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Research Article Research Article Why Underage College Students Drink in Excess: Qualitative Research Findings Virginia Dodd, Tavis Glassman, Ashley Arthur, Monica Webb, and Maureen Miller ABSTRACT Background: Excessive alcohol consumption by underage students is a serious and persistent problem facing most U.S. colleges and universities. Purpose: This qualitative study explores why underage students engage in high-risk drink- ing and examines motivational cues that may serve as behavioral deterrents. Methods: Focus groups were conducted with college students under the age of 21 years (N=59) attending a large university in the southeast. All participants reported consuming five or more drinks in one sitting within the last two weeks (four or more for a female).Results: Participants attach positive expectancies to alcohol use, including peer influence/support and reduction of social anxiety. Negative social consequences such as embarrassment and relationship issues, including perceived sexual opportuni- ties, were cited as disincentives for excessive drinking. Gender distinctions were present among the referenced costs and benefits of excessive alcohol consumption. Discussion: Overall, the negative consequences associated with excess drinking by underage college students are outweighed by positive expectancies such as social approval and acceptance by their peers. Translation to Health Education Practice: Understanding the language, motives and expectancies young people attach to alcohol use can enhance the efficacy of health education and prevention efforts. Dodd VJ, Glassman T, Arthur A, Webb M, Miller M. Why underage college students drink in excess: Qualitative research findings.Am J Health Educ. 2010;41(2):93-101. This paper was submitted to the Journal on July 23, 2009, revised and accepted for publication on Sep- tember 30, 2009. BACKGROUND Previous studies also reveal that high-risk negative consequences for college students The practice of high-risk drinking may be drinking rates among college students are including unintentional injuries, risky sexual regarded as the most serious health problem greater than rates among their same-age behavior, violence, academic difficulties and faced by U.S. colleges and universities.1,2 peers not attending college.1,5,6 This pat- trouble with the law.1,8 Further, based on the Recent findings by Hingson and colleagues tern of high-risk drinking results in serious Diagnostic and Statistical Manual of Mental indicate a lack of overall progress in attempts to reduce alcohol-related mortality and morbidity rates among 18-to-24-year-old Virginia Dodd is an associate professor in at the National Center for Chronic Disease and college students.1 National College Health the Department of Health Education and Prevention and Health Promotion, Office on Assessment data collected in the fall of 2006 Behavior, Room 5 FLG, University of Florida, Smoking and Health/Epidemiology Branch, indicate that approximately 32% of female Gainesville, FL 32608; E-mail: [email protected]. Atlanta, GA 30333. Monica Webb is a Doctoral and 47% of male college students engage edu. Tavis Glassman is an assistant professor in candidate, University of Florida, Gainesville, in high-risk drinking,3 defined as the con- the Department of Health Education & Reha- FL 32611. Maureen Miller is an alcohol & other sumption of at least five or more drinks for bilitative Services, University of Toledo, Toledo, drug prevention specialist at the Student Health men or four or more drinks for women on OH 43606. Ashley Arthur is a health research Care Center, GatorWell Health Promotion Ser- at least one occasion in the past two weeks.4 analyst, Northrop Grumman Contract Support vices, Gainesville, FL 32611. American Journal of Health Education — March/April 2010, Volume 41, No. 2 93 Virginia Dodd, Tavis Glassman, Ashley Arthur, Monica Webb, and Maureen Miller Disorders, 4th Edition, nearly one-third of is understanding what motivates underage between the age of 18 and 20 years, and to college students meet the criteria for a for- students to engage in excess drinking and have consumed five or more drinks in one mal diagnosis of alcohol abuse, and one in identifying factors that might serve as deter- sitting within the last two weeks (four or 17 can be classified as alcohol dependent.4 rents to the behavior. Previous research us- more drinks for a female).Volunteers were In order to address this problem, the U.S. ing a qualitative approach revealed complex prescreened prior to being appointed to a fo- Surgeon General established a national perspectives regarding alcohol use among cus group. Focus groups were conducted in health goal aimed at reducing high-risk Hispanic college students and provided the early afternoon and were approximately drinking among college students by 50% evidence that individual perspectives vary 60 minutes in length; a light lunch was by the year 2010; 6,7 a goal that is unlikely to according to context and outcomes. 