University of Idaho

HS 490 Health Promotion

Interventions
Assignment 2

Directions

The following pages guide you on each step of this assignment. You
will look for intervention resources on web sites, class readings, class
notes and peer reviewed journals (Research Notes 1-3). You will pull it
all together and create an evidence based plan based on your findings
(Pulling it All Together) and include references, APA format. You may
type directly on these pages but it is not required. I put the assignment
in boxes to make it easier to follow but it may be easier for you to
create a word document with all the assignment components.

Total Point Value- 100 points- 20% of course grade

Website Review -15 points

Intervention Research Readings- 15 points
Research Articles-Peer Reviewed 30 points
Pulling it All Together- 35 points

Unlike the other assignments you will submit in this in hard copy
in class and also on Bblearn.

Professor Helen Brown- Spring 2017

Name: Anna Rose Wiencek

Health Topic, Target (can be a primary and secondary target) and Location (must be
clearly defined): Alcohol Abuse Prevention at Miami University

NAME: #1
Intervention Website Review- 15 pts.
Review a website with intervention strategies related to your topic. Only 1 is
required, recommend you look at more than one for greater learning.
Website and Link:
https://www.collegedrinkingprevention.gov/CollegeAIM/Introduction/default.aspx

APA citation of website: NIH. (2017). CollegeAIM Overview. Retrieved April 13, 2017, from
https://www.collegedrinkingprevention.gov/CollegeAIM/Introduction/default.aspx

General Purpose of the Website

This website stems from the National Institute on Alcohol Abuse and Alcoholism. This website
was created because harmful drinking is very high amongst college campuses. It was created
specifically for college settings. This website gives individuals or organizations options on
how to combat and prevent alcohol abuse in the college atmosphere. They have information
on each intervention set up and different categories for if you want more effective or least
effective. There are individual strategies to help with specific people and those who are at a
higher risk. There is also environmental strategies to help where they are drinking and the
campus as a whole. College AIM provides anyone with evidence based information if they
have questions on which topic they should pick. They will also help if you need a specific
prevention strategy for your school. This website also provides worksheets to document
ones strategy.
What did you learn about effective interventions for your topic? Answer the
questions below and add additional comments.

What intervention tools and resources are available? What are the top recommended
interventions? Is there an evidence base for the recommended interventions? (Make sure the
website is useful to your topic).

There are a lot of resources available off this website. They have prevention strategies listed
by category to help people figure out which one will best fit their situation. They offer tools
like identifying which strategies will be the most effective and which ones arent. They also
offer help with combining strategies and giving you information and evidence on which ones
have new research on them. They offer both individual and environmental strategies. They
will give you the estimated costs and time frame. They list the barriers and the research
amount. They also give you a worksheet to document your strategy and to plan out ahead of
time. It gives you guidance on how to plan out these strategies. All these interventions are
evidence based and they collect data periodically to help improve their interventions. There
are around 20 different strategies for individuals on this website. For Individual Interventions
the top three most effective are Multi-Component Education-Focused Program. This is a two
part program that is online that provides feedback and education on alcohol use. This would
be done in the summer before freshman come to college because freshman are considered a
high risk group. Another individual intervention that is highly rated is the Skill Training,
Alcohol Focus: Goal/intention-setting alone. This is an approach that the person at harm
would identify they have an alcohol issue and will set goals to limit their consumption based
on their current habits and values. This would be done when people get in trouble or when
alcohol is starting to have a negative impact on their life. This allows for someone to know
they have a problem and make it entirely their own strategy. A health professional
coordinator would be in charge and the goals and meetings would last 6 months. The last
one for individual is, Skills Training, Alcohol Plus General Life Skills: Alcohol Skills Training
Program. This has multiple components and is targeted for kids who are at risk for
developing alcohol problems. This programs contains information on addiction to alcohol and
exercises that help train students to identify personal drinking cues, develop alcohol refusal
skills, and manage stress. A health coordinator would be in charge as it is done in person.
This would target Greek Life and Freshman as a group of people at risk. Now there are also
20 environmental strategies. The top three are, Enforce the Age-21 Drinking Age. This is a
strategy that would create a strong enforcement of the drinking age by regulating the
enforcement with undercover cops, more supervision of the police, and law enforcement
when it comes to fake IDs and purchasing alcohol. The next step of this intervention is to
make the punishments server. You would need the police behind you on this intervention.
The next strategy is to, Increase Alcohol Tax. This would make it more expensive on the
purchase of alcohol making it more expensive to drink a lot. One would need a policy
advocate to get this passed as it controlled by state and local governments. The last one is
to, Restrict Happy Hour/Prices and Promotion. This would restrict specialty drinks that
would encourage people to drink more than they want to. Like a 2 for 1 drink. This needs the
help of policy advocates as well. They also have a list of other groups to go to if you need
more resources for your topic. This website is all about taking action and really does a nice
job on implanting a time frame. This website reminds you that you cannot prevent drinking in
college, but you can prevent abuse by creating interventions.

