fPrevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1 1

Prevention and Health Promotion: Research, Social Action, Practice and Training is a publication of the Prevention Section of
the Society for Counseling Psychology. The publication is dedicated to the dissemination of information on prevention theory,
research, practice and training in counseling psychology, stimulating prevention scholarship, promoting collaboration between
counseling psychologists engaged in prevention, and encourages student scholars. The publication focuses on prevention in specific
domains (e.g., college campuses) employing specific modalities (e.g., group work), and reports summaries of epidemiological and
preventive intervention research. All submissions to the publication undergo blind review by an editorial board jury, and those
selected for publication are distributed nationally through electronic and hard copies.

Managing Editor
Erin E. Ayala, PhD, Albany Medical Center

Editorial Board Chair

Sally M. Hage, PhD, Springfield College

Members of the Editorial Board

Aimee Arikian, The Emily Program
Kimberly Burdine, Texas Tech University
Stephanie Chapman, Baylor College of Medicine
Robert Conyne, University of Cincinnati
Simon Chung, Toronto, Canada
Michael Gale, University at Albany
Arthur Horne, University of Georgia
Cara Maffini, San Jose State University
LeRoy Reese, Morehouse School of Medicine
Chandra Story, Oklahoma State University
Ellen Vaughan, Indiana University Bloomington

Editorial Assistant
Julianne Yavorski, Oklahoma State University

Submission Guidelines
The Prevention Section of the Society of Counseling Psychology publishes Prevention and Health Promotion: Research, Social
Action, Practice and Training. This is a blind peer-reviewed publication presenting scholarly work in the field of prevention that is
distributed nationally. Contributions can focus on prevention theory, research, practice or training, or a combination of these topics.
We welcome student submissions. As a publication of the Prevention Section of Division 17, presentations and awards sponsored by
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Editor, at ayalae@mail.amc.edu.

Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1 2
 PREVENTION AND HEALTH PROMOTION
RESEARCH, SOCIAL ACTION, PRACTICE AND TRAINING
Primary Prevention: Is It an Idea Whose Time Has Come?
Myrna B. Shure 4

Examining Associations Between Residential Status, Protective Behavioral Strategy Use, and Alcohol-
Related Negative Consequences Among College Students

Kray A. Scully, Danielle P. Cottonham, Margo C. Villarosa, Saarah D. Kison, and Michael B. Madson 15

Suicide Prevention Gatekeeper Training for Resident Assistants: A Between Groups Control Design
Study
Colleen Thomas and Martin Swanbrow Becker 27

Comparison between International and Domestic Graduate Students on Alcohol, Sexual Assault, and
Prevention Efforts: An Exploratory Study
Lei Wang, Leslie A. Fasone, and Ellen L. Vaughan 29

Teaching Interpersonal Communication Skills: Comparing the Fidelity of Online Simulations

Amy E. Dawson, Bianca L. Bernstein, Jennifer M. Bekki, and Kerrie G. Wilkins 32

Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1 3
 RESEARCH, SOCIAL ACTION, PRACTICE AND TRAINING

Invited Contribution
Primary Prevention: Is It an Idea Whose Time Has Come?
Myrna B. Shure

Drexel University

Myrna B. Shure, PhD, is a developmental psychologist and Professor Emeritus at Drexel University in Philadelphia. She is the creator
of the I Can Problem Solve (ICPS) programan evidence-based social and emotional learning/violence prevention program for use in
schoolsand Raising a Thinking Child (RATC), also evidence-based for use by parents. Dr. Shure received the 2015 Lifetime
Achievement Award from the Society of Counseling Psychologys Prevention Section in the American Psychological Association in
recognition of her continued contributions to the field. For additional information, email Dr. Shure at mshure@drexel.edu or access
her website at www.thinkingchild.com.

I am deeply honored and humbled to be the co-
recipient of the 2015 Lifetime Achievement Award from the
Society of Counseling Psychology Prevention Section of the
American Psychological Association. This recognition has
propelled me to reflect on my lifes work, barriers I met along
the way, the role of the school guidance counselor, the future
of prevention research and practice, and some of my own
satisfactions that may inspire early career psychologists and
others who are now entering the field.
With increasing violence, substance abuse, teen
pregnancy, and sexual behaviors that could lead to AIDS and
other sexually transmitted diseases, as well as various
psychological dysfunction, such as depression, there is now an
urgent need for prevention prevention that goes beyond
increased staff and security guards in our schools, metal
detectors, and lectures about the ills of unsafe sex, bullying,
and other serious outcomes (Hawkins et al., 2015). Today,
there are a number of model primary prevention programs
being conducted in the schools and with parents, under the
egis of social-emotional learning (SEL; see the Collaborative
for Academic, Social, and Emotional Learning [CASEL]
website at www.casel.org). I am going to describe how one
such program, now called I Can Problem Solve, was born.
It all began when I was a nursery school teacher, in
the early 1960s, when I noticed that the most important
problem for four-year-olds was wanting a toy another child
had. Although most children would ask for it, the answer was
almost always some form of no. Some children would then
grab the toy, hit the child, or tell the teacher and let the teacher
solve the problem for them+. Then I noticed four-year old
Zachary, who, when he was refused a wagon that Peter was
playing with, did something quite different. He asked, Why
cant I have it? Peter replied, I need it, Im pulling the
rocks. Zachary then offered, I can help you. We can pull
the rocks together. Peter said Okay, both children were
satisfied with the solution, and no teacher had to intervene,
suggest they share, or take the toy away so neither could have
it.
I met George Spivack in 1968, who was studying
how adolescents were navigating their interpersonal worlds.
As I expressed my interests in the topic, we became a team
and began assessing Means-Ends and Consequential Thinking.
With his colleague Murray Levine, George studied how
adolescents planned step-by-step; more specifically, how they
reached a stated interpersonal goal, how they anticipated
potential obstacles that could interfere with reaching that goal,
and how to gain an appreciation of the fact that it takes time to
reach the goal. A test (called the Means-Ends Problem
Solving (MEPS) test) was administered in story form; the
subjects were given the beginning of the story (e.g., John just
moved into the neighborhood and wanted to make lots of
friends) and the end of the story (John had lots of friends), and

Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1 4

were asked to fill in the middle. Spivack and Levine (1963)
found that youngsters in a residential treatment home were
significantly more deficient when compared to normal
adolescents in both Means-Ends Thinking and in the tendency
to weigh the pros and cons when making a decision, for
example, to go to a party or study for an exam they would
need to take the next day -- a skill called Consequential
Thinking.
When I began working with George, I administered
the MEPS test to fifth-graders and found that, even within a
homogeneous classroom of relatively normal children (not
diagnostically disturbed), those showing more aggression,
other impulsive behaviors, or shy/withdrawn behaviors were
more deficient in Means-End Thinking than their classmates
who did not show these behaviors (Shure & Spivack, 1972).
For example, a story of an impulsive child depicted a boy
(John) who introduced himself to the most popular child, who
in turn introduced him to his friends, which led to him having
lots of friends. This story consisted of two means, no
obstacles, and no appreciation that making friends takes time.
In contrast, a story of a behaviorally adjusted child depicted
the boy (John) offering to bring the leader to a basketball court
and teaching him how to shoot baskets. It turned out that the
leader didnt like basketball (an obstacle), so John asked him
what he did like. The leader said he liked hockey, so being the
good athlete he was, John learned how to play hockey. Three
months later (recognition of time), John showed the leader
how to shoot hockey pucks, and as a result, the leader thought
John was great and brought his friends to the rink. At the end,
John had lots of friends. What a different story between these
two children. The example stories showed how impulsive and
withdrawn youngsters were more concerned with immediate
gratification and exhibited less rational thought with regard to
steps taken toward goal completion. Importantly, these
findings held when IQ was controlled, suggesting that IQ was
not the explanatory factor. The same findings emerged when
normal adults were compared with adult psychiatric inpatients,
regardless of whether the problem revolved around friendship
choice, heterosexual relations, employment, or how to find a
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
lost object (Platt & Spivack, 1970).
The rational for studying means end thinking was
based on our hypothesis that An individual who is
overwhelmed by his environment possesses a narrower
repertoire of means-ends thinking and is preoccupied with the
end goal rather than the means to obtain it. If he is not adept
at thinking through ways to solve problems, or if unforeseen
obstacles interfere, he may make impulsive mistakes, become
frustrated and aggressive, or evade the problem entirely by
withdrawing. In any case, his/her initial need remains
unabated, and if such failures occur repeatedly, varying
degrees of maladaptive behavior may ensue (Shure &
Spivack, 1972, p. 348).
Upon completion of our first project, I said to
George, I was a nursery school teacher. I wonder if we could
study how preschoolers navigate their interpersonal worlds.
It became clear right away that means-ends thinking and
weighing pros and cons was developmentally too sophisticated
for preschoolers; however, we did find that the ability to name
different, unconnected, alternative solutions to an
interpersonal problem (Alternative Solution Thinking), and to
think about what might happen next if an act were carried out
(Consequential Thinking), could distinguish behaviorally
adjusted and prosocial children from their more impulsive and
withdrawn classmates (Shure, Spivack, & Jaeger, 1971). For
example, an impulsive child might provide two or three
solutions for obtaining a toy from another child, or to keeping
a mother from being angry after having broken property of
value, while an adjusted child could more likely give six or
seven solutions to those problems. Typical solutions to the toy
problem included take it, hit him, tell the teacher, and
share it, while more creative ones included put his name on
it and hell think its his and youll have more fun if you
play with me. To the damaged object story, such as a broken
flower pot, typical solutions included say Im sorry, fix
it, and get a new one, while more creative ones included,
pretend shes sleeping so mommy cant whoop her, and my
favorite, get her mommy a drink and shell feel better.
When the children were asked what might happen
5