6 included. As an incentive for participating be achieved. in the focus groups, students received a $20 A specific problem for senior administra- PURPOSE university book store gift card. Prior to the tors at colleges and universities involves the The purpose of this study was to gain start of each group, participants read and high percentage of underage students who greater insight into issues associated with signed the IRB-approved consent form. engage in drinking. Wechsler and colleagues excess drinking among underage college The initial male focus group served as a estimate that underage alcohol consumption students. More specifically, our goal was pilot group for testing the content and flow by college students represents about half to identify benefits and barriers relating to of questions. Based on suggestions received of the overall alcohol consumption among excessive drinking as perceived by underage from the group, minor changes to the college students.9 However, of particular college students. The overarching goal of discussion guide were made and the script concern are estimates indicating that 90% of this study was to gain a personally relevant and format revised. Each male focus group underage alcohol consumption occurs under perspective of excess drinking among un- was moderated/co-moderated by trained conditions meeting the criteria for “binge” or derage college students for the purpose of male graduate students who were part of high-risk drinking.10 As a result, institutions designing highly targeted health messages the research team. The four focus groups of higher education are an important setting to discourage the behavior and reduce as- (N=35) consisted of male students ages 18 for reaching young people and improving sociated negative consequences. to 20 years. Because the main purpose of their health status. our study was to gain personally relevant, The increased national attention focusing METHODS perspectives of excess drinking demographic on high-risk college drinking has prompted Based on their ability to add depth to data other than gender was not collected. At universities to initiate or increase their pre- research findings, focus groups were con- the time of this study many students on cam- vention efforts.4 Yet, several national studies ducted to better understand college stu- pus held a common misperception that the indicate little or no change in the high-risk dents’ attitudes and expectations regarding current administration intended to make the drinking rate among college students.1,4,10-12 excessive drinking (consuming five or more campus “dry.” Therefore, our intent was to Given the continued pervasiveness of high- drinks in one sitting for a male and four or avoid collecting any information that would risk drinking among college students, recent more drinks in one sitting for a female). make students suspicious of our motives, efforts have focused on understanding the Prior to implementation, the protocol for especially since each focus group was audio- nature of problem drinking.13 However, cur- this study was approved by the University’s recorded, students were underage, and asked rent research on college drinking is dominat- Institutional Review Board (IRB). Focus to complete the Alcohol Use Disorders Iden- ed by large-scale survey-based (quantitative) group questions were designed to: (1) deter- tification Test (AUDIT) 14 immediately prior studies such as the Monitoring the Future mine student motives for drinking in excess, to the start of the focus group Survey and the CORE Alcohol and Drug (2) identify deterrents to mitigate alcohol The AUDIT is a 10-item criterion vali- Survey.5,6,14 These studies have played an im- consumption, (3) explore the psycho-social dated measure with good construct validity portant role in directing alcohol education, differences between male and female drink- designed to measure the frequency, intensity prevention and promotion efforts through ing patterns, and (4) determine how and and alcohol-related consequences associated identification of the many social and cultural where students acquire alcohol-related with excessive drinking, as well as assessing factors influencing excess alcohol consump- information. one’s risk for alcohol abuse and depen- tion among college students. However, the Focus groups (4 male and 3 female) were dence.15 Validity of the AUDIT is similar to unremitting rate of excess drinking among conducted during the 2006 fall semester. that of other self-reported screening tests college students suggests that other forms of Participants were recruited for the study (e.g., CAGE) and is appropriate for both data, such as qualitative data, may be useful through a classified ad in the school news- males and females and has high sensitivity in augmenting present health education paper and flyers distributed on-campus. and specificity relative to alcohol use dis- and prevention efforts.6 A major challenge Inclusion data required participants to be orders for youth.16 A cut-off score of 8 has facing health education efforts in this arena currently enrolled in university classes, been cited as demonstrating sensitivity and 94 American Journal of Health Education — March/April 2010, Volume 41, No.
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