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14 July 2021

A Possible Reason High-risk Drinking is So Intractable in College?

Students Who Limit Their Drinking, as Recommended by National Guidelines, Are Stigmatized, Ostracized, or the Subject of Peer Pressure: Limiting Consumption Is All But Prohibited in a Culture of Intoxication - https://journals.sagepub.com/doi/full/10.1177/1178221818792414

First, I realize that this is a study conducted 3+ years ago and in New Zealand no less, however, its points seemed to resonate with me given my experience working with collegians in a small, private, urban university.

The gist of the argument presented is that the cost in social capital for students to identify, by declaration and/or behavior, as moderate drinkers or abstainers is high. In addition, "the labels" proffered by students when asked about their peers who drink, seem positive when a peer reports what we preventionist would classify as high-risk and derogatory regarding moderate or abstaining peers. There is more to the article than this but it got me thinking.

We know that student misperceptions about collegiate drinking are significant. We also have learned that when designed and conducted correctly, social norms marketing can be quite effective. We also know, however, that there is a stubborn core of high-risk drinkers that does not seem to budge no matter what preventive steps we take or programming efforts we mount. I am wondering if there is a "social capital" concern in this high-risk core regarding these negative if not derogatory labels affixed to moderate drinkers and abstainers...someone looking for a topic for a master’s thesis or doctoral dissertation? :)

Related to this stubborn core that appears immune to our prevention efforts to date, I was reading an article recently that suggested that social norms marketing can actually backfire if messages convy a social norm that is perceived by peers to be vastly out of their reach, as learning about this norm can actually discourage pursuing change. This got me thinking again...it would not surprise me to learn that the proportion of collegiate drinkers who meet the criteria for a diagnosis of an alcohol use disorder is higher in the persistent 22-23% of students reporting frequent "binge drinking" than in the general student population. If this is the case, especially if those AUD students have tried to change and were unsuccessful, might the traditional social norms marketing message that reports something like "X% of students report drinking 4 or fewer drinks when they drink" trigger a 'why bother' or what is called a "what-the-heck" reaction to our social norms messages?

The article I was reading suggested that if a target behavior is growing in popularity -- in our case, 
the number of moderate drinkers and abstainers is increasing -- especially if by modest amounts, instead of reporting actual percentages, simply report the upward trend, sans the details. So, instead of reporting that "X% of State Univ students report consuming 4 or fewer drinks if they choose to drink," reporting "for the Xth month/semester/year in a row, an increased number of State Univ students report moderating their drinking if they choose to drink." Where the 1st message could alienate high-risk drinking if construed as indicative of a peer group w/which I cannot or do not wish to identify, the 2nd is inclusive and uses positive peer pressure to affect change. True, someone who is drinking 10 drinks per outing 2X/wk and decides to "moderate use" by having 7 drinks 1X/wk is still engaging in high-risk behavior, but, hey..."any port in a storm."

Just a couple thought...what do you think?

06 July 2021

What if Mary Poppins was a Collegiate Preventionist?

 

Imagine, if you will, that as we emerge from 17+ months of pandemic with its related lockdowns, social distancing, and virtual meetings it is a beauteous September day much like that date in the opening scenes of the 1964 Disney film, Mary Poppins. As you walk across campus after your meeting to discuss concerns about collegiate drinking and how best to prepare for the return of partying students to campus, you notice drifting down from an azure blue sky; why it is none other than Mary Poppins herself.

 

As she stands before you, quite prim and proper with her umbrella in one hand and satchel in the other, Mary Poppins announces that she is aware of the advertisement in The Chronicle of Higher Education for


an alcohol & other drug (AOD) preventionist and was on campus to apply. She adds that she is aware that your students, much like the adorable yet incorrigible Banks children, Michael and Jane for whom she had been a Nanny, have presented your Student Affairs establishment with quite the conundrum, a “can’t seem to live with them but cannot live without them” dilemma. She suggests that she just may be able to proffer some assistance in bringing resolution to the concerns you have just addressed in your meeting.

 

Your face betrays your wonderment as to just how does she know about your recent meeting let alone its focus on high-risk and dangerous collegiate drinking, but she is just assertive enough—and you are just concerned enough as the V.P. of Student Affairs has charged YOU with the responsibility to address the collegiate drinking problem—that you agree to hear her out and you invite her to your office hear her out…and for some tea.