next if, for example, a child grabs a toy from another,
impulsive or withdrawn children gave significantly fewer
consequences than their more adjusted peers. Typical
consequences were: hell grab it back, hell hit him, or observing changes in childrens display of behaviors related to
hell tell the teacher. One more creative response was,
hell eat marshmallows in front of him and when he wants
one, hell say no, you took my truck. Interestingly, in a
second scenario, in which a child took his (or her) mothers
umbrella when she wasnt looking, typical responses included:
hell get in trouble, and shell hide it so he cant get it. It
was here that we learned young children could be empathic,
evidenced by statements such as, when it rains, shell get wet
and catch a cold thinking of the mother vs. thinking of
him/herself.
While performing these correlational studies, we
implicitly assumed Spivacks theoretical position that
Interpersonal Cognitive Problem Solving (ICPS) skills served
as an antecedent condition for healthy social adjustment
(Spivack & Shure, 1982). More specifically, Spivack asserted
that an individual who can think through and solve problems,
weigh the pros and cons of an act, and appreciate underlying
causal dynamics of an interpersonal solution will be less likely
to make impulsive mistakes and will suffer less frustration
from failure and circumstances leading to maladaptive
functioning.
The First Training Programs: Preschool and
Kindergarten
The correlational research studies discussed prior
suggested that the behavior of children who behave and think
differently was mediated by a set of Interpersonal Cognitive
Problem Solving (ICPS) skills. We wanted to know whether
we could guide behavior by enhancing the deficient ICPS
skills rather than focusing directly on the behaviors
themselves. Contrary to the assumption of educators and
clinicians that relieving emotional tension leads to the ability
to think straight, we tested the reverse idea that is, if one
could think straight, emotional tensions would be relieved.
Whether availability of ICPS skills is an antecedent
condition to adjustment, however, cannot be ascertained by
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
correlational studies alone. Thus, we examined the linkage
between ICPS ability and behavioral adjustment by
experimentally altering ICPS skills (via intervention) and
these thinking skills. The purpose of the study was to learn
whether ICPS ability would mediate such behaviors, and if
that was the case, we could pinpoint the ICPS skills that play
the most significant role in the behavioral adjustment of four-
and five-year-old children.
Our first major study took place over a two year
period, beginning with 113 preschool children trained in ICPS
skills and 106 controls. The participants were divided into
four groups during their second (kindergarten) year: (1)
trained both years; (2) trained in preschool only control
kindergarten; (3) control preschool -, trained in kindergarten;
and (4) control both years (Shure & Spivack, 1980; Shure &
Spivack, 1982). The program was implemented by following
a script, developed by Shure and Spivack, and presented in
full in Spivack and Shure (1974). The program consisted of
daily 20-minute games and dialogues for a period of about
three months, through which teachers and children interacted
in small groups. The concepts taught were essentially the
same in both the nursery and kindergarten years, although the
content was more sophisticated for the older children (Shure &
Spivack, 1980). Early games consisted of word concepts that
were later used in problem solving. For example, the words is
and not, and same and different, were played with in fun ways
such as, This is a table. It is not a chair. Can you show me
something different that is not a chair? When a real problem
would come up, for example, one child hitting another, the
teacher would ask, Is hitting a good idea or not a good idea?
Can you think of something different to do that is a good
idea? Instead of telling the child what to do, or what might
happen if he does something in particular, the teacher engages
in what we call ICPS Dialoguing to encourage the childs
use of his or her newly acquired problem solving skills to
solve real life problems. Other words included if-then and
might/maybe to be used in later consequential thinking (e.g.,
If I hit him, then he might hit me back.) and before/after
6

(beginning in kindergarten) to be used instead of the rhetorical
Why did you hit him? (e.g., Did you hit him before or after
you took his toy?). Subsequent games focused on
recognition and awareness of childrens own and others
feelings, which is awareness that could enrich the range and
nature of solutions and consequential thinking. Through
games and dialogues, the aim was to help children develop a
problem solving style of thinking. Children were never told
what the solutions or consequences to an act could be. Rather,
they were encouraged to generate their own ideas, and then to
think about how they and others might feel, and what they
might do. In addition, teachers and their aides were trained to
use these concepts, ICPS Dialoguing, during the day when
children were having actual problems in the classroom. The
goal of training was to teach children how to think, not what to
think, so they could choose and evaluate for themselves what
to do and what not to do.
We learned from this study that as children become
more sensitive to their own and others feelings, more aware
of potential consequences to their actions, and better able to
think of alternative solutions to real-life problems, they
display improved peer relations and genuine concern for
others in distress. The program also led to significantly
decreased early high-risk behaviors that research shows
predicts later violence, substance abuse, teen pregnancy,
school dropout, and some forms of psychopathology (e.g.,
Hawkins, Catalano, & Miller, 1992; Parker & Asher, 1987).
Specifically, such high-risk behaviors include overt
aggression, inability to wait, inability to share and take turns,
over-emotionality in the face of frustration, and lack of
concern for others. We found that these behaviors decreased
after as little as one three-month exposure to ICPS training in
preschool, and the ICPS skills gained held until the end of
kindergarten.
Importantly, the children who showed the most ICPS
skill gains, especially solution skills, also showed the most
behavioral gains. This direct link suggests that the ICPS skills
mediated the behavioral gains (Shure & Spivack, 1980). Also,
when compared to never-trained behaviorally adjusted
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
controls, the children who were behaviorally adjusted and
received ICPS skill training in preschool were less likely to
begin engaging in early high-risk behaviors in kindergarten
and beyond, suggesting that ICPS intervention is not only
beneficial as a treatment program, but can also be used as a
prevention program.
ICPS for Use by Parents
After our early research that examined the
effectiveness of teacher-implemented ICPS in the classroom,
we took ICPS into the home. The concepts of the program
were the same as they were for teachers, but the lesson-games
were modified to be conducted with a single child at home.
Over a ten-week period, mothers attended weekly group
meetings (40 mothers, 10 per group), during which they role-
played the lessons and practiced dialoguing techniques. The
program script, outlined in Shure and Spivack (1978), was
designed to teach both the mother (or mother surrogate) and
her child how to think in ways that would help them
successfully resolve interpersonal problems. Exercises
designed to teach the mother concepts in concert with those
she would in turn transmit to her child were interspersed
throughout the meetings. For example, when the mothers were
teaching their children to think about their own and others
feelings, and how to consider the effects of their actions on
others, they were also encouraged to think about their own
feelings and how the things they do might affect others
(including their children). In the same manner, the mothers
were taught to guide their children toward thinking of
alternative solutions to problems relevant to a four-year-old
(e.g., He hit me). They were also encouraged to think
through and solve problems that their children might have
brought to them or created for them (e.g., Johnny doesnt
listen to me). Just as the mothers learned not to tell solutions
to their children, they were encouraged to think of their own
solutions in handling problems that arose between them and
their children.
The results of the parenting study indicated that ICPS
training significantly improved impulsive and inhibited
behaviors of inner-city, low-income African-American four-
7

year-olds. Further, similarly to the teacher-implemented
program, alternative solutions were the strongest mediator of
behavior change, with consequential thinking coming in
second. We learned that children exposed to ICPS training in
one environment (the home) improved their behavior in a
different environment (the school) as well. This finding was
particularly important because the behavior improvements
were reported by teachers unaware of the training procedures
and goals. We also learned that inner-city mothers, many of
whom also displayed deficient ICPS skills at the beginning of
the program, were able to successfully improve their own
skills in addition to those of their children in time as short as
ten weeks. In addition, interviews showed that typical pre-
training telling-the-child-what-to-do childrearing style
changed to a childrearing style that included significantly
more guidance in helping children think through and solve
their own problems. While childrearing styles and ICPS skills
did have some impact on the childrens behavior, they also
had a direct impact on the childrens thinking skills skills
which in turn played a significant role in the childrens
ultimate behavioral adjustment (Shure & Spivack, 1979).
ICPS for Older Children
Adding to the concepts taught to younger children,
implemented around age-appropriate problems, we
implemented more sophisticated skills of perspective-taking
(an appreciation that someone else might have thoughts and
feelings different from ones own), recognition of peoples
potential motivations for behavior (e.g., he didnt say hello cognitive problem solving (ICPS) skills could impact
because he doesnt like me vs. he didnt see me), behavior, teachers we trained suggested some revisions to
sensitivity to problems as interpersonal, recognition of causes
of problems, and listening and awareness. These and other
prerequisite skills enriched childrens ability to generate
alternative solutions to real-life problems, anticipate potential
consequences to an act, and help develop more sophisticated
skills of the earlier-described means-ends thinking. As was
the case with the younger children, teachers learned how to
apply ICPS Dialoguing when real problems arose, in order
to help children associate their thinking with their behavior,
and to apply the concepts learned through the fictional
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
situations in the lesson-games to real life.
The curriculum was conducted with African-
American fifth- and sixth-graders from the inner-city and
implemented three times a week for four months. Briefly,
results suggested that for this age and SES group, one
exposure to ICPS in grade five enhanced the measured
solution, consequential and means-ends thinking skills, as well
as positive and prosocial behaviors; however, a second
exposure in grade six was required to reduce negative
impulsive and inhibited behaviors. Importantly, no such
interpersonal or behavior gains were seen either year in the
comparison group trained in impersonal critical thinking
skills. In fact, the impersonal skills-trained group that focused
on reasoning skills, deductive logic, and generating
impersonal alternative thinking (e.g., how water might have
disappeared from a can taken to the desert), became more
impulsive from grade five to six, further strengthening our
conclusion with the younger children that ICPS training is a
viable model of prevention for a variety of age groups.
However, full behavioral impact for latency-aged low-income
children may take longer than the briefer one-time exposure to
the curriculum required for younger children in the preschool-
and kindergarten-aged years (Shure & Healey, 1993).
Revision of the Training Manuals: From Research to
Practice
Although our interventions were originally designed
to test research hypotheses about how (and if) interpersonal
make the lesson-games more user-friendly and to prepare the
manuals for mass-dissemination. After over two decades of
further research (in Shure, 1996), with the help of teachers, the
manuals were transformed into their present form. Originally
called Interpersonal Cognitive Problem Solving (ICPS), with
the above-mentioned studies published under that name, I was
told that the name was too much of a mouthful and a name
that children could use was needed. In the middle of the night,
I woke up with an Aha! moment, and realized that a better
name would be I Can Problem Solve, which would allow us to
8

