Volunteerism, Alcohol Beliefs, and First-Year College Students’ Drinking Behaviors: Implications for Prevention

The relationship between health-related knowledge and attitudes and health risk behaviours among Portuguese university students

Scientific evidence reveals a high prevalence of health risk behaviour among university students. This calls for the creation of educational programmes that promote more knowledge about health. However, knowledge alone is not enough to change behaviours; other factors should be considered, including attitudes towards health. The objective of this cross-sectional study was to analyse the relationship between knowledge, attitudes and health risk behaviours among university students. For this, a previously validated self-report questionnaire was applied to a stratified sample of 840 students, by year of study (first- and third-year students) and their scientific area. In addition to sociodemographic issues, the questionnaire contains a health-related knowledge scale, an attitudes towards health scale, and questions about health risk behaviours. Students displayed poor knowledge about health, correctly answering 17.77 (SD = 4.59) questions out of a total of 36, and moderate scores concerning attitudes towards health (M = 2.61, SD = 0.48, range: 1-5). Students reported always engaging in, on average, 3.88 (SD = 1.45) of the seven behaviours subject to the analysis. Mediation analyses indicated that knowledge about health and attitudes towards health were statistically significant predictors of risky behaviours. Furthermore, it was indicated that attitudes towards health have a mediating effect between health knowledge and health risk behaviours. Findings from this study indicate that public health and education policies should promote healthy behaviours among university students, taking into account not only the level of knowledge but essentially the development of positive attitudes when facing behaviours which put health at risk.

Cigarette Smoking, Risky Alcohol Consumption, and Marijuana Smoking among University Students in Germany: Identification of Potential Sociodemographic and Study-Related Risk Groups and Predictors of Consumption

(1) Background: Cigarette smoking, risky alcohol consumption, and marijuana smoking are the most common behaviors related to legal and illicit drug use worldwide, including among university students. To plan effective evidence-based programs to prevent the risky consumption of these substances among university students, the present study aimed to identify potential sociodemographic and study-related risk groups and predictors of consumption. (2) Methods: A cross-sectional online health survey with approximately 270 health-related items was conducted among students at the University of Mainz, Germany. Cigarette smoking, risky alcohol consumption (AUDIT-C score: female ≥ 4, male ≥ 5), and marijuana smoking were chosen as dependent variables. Of the 270 health-related items, 56 were chosen as independent variables and collated into five groups (sociodemographic, psychological, study-related psychosocial, general psychosocial and health behavior). The prevalence of cigarette smoking, risky alcohol consumption, and marijuana smoking was assessed using established and validated instruments. Pearson's chi-square test was used to analyze the differences in prevalence between the sociodemographic and study-related groups, and binary logistic regression was used for analyses with stepwise inclusion of the five variable groups. (3) Results: Of the 3991 university students who entered the analyses, 14.9% reported smoking cigarettes, 38.6% reported risky alcohol consumption, and 10.9% reported smoking marijuana. The prevalence of these differed between genders, fields of study, and aspired degree level, among other factors. Binary logistic regression analyses revealed nine significant predictors (p ≤ 0.05) of cigarette smoking (Nagelkerke R2 = 0.314), 18 significant predictors of risky alcohol consumption (Nagelkerke R2 = 0.270), and 16 significant predictors of marijuana smoking (Nagelkerke R2 = 0.239). (4) Conclusions: This study showed cigarette smoking, risky alcohol consumption, and marijuana smoking among university students in Germany to be associated with multiple factors, especially health behaviors. Furthermore, each of the substances was highly associated with each of the two other substances we examined. Other variable groups, such as psychological or psychosocial variables, seemed to play a rather minor role. Therefore, our recommendation for future prevention programs is that substance use among university students should be addressed as a whole, not just in terms of specific substances.

The Alcohol and Polysubstance Behaviors of Mandated College Students Prior to Collegiate Sporting Events: An Assessment of Pregaming

Background: Despite a litany of education and prevention efforts seeking to curtail alcohol and other drug (AOD) use behaviors of United States (U.S.) college students, AOD use remains pervasive among the American college student population. Socio-cultural reinforcement of AOD behaviors, such as pregaming (PG), are often considered normative aspects of the collegiate experience, potentially introducing, and/or exacerbating, AOD use among U.S. college students. Objective: Due to the unique relationship PG has with the U.S. college experience and sports culture, this study explored the relationship between PG prior to a live sporting event and frequency of alcohol use, and the likelihood of persons who pregame also engaging in polysubstance use (>1 substance during drinking/use event). Methods: This study was conducted with college students (n = 816) attending a large public university in the Southeastern Conference (SEC) who violated campus alcohol use policies. Results: Beyond the influence of important demographic covariates, PG (p < .001) was significantly associated with a greater frequency of alcohol use. Moreover, students who participated in PG festivities were nearly 2.5 times more likely to participate in polysubstance use. Discussion: PG prior to live collegiate sporting events has clear public health and policy implications. Future efforts should institute and enforce risk-management policies on college campuses and employ event-specific alcohol and polysubstance use prevention and intervention strategies.

