Implementation and Outcomes of an Alcohol Bystander ... · Implementation and Outcomes of an Alcohol Bystander Intervention Program Lisa Currie, MSEd Director, Health Promotion and

Implementation and Outcomes of an Alcohol Bystander Intervention Program

Lisa Currie, MSEd Director, Health Promotion and Wellness

Susan Cushman, MPH, CHES

Coordinator, Alcohol and other Drug Prevention

Mary Desler, PhD

Senior Assessment Analyst, Student Affairs

American College Health Association 2012 Annual Meeting, Chicago, IL

Session Learning Outcomes

• Describe the curriculum of an alcohol bystander intervention program, as implemented at Northwestern University.

• Explain the implementation process at a private, highly selective, Research 1 institution.

• Discuss impact on student knowledge, attitudes and helping behaviors as evidenced by assessment results.

Northwestern University Profile

• Private, Highly selective, Research 1

• Located in Evanston, a north shore suburb of Chicago

• 8400 undergraduates in 6 academic schools

• 8100 graduate/professional students in 9 academic schools

• Big Ten/Division 1 Athletics (8 men’s and 11 women’s teams)

• 35 - 40% of undergraduates involved in Fraternities and Sororities

• 60% live in university housing or Greek chapters, 40% live off-campus

BYSTANDER INTERVENTION

Bystander Intervention Model

Source: http://rhsmpsychology.com/Handouts/steps_in_bystander_intervention.htm

Factors that influence helping

• Situational ambiguity

• Perceived cost

• Diffusion of responsibility

• Similarity

• Mood

• Gender

• Attributions of the cause of need

• Social norms Dr. William Cerbin, University of Wisconsin – LaCrosse

www.uwlax.edu/faculty/cerbin/ls/PSY%20Research%20Lesson%20Model%20of%20Bystander%20Intervention.htm

CURRICULUM

Red Watch Band History

• Developed and launched by Stonybrook University in 2009 in response to the 2008 alcohol overdose death of freshman Matthew Sunshine at Northwestern University.

• Over 135 campuses and high schools have implemented RWB

• Over 1400 students have been trained at NU since Spring Quarter 2010

Red Watch Band Purpose

The purpose of the Red Watch Band bystander intervention training is to prevent deaths and other harm caused by alcohol overdose. In order to do that, participants will gain the knowledge and skills needed to understand:

• How alcohol affects our physiology and behavior

• How to recognize an alcohol-related medical emergency

• How to respond appropriately and in accordance with Northwestern University policies/procedures.

NU Curriculum Elements

• Barriers to Intervention Discussion

• “Alcohol 101”

• Signs & Symptoms – Highly Intoxicated Person vs.

Life-threatening Alcohol Overdose

• Intervention Skills

• Facts vs. Myths

• Review of High Risk Situations

• NU Policy: Responsible Action Protocol

• Scenarios

Costs/Benefits Discussion

Not Calling for Help Calling for Help

Costs

Benefits

Progressive Effects of Alcohol Poster

Drink Pour Activity

Steps to Intervening – Key Points

• See yourself as the person who will help

• There is always something that can be done

• In uncertain situations, err on the side of caution

• Have a plan for dealing with objectors

Myth vs. Fact

• You can sober someone up by __________

• Feed them bread

• Give them water/coffee/soda

• Put them is a cold shower

• Have them walk it off

• Let them sleep it off

• Give them Tylenol

Scenarios

• Develop real-life scenarios (ask your students)

• Allow plenty of time for discussion • What concerns do you have about the situation and why?

• What would you do?

• What might make it difficult to intervene (barriers)?

• How will you respond to those barriers?

• How does it feel to be in this situation?