keep the abbreviation of ICPS.
The manuals for mass-dissemination, from preschool
through grade 6, were published in 1992. In the new manuals,
the elements that comprised ICPS Dialoguing were broken
into manageable bites one concept at a time. In our earlier
years, we asked teachers to ask all of the questions from the
beginning, which was too much to absorb and apply when
talking with children. For example, after having played
formal lesson-games with the prerequisite word pairs is/not
and same/different with preschool and kindergarten children,
so they could later be asked to think of a different way to solve
a problem, the teacher could now focus on daily use of just the
word pairs until they felt comfortable with them. First, in a
non-problem situation, the teacher might say, Johnny is
painting. Who is doing the same thing as Johnny? Who is not
painting? Who is doing something different? And soon the
question could become a little harder, such as, Who is not
doing the same thing as Johnny? When a real problem would
arise, the teacher would first ask each child what happened
from their point of view, and now she could ask, Do you two
see what happened the same way or a different way? Having
associated the words embedded in this question with fun made
it more palatable for children to respond. With many more
examples of this slow build-up presented in the manuals,
teachers could now more easily absorb the full steps of ICPS
Dialoguing, with such questions as How do you feel?,
What happened when , and Can you think of a different
way to solve this problem so that you wont feel that way and
that wont happen? Shortly thereafter, I revised our program
for parents to be used by parent educators in English, called
Raising a Thinking Child Workbook (Shure, 1995) and in
Spanish, called Enseando a Nuestros Nios a Pensar (Shure,
2000) based on a trade book I wrote for parents called
Raising a Thinking Child (Shure, 1994).
I have often been asked why we teach words like is
and not and same and different when even three- and four-
year-olds already know them. The reason is to guide the
children to think of these words in a problem solving way and
to associate the fun of playing with them and the dialoguing
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
questions to actual problems. Although we do not play these
kinds of games with the older children, we still use them in
dialoguing when actual problems arise. The importance of the
dialoguing approach was clear when we saw how the children
responded to it; they felt involved in the conversation as
opposed to being lectured to, told what to do, or even yelled at
and sent to time out a solution that teachers and parents tell
me only lasts for a few minutes.
Our feelings about dialoguing were validated when
Weissberg and Gesten (1982) found significant behavior gains
when dialoguing was added to a problem solving program
they developed for early school-aged children, and when
teachers of school-aged children reported that dialoguing
might be the key to independent problem solving thinking.
Also, the children felt so proud when they succeeded in
problem solving; for example, one four-year-old came home
from school and proclaimed, Mommy, I solved a problem
today.
In the late 1980s, Donald Meichenbaum, a clinical
psychologist at the University of Waterloo, a founder of
cognitive behavior therapy, currently a consultant to the
Melissa Institute in Florida (a think tank for the prevention of
violence in schools) said to me, You really ought to integrate
your interpersonal concepts into the curriculum. At the time,
we wanted to test the impact of interpersonal cognitive skills
on behavior and we realized the importance of examining any
added value of ICPS interventions on academic achievement
as well. Again, with the help of teachers, I incorporated each
of the ICPS concepts into subjects, such as math (e.g., Would
you be happier with a half a piece of pizza or a whole piece of
pizza?), history (e.g., What made Neil Armstrong feel
proud?), and science (e.g., What might happen if it never
rains?), with specific examples that were chosen according to
what the children were studying. We found academic
achievement gains in reading and math for fifth- and sixth-
graders (Shure, 1980), and in second graders reading and
social studies standardized achievement test scores, especially
among those trained by teachers in kindergarten and again, by
their mothers in grade 1 (Shure, 1993).
9

It is not yet known whether the integration of ICPS
directly accounts for gains in the academic curriculum, or if it
instead has an indirect gain due to another confounding factor.
Perhaps the ability to appreciate anothers point of view
(perspective-taking) in a problem situation may play a part in
the process of thinking through plans and/or solutions to
problems, but the latter ability to solve problems is what
relieves any tensions and reduces interpersonal conflict. It
also seems logical to conclude that regardless of actual IQ
level, once behaviors mediated through ICPS skills do
improve, youngsters can better absorb the task-oriented
demands of the classroom, and subsequently do better in
school. Whatever the case, academic gains have clearly been
documented with other social and emotional (SEL) programs
as well (Durlak et al., 2011), as demonstrated by the results of
a meta-analysis of 213 school-based universal SEL programs
involving 270, 034 kindergarten through high-school students.
Researchers report that when compared to non-trained
controls, SEL-trained students demonstrated significantly
improved social and emotional skills, attitudes, behavior, and
academic performance that reflected an 11-percentile-point
gain in achievement (p. 405). We now know that poor
academic achievement is in itself a high-risk marker for later
serious problems (e.g., Hawkins, Catalano, & Miller, 1992),
and ICPS and other SEL programs can play a significant role
in preventing the problems from happening.
Barriers to ICPS
During our hypothesis-testing years, researchers
thought that the behavior change we reported was a result of
teachers who did the training also rating their students
behaviors, suggesting bias in the interpretation of the validity
of ICPS. To test whether that was the case, we studied
whether the same children who improved in their problem
solving skills were the children who most improved in their
behaviors (a direct link) and we found that to be the case
(Shure & Spivack, 1982). Since the teachers were unaware of
how the children tested in their ICPS skills, a case against
rater bias could be made. To further test rater bias, we added
peer ratings and independent observers (the latter unaware of
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
the existence of a training program) and got significant gains
from peer- and independent observer ratings as well (Shure,
1993; Shure & Healey, 1993).
I also learned that to successfully conduct research, it
is important to meet the needs of the school principal and not
focus on the needs of the research project. In our early
research, I had the consent of a principal in a school where we
would study kindergarten children first trained in preschool.
At the beginning of that year, a new principal who was
assigned to the school refused our entry because
psychologists just use the schools for their own ends and
contribute little or nothing to the school or to the children. I
knew that explaining that we needed those children for our
research design because they were already trained in preschool
would fall on deaf ears. Instead, I focused on staff
development and what the program could do for the teachers
and the children (luckily this was to be a training and not a
control school), and then he became interested. Fortunately,
he allowed us to proceed, and as it turned out, he became one
of our greatest advocates.
It was in the implementation of ICPS as a service that
I found to be most difficult. I had a contract with 40 teachers
in the Philadelphia Public Schools during the very year that
the No Child Left Behind Act was being implemented.
Teachers, concerned about their students reading and math
test scores, their own jobs, and the school itself felt that
although ICPS was important, they had too much else to do to
have time for talking about feelings, solutions, and
consequences to behavior. As a result, only a handful of
teachers conducted the program with fidelity, some in bits and
pieces here and there, and some not at all. I think that today,
with the evidence that ICPS and other similar social and
emotional programs significantly enhances reading and math
scores, teachers and school administrators would be more
open to systematic inclusion of these kinds of programs into
their day. As Ruth Cross, a former principal of the Mill Street
Elementary School in Naperville, Illinois, and an ICPS-trainer,
told me, Unless teachers understand how to integrate the
ICPS skills with what they already do, they will see the
10

program as an add on and will not use it. This has turned
out to be important with the emphasis on academics and the
need to be flexible in presenting these kinds of programs to a
school or school system (August, Gewirtz, & Realmuto,
2010).
Role of the School Guidance Counselor
The school guidance counselor can play a very
significant role in the implementation of ICPS in classrooms,
and remove or reduce some of the barriers mentioned above
that teachers encounter, such as time for ICPS. As a member
of a school leadership team, the counselor can:
Participate in monitoring that provides positive
guidance, support, and encouragement to teachers;
Monitor program fidelity (checklist is available);
Discuss solutions to barriers or issues that arise in the
classroom (e.g., finding time for ICPS);
Guide teachers when necessary by modeling the
lessons with the children, or applying the problem
solving approach when real problems arise during the
day;
Participate in team leadership meetings at specified
time periods (e.g., once a month) to discuss the ICPS
initiative; and
Reinforce the teachers lessons by repeating needed
lessons and using ICPS dialogues individually with
difficult, or high-risk children.
One counselor conducted the lessons within earshot
of a teacher who was at first reluctant to get involved, and
when the teacher saw how the children responded, she became
interested and conducted the entire program with every group
of students she had from that time on. Another counselor ran
training groups with parents of kindergarten children using the
parent training manual (Shure, 1995), and one of the parents
herself became a trainer of future groups.
Satisfactions
Having experienced the earlier-mentioned
frustrations and working to circumvent them, I want to convey
the immense satisfaction I have experienced by watching
children who initially displayed impulsive behaviors become
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
more empathic, learn to wait and not fly off the handle when
they cant have what they want right away, get along better
with their peers, and do better academically. It was also
gratifying to watch shy, inhibited children become more
outgoing, stand up for their rights, and express their emotions
in appropriate ways. Ill always remember four-year-old
Tanya, for example, who before ICPS would stand outside the
doll corner watching, but being too shy to get in and play. The
teacher, meaning well, would offer, Tanya would like to pack
the suitcase. Even if the children invited Tanya in, she was
not ready. After six weeks of ICPS, Tanya watched for a few
minutes, then said, If you need a fireman, Im a fireman.
One boy shouted, The house is on fire. That time it was
Tanyas idea, not the teachers.
I will also always remember a sixth-grader, who,
when asked after the program was completed why we did
ICPS, responded, We have to learn to think for ourselves.
People wont always be around to help us. These kinds of
responses, and changes in childrens behavior was our
ultimate goal, and unquestionably, our greatest reward.
Future of Prevention Research and Practice
ICPS is a universal prevention program, designed to
train entire classrooms of children. The advantage is to catch
any false negatives. This is a possibility in that at least among
inner-city preschoolers, as our earlier-mentioned research
found, were less likely to begin showing behavior problems a
year later, in kindergarten. Were the initially adjusted non-
trained controls who did begin to show behavior problems in
kindergarten among those false negatives in preschool?
Researchers can investigate risk factors that are yet to be
identified, so that school counselors and other student support
personnel can add targeted programming for those youngsters.
One risk-factor, for example, identified by
Ehrenreich, Beron, and Underwood (2016) is a form of
aggression called relational, or social, aggression. A child
displaying this kind of aggression (not studied by us in our
earlier research) excludes peers, spreads rumors, hurts
feelings, makes mean faces, and engages in other behaviors
that affect relationships. Recently, Boyle and Hassett-Walker
11