Consequences, Motives, and Expectancies of Consumption as Predictors of Binge Drinking in University Women

The increasing presence of women, especially university women, in risky alcohol consumption such as Binge Drinking (BD), which is associated with gender-specific biopsychosocial problems, makes it necessary to analyze the variables underlying BD in order to adjust possible interventions more in line with their reality. The motives and expectancies of this pattern of consumption, as well as the consequences derived from it, are some of the variables that are shown to have the greatest weight in the prediction of BD. In the present study we analyze, on the one hand, the performance of these variables among college women with alcohol use, and on the other hand, which of these variables allow us to classify BD. A total of 501 female university consumers of alcohol (mean age 19.02 years) were assessed. Specifically, they completed a self-report of alcohol consumption (77.1% engage in BD), the Expectancy Questionnaire (EQ), the Drinking Motives Questionnaire (DMQ-R) and the Alcohol Consumption Consequences Evaluation (ACCE). BD female students scored significantly higher on these instruments, except for compliance motives. The logistic regression analysis carried out to estimate the probability of performing BD using the social and conformity motives, the ACCE and positive expectancies correctly estimated (χ2 8 = 9.149, p < 0.33) 88.6% of the cases and explained 26.2% of the BD. Thus, young women with a level of consequences classified as high risk (>25 in ACCE) have a 3.55-fold increase in the probability of having BD, compared to women classified as low risk by the ACCE. On the other hand, women classified as moderate risk by the ACCE have a 4.77-fold increase in the probability of having BD. In the case of social motives and positive expectancies, their increase multiplies by 1.165 and 1.024, respectively, the probability of having BD. The results of this study highlight the importance of adapting preventive measures to the consequences experienced by BD university students, especially in relation to the social motives and positive expectancies that modulate decision-making when engaging in this pattern of consumption.

Expectancies and Motives as Predictors of Risky Alcohol Consumption in College Women

Despite the consequences of alcohol use, it continues showing a high incidence among college students. Besides, the increasing presence of women in risk alcohol patterns calls for a gender-sensitive approach to design specific actions. Some variables have been analyzed as underlying alcohol consumption (expectations and motives). This paper assesses the type and influence of both variables on female university alcohol consumers at different levels of risk. Five hundred four college women were assessed using the Spanish adaptations of the Expectancy Questionnaire, the Drinking Motives Questionnaire-Revised, and the AUDIT. We determine the unique contributions of expectancies, motives, and the presence of binge drinking (BD) to the pattern of risky drinking. The percentage of variance explained by risky drinking is 37.7%. Negative expectancies (20.4%) are the most explanatory variables, followed by enhancement motives (10.4%). Interventions with university women should focus on their negative expectancies, in addition to addressing for improvement, coping with depression, and conformity motives.

Identifying the Assumptions and Bias That Affect Screening and Brief Interventions for Harmful Alcohol Use

BACKGROUND

Screening for harmful alcohol use (HAU) is standard in clinical settings; however, self-reports of the quantity/frequency of use are often inconsistent with population survey data and objective assessment. Inaccuracies of self-reported alcohol use prompt exploration of patients' reluctance to share this information with their health care providers.

OBJECTIVES

The purpose of this article is to identify the assumptions and biases that affect screening and brief interventions for HAU.

METHOD

A total of 22 research articles were selected for a systematic review of the literature. The studies included prospective and retrospective studies, randomized controlled trials, case studies, and quantitative and qualitative research from 2015 to 2021.

RESULTS

This systematic review identified alcohol health literacy, the inherent bias of surveys and screening tools, stigma, avoidance bias, and the normalization/villainization of alcohol use as contributors to the assumptions and biases that affect screening and brief interventions for HAU.

CONCLUSIONS

Exploring these assumptions and biases presents opportunities to develop strategies that promote positive change.

Association between marijuana use and nonmedical prescription opioid use in the United States: are we shifting from one epidemic to another?

