An Integrative Summary of Binge Drinking Among Undergraduate Students at Northern Michigan University HL 311 Fall 2013 Jamie Frederickson,

Carolyn Trela, Jenea Wheeler

Table of Contents

Title Page1 Table of Contents2 Introduction and Background..3 Target Audience(s)..7 Goals and Objectives...8 Pretesting Concepts and Messages..9 Messages.10 Materials.11 Partnerships12 References..13

Introduction and Background Overview

During the fall 2013 semester at Northern Michigan University, a group has been assembled to research and address the concerns associated with binge drinking among college students. The students involved in the Social Marketing Class worked together to develop a binge drinking intervention targeting Northern Michigan University undergraduate students. This target population, ages 18-24, includes students of many backgrounds and histories. The student work group chose to follow the social marketing process to influence undergraduate behavior in several different areas. This case will document their process as they 1) described the scope of the problem, 2) chose a specific target audience, 3) conducted formative research within that audience demographic, and 4) used the gathered information to form an independent intervention strategy for change. The social marketing process began at the beginning of the fall 2013 semester in mid-October. The work group was assembled and training began under the instruction of the Health Communications HL 311 class instructor. This class educated group members on social marketing skills including peer and public communication, research techniques, segmentation, and project strategy. There was also a strong emphasis on the importance of planning and researching prior to developing intervention strategies. Keeping the learned strategies and steps for research and project development in mind, the work group moved forward to interview and compile data via focus group.

The Problem or Issue Addressed

A work group composed of three HL 311 students worked together to gather information regarding binge drinking epidemiology on Northern Michigan Universitys campus compared to national binge drinking levels. This information was used to formulate the problem description for a social marketing plan. The goal was aimed to reduce the portion of undergraduates, ages 18-24, attending Northern Michigan University who binge drink by five percent at the end of the 2013 Fall
3

Semester. This would be possible by educating the target audience on the immediate and long-term risks of binge drinking. More specifically, by addressing health and safety issues that accompany high risk drinking behavior, as well as educating the target audience on the alternatives to binge drinking. These alternatives may include safer, smarter drinking habits, as well as any alcohol-free social events offered that take place both within and outside the campus environment. Due to the continuous decrease between 1991 and 2013 (Johnston, 2013), the work group feels optimistic about making these changes for the future. The problem description has several components. It identifies the populations with the greatest need and those most likely to change their behavior. These include men (Peralta, 2010) and first-year freshman students who are making the transition from high school to college (NIAAA, 2006). Another component of the problem is a list of behavioral factors that could potentially contribute to binge drinking behaviors. This includes research on the number of college students who have gotten a ride from a peer who had been drinking alcohol, the percentage of college students nationwide who had driven a vehicle after drinking alcohol, and the percentage of college students who drank alcohol while boating or swimming. The third component was a description of behavior-change models that could be applied to this problem. These models include the Health Belief Model, the Social Cognitive Theory, the Theory of Planned Behaviors, the Transtheoretical Model, and the Diffusion of Innovations Model. These models were studied and revisited as the team formed its intervention strategy. Another part of the problem description determined potential behavioral theories that might aid in developing the intervention. These steps within the Transtheoretical Model were particularly useful in planning. Specifically, due to research conducted by the NIAAA (2006) which stated that alcohol is a gateway to be social for a person transitioning from high school to college, the work group believed targeting students during the Precontempalation Stage of the Transtheoretical model was the best time to raise awareness and educate students on binge drinking. During the Precontemplation Stage, students are
4