(2008) found ICPS to be effective in reducing both physical
and relational aggression in rural low-income, mostly
Hispanic, kindergarten- and first-graders. When studying
these behaviors across childhood and adolescence, Ehrenreich,
Beron, and Underwood (2016) found that while physical
aggression across childhood and adolescence confers risk for
maladjustment, social aggression also confers risk for
maladjustment as youngsters enter transition into young
adulthood. Their suggestion to develop prevention programs
to reduce social aggression, and the impact Boyle and Hassett-
Walker (2008) found ICPS creates added-value to the
variables previously investigated.
In addition to identifying risk factors, defined as
variables associated with a high probability of onset, greater
severity, and longer duration of major mental health
problems (Coie et al., 1993, p. 1013), we also need to
identify protective factors, defined as conditions that
improve peoples resistance to risk factors and disorders
(Coie et al., 1993, p. 1013). Two known protective factors,
resilience and prosocial behaviors, are also significantly
impacted by ICPS (Shure & Aberson, 2012; Shure & Healey,
1993). As Bell (1992) noted, researchers must seek to identify
who is at risk for particular dysfunctions, what are transition
points that may heighten that risk, and to address the issue of
how to improve prediction to permit intervening at optimal
developmental stages. Identifying further interpersonal
cognitive problem solving skills at various ages might inform
future research in timing of intervention to reduce and prevent
both immediate (proximal) and longer range (distal) outcomes.
And I am often asked, What are the kids like now?, meaning
in high-school and beyond. We learned that we can nip high-
risk behaviors in the bud when children are young. Did we
really prevent violence, substance abuse, unsafe sex, and some
forms of psychopathology later on? With hope for future
funding opportunities, we may be able to find out.
For continuing modification with a broader audience,
practitioners can continue to refine, modify, and test various
SEL programs in various settings, including schools, after-
school groups, and mental health agencies. In schools or other
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
settings where time is limited, new ways to maximize that
time can be tried. As teachers and school administrators
continue to view programs for social and emotional learning
as a necessity, not just a luxury, it is important for us to
consider how we can best foster system-level support
mechanisms to give these programs a home needed to help
students thrive?
For the next generation of researchers and
practitioners, perhaps these thoughts will stimulate further
thought and action in this, now burgeoning, field of primary
prevention.
Final Thoughts
Having earlier expressed some barriers and
frustrations along my road to implementing ICPS to reduce
high-risk behaviors and promote protective factors in children,
I am also very gratified to see how the field of social and
emotional learning (SEL), as one form of prevention, has
grown over the years to where it is today. Enough evidence
exists, including replications of ICPS and other SEL
programs, for the value of this kind of addition to the standard
curriculum (reviewed in Shure & Aberson, 2012). Thousands
of schools are now implementing some form of SEL. The
goal that every preschool, elementary, and high-school
classroom would include the programs into their curriculum,
may now come true, more than ever. Primary prevention, an
idea as Stephen Goldston (1980) once dreamed, whose time
has come.
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RESEARCH, SOCIAL ACTION, PRACTICE AND TRAINING

Examining Associations Between Residential Status, Protective

Behavioral Strategy Use, and Alcohol-Related Negative Consequences
Among College Students
Kray A. Scully
Danielle P. Cottonham
Margo C. Villarosa
Saarah D. Kison
Michael B. Madson
University of Southern Mississippi

Correspondence concerning this article should be addressed to Michael B. Madson, University of Southern
Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406-5025. E-mail: michael.madson@usm.edu

Abstract Introduction

Alcohol consumption, alcohol-related negative consequences,
and use of protective behavioral strategies (PBS) are important
to consider when preventing college student alcohol use given
the serious public health implications. Further, there is a need
to examine contextual variables, such as where students live,
as possible explanations for drinking behaviors and targets for
prevention initiatives. The current study explored the degree to
which college students residential status and PBS use predicts
alcohol-related negative consequences while accounting for
consumption differences among 705 traditional age college
students. Living in residential halls accounted for the fewest
alcohol-related negative consequences, while living in Greek
housing accounted for the most alcohol-related negative
consequences. Use of both factors of PBS (i.e., serious harm
reduction and controlled consumption) were related to fewer
negative consequences. Research and prevention implications
are discussed.
Alcohol use by college students is considered an
increasingly serious public health problem, as alcohol is the
most reportedly used psychoactive substance among college
students (American College Health Association [ACHA],
2008). This is alarming due to the range of alcohol-related
negative consequences, such as hangovers, assaults, and
sexual victimization, that can occur as a result of college
student drinking (White & Hingson, 2013). Protective
behavioral strategy (PBS) use has been identified as a safe
drinking approach that may reduce harm associated with
college students alcohol use (Linden, Kite, Braitman, &
Henson, 2014). One contextual factor that might help to
explain college students safe and harmful drinking
experiences is residential status; where students live may
influence how and when they engage in alcohol use behaviors.
The current study assessed the degree to which college
students residential status was related to alcohol-related
negative consequences while examining the preventative
ability of PBS use.

Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1 15

According to the National Institute on Alcohol Abuse
and Alcoholism (NIAAA; 2012), over 80% of college students
have consumed alcohol during a 30-day period, with nearly
half participating in heavy episodic drinking at least once over
a two-week period. Alcohol use at these levels is concerning
to university prevention personnel because of the associated
alcohol-related negative consequences, which have resulted in
approximately one-third of college students meeting the
criteria for alcohol abuse (Borsari, Murphy, & Barnett, 2007).
All degrees of alcohol consumption can lead to a variety of
physical (e.g., assault and physical injury), mental (e.g.,
memory loss), and academic (e.g., failing a test or missing
class) consequences for college student drinkers and their non-
drinking peers (Boekeloo, Novik, & Bush, 2011; Hingson,
Zha, & Weitzman, 2009; Martin et al., 2012; Wechsler, Lee,
Hall, Wagenaar, & Lee, 2002). Almost one-third of college
student drinkers reported experiencing at least one alcohol-
related negative consequence in the past 30 days (ACHA,
2008). Additionally, non-drinking students have reported
experiencing a greater number of secondhand alcohol-related
negative consequences, such as disruption of studies and
sleep, property damage, and verbal, physical, and sexual
violence (Palmer, McMahon, Rounsaville, & Bell, 2010;
Wechsler et al., 2002a). The college environment is
conducive to alcohol use behaviors, and, by extension,
alcohol-related negative consequences (Akers, 1998), which in
part may be explained by concepts of social learning theory,
such as the development of alcohol expectancies, norm
perceptions, and modeling (Madson, Moorer, Zeigler-Hill,
Bonnell, & Villarosa, 2013b; Neighbors et al., 2008). Given
increases in primary and secondary alcohol-related negative
consequences (Hingson et al., 2009; ACHA, 2008), many
researchers and college health professionals have focused on
identifying safe drinking strategies in an attempt to ameliorate
alcohol-related negative consequences on college campuses
(Madson & Zeigler-Hill, 2013; Martens et al., 2004; Martin et
al., 2012).
The use of protective behavioral strategies (PBS) is
one approach to safe drinking that has received increased
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
empirical support (Kenney & LaBrie, 2013; Linden et al.,
2014; Madson et al., 2013b; Martin et al., 2012). The use of
PBS consists of direct planning for controlled drinking (e.g.,
setting a limit on the number of drinks one consumes) and
indirect actions to minimize serious harm when drinking (e.g.,
using a designated driver; Howard, Griffin, Boekeloo, Lake, &
Bellows, 2007). Direct/controlled consumption strategies tend
to be more strongly related to reduced alcohol consumption;
whereas indirect/serious harm reduction strategies are more
strongly related to fewer alcohol-related negative
consequences (DeMartini et al., 2013; Madson, Arnau, &
Lambert, 2013a). Factors such as mental health (e.g.,
depression, social anxiety), race, and sex are linked with
degrees of PBS use, such that students who are less
psychologically healthy, White, and male report fewer PBS
use than those who are psychologically healthy, African-
American or Hispanic, and female (LaBrie, Kenney, & Lac,
2010; Madson & Ziegler-Hill, 2013; Villarosa, Madson,
Zeigler-Hill, Noble, & Mohn, 2014). Paralleling harmful
drinking behaviors, safe drinking strategies, such as PBS, can
be learned in a college students environment (Durkin, Wolfe,
& Clark, 2005). Based on social learning theory, it may be
important to consider contextual factors, such as where
students live, to better understand what predicts students
increased alcohol use and decreased PBS use, and by
extension, leads students to experience more or less alcohol-
related negative consequences. Consequently, learning more
about contextual factors within the scope of social learning
can better inform safe drinking prevention efforts on college
campuses.
Residential status serves as a possible explanation for
the rates of alcohol-related negative consequences and
variations in PBS use among college students (Cacciola &
Nevid, 2014; Hummer, LaBrie, & Pederson, 2012). Akers
(1998) proposed that risky behaviors, such as participation in
harmful drinking behaviors, are learned from ones peer
network. Researchers suggest that the college years are
marked by an expansion of ones social networks, which
involves the introduction of new ideas and attitudes (Wrzus,
16

