Problem Drinking Behaviors:Problem Drinking Behaviors:Differential Effects of Stress and Type of Differential Effects of Stress and Type of

School on Black vs. White College StudentsSchool on Black vs. White College Students

Alvin Tran, Carla J. Berg, PhD, Eric Nehl, PhD, & Jessica M. Sales, PhDDepartment of Behavioral Sciences and Health Education,

Emory University, Rollins School of Public Health

Acknowledgements

– Co-Authors and Mentors

• Carla Berg, PhD, Emory University

• Eric Nehl, PhD, Emory University

• Jessica Sales, PhD, Emory University

– National Cancer Institute and Georgia Cancer Coalition

– Collaborators across the state of GA in developing and administering the survey

– Rollins School of Public Health Student Govt. Assoc.

Background & Importance

• Alcohol # 1 drug of choice for college students (1)

• More than 70% of college students report that they have consumed alcohol within the past 30 days, many consuming it heavily (2)

• 2 in 5 college students report binge drinking in the previous 2 weeks (2)

• African American young adults report lower rates of alcohol use and binge drinking than White young adults (3)

Background & Importance

• Most previous research studying college health have focused primarily on traditional four-year colleges

• Community college population has experienced a five-fold increase over the past 40 years– Total of 1,685 public and independent US community colleges (4)

– Only 25% of students report recent binge drinking (5)

Objective

To determine the sociodemographic and psychosocial factors related to problem drinking behaviors (PDB) among Black and White students attending two-and four-year colleges

Methods

– Students at six colleges recruited to complete online surveys

• Random sample of 5,000 students at each school (exception of 2 schools)

• Total invited: 24,055• Email invitation with a link to consent form and survey

• Incentive: entry for cash prizes at each school ($1,000 (1), $500 (2), $250 (4))

• Approval from Emory University IRB (#0030631)

Methods

– Demographic characteristics

• Race/Ethnicity classified as non-Hispanic White or Black

– Problem Drinking Behavior (PDB)

• Focused on 3 survey measures

– Number of days (within the past 30) where 5 or more alcoholic beverages were consumed on one occasion

– Drug/alcohol use before most recent sexual episode

– Number of times driving while intoxicated (within past 30 days)

• Aggregated problem drinking behavior score (0 to 5)

Methods

– Psychosocial variables:

• Depression (PHQ-2)• Perceived Stress (PSS-4)• Satisfaction with Life (SWLS)

– Data Analysis

• Bivariate analyses• Multivariate regression• PASW 18.0

• α = 0.05

Results

Variable Mean (SD) or N(%)

Sociodemographic variables

Age (SD) 23.70 (7.39)

Gender (%)

Male

Female

1151 (28.1)

2947 (71.9)

Ethnicity (%)

White

Black

2193 (53.5)

1905 (46.5)

Type of school (%)

Four-year

Two-year

2445 (59.7)

1653 (40.3)

Psychosocial variables

PHQ-2 (SD) 1.21 (1.31)

PSS-4 (SD) 6.08 (3.42)

Satisfaction with Life (SD) 22.30 (7.54)

Problem Drinking Behaviors

Binge drank in past 30 days (%)

0 days

1-2 days

3 or more days

2966 (77.1)

477 (12.4)

402 (10.5)

Used drugs or alcohol prior to most

recent sexual intercourse (%)

No

Yes

2728 (85.8)

548 (14.2)

Drove after drinking in past 30 days (%)

0 days

1 days

2 or more days

3208 (83.4)

358 (9.3)

280 (7.3)

Problem drinking behaviors index (SD) 0.54 (0.84)

Table 1: Participant Characteristics

Results Table 2: Bivariate Analyses Examining Factors Associated with PDB

ResultsTable 3: Multivariate Regression Model Indicating Factors Associated with PDB

Index

Variable B 95% CI p

Age .01 (.00, .01) .63

Gender

Male

Female

Ref

-.18

--

(-.58, -.36)

<.001<.001

Ethnicity

White

Black

Ref

-.43

--

(-1.44, -.61)

<.001<.001

Type of school

Four-year

Two-year

Ref

-.21

--

(-.62, -.41)

<.001<.001

PHQ-2 .09 (.03, .13) .001.001

PSS-4 -.06 (-.04, .00) .06

Satisfaction with Life -.09 (-.02, -.01) .002.002

Ethnicity x Gender .09 (.05, .40) .01.01

Ethnicity x Type of school .11 (.20, .54) <.001<.001

Ethnicity x PHQ2 -.04 (-.12, .03) .24

Ethnicity x PSS-4 .12 (.01, .07) .01.01

Ethnicity x Satisfaction with Life .05 (-.01, .02) .41

Fig. 1: Interaction of Ethnicity and Gender on PDB

Fig. 2: Interaction of Ethnicity and Type of School on PDB

Fig. 3: Interaction of Ethnicity and Perceived Stress on PDB

Limitations

• Limited generalizability

– May not apply to other populations

• 20.1% response rate

• Participants were primarily female and White, responder bias

Conclusions

• Male college students were more likely to engage in one or more of the three problem drinking behavioral factors

• White students attending four-year schools had higher problem drinking behavior indexes compared to Whites students attending two-year schools

• Despite having lower problem drinking behavior indexes, Black students were more negatively affected by higher perceived stress in terms of their problem drinking behaviors compared to White students

Implications for Future Research and Action

• Future efforts to identify high-risk subgroups on college campuses

• Interventions aimed at specific subgroups

– Males, four-year college students, those with significant depressive symptoms

• Further studies on two-year colleges where a knowledge gap still exists

References

1. O'Malley PM, Johnston LD. Epidemiology of alcohol and other drug use among American college students. J Stud Alcohol Suppl. 2002(14):23-39.

2. Wechsler H, Lee JE, Kuo M, Seibring M, Nelson TF, Lee H. Trends in college binge drinking during a period of increased prevention efforts. Findings from 4 Harvard School of Public Health College Alcohol Study surveys: 1993-2001. J Am Coll Health.2002;50(5):203-217.

3. Windle M. Alcohol use among adolescents and young adults. Alcohol Res Health. 2003;27(1):79-85.

4. Degree Granting Institutions, by Control and Type of Institution: 1963 Through 2005.Washington, D.C.: National Center for Educational Statistics: National Center for Educational Statistics; 2007.

5. Sheffield FD, Darkes J, Del Boca FK, Goldman MS. Binge drinking and alcohol-related problems among community college students: implications for prevention policy. J Am Coll Health. 2005;54(3):137-141.

Questions?Questions?

Thank YouThank You

Alvin Tran, MPH Candidate 2012alvin.tran@emory.eduCarla Berg, Ph.D.cjberg@emory.edu