unaware of any potential health concerns and are more susceptible to influential information regarding the risks associated with binge drinking. The work group considered every stage of the model and the aforementioned is an example of what can be found in future reports. Due to the fact that the primary objective is to educate the target population, this fourth point discusses the main approaches in which the problem can be prevented. Through research, it was discovered that binge drinking can be prevented when a person chooses to stay within low-risk drinking limits, when a person is educated on potential risks, and when a person chooses healthy alternatives such as choosing to go to a social event on campus instead of partying or going to the bar on the weekends. The work group also encountered a plethora of information on the most serious consequences of binge drinking. These consequences can include burn injuries, drowning, homicide, trauma injury, sexual assaults, motor vehicle crashes, suicides, and fatal falls (NIAAA, 2013). It has been found that the target audiences knowledge on binge drinking was relatively low and their attitudes toward binge drinking corresponded with fun, entertaining, social events. It has also been found that there are high national percentages on data that relates to binge drinking. The data at Northern Michigan University was not an exception. It is understood that there are several barriers to the cause, such as fraternities and sororities at Northern Michigan University who advocate for binge drinking, host parties, and overall encouragement of alcohol consumption campus-wide. There are however, many facilitators on campus that have a set curriculum for education and prevention of binge drinking among students. These include Northern Michigan University Health Promotion office and Marquette County Health Department which can be accessed for the campaign. Finally, the problem description includes several media practices that have successfully been used by other programs in past intervention campaigns to address binge drinking among undergraduate students on college campuses. It has been found that the Marquette County Substance Abuse and Prevention Coalition has done a lot of work in the community focusing on binge drinking. They have
5

proven to successfully integrate strategies to prevent substance abuse. It was also found that Alcoholics Anonymous of Marquette has had great success through attendance of their group meetings. Members have the ability to share experiences and help each other through the twelve-step program as a community. Lastly, the work group would like to interview current professionals who have become experts on this topic. These include, Sarah Derwin who is the Health Coordinator for Marquette County Substance Abuse and Violence Prevention Coalition, Lenny Shible who is a Health Promotion Specialist for Northern Michigan University Health Promotion Office, Deputy Kody Carlson who is an employee of Marquette County Sheriffs Department, Bernadette Norden the Principal Secretary for Northern Michigan University Health Promotion Office, and Lynn Krahn the Community Health Educator for the Marquette County Health Department. Having access to these experts allows the work group to expand on knowledge and experiences that can be an important tool in providing quality information to the target audience. Knowing the main goal is to properly educate the target audience, reaching out to current professional experts may be a necessary tool for the work group to integrate.

Evidence of Need
The issues and risks associated with alcohol consumption play a large factor in the life of many college students. Alcohol is frequently used in the social situations to increase enjoyment and participation. Recreational drinking occurs frequently in the college atmosphere. So much so, that even those who take no interest in drinking are exposed to its effects through their peers. In a study conducted by the Centers for Disease Control and Prevention in 2010 the data collected found the overall prevalence of binge drinking was 17.1%, with the frequency among binge drinkers being 4.4 episodes per month, with 7.9 alcoholic drinks on occasion (CDC, 2012). According to a study by Peralta (2010), 33% of men are classified as frequent binge drinkers compared to 14% of women. When considering what role race and ethnicity play in binge drinking behaviors studies have found that binge drinking behaviors were most common among non-Hispanic Whites at 11.9%, followed by Latinos at 10.8%, and
6

African Americans at about 8% (Bryant, 2012). Data also shows that binge drinking is more common among those with household incomes of $75,000 or more than those with lower incomes (CDC, 2012). There is also data to show that transitioning from high school to a college lifestyle can be difficult, which ultimately allows alcohol to be used as a common gateway to be social (NIAAA, 2006.) While alcohol does play a major role in the social environment during many college experiences, very few people have a correct understanding for how alcohol consumption can inflict danger in the short and long term. According to the National Institute on Alcohol Abuse and Alcoholism (2013), binge drinking increases an individuals chances of being injured or even killed. It is related to around 60% of fatal burn injuries, drowning and homicide, 50% of severe trauma injuries and sexual assaults, and 40% of fatal motor vehicle crashes, suicides, and fatal falls (NIAAA, 2013). Alcohol consumption also plays a key role in long-term health risks including heart disease, liver failure, cancer, and high blood pressure.

