Title: The Transtheoretical Model of Change for Mutli-Level Interventions for Alcohol Abuse on Campus
Abstract: Abstract This paper brings together the pressing problem of alcohol abuse on college campuses on one of the most promising solution--stage-based interventions applied at multiple levels. The interventions fit the Transtheoretical Model, which construes behavior change as a process that unfolds over time and involves progress through a series of stages. Unique to the paper is how the stage paradigm can be applied at four levels of the university (leadership, facility, and staff, students, and alumni) and into the community. This approach to change can produce impressive impacts on alcohol abuse and its serious consequences. Index Terms: alcohol abuse on campus, Transtheoretical Model, multilevel interventions ********** Alcohol abuse is considered by college presidents and administrators to be the number one health problem on campuses (Presidents Leadership Group, 1997). One of the most promising approaches to this problem on a population basis is to apply the Transtheoretical Model of Change (TTM) at multiple levels of a campus. TTM construes behavior change as a process that unfolds over time and involves progress through a series of changes: Precontemplation, Contemplation, Preparation, Action and Maintenance (Prochaska, Diclemente, & Norcross, 1992). The TTM is a comprehensive model that integrates ideas from several different theories and approaches to change to explain and predict how and when individuals end high-risk behaviors or adopt health ones. This paper will describe TTM and how it can be applied at four levels (leadership, faculty and staff, students, and alumni). Practical examples will be presented, drawing primarily from experiences at a state university in the northwest that has been part of Weschsler and colleagues' (2002) studies since 1993. Finally, results will demonstrate how an organization and population approach to change can produce impressive impacts on alcohol abuse and its serious consequences. Alcohol abuse is a major contributing factor to individual and social problems on campuses throughout the United States (Carnegie Foundation for the Advancement of Teaching, 1990; Presley, Meilman, & Lyerla, 1995; U.S. Department of Education Safe and Drug-Free Schools Program, 2000). The first two years of college is a time of transition to independent adulthood for many students, and offers new opportunities to experiment with lifestyles and behaviors that place students at high risk for alcohol abuse. While most traditional college age students cannot drink legally, Wechsler's 2002 Harvard School of Public Health study at 119 nationally representative colleges reported that 44.4 percent of college students admitted binge drinking (five or more drinks in one sitting for males, four for females) in the previous two weeks. Moreover, this percentage remained relatively unchanged from similar Harvard studies by Wechsler and colleagues (Wechsler, Davenport, Dowdall, Moeykens, & Castillo, 1994; Weshsler, Dowdall, Maenner, Gledhill-Hoyt, & Lee, 1998; Wechsler, Lee, Kuo, & Lee, 2000). Heavy drinking by college students has been consistently associated with higher rates of property damage, driving under influence, injury, behaviors that are regretted, missed classes, interpersonal relationship difficulties, and unprotected or unplanned sex (Johnson, O'Malley, & Bachman, 1996). Wechsler and colleague's (1994) national college study reported that students who binged were at higher risk for experiencing a variety of alcohol related problems than those who drank but did not binge. In that study heavy drinkers were five times more likely than non-binge drinkers to report that they had experienced five or more of twelve alcohol-related problems. A dose response relationship has also been observed, with more frequent bingers experiencing substantially higher risks than less frequent bingers (Johnston et al., 1996). In the 1996, the northeastern university reported that approximately 80% of violations of community standards involved substance use, primarily alcohol abuse (Cohen & Rogers, 1997). …
Publication Year: 2004
Publication Date: 2004-03-01
Language: en
Type: article
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Cited By Count: 24
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