• Tie discussion questions back to bystander intervention model

• Leave time for participants’ real-life experiences

Once Students are Trained…

• Receive NU Red Watch Band silicone wristband and certificate of completion

• Added to NU Red Watch Band listserv and database

• Invited to “like” the NU Red Watch Band Facebook page

/NURedWatchBand

Curriculum Lessons Learned

• Facilitators need alcohol and other drug knowledge to present Stonybrook’s curriculum as originally written

• Curriculum should focus on the knowledge and skills needed to encourage intervention

• Making it interactive enhances the students’ experience

• Tailor your approach to your students and campus culture

• It’s challenging to clearly and concisely talk about AOD policies and sanctions

• We’re always improving the curriculum

IMPLEMENTATION

RWB Implementation History

Spring 2010

•All trainings facilitated by Lisa Currie and Kelli Greenberg ’11

•May: Susan joined HPaW staff

Summer 2010

•Assessment Plan designed

•Curriculum Revisions begin

2010 - 2011

•September: RWB graduate assistant added to HPaW staff

•October: Assessment Plan implemented

•January: Held first train-the-trainer of other Student Affairs staff and students

2011 - 2012

•Continued curriculum revisions

•January: Held second train-the-trainer/refresher

Collaborators

• New Student & Family Programs – Wildcat Welcome Peer Advisers

• Office of Fraternity & Sorority Life – Presidents, Risk Managers, Social Chairs, members at large

• Athletics – PURPLE Peer Mentors

• Health Promotion and Wellness – SHAPE & MARS peer education groups

• University Residential Life – Hall Government members

• Pre-Orientation Programs – Student counselors

• Office of Student Conduct and Conflict Resolution – Students referred through conduct process

Participation

2009-

2010 2010 - 2011 2011 - 2012

Spring

Quarter

Fall

Quarter

Winter

Quarter

Spring

Quarter

Fall

Quarter

Winter

Quarter

Spring

Quarter TOTAL

Trainings 14 5 7 15 4 7 14 66

Students 330 95 65 349 62 194 356 1451

Implementation Costs

Must Haves

• Trained facilitators

• Staff time

• Copies/handouts

• Pens

• Appropriate room/space

• Watches (or substitute)

May Haves

• CPR Training instructor

• Visual aids/Poster

• Props for drink pour activity

• Certificates of Completion

• Snacks/Drinks

• Recognition Reception

Implementation Lessons Learned

• Can be very low-tech and low-cost

• Collaborating with existing leadership groups is essential for widespread implementation

• Develop means to address capacity issues

• Student co-facilitation is highly beneficial

• Quality facilitator training is critical

• Need AOD knowledge to present Stonybrook’s curriculum (as originally written)

• Need to give students their watches (or a substitute)

ASSESSMENT

Assessment & Learning Outcomes

• Students will positively evaluate the Red Watch Band Training

• As a result of participation in the Red Watch Band Training program, students will be able to . . .

– accurately identify the signs of alcohol overdose

– accurately identify basic ‘alcohol 101’ facts

– express a greater willingness to intervene in an alcohol-related emergency

– describe how they used the helping behaviors they learned to intervene effectively in high risk drinking situations

Assessment Considerations

• Incorporated—but went beyond—the Stony Brook assessment plan

• Considered self-reported gains, but also attempted to measure learning in more meaningful ways

• Explored short and long-term effects of the training

• Utilized a mixed methods approach – quantitative and qualitative data

IRB Approved Assessment Strategy

• A 92-question online instrument (implemented Fall 2010) • Measured knowledge and attitudes about alcohol overdose and collected

information about student experiences in high risk environments • Voluntary

• A 16-question evaluation instrument required by Stony Brook University • Collected student evaluation of workshop, including satisfaction • Measured self-reported learning and attitudes

• An 87-question online instrument (implemented Fall 2010) • Re-measured knowledge and attitudes about alcohol overdose and collected

information about student experiences in high risk environments • Voluntary

• Eight interview questions explored how students used the training, how it affected their personal use of alcohol, and their level of commitment to intervene (First held in Spring 2011)

Pretest (N = 328)

Workshop Evaluation

(N = 899)

Six Month Questionnaire

(N = 200)

One Year Focus Groups

(N = 24)

Demographic Characteristics All

Participants (N = 892)