Target Audiences
While defining the problem, the work group identified two potential audiences: Northern Michigan University undergraduates ages 18-24 and Northern Michigan University undergraduates ages 18-20. There was a debate on whether or not the work group should focus on those students who were under the legal drinking age, or if it would be more beneficial to focus on the general age group 18-24 years. The group chose to focus on the general age group of undergraduate students ages 18-24 for several reasons. Group members were able to recruit a sufficient number of students for a focus group by opening the invitation to participants over the legal drinking age. This also allowed the work group to attain information from a focus group that best represented all undergraduate students attending Northern Michigan University. I was also discussed that any student under the legal drinking age might feel uncomfortable talking about any illegal participation in alcohol consumption. If this were the case,
7

information would be withheld and therefore any data collected from the focus group would be unreliable and skewed. Lastly, the work group found that it would be much more valuable to include the groups of students that were eligible to drink legally as they most likely have more experiences with binge drinking in many different situations and environments. Choosing to focus on Northern Michigan University undergraduates ages 18 to 24 is still a broad target audience. This group can include those who are under the legal drinking age, those who may legally drink, students who choose not to participate in alcohol consumption, those who enjoy drinking, those who drink to excessively on a regular basis, those who are educated on the topic of binge drinking, and those who are not familiar with the term binge drinking. The final decision of the work group led to the invitation of students from Northern Michigan University HP 200 course to voluntarily participate in the focus group session. While the primary target audience consists of undergraduate students at Northern Michigan University ages 18 to 24, the secondary audiences are also important to address. These secondary audiences include anyone who can also influence the primary audience. Family and friends must also be open to the information and intervention strategies. By educating friends and family members, the work group has the ability to greater influence the primary target audience. These secondary audiences can also include any faculty and staff at Northern Michigan University, as well as any Public Safety enforcers and policy makers.

Goals and Objectives

The work group has set the overall program goal to reduce the proportion of Northern Michigan University undergraduate students who engage in binge drinking behaviors by 5% at the end of the 2013 fall semester. In order to successfully reach this goal there are several smaller goals, or objectives, that must be attained and build toward the overall goal. These objectives have also been developed by the work group as part of integrating and building a successful intervention campaign program. The first
8

objective is to expose 60% of Northern Michigan University students enrolled in HP 200 to proper knowledge on binge drinking by the end of the 2013 fall semester. In order to successfully fulfill this objective the work group must reach out to students enrolled in HP 200 classes. Reaching out to a specific group of students will allow exposure to a segment of the primary target population. This leads to the next objective. By successfully educating 60% of the students enrolled in HP200 classes the work group will then be able to attain the second objective by influencing 60% of students at Northern Michigan University enrolled in HP200 to form an educated opinion on the effects of binge drinking by the end of the 2013 fall semester. By encouraging students to form their own opinion on the risks associated with binge drinking behaviors, the work group can then measure and focus on how the information is being interpreted and retained by the students. The final objective is to increase the number of students at Northern Michigan University enrolled in HP200 who have received data on behaviors, attitudes, and knowledge associated with binge drinking by the end of the 2013 fall semester by 60%. Again, by increasing exposure of the information and data to the students within the target audience, the work group hopes to empower students to make better, safer, more informed decisions while drinking. If these individual objectives can be reached through successful communication techniques, the goal of this campaign project can be met.

Pretesting Concepts and Messages

To begin research and collect accurate data, the work group has conducted an in-depth focus group consisting of ten students from one of the HP 200 courses offered during the fall 2013 semester at Northern Michigan University. The data collected during the one hour long session will be gathered and used to formulate the intervention campaign. Attached to this report is a copy of the focus group moderators guide for focus group #1. The complete transcript for focus group # 1 has already been submitted to the HL 311 instructor.
9