Hnel, Wagner, & Neyer, 2013). According to social learning
theory, as applied to college student alcohol use, drinking
behaviors may be facilitated by factors such as positive
evaluations/expectations of drinking and perceived norms
engendered by ones peer network including the peers with
whom they live (Durkin et al., 2005). Thus, residential status
may play a crucial role in the development of a college
students attitudes towards drinking, meriting the exploration
of this factor as a possible explanation for alcohol-related
negative consequences and PBS use.
Further exploration of residential status is also
needed due to the dearth of literature regarding this factor.
Thus far, the majority of alcohol-related research exploring
residential status has focused solely on Greek organizations
and Greek housing or residence halls (Chauvin, 2012;
Hummer et al., 2012; Ragsdale et al., 2012; Scott-Sheldon,
Carey, & Carey, 2008). Previously, most findings have shown
that students who engage in more alcohol consumption and
experience more alcohol-related negative consequences on
college campuses have been those with Greek life affiliation
and those living in Greek housing (Bersamin, Paschall, Saltz,
& Zamboanga, 2012; Ragsdale et al., 2012; Scott-Sheldon et
al., 2008). Page and OHagerty (2006) found that there was
greater risk for heavy-drinking and alcohol-related problems
among members of fraternities and sororities than among
students living in residence halls. However, the findings of
the relationship between living in residence halls and alcohol
use have been mixed. Akmatov, Mikolasjczyk, Meier, and
Kramer (2011) showed that living in residential halls has been
related to problematic drinking behaviors; conversely, Boyd et
al. (2008) found that less alcohol consumption was associated
with fewer primary and secondary alcohol-related negative
consequences for students living in residential halls. Until
recently, little attention has been given to other residential
environments, such as living with parents (Cacciola & Nevid,
2014) or in apartments off-campus (Wechsler, Dowdall,
Davenport, & Castillo, 1995). Additionally, we were unable
to find any studies exploring the association between
residential status and PBS use among college students. Thus,
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
the relationship between a wider array of residential statuses
(i.e., with parents, apartments off-campus) and alcohol-related
negative consequences needs to be further explored, as well as
their relationship to PBS use.
The current study sought to examine the degree to
which residential status and PBS use accounted for alcohol-
related negative consequences in traditional age college
students above and beyond alcohol consumption. Researchers
suggest that consumption variances can encapsulate
differences among demographic variables, such as sex and
race (Borsari et al., 2007; Madson & Ziegler-Hill, 2013),
therefore, we controlled for alcohol use in the present study.
Further, the current study explored the differences in PBS use
among the different residential statuses. Because alcohol
consumption behaviors are normative in a college students
environment, it was hypothesized that residential status would
be a significant predictor, above the effects of alcohol
consumption, of alcohol-related negative consequences in
college students, such that students living in Greek housing
and apartments off-campus would experience the most
alcohol-related negative consequences, while those living in
residential halls and with parents would experience the least.
Since participation in safe drinking behaviors may also be
influenced by ones surroundings, it was hypothesized that
students living in housing with higher social interaction (i.e.,
residential halls and Greek housing) would report fewer PBS
than more isolated settings (i.e., apartment off-campus and
with parents).
Methods
Participants and Procedures
Participants included 705 traditional age (M = 20.21,
SD = 1.94) college students from a mid-sized southeastern
university. Those eligible for the study consumed alcohol at
least once within 30 days prior to completing the survey. A
majority of participants (80.5%) were female with a relatively
even distribution across academic status30% freshmen,
24.9% sophomores, 21.5% juniors, and 23.6% seniors. Most
students identified as White, non-Hispanic (61.7%), or African
American (33.7%). The majority of participants reported
17

living in a residential hall (46.5%), or in an apartment off-
campus (40.4%), with 7.4% living in Greek housing, and 5.7%
of participants living with parents. Upon providing an
Institutional Review Board approved informed consent,
participants completed measures using a secure online survey
system assessing alcohol consumption, alcohol-related
negative consequences, and PBS use in partial fulfillment of
class credit.
Measures
Typical alcohol consumption. The Daily Drinking
Questionnaire (DDQ) was used to assess typical weekly
alcohol consumption. Participants reported the number of
drinks they consumed and time spent drinking for each day
during a typical week (Collins, Parks, & Marlatt, 1985).
Participants were then classified into one of three drinking
categories based on guidelines offered by Collins et al. (1985):
light (3 drinks or less drinks/week), moderate (4-11 drinks per
week), and heavy drinkers (more than 12 drinks per week).
Alcohol-related negative consequences. The 20-
item Young Adult Alcohol Problems Screening Test
(YAAPST) was used to assess alcohol-related negative
consequences within the past year (Kahler, Strong, Read,
Palfai, & Wood, 2004). Participants responded to the first 6
items, such as Have you gotten into physical fights when
drinking? and Have you gotten in trouble at work or school
because of drinking?, using a Likert-type scale that ranged
from 0 (no, never) to 9 (yes, 40 or more times) and responded
to the remaining 14 items, such as Have you neglected your
obligations, your family, your work, or school work? and
Has your drinking gotten you into sexual situations which
you later regretted?, using a Likert-type scale ranging from 0
(no, never) to 4 (yes, 3 or more times). Scores range from 0 to
110 with higher scores indicating a greater frequency of
experiencing alcohol-related negative consequences (Walters
& Baer, 2006). The YAAPST has been found to have
satisfactory criterion validity, concurrent validity, and
construct validity (Hurlbut & Sher, 1992). Internal
consistency with this sample was adequate ( = 0.80).
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
Protective behavioral strategies. The Protective
Behavioral Strategy Scale Revised (PBSS-R; Madson et al.,
2013b) was used to measure participants use of protective
strategies while consuming alcohol. The 18-item PBSS-R
assesses PBS use across two domains: indirect/Serious Harm
Reduction (SHR) and direct/Controlled Consumption (CC).
Items on SHR include using a designated driver and
avoiding drinking games, while items on the CC subscale
include determine not to exceed a set number of drinks and
stop drinking at a predetermined time. Participants were
asked to score the items using a Likert-type scale ranging from
1 (never) to 6 (always). Subscale scores range from 12 to 72
for CC and from 6 to 36 for SHR, with higher scores
representing greater PBS use. The PBSS-R has been shown to
have convergent validity (Madson et al., 2013b). In the
present study, the PBSS-R subscales demonstrated acceptable
internal consistencies (CC - = 0.87 and SHR - = 0.80).
Data Analytic Approach
Three separate hierarchical regression analyses were
conducted to assess residential statuses (i.e., residential halls,
Greek housing, apartments off campus, with parents) and PBS
use (i.e., PBS-SHR, PBS-CC), as predictors of alcohol-related
negative consequences, as well as residential status as a
predictor of each type of PBS use. Because of its high
response rate, college students living in residential halls were
embedded in the constant for comparison purposes (Field,
2013). For all analyses, consumption or participants DDQ
scores were utilized as a control variable in Step 1. The
remaining residential statuses were entered as predictor
variables in Step 2 for each analysis.
Results
Means, standard deviations, and intercorrelations for
the measures are presented in Table 1. The mean number of
drinks consumed weekly was 9.44 (SD = 11.75). Moderate
drinkers represented the majority of the sample (n = 296,
41.2%). Two hundred forty-eight participants (34.5%) were
classified as light drinkers and 175 participants (24.3%) were
classified as heavy drinkers (Collins et al., 1985). Consistent
with prior literature, men reported drinking more alcohol,
18

t(703) = 6.35, p < 0.001, and experiencing more alcohol-
related negative consequences than women, t(703) = 4.47, p <
0.001, further supporting the need to account for consumption
differences in the analysis. Additionally, means and standard
deviations for PBS use across both factors, for all residential
statuses, are presented in Table 2.
Residential Status and PBS Use as Predictors of Alcohol-
Related Negative Consequences
Results for the first hierarchical regression analysis
can be found in Table 3. After accounting for alcohol
consumption and residential status, PBS use accounted for an
additional 13% of the variance in alcohol-related negative
consequences. College student residential status positively
predicted alcohol-related negative consequences after
accounting for consumption differences. All living conditions
significantly predicted alcohol-related negative consequences,
such that students living in Greek housing (B = 14.22, t = 3.08,
p < .01), with parents (B = 13.34, t = 2.13, p < .05), and in off-
campus apartments (B = 12.68, t = 3.35, p < .001) reported
higher rates of alcohol-related negative consequences.
Specifically, living in Greek housing predicted the most
alcohol-related negative consequences, while living in
residential halls (B = 10.38, t = 22.52, p < 0.001) predicted the
least alcohol-related negative consequences. Conversely, both
factors of PBS use had inverse associations with alcohol-
related negative consequences. Increases in PBS-SHR (B =
10.24, t = -2.05, p < .05) and PBS-CC (B = 10.15, t = -8.37, p
< .001) use predicted fewer alcohol-related negative
consequences.
Residential Status as a Predictor of Protective Behavioral
Strategy Use
Results for the second set of hierarchical regression
analyses can be found in Table 4. Residential status
significantly predicted PBS-SHR use and accounted for 6% of
the unique variance after controlling for alcohol consumption.
Living in apartments off-campus (B = 30.72, t = -4.01, p <
0.001) significantly predicted decreased use of PBS-SHR
while living in residential halls (B = 32.33, t = 118.70, p <
0.001) significantly predicted increased use of PBS-SHR.
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
There were no significant associations found between PBS-
SHR and living in Greek housing and with parents. Similarly,
residential status predicted variance in PBS-CC use,
accounting for 5% of unique variance after accounting for
consumption differences. Specifically, living in Greek
housing (B = 42.58, t = -2.85, p < 0.01) and in apartments off-
campus (B = 44.50, t = -3.33, p < 0.01) predicted significantly
decreased use of PBS-CC with the strength of that prediction
being stronger for living in Greek housing. Conversely, living
in residential halls (B = 48.87, t = 70.08, p < 0.001) predicted
increased use of PBS-CC. No relationships were found
between students living with their parents and PBS-SHR or
PBS-CC use.
Discussion
The present study aimed to explore the relationships
among residential status, PBS use, and alcohol-related
negative consequences in college students while accounting
for gender differences in alcohol consumption patterns. Based
on our results, it appears that residential status might serve an
important role in predicting whether or not college students
experience adverse alcohol-related outcomes, in part because
of its significance to students social networks and potential
modeling of behavior. Moreover, results from this study
further support PBSs utility as a safe drinking behavior
college students can use to reduce alcohol-related negative
consequences. Alcohol researchers and practitioners may
benefit in a concerted effort to increase PBS exposure,
especially for students living in Greek housing and off-
campus, such that these safety strategies become a learned part
of college students normal alcohol use behaviors.
Alcohol-related Negative Consequences
Regarding alcohol-related negative consequences,
living in residential halls predicted the fewest alcohol-related
negative consequences, whereas those living in Greek housing
predicted the most alcohol-related negative consequences.
Drinking is often perceived as a normative behavior in Greek
life, which can result in students engaging in riskier drinking
behaviors and ultimately contribute to increased alcohol-
related negative consequences (Barry, 2007; Goodwin, 1989;
19

