drink: Confronting Binge Drinking on College Campuses", by Henry Wechsler, Director, Harvard School of Public Health, College Alcohol Study, and Bernice Wuethrich, Rodale 2002.

BONFIRE
"...Every year since 1909, when a group of student cadets razed furniture from around campus and set it ablaze, students at Texas A&M University in College Station have built Bonfire.  They burn their creation before the season's final football game, played between Texas A&M and arch rival University of Texas, or TU, as it is called. For Aggies, Bonfire represents "the burning desire to beat the hell out of TU.".....
    By 1999 Bonfire had grown to be a student-managed project of massive proportions.  From a simple tepee structure it had evolved into a layered wedding-cake design with thousands of logs piled together, stack upon stack.  It reached a height of sixty feet and weighed close to two million pounds, about as much as two 747 jets.  Students passed down instructions for building Bonfire by word of mouth, year after year, as older students instructed younger. There was neither blueprint nor systematic professional engineering oversight........
  On the night of November 19, 1999, as Bonfire neared completion, the unthinkable happened. At 2:45 that morning, with seventy young mend and women working on the structure, something shifted at its base as a restraining wire wrapped around several logs in the bottom-most tier snapped.  Then another wire snapped, and another. Suddenly all that had been holding the mammoth structure together, every safeguard assumed to be in place, failed as the structure collapsed like a house of cards.  Logs began to fall away from the bottom stack's southeast side. Second-stack logs followed, shifting sideways and hurtling into the gaps below. Students screamed and scrambled for safety as their friends plunged down with the logs....
   Twelve students were crushed to death, and twenty-seven were injured, retrieved from the twisted pile of logs and wire disbelief and grief were as tangible as death was intangible.  The loss reverberated throughout the university and the state.  When alumni heard the news, some are reported to have wept. ...
  In the tragedy's aftermath the university appointed an independent special commission to determine the cause of the collapse....
   What role did alcohol play in this college tradition?  The report found "considerable evidence of irresponsible behavior in Bonfire.  Alcohol use was substantial, although student leaders prohibited alcohol....Laban Toscano, a Sergeant with the Texas Alcoholic Beverage Commission who helped investigate the Bonfire tragedy, said " You've got people drinking beer while putting together a complex structure.  You have to wonder if, over the years, that isn't what caused the change in the structure, the hand-me-downs of instructions from students getting convoluted while under the influence."

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     I invited the JMU Board of Visitors to appoint an Independent Commission at it's October 1, 2010 meeting.  The Rector rejected that suggestion.  I have asked the Governor to consider the issue also- have not heard back from him as yet.  I believe that you can appoint a commission before students die and I believe the Springfest riots of April 2010 were the signal that the JMU Springfest tradition is as out of control as the Texas A&M Bonfire tradition was out of control in 1999.
   The more I review the literature and JMU's own data, the more convinced I am that it will take an external force such as an independent commission or a lawsuit in order to change the negative alcohol culture at JMU

BASICS

JMU provides an alcohol education program called BASICS. This program is evidenced based and in use nationwide. I have asked JMU for information about the effectiveness of the JMU program and will post that when I receive it.  One of my questions has to do with the premise that increased knowledge equals change in behavior.  The BASICS program may be effective in imparting knowledge about alcohol to at risk students but does it lead to change in alcohol behavior by students? We know that society has done a good job informing students about the association of tobacco use with cancer yet we still have a significant number of students who use tobacco products, so knowledge alone does not always lead to behavior change.

Below is a description of BASICS from the JMU web site.

What is BASICS?

At James Madison University, the University Health Center’s Substance Abuse Prevention coordinates BASICS - Brief Alcohol Screening and Intervention for College Students. This evidence-based program is an early intervention strategy specifically designed for traditional college age students.
The BASICS program is designed to help students evaluate their risk and alcohol expectancies; it is not an abstinence based program.

Who is it for?