The United States (US) is grappling with a severe opioid epidemic. Marijuana is emerging as a therapy for pain management and an alternative to opioids, but little evidence supports its long-term benefits. This study aims to examine the association of marijuana use among patients on prescription pain relievers in a retrospective cross-sectional study using zero-inflated negative binomial regression. The recipients of prescription pain medicines were identified using National Survey on Drug Use and Health (2015-2017). Irrespective of the state marijuana laws, marijuana use days were 34% higher and odds of having zero days of marijuana use were 73% lower in those using nonmedical prescription opioids vs. not (IRR = 1.34, p < 0.0001; OR = 0.27, p < 0.0001, respectively). In the absence of consequential evidence supporting marijuana for pain management and more states venturing into legalizing it, there needs to be more caution as the country struggles to recover from one epidemic.

What lessons can Africa learn from the social determinants of COVID-19 spread, to better prepare for the current and future pandemics in the continent?

This paper examines the determinants of the spread of coronavirus disease 2019 (COVID-19) in Africa, based on the framework of social determinants of health. Applying Poisson Pseudo Maximum Likelihood (PPML) and quantile regressions to panel data and country-specific socioeconomic background data from 53 African countries, the study finds that enhancing capacity for early testing helps for timeous uncovering of cases, early isolation and contact tracing for effective control of the spread. Other factors such as managing of international movements through reduction of international exposure and ensuring better sanitation and hygiene were found to be relevant in diminishing COVID-19 spread, whereas alcohol consumption and population density heighten the spread. The work also highlights that stringent measures will be counter-productive unless they are coupled with measures to create and preserve livelihoods, together with humanitarian relief assistance to the poorest segments of the population. The results are robust to alternative techniques. As policy recommendations, we implore African governments to the promotion of sustainable livelihoods and social safety nets as measures to accompany stringent lockdowns; and good sanitation programmes to become a lifestyle of citizens. Careful attention should be paid to the socioeconomic trade-off in respect of international travel restrictions given the high dependence of most African economies on tourism.

Going against the Norm: A Mixed Methods Analysis of College Students' Arguments against the College Drinking Culture

College alcohol beliefs (e.g. "College is a time for experimentation with alcohol") are highly predictive of heavy drinking and its consequences. Yet, current college alcohol interventions do not address this belief system even though researchers have recommended that these beliefs be targeted. Using a mixed methods approach, we conducted two studies to generate arguments against the college drinking culture and to evaluate the effectiveness of such arguments. In Study 1, freshman students (N = 104, 65% women) wrote an essay to a fictitious roommate presenting arguments against the college drinking culture. Responses were reliably coded into a 19-category scheme. The most common arguments included that (1) one's focus should be on academics, (2) drinking will lead to academic consequences, and (3) drinking is not a rite of passage in college. In Study 2, college students (N = 488) rated the effectiveness of prototype arguments drawn from each Study 1 category. According to their ratings, the most effective arguments were that (1) one's focus should be on academics, (2) drinking could have a negative impact on one's career, and (3) one could do potential harm to others. The student-generated arguments against the college drinking culture identified in his research have inherent ecological validity and will help inform the development of new interventions to counter such beliefs. We offer suggestions for translating our findings into clinical interventions.The problem of college student drinking has been long-standing (Kilmer et al., 2014) and remains a significant public health issue today (Hingson et al., 2017). Decades of research on college student drinking and its consequences have identified key cognitive factors that underlie drinking and its consequences, such as the misperception of norms for drinking (Borsari & Carey, 2003) and the positive expectancies students hold about the effects of drinking (Jones et al., 2001; Monk & Heim, 2013). The robust relationships between these cognitive variables and alcohol consumption among college students have led to the development of interventions that target these variables. Social norms marketing campaigns (DeJong et al., 2006), personalized normative feedback (Lewis & Neighbors, 2006), and expectancy challenge techniques (Scott-Sheldon et al., 2012) have been a part of interventions designed to correct students' misperceptions about the percentage of and amount students drink and the effects that alcohol has on their functioning in social situations. Reviews of the literature have demonstrated that interventions containing these components are effective for first year students (Scott-Sheldon et al., 2014) and mandated students (Carey et al., 2016), except for interventions targeting student members of Greek letter organizations (Scott-Sheldon et al., 2016). Effect sizes in most interventions across freshman and mandated students tend to be modest and not very durable in the long-term (Carey et al., 2016; Scott-Sheldon et al., 2014). However, recent research reveals that a variety of new intervention strategies may be useful in addressing the problem of college student drinking (Dunn et al., 2020; Kazemi et al., 2020; King et al., 2020; Magill et al., 2017; Pedrelli et al., 2020; Young & Neighbors, 2019). Aside from social norms and positive alcohol expectancies, another cognitive variable has been found to be a very robust predictor, mediator, and moderator of college student drinking and its consequences - college alcohol beliefs (Crawford & Novak, 2006; Osberg et al., 2010).