Sher, Barthalow, & Nanda, 2001). Moreover, research
suggests there is an inherent risk for those living in Greek
housing because they experience more injury and harm as a
result of alcohol consumption (Walters, Roudsari, Vader, &
Harris, 2007). Because participation in harmful drinking
behaviors is viewed as normative for college students in Greek
housing and modeled by other students, adverse outcomes
may result in a pattern of learned behaviors, attitudes, and
ideas in this environment (Durkin et al., 2005; Scott-Sheldon
et al., 2008). Such behavior could also be a result of a lack of
enforced policies in procedures that are present at the
university level. Perhaps, a deficiency of supervision and
regulation at apartment complexes and Greek housing may
contribute to higher consumption and alcohol-related negative
consequences (Wechsler et al., 1995). Thus, other non-policy
related prevention efforts may need to be considered for
students living in these environments.
College students living on campus in residential halls
reported experiencing the least amount of alcohol-related
negative consequences. Although this result lends support to
residential halls as a protective factor (Boyd et al., 2008; Page
& OHagerty, 2006), some researchers have found residence
halls to be a risk factor for developing harmful drinking
behaviors (OHare, 1990; Willoughby & Carroll, 2009).
These inconsistencies may be attributable to varying campus
drinking policies (e.g., zero alcohol tolerance policies vs. less
drinking restrictive policies). For instance, the current study
collected data from a campus with a relatively restrictive
alcohol policy (i.e., no alcohol in the residence halls even for
students 21 and older), which may have contributed to the
lower levels of drinking for students living in the residence
halls. Further, this finding may be explained by vicarious
learning of peer alcohol use norms (Ward & Gryczynski,
2009), wherein participation in alcohol use behaviors may be
discouraged or encouraged by a college students immediate
environment. Future research should compare the differential
effects of residential status on drinking behaviors among
campuses with diverse drinking policies. Such findings could
inform whether prevention efforts should be tailored
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
depending on the drinking policies of the university.
Further, living in apartments off-campus and with
parents was predictive of more alcohol-related negative
consequences than living in residence halls. A unique finding
was that living with ones parents while attending college was
predictive of the second highest rate of alcohol-related
negative consequences. This could be a product of
consequences that may result from increased parental
monitoring (Patock-Peckham & Morgan-Lopez, 2006) and
engaging in drinking behaviors that tend to be more normative
to the college environment. The higher number of alcohol-
related consequences may also be attributed to the salience of
peer influence to those living with their parents (Valliant &
Scanlan, 1996). Future studies are needed to investigate the
factors associated with more alcohol-related consequences
experienced by college students living at home. Additionally,
increased campus-wide prevention efforts have been effective
in reducing maladaptive drinking behaviors across residential
statuses (Wechsler et al., 2002b). Perhaps, future prevention
endeavors could include initiatives such as safe drinking
policies with college student groups and organizations in
environments to enhance external supervision.
Protective Behavioral Strategies
A novel aspect of this study was exploring the degree
to which residential status predicted PBS use. We found that
college students residential hall living arrangements were
related to increased use of PBS-SHR and PBS-CC. Such
findings suggest that living in residential halls may be a
preventive and protective factor in and of itself, which is
contrary to Willoughby and Carrolls (2009) findings about
residence halls potentially being a risk factor for harmful
behavior. Moreover, living in apartments off-campus
predicted less use of PBS-SHR use and PBS-CC use while
Greek housing was only predictive of lowered PBS-CC use.
This finding may be due to the risky drinking culture created
in college environments (Chauvin, 2012) and the dearth of
prevention and intervention strategies available to those living
off-campus and in Greek housing, thus making college
students less inclined to utilize PBS. It can be speculated that
20

problematic alcohol use behaviors are encouraged and
accepted as normal by college students in these residential
statuses (Roemer & Walsh, 2014). Moreover, with the lack of
PBS exposure in these environments, college students may not
be able to learn safe drinking strategies that can protect
themselves thus, keeping safe drinking from becoming a
normative behavior. Therefore, availability and accessibility
to PBS needs to be addressed for college students as a whole.
Implications
Our findings may have implications for alcohol use
prevention and intervention efforts. One possible proactive
policy would be the creation of a university-based or
community overseen safe-ride home program, particularly for
Greek students and those living off-campus. A safe-ride home
program involves the use of designated drivers to provide safe
transportation for students who consume alcohol. The
presence of such a program could encourage safer drinking
behaviors as well as possibly reduce alcohol-related negative
consequences related to personal injury and drunk driving
(Rivara et al., 2007). Similarly, based on our findings, it
appears that increased exposure to PBS for those living off
campus and in Greek housing is needed. Many colleges and
universities require incoming freshmen students to complete
an alcohol education course before being successfully
admitted to the institution. The implementation of an annual,
online alcohol psychoeducational program for all students
could increase students exposure to PBS and, consequently,
increase PBS use, likely reducing students susceptibility to
alcohol-related negative consequences. Moreover, future
research should take into account other alcohol-related
variables, like drinking context and self-regulation, regarding
the roles they play concerning residential status and the
aforementioned alcohol-related factors. Future research might
also benefit from exploring the mediating effects of PBS on
the association between residential status and alcohol-related
negative consequences.
Limitations
Although our findings contribute to the literature on
college student drinking, some limitations associated with the
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
present study restrict the generalizability of the results. We
acknowledge that a simple categorization of residential status
into four separate variables does not completely capture the
complexity of the construct. Future research may benefit from
examining residential status as a covariate or moderator in
associations between alcohol use behaviors and environmental
variables, such as drinking context. These analyses are
exploratory in nature and are intended to generate further
research on residential status and college student peer-related
variables (e.g., perceived norms, expectancies, resistance to
peer influence) in an effort to better understand how the
factors may better predict student drinking behaviors.
Moreover, while consumption was controlled in the data
analyses, over 80% of respondents were female, which limits
the scope of this studys findings. This study employed a
cross-sectional design, subsequently limiting inferential
conclusions. The use of more longitudinal designs assessing
drinking behaviors as students change living locations over the
course of an academic career may help address this limitation.
This research was conducted at one midsized university with a
no alcohol campus policy in the southern United States, which
may limit generalizability of findings. Future studies may
address this limitation by including multiple universities
across the country with different types of campus alcohol
policies.
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Table 1

Means, Standard Deviations, and Intercorrelations for the DDQ, YAAPST, PBSS-SHR, & PBSS-CC.

M (SD) DDQ YAAPST PBSS-SHR PBSS-CC

DDQ 9.44 (11.75) --

YAAPST 11.72 (10.27) .46* --
PBSS-SHR 31.51(5.16) -.22* -.31* --
PBSS-CC 45.92(13.30 -.32* -.47* .49* --
Note: DDQ- Daily Drinking Questionnaire; YAAPST- Young Adult Alcohol Problems Screening Test; PBSS-SHR-
Protective Behavioral Strategies Scale- Serious Harm Reduction; PBSS-CC- Protective Behavioral Strategies Scale-
Controlled Consumption.

* p < 0.01

Table 2

Means and Standard Deviations for PBSS-R-SHR and PBSS-CC Across Residential Statuses

PBSS-R-SHR PBSS-R-CC
M (SD) M (SD)

Residential Halls 32.46 (4.98) 48.35 (14.32)

Greek Housing 31.13 (4.68) 41.57 (11.27)
Apartments Off-Campus 30.60 (5.34) 44.21 (12.20)
With Parents 30.88 (4.79) 44.22 (11.35)
Note: PBSS-R-SHR- Protective Behavioral Strategies Scale- Revised- Serious Harm Reduction; PBSS-R-CC-
Protective Behavioral Strategies Scale-Revised- Controlled Consumption

Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1 25


Table 3

Hierarchical Regression Analysis for Experienced Alcohol-Related Negative Consequences among College Students
(N=705)

YAAPST

Predictor B SE B R2

Step 1: .21***
DDQ .40 .03 .46***
Step 2: .34***
Apartment OC 2.30 .69 .11**
Greek Housing 3.84 1.25 .10**
With Parents 2.97 1.39 .07*
PBS-SHR -.23 .30 -.30***
PBS-CC -.14 .70 -.07*
Note: DDQ- Daily Drinking Questionnaire; YAAPST- Young Adult Alcohol Problems Screening Test; PBS-R-
SHR- Protective Behavioral Strategies-Revised Serious Harm Reduction; PBS-R-CC- Protective Behavioral
Strategies-Revised- Controlled Consumption.

