Beginning in Fall 2012, Partners in Prevention began publishing monthly research briefs. Each month, PIP members and campus administrators will receive a one-page research brief to keep key players updated on the most recent trends in the health and safety behaviors of Missouri college students.
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*Please note that there was a data error shared in the original Volume 3, Number 3 regarding the number of students who used marijuana in the past year. This is the corrected research brief.
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Partners in Prevention (PIP) is a statewide coalition of 21 public and private colleges and universities in Missouri with the mission of building safe and healthy campuses. PIP tracks efforts to reduce high-risk behaviors with trend data gathered through the annual implementation of the Missouri College Health Behavior Survey (MCHBS). Data from the 2015 MCHBS can be used to better understand drinking and driving among Missouri college students.
According to the Centers for Disease Control and Prevention* drinking and driving, even below the legal limit, increases the risk of an accident. For people who are at least 21 years old, the legal limit to drive is 0.08; however, having a BAC of 0.05 doubles your risk of having a crash and a BAC of 0.08 equates to 7 times the risk of an accident as compared to not drinking at all. Research shows that impairment is evident at a 0.02 BAC level. The consequences of drinking and driving can include jail time, fines of up to $500, suspension of driving privileges, or revocation of a license.
According to the 2015 Missouri College Health Behavior Survey approximately 21% of students report driving a motor vehicle after consuming any alcohol in the past year. Most students reported driving after drinking only one (8%) or two (5%) times in the past year. However, 4% reported drinking and driving 3 to 5 times and 4% reported drinking and driving more than five times in the past year. Less than 1% of students reported being arrested for a drinking and driving violation.
Some student groups report higher levels of drinking and driving. Groups with identified higher risk included male students (27%), gay male students (31%), female lesbian students (33%), students who report having ADD or ADHD (26%), and male Greek students (29%). Interestingly, female Greek students (21% ) were below the overall student average. The most telling group, however, was upperclassmen with the prevalence of drinking and driving clearly increasing from freshman to senior year, in as depicted the chart below.
Of the students who reported drinking in the past year, 67% reported that they usually (18%) or always (49%) used designated drivers. Additionally, 82% of Missouri college students defined the designated driver as someone who has not consumed any alcohol. In comparison, 17% define the designated driver as someone who had a couple of alcoholic beverages but was sober enough to drive, and less than 1% define the designated driver as the least drunk person in the group.
CHEERS was designed to increase the number of designated drivers throughout the state of Missouri. Participating bars, restaurants, and nightclubs provide free non-alcoholic beverages to the acknowledged designated driver in a group of two or more. It’s a way of thanking these individuals for caring about the safety of their friends and community. Establishment owners all across the state have been invited to join CHEERS and to play an active role in ensuring the health and safety of their patrons in exchange for free promotional and supply items and limited advertising. Please support bars, restaurants, and nightclubs that participate in CHEERS, and, if your favorite place is not a member, encourage them to adopt the program.
PIP member campuses and the Missouri Department of Transportation are driven to help Missouri’s college students Drive Safe Drive Smart (DSDS). DSDS is a safe driving campaign reaching students via social media, tabling events, and posted educational materials and encouraging them to not only make smart decisions behind the wheel, but also to act as an active bystander and keep their friends driving safely. Currently, DSDS has billboard campaigns throughout the state, encouraging drivers to designate a texter and a sober driver.
Partners in Prevention (PIP) is a consortium of 21 college and university campuses across Missouri devoted to improving the health and safety of Missouri college students. This is the third in a series of briefs on the most critical public health issues in Missouri higher education. We define critical issues as the behaviors on campus which cause threats to the safety of our students on a daily or weekly basis. Power-based personal violence (PBPV), defined as any violence motivated by the desire to assert power, to control, and/or to intimidate in order to harm another person, is a problem on campuses nationwide. PBPV includes relationship/partner violence, rape/sexual assault, stalking and other harassment, as well as the use of predatory drugs. While not all aspects of PBPV are captured in our statewide data, the annual Missouri College Health Behavior Survey (MCHBS) gathers data about non-consensual sexual contact and has expanded questions on stalking behaviors and tactics on the 2016 survey.
