Prevention efforts to reduce undergraduates' high-risk alcohol use at a small, private, urban research University in the Northeast: a 20-year case study

Abstract

High-risk alcohol use by U.S. undergraduates has been a widely studied topic over the past 25 years, and there are numerous individual- and environmental-level strategies being implemented at colleges and universities nationwide. Nonetheless, high-risk alcohol use by college students remains a pervasive and seemingly intractable challenge for health practitioners employed at institutions of higher education, one that they have made a priority due to the severe consequences that undergraduates can experience during a sensitive time in their physical, cognitive, and emotional development. This dissertation uses a case study approach to develop a chronology of the alcohol prevention efforts implemented at a small, private, urban research university in the Northeast between 1996 and 2016 and a rich, thick description of the historical alcohol-related events and contextual conditions that occurred during that time. The study’s primary aim is to identify the factors that have sustained positive gains from the University’s alcohol prevention programs. This is a mixed-methods study, predominantly qualitative but also including an additional quantitative approach. Qualitative methods included intensive interviews of current University employees with knowledge of the prevention efforts implemented during the study period, plus a review of internal and publicly available documents and reports, newspapers and other publications, and online media content from University and local community sources. Existing annual survey data collected between 1997 and 2016 were examined to assess the relationship between the chronology of prevention efforts and the trends and fluctuations observed in student alcohol use and its negative consequences over time. The data and lessons learned from this case study informed a framework for how health practitioners in higher education can assess: 1) the degree to which their institution is implementing a comprehensive mix of evidence-based prevention efforts – which collectively operate at all levels of the Social-Ecological Model – to reduce high-risk alcohol use by undergraduates; and 2) the presence of factors that can increase their institution’s capacity to sustain positive gains from these efforts over time.