It is aimed at students who drink alcohol heavily and have experienced or are at risk for experiencing alcohol-related negative consequences.
The BASICS program is a service available to JMU students who want to consider changing or reducing their substance use. This may include students who:

• self-refer
• are referred by administrators, faculty/staff, coaches, or friends
• are mandated by Judicial Affairs for a JMU alcohol policy violation
• are court-mandated to complete substance abuse prevention hours

Approach

The BASICS program is comprised of two 50-minute interview sessions.
The first session retrieves information from the student about his/her substance use, using a self assessment instrument.
The second session is a feedback session designed to help the student assess his/her own behavior and potential risks, identify potential changes, and help reduce future problems related to substance abuse.
The program’s style is empathetic, non-confrontational, and non-judgmental, making it engaging to most college students.

Confidentiality

Without the student’s consent, everything the student says in the sessions is confidential, unless the facilitator is required, by law, to break confidentiality to protect that student or somebody else from harm.
If you have questions about confidentiality or its limits, the facilitator will be able to answer these questions at the first session.

Scheduling BASICS

To discuss the appropriateness and scheduling of BASICS for an individual student, please contact Tia Mann (BASICS Prevention Specialist) at manntl@jmu.edu or 540-568-5501 begin_of_the_skype_highlighting              540-568-5501      end_of_the_skype_highlighting.

BASICS Effectiveness

In Fall 2009, the University Health Center’s Substance Abuse Prevention started to formally evaluate the effectiveness of BASICS at JMU. The evaluation includes a pre-test, 1-month posttest, and 3-month posttest design.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has given basics a Tier 1 classification, which includes "strategies that show evidence of effectiveness with college students." Many research studies have shown motivational interviewing to be effective in reducing peak BAC, typical BAC, negative consequences related to drinking, and quantity and frequency of drinking. For a comprehensive look at these studies, please visit http://www.motivationalinterview.org/library/outcome_files/frame.htm.

Basics Presentations

Motivational Interviewing

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I have asked JMU for information on the effectiveness of the JMU BASICS program and will post that when it is received. 

JMU Student Affairs and University Planning: Vision and Strategic Plan 2014

The JMU web page has a link to their Strategic Plan, which appears to have been developed for 2008-2014. The plan has some specific Performance Indicators dealing with measuring the impact of change efforts on alcohol behavior of students.  Below is the first goal and performance indicators. I have highlighted part of Performance indicator 1.3

JMU Student Affairs and University Planning Vision and Strategic Plan 2014

Goal 1: We will create and maintain campus environments that increase students’ ability to make healthy choices in their lives.
Objectives
1.1  We will more effectively teach and engage students in the components of a life that balances physical, spiritual, social, occupational, emotional, intellectual, cultural and environmental aspects.

Performance Indicators 1.1
We will adopt a common “healthy choices” wellness model. Staff members in all departments will know how to use the model to create and maintain programs and services.
We will use a variety of methods to inform students about the most common issues and concerns impacting them and will provide students with resources, assistance and strategies to effectively address these concerns.
All graduates will participate in wellness programs in which they learn strategies and principles related to maintaining a healthy lifestyle, as measured through the Continuing Student Survey and an Assessment Day instrument.

1.2   We will help students assume greater responsibility for their personal safety, and we will minimize risk in divisional programs and services.

Performance Indicators 1.2
Students will demonstrate increased knowledge and more appropriate behavior regarding their responsibility for personal safety in such areas as sexual health, harm to self and others, living areas, alcohol, substance abuse and transportation, as measured by differences between reported behaviors at the time of enrollment and later reported behaviors through departmental assessments.
Students will receive monthly communication from the university regarding timely safety issues and each student’s own areas of responsibility (e.g., flu shots, securing apartments during holidays, healthy alcohol choices, etc).
All Student Affairs and University Planning (SAUP) departments will identify the risk management and personal safety issues most relevant to their programs and services. These departments will collaborate with other university offices to develop appropriate interventions.
Staff in all SAUP departments will complete instruction related to recognizing and responding to the warning signs of student behaviors that might be detrimental to themselves and others