The more inclusive term PBPV is used to recognize that violence happens to persons of all genders and sexual orientations; however, MCHBS and national data demonstrate that marginalized groups, including women, people of color, and people who identify as part of the LGBTQ community, are more likely to be victims of PBPV than majority groups, like men or persons who identify as heterosexual. A report by the U.S. Department of Justice found that 1 in 5 women and 1 in 16 men will experience non-consensual sexual contact during their college careers*. In 2015, 17% of Missouri college students reported having experienced “non-consensual sexual contact” at some point in their lives, and approximately 4% of students reported experiencing non-consensual sexual contact within the last year. Given that the majority of students do not report PBPV, more Missouri students likely experienced assaults than MCHBS data indicates; however, even using our more conservative frequency of 4% yields alarming results.With a combined enrollment of over 204,000 students at the 21 campuses, Missouri college students were assaulted at a rate of about one student every hour of every day in 2015.
According to the Bureau of Justice Statistics, survivors are less likely to report PBPV if they know their perpetrators, and perpetrators are statistically more likely to be acquaintances than strangers. As reporting systems and requirements, such as the Clery Act and Title IX, continue to improve, we are better informed about stranger violence, as reflected by the majority of Clery reports describing unknown perpetrators and asking for assistance in identifying them. However, other PBPV still happens. The best way to learn more about acquaintance violence happening to college students is to provide confidential resources that students can easily access without launching investigations or mandatory reporting, in addition to providing Title IX resources, either on campus or in the local community. Additionally, many schools are implementing evidence-based bystander violence prevention programs, such as Green Dot or STEP UP, to reduce instances of PBPV on their campuses. Making it clear that PBPV will not be tolerated on campus also creates a more supportive environment for survivors, which may positively impact reporting rates.
Educating against common misperceptions is important; however, we must be careful not to invalidate the experiences of survivors of stranger violence. For example, while data tells us that about 80% of rapes and sexual assaults are perpetrated by acquaintances, messaging such as “the rapist isn’t a masked stranger” or “the perpetrator’s not hiding in the bushes”** could be interpreted as making light of or ignoring that stranger violence does still happen. In order to educate about, respond to and prevent non-consensual sexual contact, campuses need to train staff to respond in a trauma-informed way.
As Missouri’s consortium in promoting healthy behaviors among college students, Partners in Prevention (PIP) is dedicated to creating safe and healthy campus environments, including addressing student self-harm. PIP implements the annual Missouri College Health Behavior Survey (MCHBS), which contains questions regarding mental health and suicidal ideation. Although suicide is an issue on all college campuses, training and prevention programs are largely underrepresented. Ask Listen Refer (ALR), a suicide prevention training created in 2009 for campuses across Missouri, offers information that teaches faculty, staff, and students how to identify risk factors and warning signs of suicide. ALR also guides participants through the process of talking to individuals who are at risk and helping them find resources in their area. This is the second in a series of briefs on the most critical public health issues in Missouri higher education. We define critical issues as the behaviors on campus which cause threats to the safety of our students on a daily or weekly basis.
During the 20 minute ALR training program, participants learn about signs and symptoms of suicidal behavior, common myths about suicide, how to ask if someone is considering suicide, and how to make trauma-informed resource referrals. Participants are given a pre and post-test to evaluate knowledge, attitude, and willingness to intervene, and they have the opportunity to take 3 follow-up surveys to assess the overall use and effectiveness of the program.
Data from ALR participants suggest that it is a promising practice to teach students, faculty, and staff about how to help a friend or student who may be considering suicide. When comparing student, faculty, and staff pre-test and post-test scores, there is a significant rate of change which suggests that individuals are learning more about suicide prevention while taking the training. Out of a possible 40 points, both pre-test and post-test scores ranged almost the entire spectrum from 8 to 40 points. Averaged pre-test scores for the last 66 months of 2015 ranged from 27.3 to 30 points, while averaged post-test scores ranged from 34.6 to 36.9 points. Students and staff showed the greatest increases in scores with both groups having a percent increase of 27%.
According to the 2015 MCHBS data, 40% of students reported having ever had suicidal thoughts, and 15% of students reported having suicidal thoughts within the last year. Two percent of Missouri college students reported attempting suicide in the last year, but only 32% of students sought assistance for suicidal thoughts or attempts in the past year. While the majority of students (53%) are still not seeking assistance for suicidal thoughts and attempts, MCHBS data suggests an improvement in the last year, as 67% of students did not seek assistance in 2014. Additionally, 31% of students reported being concerned about a friend having suicidal thoughts and 48% of them reported they would be willing to complete an online suicide prevention training program (ALR). When asked if students were aware of the ALR program, 27% of students answered “yes.” Nineteen percent of students also utilized ALR at least once in the past year, 5% twice and 2% more than twice when concerned about an individual at risk for suicide.