%age of Participants

Gender Female Male

516 376

58% 42%

Racial/Ethnic Background Asian/Pacific Islander African American Hispanic White Multiracial International Unknown

145 34 65

578 20 26 24

16% 4% 7%

65% 2% 3% 3%

Class Standing Freshman Sophomore Junior Senior Graduated

203 328 212 148

1

23% 37% 24% 17% 0%

School Bienen School of Music School of Communication School of Education & Social Policy McCormick School of Engineering Medill School of Journalism Weinberg College of Arts & Sciences

33

128 55

140 84

452

4%

14% 6%

16% 9%

51%

Paired or Matched Respondents

Pretest – Workshop Evaluation (N = 192)

Pretest – Six Month Questionnaire (N = 50)








Assessment Results








Assessment Results

Assessment Results

Pretest

Mean (SD)

Workshop Evaluation Mean (SD)

Differ-ence

t df Sig.

(2-tailed)

I feel knowledgeable about alcohol overdose

3.59 (0.88) 4.44 (0.55) 0.85 -12.721 192 .000

I can identify high risk environments and high risk behaviors involving alcohol

4.05 (0.74) 4.47 (0.58) 0.42 -6.804 192 .000

I can identify the facts from the myths about how to help a friend sober up

3.78 (0.87) 4.41 (0.57) 0.63 -8.585 192 .000

I can identify the signs of alcohol overdose

3.76 (0.85) 4.44 (0.538 0.68 -10.418 192 .000

Results of Paired T-Tests

Changes in Self-Reported Knowledge

Between Pretest and Workshop Evaluation (1 = strongly disagree to 5 = strongly agree)

Assessment Results

Pretest

Mean (SD) Six Month Mean (SD)

Differ-ence

t df Sig.

(2-tailed)

I feel knowledgeable about alcohol overdose

3.50 (0.95) 4.16 (0.55) 0.66 -4.858 49 .000

I can identify high risk environments and high risk behaviors involving alcohol

4.18 (0.63) 4.54 (0.58) 0.36 -3.397 49 .001

I can identify the facts from the myths about how to help a friend sober up

3.64 (0.90) 4.28 (0.73) 0.64 -5.472 49 .000

I can identify the signs of alcohol overdose

3.50 (0.95) 4.16 (0.55) 0.66 -6.743 49 .000

Results of Paired T-Tests

Changes in Self-Reported Knowledge

Between Pretest – Six Month Questionnaire (1 = strongly disagree to 5 = strongly agree)

Assessment Results

Percent of Students Correctly Answering True/False Questions

About Alcohol Overdose

*p < .05

Assessment Results

Percent of Students Correctly Answering True/False Questions

About Alcohol Overdose

Assessment Results

Percent of Students Correctly Answering

True/False Questions About Alcohol Overdose

* p < .05

Assessment Results Signs of Alcohol Overdose

(Oster-Aaland, Lewis, Neighbors, Vangness, & Larimer, 2009)

Signs Not Signs

Vomiting Memory loss

Bluish skin color Withdrawal symptoms

Cannot be roused Headache

Low body temperature Violent behavior

Irregular breathing Argumentative

Pale skin color Went to work drunk or high

Slow breathing Went late to work due to drinking

Passed out

Seizures

Nausea

Confusion

Assessment Results Knowledge – Concern - Helped

SIGNS

PRETEST (N = 328)

SIX MONTHS (N = 200)

Knowledge

99%

97%

97%

96%

95%

93%

90%

79%

Concern

4.90

4.40

3.91

4.49

4.30

4.83

4.22

4.40

Helped

32%

24%

82%

19%

66%

12%

29%

28%

Knowledge

99%

99%

95%

97%

96%

97%*

92%

71%*

Concern

4.99*

4.67*

3.86

4.73*

4.43

4.95*

4.47*

4.48

Helped

25%

18%

87%

14%

65%

8%

23%

25%

Cannot be roused/awakened

Irregular breathing

Vomiting

Low body temperature

Passed out

Bluish skin color

Slow breathing

Pale skin color

* p < .05

Assessment Results Knowledge – Concern - Helped

SIGNS

PRETEST (N = 50)