1.3  We will refocus and improve alcohol education and behavior management programs.

Performance Indicators 1.3
The SAUP division will engage in a comprehensive review of alcohol education and behavior management resulting in:

• adoption of a comprehensive plan for substance abuse prevention.
• communication of a consistent university-wide position on alcohol use/abuse
• .implementation of key strategies to increase alcohol knowledge and decrease the negative consequences of alcohol abuse.

Students will demonstrate increased knowledge of alcohol laws and consequences, health considerations, social norms, personal values and university expectations regarding alcohol use.
Students will report a decrease in negative behaviors associated with alcohol use as reported by the Core Alcohol and Drug Survey, the American College Health Association survey and other campus reports.
All SAUP staff members and student employees will successfully complete professional development training on college student alcohol use/abuse.
The division will develop web-based and other programming efforts to help instructional faculty respond to student behavior that commonly causes uncertainty, concern and/or alarm

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I have asked JMU for copies of the results of the Surveys and other campus reports to see if their is any decrease in negative behaviors associated with alcohol use at JMU. I will post that data when I receive it.

What Communities Can Do?

"Ordinary citizens need to take the lead in reshaping the alcohol environment because if we do not, the industry will continue to misdirect resources and others' good intentions down dead ends while undermining efforts that would make a real difference.
  Over the years, our College Alcohol Study has found conclusively that:

• The lower the price of alcohol, the higher the level of binge drinking.
• The greater the outlet density, the higher the level of binge drinking.
•  The more special price promotions, the higher the level of binge drinking
• The less enforcement of underage drinking laws, the more alcohol underage people consume.

These findings give us a good idea of where to start to effectively change the binge-drinking environment.  As an extended community we need to:

1. Raise the price of alcohol.
2.  Limit the number of bars and other alcohol outlets around our college campuses.
3.  End special price promotions that lower prices even further.
4.  Enforce underage drinking laws" (p255-256)

"Dying to Drink: Confronting Binge Drinking on College Campuses", by Henry Wechsler, Director, Harvard School of Public Health, College Alcohol Study, and Bernice Wuethrich, Rodale2002.

"Dying to Drink" - Big Alcohol

"Dying to Drink: Confronting Binge Drinking on College Campuses", by Henry Wechsler, Director, Harvard School of Public Health, College Alcohol Study, and Bernice Wuethrich, Rodale2002.

   Wechsler's book is frequently referred to in the college alcohol literature. He notes that "Big Alcohol" - the alcohol industry is a powerful force impacting the issue of college drinking. The alcohol industry is a "$110 billion-a-year industry" (p132).  Wechsler notes that "Several major trade associations work nonstop to influence lawmakers and public opinion:

• The Beer Institute...operates on annual budget of about $2 million.
• The National Beer Wholesalers Association (NBWA)- ...In 2001, Fortune magazine voted it one of the top-ten most effective lobbying groups on Capitol Hill.
• The Distilled Spirits Council of the United States (DISCUS)-..employs forty-five people and has a budget of $7.5 million.
• The Wine Institute.. operates a $6.5 million budget. It has satellite offices in seven other cities and lobbyists in more than forty states.
• The American Beverage Institute- represents restaurant owners who serve alcohol, including both independent operators and some of America's largest restaurant chains.
• National Licensed Beverage Association ...It represents more than sixteen thousand bar, tavern, restaurant, and package-store owners across the United States.  (p126-127) "

"One reason Big Alcohol can seem so untouchable is its tie-in to other economic sectors: Dining, travel, entertainment, and gambling all  rely on alcohol sales to increase their margins of profit.  And key indrutry players are very much aware of the need for a united front"

One has to wonder what role does "Big Alcohol" play at JMU?