Of the 21 PIP campuses, 20 participate in the ALR program. For the purposes of this brief, 5 schools are considered active participants in the ALR program, meaning that they had at least 200 participants from their campus in 2015. Comparing these active schools to the rest of the PIP campuses reveals no difference in suicidal ideation or attempts; however, these students do show an increased awareness of the programs on their campuses. Students at active ALR schools were slightly more likely to report being concerned about a friend having suicidal thoughts in the past year than students from other schools (33% vs. 30%) and were more likely to report having heard of ALR than students from less active schools (36% vs. 24%). Interestingly, students from active ALR schools did not show much difference in their likelihood of discussing suicide with someone at risk of suicide or referring someone at risk to local resources. Some of these differences could be accounted for by higher rates of staff and faculty participation on some campuses, meaning that more outreach to students is needed.
According to the National Center for Injury Prevention, suicide is the second leading cause of death for college-aged young adults (ages 15-34). With 15% of Missouri students self-reporting suicidal ideations and 31% of students being concerned about a friend within the last year, suicide prevention is a priority for PIP. Furthermore, over 50% of Missouri students said they would likely bring up the topic of suicide with someone who may be at risk. This willingness means Missouri students are at a great starting point when it comes to addressing mental health and improving their own mental health.
Even though students are more likely to turn to their friends first when seeking help, faculty and staff on Missouri college campuses have unique access to students, and these relationships can be utilized to help address mental health issues. Despite the fact that ALR is designed to reach all of these audiences, not all of those who are in a position to intervene with high-risk or at-risk individuals are taking advantage of this resource. For more information, please visit the ALR website at www.asklistenrefer.org.
Missouri Partners in Prevention (PIP) is a statewide coalition of 21 campuses dedicated to creating healthy and safe college and university environments. PIP implements the Missouri College Health Behavior Survey (MCHBS) each year, which helps to measure student health behaviors and perceptions. This is the first in a series of briefs on the most critical public health issues in Missouri higher education. We define critical issues as the behaviors on campus which cause threats to the safety of our students on a daily or weekly basis. Reducing high-risk behaviors, such as binge-drinking*, remains a core focus, despite improvements in trend data since 2011. Analysis of 2015 MCHBS data indicated noticeable differences in binge drinking rates among student groups.
Binge-drinking has been linked to many health and behavior issues, including alcohol poisoning, physical assault, sexual abuse, injury, and academic problems. Because of these health and behavior issues, it is a main focus for many campus programs. PIP schools consistently rank below the national average of binge-drinking on college campuses, and PIP schools have seen a 22% reduction in reported binge-drinking rates from 2011 to 2015, with the statewide average decreasing from 31% to 24% in those five years.
Despite this overall positive trend, binge-drinking rates on individual campuses in 2015 ranged from 3% to 37%. When further investigating binge-drinking and risky drinking behaviors, many campuses requested information on specific subpopulations. The most requested groups were students who identified as part of a sorority or fraternity (Greek) versus those who did not (non-Greek), students who identified their race as white or Caucasian (majority) versus students who identified as a minority race (minority)**, student leaders (leaders) versus non-student leaders, and finally student athletes versus non-athletes. Of those groups, students who identified as part of a sorority or fraternity and students who identified their race as white or Caucasian reported the most negative consequences as a result of alcohol consumption. Less significant differences are seen between student athletes and non-athletes and student leaders and non-student leaders. The table below highlights some of the negative consequences of drinking that might impact student health and academic success.
Because binge-drinking can be associated with many health and behavior concerns among college students, it is important to continually monitor and work to decrease these rates. The 2015 MCHBS reveals encouraging information with the decreasing binge-drinking rates thanks to annual monitoring and positive programs and social norming assisted by Partners in Prevention. However, certain groups, such as students participating in Greek Life on college campuses, continue to have high-rates of binge-drinking and are a higher risk for the negative consequences associated with drinking than their peers.