Critical thinking and relation to your health promotion topic

What did you learn from the website that you can apply to your project? Organize by
answering # 1-3 below:

1) Intervention activities that are appropriate for your project, 2) Useful tools and resources,
including health education/promotion resources; 3) Other resources- give web links for at
least two other helpful resources the web page directed you to and write 1-2 sentences about
what you was helpful about each site.

I want to help prevent alcohol use at a whole at Miami University, so the environmental
strategies are very important to me. As trying to target individuals will be hard as this
campus has a culture of drinking, so reduce that targeting individuals will be fewer and more
specific. One intervention that is appropriate for my project is enforce the age 21 drinking
age. Miami has 9 bars that are 18 and up, but the problem is they dont enforce the drinking
age once inside the bar. They do not ID at the bar and the only thing that says you are under
21 is a black sharpie mark on your hand. It is extremely easy to get alcohol at the bars even
though you are not 21. If we can target that issue then the people under 21 wont be able to
drink at the bars anymore. This would really reduce the population that abuses alcohol. This
would require having undercover cops to check their hands if they try to scrub it off in the
bathroom. Also having the bar tenders check IDs when they order drinks. Also another one
that I think would have the biggest effect is the increase in alcohol tax. This would make it
more expensive to drink a lot. This would affect the amount of alcohol sold because college
kids are not made of money. This would help the abuse and easy access for college kids to
drink. These are all interventions that I could list on my website to help inform people on
what to do. The next step after environmental is to make an education intervention like Skills
training and alcohol focus. A useful tool that I could put on my website is the worksheet to
help with organization of the planning of their strategy. This would help combine strategies.
This is more of an action website instead of a promotion website. The individual strategies
are all information based to teach the individual about their own personal issue. Under
additional information there are some useful links like, College Drinking: Changing the
Culture and Report to Congress on the Prevention and Reduction of Underage Drinking.
The first website would help tackle my issue of Miami being a huge drinking culture. This
would give me information on alcohol use by college students. This would apply to my
website by getting people to see that Miami has a drinking culture that is very strong and
then how to improve that. The other website talks about policy summaries and have current
legislative efforts. This would help with giving information to people who choose the policy
interventions on what is going on right now and what still needs to be done.

#2 Intervention Research Readings- 15 pts.

General Intervention Considerations- Answer the following using lectures and
readings. 1 paragraph for each.

1. Health Behavior Theory- Identify the theory (or theories) that is most important to
guide your intervention and discuss how that theory will guide interventions. (See
Theories at a Glance).

The Health Behavior Theory will help my intervention greatly. I want to start with enforce
the drinking age intervention as well as the multicomponent educational focused program.
This theory helps break down the interventions on how the action could take place. In the
first section the topic that stands out for my intervention is behavioral belief. This leads to
the attitude towards the behavior and right now the attitude towards drinking is not
healthy. The people at the university have a behavior so that drinking a lot is natural.
Taking that into account our intervention should target that behavior belief because if you
dont believe then you wont do it. Having the intervention switch students into believing
the best behavior is drink moderately/safely or not all will halt the key part that causes the
behavior. The most important section to my intervention is the middle section where the
topics are normative beliefs and motivation to comply. It is normal to drink Thursday
through Saturday at Miami given the access. Making the motive to comply being that one
wants to have friends and live out the college experience. No one wants to feel alone and
one way to do that is to go out to parties. Making that a big part of my intervention will
make it normal to think be safe and drink safely. That it will be normal to stay in with
friends, so the motivation to comply is lower on the going out side and higher on the
drinking safely side. This will help limit the behavior intention to drink too much. The last
part that will go into effect for my intervention is perceived power. If the power to drink
too much at the bars is taken away then the behavior will have to change. This will be a
barrier for kids who drink too much at the bars. That is why I picked those two
interventions in theory to have for my issue. The theory talks about the belief and
changing the belief will change the behavior.