 

I could continue this scenario and detail a hypothetical dialogue with Mary in some detail but I choose this introduction to proffer a thought not frequently considered when entertaining ideas about how best to prevent high-risk student behavior, AOD use in particular…the gamification of AOD programming.

 

Historically, prevention has focused on, as the profession’s name implies, preventing high-risk and dangerous behavior. To accomplish this objective, its efforts almost exclusively fixated on “the problem.” Such problem-focused approaches unwittingly suggested that high-risk AOD use was an all but insurmountable collegiate problem. Like a closeup photo of an object devoid of any reference in the frame for comparison, determining the extent of “collegiate drinking” as a problem becomes somewhat subjective, left to the interpretation of the observer. This, coupled with a decades-long history of preventionists almost exclusively addressing “the problem” of high-risk and dangerous drinking, has left some wondering if collegiate drinking is actually the problem we have been led to believe it is.



But back to Mary Poppins…gamification is exactly what Mary does when she assumes the responsibility of Nanny for the Banks children. To re-establish order through the introduction of routine and the instituting of basic procedures for the children to follow, she “gamifies” said routines and procedures, rules if you will, to entice compliance and, as a result, behavior change. It is, as one of the more memorable songs from the film goes, a “spoonful of sugar” that “make the medicine go down.” In that same song, Mary sings, In every job that must be done, there is an element of fun. You find the fun, and  snap! The job’s a game.[1]

 

Now I am not so naïve as to suggest that moderating student behavior is a simple matter of making low-risk decision making fun. Is there, however, a way—or are there ways—to increase the likelihood that students buy into some of our existing approaches to prevention? Can we “gamify” any of our prevention efforts?

 

To modify their behavior, students must conduct a cost-benefit analysis of any proposed change, realizing that if made, it will yield access to what they perceive as having a greater value than what they must give up to obtain it. Unfortunately, risk avoidance has not historically proven effective as such a motivator.

 

A major barrier to change is impulsivity or what Katy Milkman[2] calls present bias or the tendency to opt for the short-term reward over a longer-term benefit. For students this is avoiding the short-term reward of an “instant party”…just add alcohol…with all its social promises for the long-term benefit of better grades at the end of term. As the WWI song queried, How ya gonna keep ‘em down on the farm, after they’ve seen Parie?

 

“So,” as an effective parent says to a complaining child, “what do you propose we do?” What might the gamification of AOD prevention look like…or at least what might be a straw man to pull apart as we kick-about this idea? Again, as Katy Milkman suggests—can you tell I just read her book--

 

Gamification is another way to make goal pursuit instantly gratifying. It involves making something that isn’t a game feel more engaging and less monotonous by adding gamelike (sic) features such as symbolic rewards, a sense of competition, and leaderboards (59).

 

 

Perhaps it could involve offering “symbolic rewards” as a student “advances through successive levels” in an online alcohol awareness program. Perhaps it could involve incorporating geocaching into a social norms campaign to make it “more engaging.” Perhaps it could use a “leaderboard” to introduces a “sense of competition” between first-year resident halls for completion of a required online alcohol program. Perhaps voluntary referrals to B.A.S.I.C.S. would increase if B.A.S.I.C.S. was one stop on a term-long “campus services scavenger hunt” with an appropriately enticing prize for those who complete the hunt where a clue/direction to “the next” service came as each service is completed/visited.

 

Limits to the possibilities for the gamification of collegiate prevention efforts know no end. The creativity and resourcefulness of those who choose to incorporate the concept into a campus prevention program represents the only boundaries.


The purpose of this essay, however, is not to suggest HOW to gamify prevention—let alone suggest that any of the ideas just mentioned above are good or even likely to meet with student acceptance—but to simply ask WHAT IF we were to consider gamification as another arrow in the preventionist’s quiver? Perhaps if we were, we just might see Mary open her umbrella and drift off into the evening sky, barely audible as she hums, a spoonful of sugar…

 

What do you think?

__________


1 Milkman, Katy (2021). How to change: The science of getting from where you are to where you want to be. Penguin Random House, N.Y., N.Y.

2 Milkman, Katy (2021). How to change: The science of getting from where you are to where you want to be. Penguin Random House, N.Y., N.Y.