Partners in Prevention (PIP) works with 21 college and university campuses in the state of Missouri to improve student health behaviors. PIP gathers data annually from the Missouri College Health Behavior Survey (MCHBS) to inform and improve campus programs. This brief will focus on students’ sense of belonging and their likelihood of accessing resources both on and off campus, specifically for students who identified as LGBQQ* on the 2015 MCHBS. Students who identified as transgender are not included in this brief unless they also identified their sexual orientation as LGBQQ. As sexual orientation and gender are different constructs, the stressors and experiences of the transgender student population cannot be conflated with those of LGBQQ student population.
According to the 2015 MCHBS data, 8.3% of students identified as LGBQQ**. Of those students who identified as LGBQQ, 26% did not feel a sense of belonging on their campuses, compared to 22% of students who identified as heterosexual. Students who identified as LGBQQ were also less likely than their heterosexual peers to report feeling like a member of their campus community (49% compared to 56%).
Since students’ attachment to campus may impact their perceived access to and utilization of resources, the relationship between a student’s sexual orientation and the likelihood of going to specific resources, both on- and off-campus, was explored. While many resources showed no significant difference in likelihood of use, certain resources, such as faculty or professors, mental health professionals in the community, and chat rooms or online support groups, were more likely to be used by students who identified as LGBQQ than those who identified as heterosexual. Conversely, students who identified as LGBQQ reported a lower likelihood of utilizing other resources, such as religious or spiritual advisors, law enforcement, and family members, than their peers who identified as heterosexual.
Students who identified as LGBQQ are less likely than their heterosexual peers to report feeling as though they belong on their campuses or that they are active members of their campus communities. Having a dedicated space and staff for LGBQQ students, as well as having an ally group or providing access to online chat and help resources, are factors that could increase these students’ sense of belonging and connection to campus. To date, few PIP campuses are able to provide these resources. Beginning in 2016, the MCHBS will include asexual as a sexual orientation option in an attempt to decrease the high prefer not to respond rate for that question. In the future, campuses may want to consider allowing multiple responses for the sexual orientation question the MCHBS to empower students to select responses that more accurately reflect their identities.
Partners in Prevention (PIP) has been Missouri’s higher education substance abuse consortium since 2000. The coalition, made up of 21 universities in Missouri, works to promote healthy behaviors on college campuses. To gain an understanding of the current health behaviors of college students, PIP implements the Missouri College Health Behavior Survey (MCHBS) each year. The information gained from the MCHBS allows PIP to learn more about the high-risk behaviors that students are engaging in, such as illicit and prescription drug misuse.
Prescription drug misuse, defined as using prescription drugs without a doctor’s consent, has been decreasing over the last 8 years from 21% in 2008 to 14% in 2015. Conversely, there has been a small increase in students who report using illicit drugs (other than marijuana) from 5.7% in 2009 to 6.5% in 2015.
The most commonly misused prescription drugs were stimulants (7.5%) and pain medication (6.9%), followed by sedative/anxiety medication (3.1%). Of the 6.5% of students previously mentioned who used illicit drugs, 3.8% reported using amphetamines, 3.0% reported using club drugs, 2.8% reported using cocaine, and inhalants, K2, and methamphetamines were each reported at 1.2%. Approximately 4.5% of students reporting misusing both prescription and illicit drugs (other than marijuana) in the last year. More than 75% of students who reported using marijuana in the last year did not use any other drugs; however, over 80% of students who reported any other drug usage also used marijuana. The data suggests that while marijuana use cannot be used to predict other drug use, misuse of prescription or illicit drugs is a strong predictor of marijuana use.
About 16% of Missouri college students are using some form of prescription or illicit drug. Most of these students are misusing prescription drugs, not illicit drugs. However, it is important to note that the majority of students who use illicit drugs are also misusing prescription drugs and using marijuana, meaning there is a small but high-risk subpopulation of polydrug users among Missouri college students. For campus programming and planning purposes, it may be important to note that stimulants and pain medications are misused significantly more often than other prescription drugs. Beginning in 2016, the MCHBS will collect data on students who misuse their own prescription drugs and the overlap of misusing prescription drugs while consuming alcohol.
Partners in Prevention, a coalition of 21 colleges and universities across the state, is dedicated to reducing high-risk behaviors among Missouri college students. Several risky behaviors involve distracted driving, which includes texting or talking on the phone while driving, eating or drinking while driving, speeding, and becoming angry while driving. Texting while driving is one of the most dangerous behaviors because it encompasses the three main types of distraction – visual, manual and cognitive. It also reduces the driver’s focus from the road more frequently and for longer periods than other distractions (National Highway Traffic Safety Administration [NHTSA]).
