When Awareness Just Is Not Enough

Who in the prevention field has not invested countless hours to raise awareness about the risks associated with high-risk and dangerous collegiate drinking? I know I have...in almost 20-years at La Salle University coordinating its alcohol and other drug program and then, after retiring from La Salle, as a professor of Behavioral Health Counseling at Drexel University…in the classroom, on University committees, and with the former U.S. Department of Ed's supported Network Addressing Collegiate Alcohol & Other Drug Issues.

The argument for making this enormous investment of effort was that if intelligent students simply knew the risks associated with high BAL (blood alcohol level) consumption, they would make the logical decision to moderate their consumption and, thereby, reduce the likelihood of untoward alcohol-related consequences occurring on campus. This reasoning made logical sense and many of us followed it faithfully for years. However, by the later 1990s, we began to realize that information alone was not sufficient to motivate the desired change in collegiate drinking. As we became aware of the work of Prochaska and DiCelemte and their Transtheoretical Model of Change, we realized that although information and awareness might be effective in moving collegiate drinkers beyond a "pre-contemplative" or perhaps "contemplative" stage of readiness to change their drinking behavior, it was not particularly effective in moving students farther along the continuum to an "action" stage of readiness.

Realizing the limits of awareness campaigns being

the only type of "arrow in the preventionists^[1]  quiver" led us to explore more action-oriented means of engaging students, and a good job we have done with this...BASICS and employing brief motivational interviews with feedback when speaking with students, environmental management, employing the ecological model when considering changing the campus culture, and recognizing the role social norming can play in affecting how students view actual alcohol consumption on their campus and in their individual peer groups. That said, we have nonetheless reached a point where the numbers related to student drinking seem to have plateaued. Are those who continue to engage in high-risk and dangerous drinking practices simply intractable or worse yet, incorrigible? Have preventionists reached the limits of their effectiveness? Is high-risk and dangerous collegiate drinking...or drinking by anyone irrespective of college affiliation...just something with which we must learn to live?

Although I have written a number of articles on additional options the prevention field might entertain when pursuing future efforts or approaches to proffering its messages on campus[2], the Stanford Social Innovation Review hosts an article written by Ann Christiano & Annie Neimand entitled "Stop Raising Awareness Already"[3] that is both provocative and of likely interest to all who seek to affect the campus drinking culture. NOTE: This article is long, so be prepared. That said, to "skip ahead to the good part," the good part meaning that section most likely of practical use to AODT preventionists, visit the article and scroll down to Creating Awareness that Leads to Action.

There is a distinct role that increased awareness

plays in forwarding the efforts of preventionists concerned with high-risk and dangerous collegiate drinking. This role is not, however, likely to directly result in behavior change. Put another way, the student who is moved by an inspirational speaker or creative and memorable prevention message on Tuesday is not likely to change her or his drinking behavior come Friday. That said, this student may just move from a pre-contemplative stage of readiness to change and begin to contemplate that what causes a problem is a problem when it causes a problem.

What do you think?

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^[1] “Preventionist” is coined to refer to the behavioral health professional whose interest and focus is the prevention of high-risk and dangerous alcohol and other drug use.

^[2] See essays on the possible role of behavioral economics and social psychology in prevention at https://robertchapman.blogspot.com/ or monographs #1 & #2 on how exploring the process by which students ascribe meaning to alcohol as a substance and drinking as a behavior can "add arrows to the preventionist's quiver" at https://tinyurl.com/yb2v5vta-

^[3] If unable to access this article by clicking its title, the URL is https://ssir.org/articles/entry/stop_raising_awareness_already

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