Spectrum of Prevention- Based on the reading from the Prevention Institute-what levels of
prevention are most important for your topic/target and location? The type/level of change
 desired will direct you to types of interventions that will have the most impact.

The level that I chose is the, Influencing Policy and Legislation and Education
Providers. The Influencing Policy change will help with my enforcing the 21 age for
drinking alcohol. The bars are 18 and up and do not have good resources to prevent
alcohol abuse. The students most at risk are freshman and Greek Life. Changing the
policy to 21 and up will prevent students from even going to the bars and taking students
out of the situation. Then having the under 21 wear wrist bands so they are better
identified will help with bartenders that serve people under 21. Then changing to having
people who buy drinks show their IDs will prevent people under 18 to not buy alcohol.
Then educating providers is always important. Knowing why one should not abuse alcohol
will go a lot farther then forcing them to not drink. So with the enforcement comes the
education. Having students take educational classes to try and stop them before they
start to abuse. Then also educating the police on fake IDs and bartenders on fake IDs will
also help. Letting a bartender learn when to spot someone who has had too much.
Educating will help reinforce the enforcement.

2. Discuss what you learned about the predisposing, enabling and reinforcing factors that
are most related to the health behaviors you are trying to change.

The most important predisposing factors in my health behavior is the lack of education and
knowledge on safe drinking strategies, on what alcohol is, and what alcohol does to your
body. Knowledge is a predisposing factor when it comes to my behavior. Not knowing that
drinking 5 drinks in one hour is harmful is not always common knowledge, but knowing what
a standard drink is and how to drink wisely would help in prevention of alcohol abuse.
Another predisposing factor is the belief that Miami is a party school and everyone drinks.
Learning that there are more people and clubs might help with kids who dont want to drink,
but have nothing to do. Now an enabling factor at Miami is that the bars are 18 and up and
there are 9 of them all right next to each other. Also all the bars are in walking distance from
the dorms and campus. Some reinforcing factors are more people look like they are having
fun via social media when they go out and party. Seeing all your friends party is reinforcing
that you might be missing out on a good time. Or that the people with a lot of friends are
always going out and that the Greek system is very popular at Miami.
 #3 RESEARCH ARTICLES PEER REVEIWED- 1 of 3
3 peer reviewed research articles needed- 1 can be a review article. You do not
need to use this box format, you can use a word doc and include the headings
below. 10 pt. each -30 pt. total
APA Citation of article

Carey, C. B., Scott-Sheldon, L. A., Carey, M. P., & DeMartini, K. S. (2007, November). Individual-level
interventions to reduce college drinking: meta-analytic review .Vol 32. Issue 11. Retrieved April 12, 2017,
from http://www.sciencedirect.com/science/article/pii/S0306460307001451

Participants or population reached

Young adults from the age 18-25

Describe the intervention and its effectiveness

Briefly describe the intervention what did they do? What was unique or most
interesting to you?

They took a behavioral-cognitive approach to combat the heavy drinking. Most of the
intervention was done face to face in a small or individual group. Within their intervention
their target was to change their thought process about the behavior. They brought in the
negatives about consuming too much alcohol and how the behavior to indulge in will cause
negative effects on your life. They had multiple meetings over a course of 3 months than 26
weeks later they came back to test them again on their changes. Then at 195 weeks later
there was another follow up. Each one there was a reduction of alcohol usage. The unique
part about this intervention is they follow up on the progress of people. They dont just do it
once, but twice to make sure that the behavior has changed. This intervention changes the
thought process for long-term effect. I found that even though in their interventions they
talked a lot about negatives, but they did succeed in reducing the use of alcohol. Also there
was less drinking in a controlled environment.