Trend results from the Missouri College Health Behavior Survey (MCHBS) indicate that despite decreases in texting and driving behavior since 2012, texting and driving remains a prevalent risk behavior among Missouri college students.
NHTSA reports that at least one out of every 10 traffic fatalities is a result of distracted driving; therefore, it is important that campuses continue to monitor and educate students on multiple facets of traffic safety, including distracted driving.
Since the MCHBS first began measuring texting and driving behavior in 2010, a little more than a third of Missouri college students have reported this behavior each year. Texting and driving peaked in 2012 with 44% of students reporting this behavior. By 2014, texting and driving dropped to the lowest recorded rates of 32%. However, in the past year there has been a gradual increase to 35%.
When compared to other dangerous driving behaviors, students are texting and driving at much higher rates than they are driving without seatbelts or drinking and driving. Additionally, while we have observed reductions in other driving behaviors over the past two years, texting and driving has remained relatively constant. Interestingly, students who report texting while driving also report all the other distracted driving behaviors at much higher levels.Students who text and drive are...
Continued monitoring indicates reductions in risky driving behaviors and, specifically, texting while driving. While there appear to be significant improvements since 2012, texting and driving is still disproportionately high compared to other dangerous behaviors, such as impaired driving and driving without a safety belt. It is important for campuses to continue efforts to educate their students about the dangers of text messaging and driving.
Partners in Prevention (PIP) is a consortium of 21 colleges and universities in Missouri dedicated to creating safe and healthy campuses. Since 2007, PIP has been annually implementing the Missouri College Health Behavior Survey (MCHBS) to gather information about student demographics, alcohol use, drug use, and other health behaviors. Beginning in 2014, the MCHBS added questions for students who identify as sober and in recovery from alcohol and other drug addiction to better understand their experiences on campus. This brief will focus on responses from students who identified as sober and in recovery on the 2015 MCHBS, highlight the work being done on PIP campuses to support these students, and include feedback from a recent focus group with the University of Missouri-Columbia’s Sober in College (SIC), one of the current collegiate recovery programs in Missouri.
The prevalence of students at Missouri colleges and universities who identify as sober and in recovery varies widely among PIP schools, from 3-12%, with an average of 5% statewide. Also, a relatively large percent of students (4%) responded “prefer not to respond” to this question. Slightly more of these students disagree that they are a member of their campuses (21%) or that they feel a sense of belonging (24%) than the overall student population does (20% and 22%, respectively). Students who identify as sober and in recovery report wanting to feel more connected to their campuses than the overall student population (68% vs 54%). This difference in desire for increased connection to their campus communities could reflect an unmet need for creating supportive spaces and communities for students who are sober and in recovery on campus.
Despite the majority of students in recovery feeling connected to their campuses and like members of their college communities, one in three (33%) students in recovery reported considering transferring from their current college or university and 16% have thought about discontinuing their education entirely. In comparison, 25% of students who do not identify as sober and in recovery reported considering leaving their current college or university, and 14% have thought about discontinuing their education. In order to better understand what factors influence these students’ sense of belonging and membership on campus, as well as what impacts their decisions to stay enrolled, more questions will be asked to this subpopulation on the 2016 MCHBS.
One of the ways that campuses can increase success and retention of students in recovery is by ensuring the campus climate is supportive. Currently, six PIP schools have active collegiate recovery programs, each using a different model tailored to suit the needs of that campus and their students. This year, PIP began a new initiative to support these schools. MACRO, the Missouri Alliance of Collegiate Recovery Organizations, is the first organization of its kind in the state of Missouri to create a statewide network for growing and enhancing collegiate recovery support services. Its mission is to unite collegiate recovery efforts across the state and to be a top resource for Missouri schools as they build their own recovery support organizations. In doing so, we hope to increase the capacity of colleges and universities in Missouri to address recovery on their campuses, and in their communities. MACRO is currently housed at the University of Missouri-Columbia. More information can be found online at macro.missouri.edu.
As Missouri’s consortium in preventing higher education substance abuse, Partners in Prevention promotes healthy behaviors on college campuses. PIP implements the Missouri College Health Behavior Survey (MCHBS) in order to gain a better understanding of health behaviors and experiences on campuses across Missouri. The survey also gathers information on the prevalence of relationship abuse experienced by Missouri college students.