Messages
There are several messages the work group hopes to convey to the target audience. The major message is the fact that alcohol consumption can have many short-term and long-term consequences. While striving to reach the objective of educating the target audience, one message that needs to come across to undergraduate students is that staying within low-risk drinking limits enables students to have a less likely chance of developing an alcohol related problem. In the short term, these problems can include immediate negative effects on sleep cycles, immediate risk of injury to yourself and to others, dangers of driving while under the influence, impaired judgment, impaired cognitive function, and unstable emotional responses. A number of these outcomes not only impact the individual who was binge drinking, but also a large number of people around them. Close friends, acquaintances, family members, significant others, peers, neighbors, fellow drivers, and pedestrians can all suffer from the negative effects of high risk drinking. Alcohol can have an effect on every dimension of health, physical, mental, and emotional. Healthy drinking habits promote overall well-being on an individual level which will ultimately reflect on the overall public health and eventually increase the quality of life in the community. Educating the target audience about long term effects of alcohol consumption will show the magnitude of the problems it can cause down the road. Long-term health can be compromised by high-risk alcohol consumption. Alcohol is linked to heart disease, liver failure, cancer, high blood pressure, and many other potentially life-threatening conditions. These messages can be conveyed through face-to-face communication with the target audiences, campus wide newsletters and emails, as well as educational brochures and fliers. Messages concerning the short-term and long-term effects would be especially important to get to students during times of celebration and high stress. These would include graduation, holidays, final exam week, as well as the beginning and end of each semester.
10

In addition to information about the effects alcohol has on the human body, the work group also hopes to convey messages of alternatives to alcohol. Advertising other social events that do not promote alcohol consumption gives students the opportunity to explore the college environment without focusing on drinking. It is important to give students the opportunity to interact in a social environment and enjoy the time spent with others in the absence of alcohol. These events could be advertised on campus using posters and fliers, through social media such as Twitter and Facebook, and campus-wide newsletters and student notifications. It would be important to offer these events at the beginning of the school year before many incoming freshman have the opportunity to form drinking habits. Such events would also be necessary during customarily celebratory times such as graduation, holiday seasons, and finals week.

Materials
In order to create a successful social marketing plan there are many options for materials that can be used to engage the target audience. The work group decided to integrate easy to read brochures and a FAQ sheet as tools to help educate the students. The brochures include interesting facts and statistics that demonstrate the effects of alcohol. They also share information regarding what can be done to prevent binge drinking and encourage others against it. The brochures also suggest that students contact the Health Promotion office to receive more information and help if they chose. The second tool, a FAQ sheet, is a quick and efficient way to answer many of the questions people frequently ask regarding alcohol and binge drinking. These materials can be made available to any individual by handing them out at events on campus, and keeping them on hand in the Health Promotion Office, Campus Health Center, and Public Safety offices. These materials along with educational information provided through social media, campus newsletters and emails, and education information given during sessions with the students are likely to prove successful when integrating the social marketing plan.

Partnerships
11

While much of the program will be handled by the work group itself, there are several outside organizations that would be able to assist in making the program successful. If students would like to seek more help or information the Northern Michigan University Health Promotion Office works on campus to promote health and well-being. Students have access to bulletins, flyers, and emails, all of which can be beneficial in reducing the amount of students who engage in binge drinking behaviors. The Vielmetti Health Center would also be beneficial to join forces with. The health center provides currently enrolled students the opportunity to seek affordable, quality, health care from a professional medical staff. This gives the work group an opportunity to directly work with trained, certified health professionals, which enables them to gain and gather knowledge concerning how to address the students on the effects of binge drinking. The work group believes that partnering with Northern Michigan Universitys Health Promotion Office along with the Vielmetti Health Center will help inform and remind undergraduates about the risks associated with binge drinking beyond the scope of the work group. This provides the chance to reach the students directly through the environment they spend most of their time in. As students receive emails and newsletters on a daily and monthly basis, the work group can easily access to the students regularly.

12

References
National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2006). Alcohol Alert: Young Drinking (Number 68). Retrieved from http://pubs.niaaa.nih.gov/publications/aa68/aa68.htm

Johnston, L., et al, U. of Michigan. (2013). National Survey Results on Dug Use from the Monitoring the Future Study, Volume II. Retrieved from http://centurycouncil.org/bingedrinking/statistics National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2013). What are the risks?

13