What did you learn about the effectiveness of the intervention?

That this intervention was about changing an entire behavior and not just the thought. It was
individualized, so it could target someone specially. That when people felt more
individualized them changed their behavior to make it their own.

If a health behavior theory was identified, briefly discuss which one was used and how
it shaped the intervention?

They identified the behavior belief. That is what they were trying to change that their belief
towards their over drinking was not bad and it wont affect them. This was an attitude
change that had them thinking more about this will hurt me in the long run if I keep drinking
this much. It was that they were able to change, so the behavior changed. It cut off the idea
or attitude towards heavy drinking and then turned it into a negative stigma. Having the
intervention be about behavior cognitive approach it allowed to change an attitude.

For what were the main conclusions about the interventions reached by the author(s)
including limitations?

That providing good interventions to college students do make a difference in their drinking
habits. That risk prevention did lead to lower use of alcohol in their follow ups. The change
of behavior would be hard, but effective over time. The only limitation listed is that they
didnt have enough people that were at a high risk to see if they relapse or decrease.

Critical thinking and relation to your project

What did you learn from this research/intervention that can be applied to you project?

That changing the mindset of individuals is important. Taking away their opportunity to
drink wont completely change their behavior. You have to educate and change the
environment to get the best results. Having that type of intervention will help my project
give the best information to people who come to learn. Knowing you cant just do one
approach. Also having them come back would be helpful to see if my intervention is
working.

What would you need to do to adapt the intervention to fit your population and why?

I would need to get a lot more people to help with the interventions as the campus is huge.
Also having to change their behavior will be different because it is a different lifestyle. Also I
would have to find information on past alcohol issues at Miami to make it more personal to
the student, so they can actually apply it.
 #3 RESEARCH ARTICLES PEER REVEIWED- 2 of 3

APA Citation

Foxcroft, D. R., Ireland, D., Lister-Sharp, D. J., Lowe, G., & Breen, R. (2003). Longer-term primary
prevention for alcohol misuse in young people: a systematic review. Addiction, 98(4), 397-411.
doi:10.1046/j.1360-0443.2003.00355.x

Participants or population reached

People up to age 25

Describe the intervention and its effectiveness

Briefly describe the intervention what did they do? What was unique or most
interesting to you?

They chose an education intervention. It was based around education of alcohol abuse. This
was to develop psychological and social skills in young adults. This is a type of peer
resistance that will help with the misuse of alcohol. The interventions were aimed more
towards alcohol misuse outcomes. They also took a multicomponent approach because just
working on one aspect didnt give them best results. This was to make people aware of the
dangers of alcohol when consumed too much. I found that taking a social skills and
psychological route was unique. I never thought about doing anything with that and it really
opened my eyes to people dont know how to say no. It is hard to say no when people ask
you to do something especially if it is their friend. Most of the time people drink because they
felt pressured into it and not because they wanted to. Being able to say no and then also
maintain a friendship is hard. That was very unique part of their intervention.

What did you learn about the effectiveness of the intervention?

Not extremely effective as 20 out of the 56 studies were not effective. So it was almost a
50/50 chance it would work. The long-term effects were extremely positive for the ones that
worked. That giving people the tools to say no and think about were effective. But overall
this one wasnt the most effective. Also the USA had the best results for limiting drinking.

If a health behavior theory was identified, briefly discuss which one was used and how
it shaped the intervention?

One was kind of discussed which is the motive to comply. Learned social skills will change
your response to the behavior. Being able to say no and being confident in that will stop the
behavior of abuse. The motive changes if you are more aware socially of what is going on.
Not being caught up the hype will help with younger people trying to figure out college.

For what were the main conclusions about the interventions reached by the author(s)
 including limitations?

That this research study should be conducted again for short-term results. That there was
some signs of improvement in the long-term. Also the methodology needs to be changed for
better results. Also having different criteria internationally will be helpful.

Critical thinking and relation to your project

What did you learn from this research/intervention that can be applied to you project?

That social skills are important to learn especially for incoming freshman. Having an
intervention part that covers how to say no and how to be social is important. That having a
bigger spectrum on this issue is going to get more information and better results.