Relationship abuse is a pattern of assaultive and coercive behaviors an intimate partner may use in order to gain and maintain power and control. In the 2015 MCHBS, we measured reports of several types of intimate partner abuse, including emotional-verbal, sexual, physical, mental and financial. The most common forms of abuse and those discussed in this brief include emotional, mental and physical intimate partner abuse. Sexual abuse will be addressed in subsequent briefs.
Emotional abuse includes a broad category of behavior and is the most common form of abuse reported by Missouri college students. Some forms of emotional abuse are name-calling, put-downs, threats, intimidation, doing anything to win an argument, and blaming the partner for relationship failures*. Sixteen percent (16%) of Missouri college students report ever experiencing emotional abuse and 9% in the past year. Mental abuse, also referred to as psychological abuse, is the second most common form of abuse reported by Missouri college students. It includes behaviors such as isolating individuals from friends and family, controlling where individuals go and what they do, ignoring feelings, and being forced to perform acts perceived as degrading**. Thirteen (13%) percent of Missouri college students report ever experiencing mental abuse and 7% in the past year. Physical abuse is the least common form of abuse reported and includes but is not limited to pushing, strangling, hitting, punching, slapping, kicking, preventing individuals from eating or drinking, and keeping individuals from seeking medical care***. Five (5%) percent of Missouri college students report ever experiencing physical abuse and 2% in the past year.
A substantial proportion of our students report intimate partner abuse on our campuses. At any point in their life, 42% of our students report abuse. Additionally, 23% of students report that they have experienced some form of intimate partner abuse in the past year.
The Missouri College Health Survey (MCHBS) is distributed annually to 21 campuses in the state of Missouri by Partners in Prevention (PIP). PIP is Missouri’s higher education substance abuse consortium and is dedicated to promoting health and wellness on campuses statewide. The MCHBS collects data on several different student health behaviors, including the use of marijuana. According to the 2015 MCHBS, 23% of Missouri college students reported using marijuana in the past year.
The MCHBS data show that the self-reported actual use of marijuana is drastically different than how students perceive the use of others. Data shows that while reported marijuana use over the last three years has remained relatively constant around 23%, the perception students have of other people’s use has decreased and leveled off. In 2013, students perceived that 92% of their peers had used marijuana in the last year. For the past two years, this perception decreased to 81%. Since 2013, the data shows an increase of actual marijuana use from 22% to 23%. In the last three years, perceptions about the frequency of other’s marijuana use began to change. Students reported a perception of 14% of students using marijuana 3 or more times a week in 2014; however, that same perception dropped to 6% in 2015. In 2013, students perceived/believed that 13% of students used marijuana 1-6 times per year, which has increased by 250% to 32% this year.
Through the growing discussion on the legalization of marijuana, this topic remains a staple in the discussion of student wellness. The high perception of use by other people may also contribute to the slowly increasing rate of reported use, even though the perceived rate is decreasing. Over the course of the last few years, there has been a slight increase in reported marijuana use that has coincided with a significant drop in how much students perceive their peers to be using marijuana. Between 2014 and 2015 the trend for the perceived use of other students has leveled off at a low of 81%. More updates can be found at pip.missouri.edu/research.html as future data is collected.
Missouri Partners in Prevention (PIP) implements the Missouri College Health Behavior Survey (MCHBS) each year to monitor student behaviors and perceptions on a variety of health and safety topics, including tobacco use and policy. Of the 21 campuses that are part of the PIP consortium, 9 are tobacco free (6 campuses with newer tobacco free policies and 3 with tobacco policies for 3 or more years), 5 are smoke free, and 7 have somewhat restrictive policies, meaning they may only have indoor policies or designated outdoor smoking areas available on campus. It is important to note that some campuses will implement tobacco free policies this fall, but their data from the 2015 MCHBS is categorized in the somewhat restrictive policy category.
According to the 2015 MCHBS, 80% of students statewide prefer having smoke-free outdoor university areas. Student perceptions of smoking have greatly changed in the last four years, as 2012 MCHBS data showed that only 58% of students statewide preferred having smoke-free outdoor areas on campus. Since 2013, the number of students not using tobacco products has increased, while the number of those using cigarettes has steadily decreased. However, other products are becoming more popular with tobacco users. For example, hookah use increased 43% from 2012 to 2015 (14% to 20%), and e-cigarette use is up 300% (3% to 12%) statewide since 2012. Tobacco pipes and smokeless tobacco use have remained relatively stable statewide since 2010, but certain campuses saw a noticeable increase for one or both of these products in 2015.