SIX MONTHS (N = 50)

Knowledge

98%

100%

98%

94%

92%

98%

92%

73%

Concern

4.92

4.40

3.89

4.58

4.35

4.90

4.38

4.36

Helped

25%

19%

79%

10%

50%

8%

25%

25%

Knowledge

100%

100%

96%

96%

100%*

100%*

90%

73%

Concern

5.00*

4.77*

3.92

4.79*

4.58*

4.98*

4.61*

4.52

Helped

26%

14%

82%

18%

52%

10%

25%

26%

Cannot be roused/awakened

Irregular breathing

Vomiting

Low body temperature

Passed out

Bluish skin color

Slow breathing

Pale skin color

* p < .05




– accurately identify the signs of alcohol overdose (also known as alcohol poisoning)




Assessment Results

Assessment Results

Pretest (N = 181)

Another student (73%)

Residence hall staff member (35%)

A leader/officer in my group (29%)

Emergency Room/Hospital (18%)

9-1-1 (17%)

Parent (13%)

Community Service Officer (12%)

Six Months (N = 89)

Another student (81%)

A leader/officer in my group (45%)

Residence hall staff member (31%)

9-1-1 (16%)

Emergency Room (13%)

Northwestern Police Department (10%)

Community Service Officer (10%)

Sources of Help

Assessment Results

Pretest (N = 37)

Six Months (N = 8)

Consequences Afraid my friend would get in trouble with the University/police/student group/parents

3.86 1.87

Judgment Someone else was already helping 3.46 3.37

Judgment Did not believe the student was at risk 3.32 3.75

Judgment Thought what I was doing was the right thing to do 3.24 3.75

Judgment Did not think the student needed help 3.22 3.00

Consequences Did not want my friend to be angry 3.00 2.37

Consequences Afraid a student group/organization would get in trouble with the University or police

2.95 2.00

Knowledge Not sure what to do 2.92 2.12

Consequences Other people discouraged me from getting help 2.70 2.12

Knowledge No one else seemed concerned 2.65 2.50

Consequences Afraid of myself getting in trouble with the University/police/student group/parents

2.59 1.87

Reasons for Not Seeking Help




– accurately identify the signs of alcohol overdose (also known as alcohol poisoning)




Assessment Results Stories

Summary of Assessment Results

• Even before the training, students’ self-reported knowledge about the signs of alcohol overdose was high. But the Red Watch Band training seems to further bolster that confidence.

• Whether they were mandated to attend, or did so voluntarily, immediately following the training, students gave the Red Watch Band training high marks.

• Students’ ability to remember some facts about alcohol overdose may slip slightly during the six months following the training.

Summary of Assessment Results

• The Red Watch Band training appropriately raises students’ concern when witnessing signs of alcohol overdose.

• Other students are the major source of support when students are faced with a life-threatening alcohol overdose.

• The Red Watch Band training appears to boost students’ confidence in their ability to respond effectively in an alcohol-related emergency and their willingness to do so.

Assessment Limitations

• Small numbers of matched respondents for all three surveys

• Participation in the study was completely voluntary

• No control group

• Multiple trainers with varying levels of knowledge and experience with alcohol education

Assessment Lessons Learned

• The pre- and post-test instruments need to be streamlined.

• Ensure assessment questions reflect curriculum revisions.

• Offering incentives may boost response rates.

Questions and Comments?

Thank you!

Lisa Currie, MSEd Director, Health Promotion and Wellness

[email protected]

847.491.7168

Susan Cushman, MPH, CHES

Coordinator, Alcohol and other Drug Prevention [email protected] 847.491.1370

Stonybrook website: www.redwatchband.org NU website: www.northwestern.edu/redwatchband

Documents

Implementation and Outcomes of an Alcohol Bystander ... · Implementation and Outcomes of an Alcohol Bystander Intervention Program Lisa Currie, MSEd Director, Health Promotion and