What would you need to do to adapt the intervention to fit your population and why?

Having social skills would be nice to adapt to my intervention. Miami us extremely social and
so it will be important. Adding that to the educational part will be important. There is more
than just the behavior of saying no and not drinking, but how to and what it looks like is
important.

#3 RESEARCH ARTICLES PEER REVEIWED 3 of 3

APA Citation

Larimer, M. E., & Cronce, J. M. (2002). Identification, prevention and treatment: a review of individual-
focused strategies to reduce problematic alcohol consumption by college students. Journal of Studies
on Alcohol, Supplement, (S14), 148-163. doi:10.15288/jsas.2002.s14.148

Participants or population reached

College students

Describe the intervention and its effectiveness

Briefly describe the intervention what did they do? What was unique or most
interesting to you?

They used literacy to see if it will change alcohol abuse outcomes. They studied the behavior
after college kids read about alcohol abuse and what is does to your body. They then studied
what the college kids did after reading all that information. This was unique in that it involved
the person reading and learning by themselves. Then they didnt give them any instructions,
but just watched to see if the person would listen to the information and take it seriously.

What did you learn about the effectiveness of the intervention?

This was no effective at all. They said that there was little change in their behaviors when
trying to educate them about alcohol use. This was not a good intervention to use on its own.
This was to compare to cognitive-behavior method, which had more effectiveness to changing
a behavior.

If a health behavior theory was identified, briefly discuss which one was used and how
it shaped the intervention?

They tried to identify behavior beliefs by changing their attitude towards drinking, but it
wasnt successful. People still went through with their behavior. They were studying the
behavior after they learned about the negatives to drinking. Just trying to change a behavior
through education wont always work.

For what were the main conclusions about the interventions reached by the author(s)
including limitations?

That having multicomponent interventions will be more effective. That just knowing the
information wont be the most effective way to change the behavior. That it will take more
than just education to change a behavior. The limitation was that they did not test to see if
the student even read entirely or took in the information.

Critical thinking and relation to your project

What did you learn from this research/intervention that can be applied to you project?

That having just an educational part wont be the most effective way. That blending
interventions will be the most effective to change a whole population. So having just one
intervention in my project wont be good enough. I have to have many aspects.

What would you need to do to adapt the intervention to fit your population and why?

I dont think I would adapt anything they did specifically because it didnt work out for them.
My population is going to be hard to change just through them reading facts and information.
I would not adapt and learn from their mistakes to format by interventions better.
Pulling it All Together- 35 pts.

1. Select a performance measure target based on the Healthy People 2020

objectives or Healthy Campus 2020 as appropriate. If you have an emerging issue
without a performance measure, please see me to discuss an alternative. 1 pt.
Substance abuse: 12th graders will increase their disapproval or people having
one or two alcoholic drinks nearly every day to 77.%.

2. Deciding on strategies for interventions (must be appropriate for target(s). 8 pt.

each- 24 pts.

Based on the intervention activities discussed in class (see ppt) and the findings of the
literature, select the 3 most important types of interventions for your project and list 4-
5 strategies for each strategy. These strategies need to be related to evidence based
practices. Add enough information about the intervention strategies selected that it is
clear what the intervention will accomplish.

Example: Substance Abuse (Alcohol Thought for 12th graders)

Population Based-Interventions
o Since it is a specific target population a population based intervention is
important.
o I would conduct a community assessment of their feelings towards the
topic of people having more than 2 drinks a day. Seeing their feelings
towards it will see why they chose their opinion and what to do to help.
Then seeing their feedback will help see what their education level is and
how to help get them more knowledgeable.
o Then educating that population during their health class on what will
happen if you drink more than two drinks a day and why it is important to
be aware of it. Having them learn the effects of alcohol usage. Then
educating them about what to do if someone they know is drinking a lot
how they can help them and handle their situation.
o Building a coalition is important to get the community involved. Having
one be about why you should not drink more than 2 drinks a day. Just
telling them wont educate them on why we are saying that is bad. They
are going to college soon and so knowing about the effects of alcohol early
will be important. Having parents involved as well will get them more
aware of what is going on the community as well.

