HAZARDOUS ALCOHOL USE AND CULTURAL ADJUSTMENT AMONG U.S. COLLEGE STUDENTS ABROAD IN ITALY

Michael A. Mitchell, MA

VA Pittsburgh’s Interdisciplinary Program Addictions Education and Research (“VIPER”)

VA Pittsburgh Healthcare System, Pittsburgh, PA

Co-authors: Poyrazli, S. & Broyles, L.M.

Disclaimer• The views expressed in this presentation are those of the

authors and do not necessary reflect the position or policy of the Department of Veterans Affairs or the United States government.

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Acknowledgements• Funding

• This material is based upon work supported by the Office of Academic Affiliations (Mitchell), Health Services Research and Development (Broyles, CDA 10-014) and with resources and the use of facilities at VA Pittsburgh Healthcare System.

• Authors have no conflict of interest to disclose.

Background• Italy a top destination for U.S. college students studying

abroad• Staff, international news provide anecdotal accounts

about the severity and types of alcohol-related problems• Students with hazardous alcohol consumption (e.g., binge

drinking) may experience direct/indirect adverse consequences

• Heavier drinkers more intentions to go abroad, may be responsible for “transporting” cultural norm

Purpose• Assess the prevalence of hazardous alcohol use and

recent binge drinking in a sample of U.S. college students studying abroad in Italy

• Identify the relationships between drinking and cultural adjustment

• Determine which sociocultural factors predict binge drinking

Design and Methods• Cross-sectional, web-based survey • Students studying abroad in Italy between 2012-2013• 2 institutions from Northeast U.S.• Convenience sampling recruitment procedures with study

abroad advisors as gatekeepers

Alcohol Misuse• Hazardous alcohol consumption

• Alcohol Use Disorders Identification Test (AUDIT)• Cut-off score >8

• Binge drinking• Gender-specific item (>5 drinks/male, >4 drinks/female)

Saunders J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R., & Grant, M. (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption — II. Addiction, 88, 791-803.

Cultural Adjustment

Pedersen, E. R., Neighbors, C., Larimer, M. E., & Lee, C. M. (2011). Measuring Sojourner Adjustment among American students studying abroad. International Journal of Intercultural Relations, 35(6), 881-889.

Sojourn Adjustment Measure (SAM)

• 24 items, 7-point Likert scale (Strongly disagree Strongly agree)

Factor Example

Social interaction with host nationals Had meaningful social interactions with local people

Cultural understanding, participation Actively tried to learn more about local customs, traditions in my host country

Language development, use Used my host country’s language (or dialect/idioms) to communicate with local people

Host culture identification Behaved in ways that are typical of members of my host country

Social interaction with co-nationals Socialized a good deal with other Americans

Homesickness or feeling out of place Felt sad or depressed about being far from home

Analysis• Descriptive statistics• Bivariate analyses for correlations• Logistic regression

Sample CharacteristicsDemographics (n= 111)

Female 76%

Age, mean (SD) 20.17 (1.06)

White/Caucasian 91%

Heterosexual 96%

Single 67%

Location

Rome 47%

Florence 38%

Junior year 51%

Hazardous Alcohol UseHazardous Alcohol Use

AUDIT score, Mean (SD) (Range) 8.02 (4.85) (1-22)

Male 9

Female 6

% with AUDIT >8 46%

Binge Drinking

% Binge Drinking 63%

Male 65%

Female 63%

Associations between Alcohol Use and Cultural Adjustment

• Binge drinking associated with:• Hazardous alcohol use (r = .62**)• Social interaction with American peers (r = .42**)• Social interaction with Italian nationals (r = .21*)

• Social interaction with American peers associated with: • Hazardous alcohol use (r = .30*)• Host culture identification (r = .32*)

* p < .05, ** p < .001

Predictors for Binge Drinking Abroad• Students socializing with American peers while abroad

had a 19% increase in the odds of binge drinking (Factor 5) (OR = 1.192, CI = 1.087 - 1.306, p = .000)

• Socializing with American peers was the only variable factor in the multivariable model that predicted binge drinking

Discussion• Sizeable proportion students self-reported recent binge

drinking • Nearly half considered hazardous drinkers• Binge drinking and hazardous alcohol use linked to

socializing with American peers• Social interaction with peers associated with greater

understanding Italian culture

Implications• Alcohol education

• Partnerships with local community about cultural awareness

• Alcohol intervention/research• Partnerships with regional study abroad organizations for further

research, evaluation• Qualitative and mixed-method research studies for more in-depth

understanding• Vulnerable student groups, e.g. student veterans, women

Contact Information

Michael A. Mitchell, MA

Michael.mitchell10@va.gov

VA Pittsburgh Healthcare System (VAPHS)

University Drive (151C), Building 30, 2nd Floor

Pittsburgh, PA 15240

412-360-2139 (office)

Cafe500

“Nella fabrrica delle notti shot degli americani”

• http://corrierefiorentino.corriere.it/firenze/notizie/cronaca/2010/26-aprile-2010/nella-fabbrica-notti-shot-1602906420327.shtml