* p < 0.05, ** p < 0.01, *** p < 0.00

Table 4

Summary of Hierarchical Regression Analyses for Protective Behavioral Strategy Use among College Students
(N=705)

PBSS-R SHR PBSS-R CC

Predictor B SE B R2 B SE B R2

Step 1: .04*** .10***

DDQ -.10 .02 -.22*** -.36 .40 -.31***
Step 2: .06*** .12***
Apartment OC -1.62 .40 -.15*** -3.37 1.01 -.12**
Greek Housing -.94 .74 -.05 -5.29 2.86 -.10**
With Parents -1.46 .83 -.07 -3.68 2.07 -.06
Note: PBSS-R-SHR- Protective Behavioral Strategies Scale Revised- Serious Harm Reduction; PBSS-R-CC-
Protective Behavioral Strategies Scale Revised- Controlled Consumption.

* p < 0.05, ** p < 0.01, *** p <0.001

Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1 26

RESEARCH, SOCIAL ACTION, PRACTICE AND TRAINING

Suicide Prevention Gatekeeper Training for Resident Assistants: A

Between Groups Control Design Study
Colleen Thomas
Martin Swanbrow Becker
Florida State University

Colleen Thomas and Martin A. Swanbrow Becker, Department of Educational Psychology and Learning Systems,
Florida State University. Correspondence concerning this article should be addressed to Martin A. Swanbrow
Becker, Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL,
32306. E-mail: mswanbrowbecker@fsu.edu

Abstract

Suicide remains a leading cause of death among college
students (Centers for Disease Control and Prevention [CDC],
2013), despite efforts to train campus gatekeepers, such as
Resident Assistants (RAs), in suicide prevention. Research is
warranted to better understand the effectiveness of these
trainings and to determine how they might be adapted for
improved potency. This study represents the first known
between groups experimental design examining the efficacy
of suicide prevention training for RAs on a college campus.
Participants were 160 RAs from a large southeastern
university. Approximately 60% of the RAs were female, and
the ethnic representation of the sample was 64.6% Caucasian,
9.3% Black, 8.1% Latino, 4.3% Asian, 9.9% mixed ethnicity,
and 3.8% identified as Other. RAs in the treatment group
participated in a one-hour suicide prevention gatekeeper
training amidst their RA orientation trainings, while the
control group received a one-hour training in stress and time
management. All RAs completed pre-training surveys, which
measured their: (a) baseline knowledge of the warning signs
of suicide and intervention strategies with suicidal students,
(b) perceived competency to identify and help students in
distress, and (c) attitudes towards seeking professional help.
Post-semester surveys assessed for the impact of the
training on RAs knowledge, attitudes, and perceived
competency. Post-semester surveys also measured the
frequency of RAs suicide prevention behaviors and
interactions with distressed residents during the semester.
Paired samples t-tests were used to assess within group
change. All RAs, regardless of condition, reported greater
perceived competency to intervene with a suicidal student at
post-semester. However, the treatment group reported
significantly improved attitudes towards seeking professional
help, whereas the control groups attitudes worsened.
Independent samples t-tests yielded no between group
differences of frequency of intervention behaviors at post-
semester; thus, the RAs trained in suicide prevention did not
report more interventions with distressed students as
compared to the control group. These results suggest that a
one-hour suicide prevention gatekeeper training was
sufficient for improving participants knowledge about the
warning signs of suicide, perceived competency to intervene,
and attitudes towards help-seeking. However, the training did
not lead to an increase in gatekeepers suicide prevention
behaviors and interventions with students in distress, and

Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1 27

therefore many students in distress remain disconnected from
professional help. Future research should focus on adapting
suicide prevention gatekeeper trainings (e.g., emphasizing
role plays, adding booster sessions, addressing barriers to
intervention) to increase their effectiveness in increasing the
frequency of gatekeepers suicide prevention behaviors.

References

Centers for Disease Control and Prevention (CDC). (2013).

Ten leading causes of death by age group, United
States-2013. Retrieved July 26, 2015 from
http://www.cdc.gov/injury/wisquars/pfd/leading_caus
es_of_death_by_age.

Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1 28


RESEARCH, SOCIAL ACTION, PRACTICE AND TRAINING

Comparison Between International and Domestic Graduate

Students on Alcohol, Sexual Assault, and Prevention Efforts:
An Exploratory Study
Lei Wang
Leslie A. Fasone
Ellen L. Vaughan
Indiana University Bloomington

Lei Wang, Department of Counseling and Educational Psychology, Indiana University Bloomington; Leslie A.
Fasone, Department of Applied Health Science & Division of Student Affairs, Indiana University Bloomington;
Ellen L. Vaughan, Department of Counseling and Educational Psychology, Indiana University Bloomington.
Correspondence concerning this article should be addressed to Lei Wang, 201 N Rose Ave, Room 4054,
Bloomington, IN 47405. E-mail: lw55@indiana.edu, Tel: 573-777-2001

Abstract study. Participants included 52 (15%) IGS and 305 (85%)

DGS studying at a large public Midwestern university in
International students are a growing population on
spring 2014. The mean age of IGS was 27.87 (SD = 5.22) and
college campuses in the U.S. (Institute of International
the mean age of DGS was 28.92 (SD = 7.34). Approximately
Education, 2015); however, their mental health concerns have
58% of IGS and 60% of DGS were women. Eleven percent of
often been overlooked (Mori, 2000). There is limited
IGS and 15% of DGS self-identified as being part of the LGB
empirical research conducted on this population with regards
community. Most of the students resided off-campus (83%
to alcohol use, with the existing studies focused on the
IGS and 90% DGS). Participants were asked to report their
relationship between academic stress and alcohol use (Misra
frequency of alcohol use, incidents of
& Castillo, 2004). In addition, there are no studies on sexual
physical/emotional/sexual violence they have experienced, the
assault and prevention efforts among international students.
frequency of witnessing problematic behaviors (e.g., someone
This study aims to explore the differences between
being discriminated against, someone being hazed to join an
international graduate students (IGS) and domestic graduate
organization, someone who had too much to drink, someone
students (DGS) in terms of engagement in drinking behaviors,
who has been taken advantage of sexually), situations in
witnessing risky behaviors among peers, and ways to
which they believe it is important to intervene, and their
intervene to reduce risk.
confidence level of intervening in those situations. Chi-
Data from the American College Health Association
square and one-way ANOVA results revealed significant
National College Health Assessment II was utilized in this
differences between IGS and DGS. In terms of alcohol use,

Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1 29


IGS were found to consume less alcohol in the last 30 days (F
= 5.59, p < .05) and lower rates of driving after drinking any
alcohol ( = 15.86, p < .001). IGS reported encountering
more incidents of sexual penetration attempted without their
consent (F = 5.95, p < .05) and witnessing more struggles with
severe stress, anxiety or depression (F = 10.62, p = .001),
drinking too much (F = 8.68, p < .05), and abusing drugs (F =
6.01, p < .05) than DGS. Compared to DGS, IGS believed
that it was more important to intervene when someone has too
much to drink (F = 8.78, p < .05), abused drugs (F = 4.77, p <
.05), or been taken advantage of sexually (F = 12.72, p <
.001). IGS felt more confident in their abilities to help
someone who needed assistance in sexual assault/harassment
situations (F = 4.07, p < .05) than DGS did.
Based on the findings of this study, it may be
helpful for prevention specialists to develop programming
on providing resources to intervene in different situations with
IGS. Although the IGS in this sample engage in fewer risky
behaviors, they do report experiencing more attempts of non-
consensual sexual penetration as well as observing
problematic behaviors. Several studies in the past have
examined alcohol-related sexual assault along domestic
college students (e.g., Abbey, 2002; Abbey et al., 2001).
However, due to the cultural differences (Leong &
Mallinckrodt, 1990) between their home countries and the
U.S. as well as acculturative stress (Zhang & Goodson, 2011),
it may be especially helpful for practitioners to be aware of
ways to inform IGS of resources available and to equip them
with legal and institutional knowledge by taking into account
their levels of English proficiency and acculturation to U.S.
culture. Information may also be received better by IGS by
teaching methods of intervening that are congruent with their
cultural values and beliefs. In addition, practitioners should
also be sensitive to the unique stressors of IGS, including
language barriers (Chen, 1999), lack of social support
(Pedersen, 1991), academic stress (Misra & Castillow, 2004),
perceived language discrimination (Wei, Wang, & Ku, 2012),
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
homesickness (Olivas & Li, 2006), etc., which may all
attribute to IGS not knowing how to intervene or even
discouraging them to be an active bystander. Although this is
not an exhaustive list, we add that certain cultural values and
the need to maintain documentation/visa status may also be
potential barriers that prohibit them from intervening.
References
Abbey, A. (2002). Alcohol-related sexual assault: A
common problem among college students.
Journal of Studies on Alcohol, Supplement,
14, 118-128. doi:10.15288/jsas.2002.s14.118
Abbey, A., Zawacki, T., Buck, P. O., Clinton, A. M.,
& McAuslan, P. (2001). Alcohol and sexual
assault. Alcohol Research and Health, 25, 43-
51.
Institute of International Education (2015). Open
Doors Data: International Students: All
Places of Origin. Retrieved June 8, 2015,
from http://www.iie.org/Research-and-
Publications/Open-Doors/Data/International-
Students/All-Places-of-Origin/2012-14.
Leong, F. T., & Mallinckrodt, B. (1990). Cross-
cultural variations in stress and adjustment
among Asian and Caucasian graduate
students. Journal of Multicultural Counseling
and Development, 18, 19-28.
doi:10.1002/j.2161-1912.1990.tb00433.x
Misra, R., & Castillo, L. G. (2004). Academic stress
among college students: Comparison of
American and international students.
International Journal of Stress Management
11, 132-148. doi:10.1037/1072-
5245.11.2.132
Mori, S. C. (2000). Addressing the mental health
concerns of international students. Journal of
Counseling and Development, 78, 137-144.
30


doi:10.1002/j.1556-6676.2000.tb02571.x
Olivas, M., & Li, C. (2006). Understanding stressors
of international students in higher education:
What college counselors and personnel need
to know. Journal of Instructional Psychology,
33, 217-222.
Pedersen, P. (1991). Counseling international students.
Counseling Psychologist, 19, 10-58.
doi:10.1177/0011000091191002
Wei, M., Wang, K. T., & Ku, T. (2012). A
development and validation of the Perceived
Language Discrimination Scale. Cultural
Diversity And Ethnic Minority Psychology,
18, 340-351. doi:10.1037/a0029453
Zhang, J., & Goodson, P. (2011). Predictors of
international l students psychosocial
adjustment to life in the United States: A
systematic review. International Journal of
Intercultural Relations, 35, 139-162.
doi:10.1016/j.ijintrel.2010.11.011

Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1 31

RESEARCH, SOCIAL ACTION, PRACTICE AND TRAINING

Teaching Interpersonal Communication Skills:

Comparing the Fidelity of Online Simulations
Amy E. Dawson
Bianca L. Bernstein
Jennifer M. Bekki
Kerrie G. Wilkins
Arizona State University

Amy E. Dawson, Counseling Psychology, Arizona State University; Bianca L. Bernstein, Counseling and
Counseling Psychology, Arizona State University; Jennifer M. Bekki, Department of Engineering, Arizona State
University; Kerrie G. Wilkins, Counseling Psychology, Arizona State University This material is based upon work
supported by the National Science Foundation under Grant Number 0910384. Correspondence concerning this paper
should be addressed to Amy E. Dawson, Counseling Psychology, Arizona State University, Payne Hall 311-I,
Tempe, AZ 85287-0811. Email: amy.e.dawson@asu.edu.

Introduction presenting technical content within online learning

Interpersonal communication skills (ICS) have been
identified as one of the 21st century skills that students
should acquire in order to succeed in higher education and
future employment (Pellegrino & Hilton, 2012, pg. 34).
Communication skills are essential to working effectively in
teams, responding to feedback, and navigating academic and
professional complications (Bernstein, 2011; Rugarcia,
Felder, Woods, & Stice, 2000). In the realm of positive
psychology and resiliency based prevention programs,
protective factors such as communication skills are
identified as candidates for assisting at-risk individuals
avoid later difficulties (Coie, Watt, West, Hawkins,
Asarnow et al., 1993; Romano, Koch, & Wong, 2012). Yet,
educators struggle with how best to provide substantial
learning and practice opportunities in a scalable way
(Duggan & Adcock, 2007). A promising means to offer
widely accessible instruction and practice in ICS is in an
online interactive learning environment (Duggan & Adcock,
2007). Multiple types of media have been explored for
environments. Simulations, in particular, are growing in
popularity because they allow for addressing educational
objectives explicitly, while still allowing learners to engage
actively in the study of complex and real life phenomena
(Suave, Kaufman, & Marquis, 2007). However, research on
the use and effectiveness of simulations for teaching soft
skills such as communication is in its infancy. Further,
little is known about the design features that might be
especially relevant to teaching ICS, such as the fidelity or
realism of simulations.
The purpose of the study reported here was to assess
the value of visual and audio realism in an interactive
simulation for teaching active listening, a key aspect of ICS.
We compared the effectiveness of simulations that featured
either live actors or animated characters paired with human
or animated voices. We hypothesized that participants who
experienced a more realistic live actor condition would
benefit more from the program than those exposed to
animated simulations.

Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1 32

Methods
Participants included undergraduates (196 women, 76
men) recruited from a large university in the Southwest. Ages
ranged from 19-60 years of age, M = 27.6; SD = 7.76, and
race/ethnicity self-reports included 7% African American,
7% Asian or Pacific Islander, 17% Hispanic, 2% Native
American or Alaskan Native, 55% Caucasian/White, .02%
other, and 9% multiethnic.
Participants were randomly assigned to one of three
Active Listening Communication Simulation (ALS)
conditions as they enrolled in the study. In the ALS,
described in full detail elsewhere (Prim et al., 2013),
participants viewed video clips of a doctoral student and her
advisor discussing the advisors feedback about the students
research. At various points the video stopped and the
participant was asked to decide what the students best
response would be. Based on the users selection, a second
video was displayed and the dialogue continued until the next
decision point was reached. The three simulations featured
exactly the same content and dialogue. Condition 1 (N = 74)
showed live actors using their own voices, condition 2 (N =
98) paired animated characters with the live actors voices,
and condition 3 (N = 97) paired animated characters with
computerized voices.
Participants were instructed to complete the
simulation, an outcome survey and a short demographic
survey. Two scales from the Science Technology
Engineering Mathematics-Active Listening Skills
Assessment (STEM-ALSA; Wilkins, Bernstein, Bekki,
Harrison & Atkinson, 2012) were used to measure targeted
outcomes. The 12-item Knowledge Scale ( = .87) was
designed to measure self-reported knowledge of active
listening skills. Responses were rated on a 5-point Likert-
type scale ranging from 1 (strongly disagree) to 5 (strongly
agree). An 18-item Skills Scale ( =.55) measured
participants ability to apply active listening skills. Similar to
a Situational Judgment Test (Lievens & Sackett, 2012),
participants read interpersonal communication scenarios and
rated response options on a five-point Likert-type scale from
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
1 (very unlikely) to 5 (very likely) on the likelihood of
achieving a stated desired outcome. Participants also
completed a 15-item Overall Experience measure ( = .86),
rated from 1 (strongly disagree) to 5 (strongly agree),
designed to capture the worth or significance that they placed
on the skills taught and their experience with the learning
environment. Responses on items within each scale were
averaged and used as the dependent variables for each
analysis.
Results
A series of 2x3 ANOVAs compared participant
performance on each of the three measures by Gender and
Condition. There was a significant main effect for Condition
on the Knowledge outcome (2 = .029). Participants in
condition 2 (animated with live actor voice) had significantly
higher scores on Knowledge (M = 2.18) than participants in
Condition 1 (live actor) and Condition 3 (animated with
computerized voice) (M = 1.98, M = 1.98 respectively): F (2,
263) = 3.88, p = .022. There were no significant differences
between conditions 1, 2, and 3 on Skills or Overall Experience.
No main effects were found for Gender on Knowledge and
Skills. On Overall Experience, men rated their experience
significantly higher (M = 2.30) than did women (M = 2.06): F
(1,263) = 8.12, p = .005, 2 = .03.
Conclusions
The preliminary results demonstrate that minimal
differences in relevant outcomes were generated based on the
type of medium used in an online interactive environment to
teach interpersonal communication skills. Contrary to our
hypothesis, the live actor condition was actually less effective
than the animated character condition for increasing
Knowledge of ICS. It may be that experiencing the full
complexity of contiguous verbal and nonverbal communication
of live actors burdens a learners cognitive load (Pass & Van
Merrienboer, 1994). Vocal quality transmits salient nonverbal
information (Scherer, Ladd, & Silverman, 1984), and therefore
condition 2 (animated character with live actor voices)
participants may have benefitted from focusing on the vocal
cues without being distracted by live actor nonverbal behaviors.
33

Similarly, it is possible that the communication lesson was
more distilled in the animated plus live actor voice condition
and therefore easier to understand and learn.
Replication of our findings and more research on the
use of simulations for interpersonal communication skills
training are needed. Nonetheless, the results raise the
possibility that animations, especially paired with live actor
voices, can provide scalable ICS learning and practice
opportunities for a fraction of the cost required to develop
simulations with live actors. The learning of any skill, including
communication techniques, requires numerous iterations of
practice according to the power law of practice (Pellegrino &
Hilton, 2012, pg. 80). At first, this rehearsal results in rapid
improvements in performance, and then slow, steady
progression follows (Pellegrino & Hilton, 2012). Interpersonal
communication skills training available via an online format
allows learners to return to the simulations and practice the
scenarios as many times as desired or needed in order to master
the skills. Furthermore, while research has shown (cf., Salas et
al., 2008) that team training interventions can increase
interpersonal competencies, such as communication, these are
labor and time-intensive and geographically limited. In
contrast, online training in communication skills, an important
type of protective factor (Romano & Hage, 2000), can reach a
larger audience and thereby increase the probability of assisting
at-risk individuals improve communication in challenging
situations. Given the difficulties in providing widely accessible
instruction and practice in ICS, these findings may have
significant implications for the future of ICS training and new
applications of educational technology.
References
Bernstein, B. L. (2011). Managing barriers and building
supports in science and engineering doctoral
programs: Conceptual underpinnings for a new online
training program for women. Journal of Women and
Minorities in Science and Engineering, 17, 2950.
Prevention and Health Promotion: Research, Social Action, Practice And Training: Volume 9, Issue 1
Coie, J. D., Watt, N. F., West, S. G., Hawkins, J. D., Asarnow,
J. R., Markman, H. J., Ramey, Sharon L., Shure, M.
B., & Long, B. (1993). The science of prevention: A
conceptual framework and some directions for a
national research program. American Psychologist, 48,
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Duggan, M. H., & Adcock, A. B. (2007). Animated agents
teaching helping skills in an online environment: A
pilot study. Journal of Interactive Online Learning, 6,
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Lievens, F., & Sackett, P. R. (2012). The validity of
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Pellegrino, J. W., & Hilton, M. L. (2012). Education for life
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skills in the 21st century. Washington, DC: The
National Academies Press.
Prim, D., Bernstein, B. L., Way, A., Hita, L., Liddell, T.,
Sarma, A., & Bekki, J. M. (2013). Development of an
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