Group Interventions
o This could help target the population that is still not seeing a problem with people
who drink more than two drinks a day.
 o Start out by taking their feedback and placing them in groups based off their
feedback on the topic. Get them with other people that see it as bad, so it comes
also from their friends and peers. Having them be in a group of classmates might
have them change their mind. Also there can be less pressure to answer and just
listen if it is in a group.
o Start out with a small group and have them learn about the issues of alcohol, so they
can obtain all the information. Have this be part of their education at their school.
Have them take tests to see if they retain the information and then apply it. Have
them meet once or twice a week and make them do a project about the use of
alcohol on your body.
Direct Community Interventions
o Start in the schools and promote that drinking alcohol every day is not healthy
and or seen as normal. Start in the health classes with teaching them about
alcohol usage. Have them learn about junior year, so it sticks with them all more
as they go to college.
o Start having an alcohol awareness week during the school year. Make it a school
wide function where it is promoted about the effects of alcohol and safe drinking.
Make students get involved on planning it, so they feel more like they are a part
of it. Then have themes every day, so there is some structure.
o Putting up flyers in schools, churches, and common hang outs will make people
aware of the movement and idea of alcohol consumption. Now the whole
community is aware and maybe someone who does drink more will see it and
become aware of their behaviors. Then make people more interested when the
coalitions start.
3. Potential for Success- 10 pts (critical thinking questions)

a.) Discuss why your intended approaches would work (e.g., how do they impact
predisposing, enabling or reinforcing factors?) Write no more than 2 paragraphs and
cite the literature you used to come up with your ideas/strategies.

The CDC is currently trying to increase by 10% on this disapproval of children ideas
of drinking 2 or more drinks a day (CDC). They are already at 70%, so a lot of 12 th
graders do have that feeling (CDC). It is now a small population that needs to be
targeted for the change to occur. I find that my approaches would work because
they target the population, but dont single them out (NIH). I got some of the ideas
from the College Aim page that even ranked the interventions by effectiveness. The
one that will probably be the most effective is the group interventions. Those were
the highest and least cost on College AIM (NIH). They allow for cognitive change
that will lead to a thought change (NIH). We arent trying to change a behavior, but
change a thought process that could eventually change a behavior. Also having
group interventions could make it more unique to the people that are still in the
minority. Special populations are best dealt with group interventions to feel included
but not overwhelmed (Addiction Blog, 2017). Then the flyers are the best and
cheapest way to spread the movement and idea (NIH). They are cheap and can be
spread to a lot of locations (NIH). It is not too forceful, but there is education behind
it (Addiction Blog, 2017).
b.) Discuss sustainability of the intervention plan- what will help this work continue?
This is a cheap plan that is universal for every year. Take the survey and see what the
score are and then base the groups on that. The flyers can always be hung up and
changed. After every year there can be feedback to see how it can improve and what it
is lacking. It is important to educate and health classes should always be there and so
it is part of the criteria. It is useful and it will help seniors be prepared for college.
 References
Addiction Blog - "a" is for addiction. (n.d.). Retrieved April 17, 2017, from http://addictionblog.org/

Carey, C. B., Scott-Sheldon, L. A., Carey, M. P., & DeMartini, K. S. (2007, November). Individual-level
interventions to reduce college drinking: meta-analytic review .Vol 32. Issue 11. Retrieved April 12, 2017, from
http://www.sciencedirect.com/science/article/pii/S0306460307001451

Foxcroft, D. R., Ireland, D., Lister-Sharp, D. J., Lowe, G., & Breen, R. (2003). Longer-term primary
prevention for alcohol misuse in young people: a systematic review. Addiction, 98(4), 397-411.
doi:10.1046/j.1360-0443.2003.00355.x

Larimer, M. E., & Cronce, J. M. (2002). Identification, prevention and treatment: a review of individual-
focused strategies to reduce problematic alcohol consumption by college students. Journal of Studies on
Alcohol, Supplement, (S14), 148-163. doi:10.15288/jsas.2002.s14.148

NIH. (2017). CollegeAIM Overview. Retrieved April 13, 2017, from

https://www.collegedrinkingprevention.gov/CollegeAIM/Introduction/default.aspx