How much does school policy influence students’ tobacco use? In order to answer this question, schools were categorized by type of tobacco policy in the following groups: tobacco free policy, tobacco free policy for at least three years, smoke-free policy and somewhat restrictive policy. Type of school policy was compared to any tobacco use in the past year, which includes the full spectrum of students who perhaps tried hookah once or twice with friends to those who use cigarettes or smokeless tobacco on a daily basis.
Perhaps unexpectedly, schools with tobacco free policies have a higher average of tobacco use (38%) than the statewide average (36%). There are several potential influencing factors for this high rate of use. Some schools very recently changed policy and may be facing some resistance to that change or haven’t had time to see any behavior change from what happened under their somewhat restrictive policies. These campuses may also have more infrequent tobacco product users that are inflating that statistic. A better indicator of the effect of tobacco free policy is the group of schools that have had policies in place for three or more years. Students from schools with established tobacco free policies reported statistically significant lower tobacco use than any other group. According to the data, there is no difference in tobacco use on campuses with smoke free policies versus those with only somewhat restrictive policies.
The MCHBS data seems to support the argument that tobacco free policies, which are the most restrictive, result in lower rates of tobacco use on campuses once they have been in place long enough to be recognized and enforced. The trend of preferring smoke-free indoor and outdoor areas continues to gain popularity with students at schools across the state, but data suggests that student behavior is not significantly impacted by smoke-free policies. It is possible that campuses with newer smoke-free policies face similar challenges as those that recently transitioned to tobacco free policy, or that implementation and enforcement of smoke-free policy pose unique challenges. Certain campuses and student behaviors around the state may also be influenced by city tobacco policies more so than campus policy. Because quitting tobacco products requires challenging behavior change, it can take several years before the benefits of policy change are evident in student behavior. As more campuses statewide switch to tobacco free policies and those already tobacco free campuses continue to consistently enforce their existing policies, this trend will be re-evaluated.
Since 2000, Missouri Partners in Prevention (PIP) has been providing training, funding and technical assistance to member campuses dedicated to creating healthy and safe college and university environments. While the focus of our statewide coalition has been on preventing high-risk and underage drinking among Missouri’s college students, the coalition is also dedicated to addressing other health behaviors such as prescription drug use, high-risk driving, tobacco use, and problem gambling. In addition, PIP also provides support and services to campuses across the state to prevent suicide and support positive mental health among college students. In the past year, Partners in Prevention has begun exploring two new growth areas: helping campuses regarding compliance with Title IX regulations and addressing the needs of students in recovery.
Last year, PIP provided the Missouri higher education community with a series of thirteen research briefs. These briefs highlighted the range of health behaviors, including high-risk drinking, driving behaviors, and health behaviors of subpopulations of students. In addition, the briefs provided information about current work being implemented in the state to address these behaviors. PIP is pleased to provide Missouri campuses with the fourth volume of research briefs. Briefs will be published monthly and include additional examination of the health behavior of subpopulations of students as well as additional key metrics of the Missouri College Health Behavior Survey, such as students’ sense of belonging and student engagement. PIP will continue to examine key health behavior issues such as alcohol, drug, and tobacco use, driving behaviors, and mental health, along with new topics, such as interpersonal violence and addressing the needs of students in recovery.
PIP has made tremendous progress since its inception in 2000. National research in college prevention is clear - campus prevention efforts that are evidence-based, comprehensive and are supported by campus administrators are the most effective strategies to reduce high risk and underage drinking and the associated negative consequences among college students. While binge and high risk drinking rates have been static nationally, Missouri rates have dropped drastically from 34% in 2007 to 24% in 2015. PIP encourages campus leaders to be vocal, visible, and visionary on issues related to alcohol, drugs, and mental health. The goal of Volume Four of the Partners in Prevention briefs is to assist campus’ understanding of the key issues facing Missouri college students, as well as how campuses are working to create healthier and safer campus communities.
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Partners in Prevention (PIP) is a statewide coalition of 21 public and private colleges in Missouri with the mission of building safe and healthy campuses. PIP gathers data from the Missouri Assessment of College Health Behaviors (MACHB) in order to assess risk among college students. Data from the MACHB can be utilized to gain a better understanding of student choices and assist in program development to best address student environments. The survey inquires if students participate in Greek organizations (IFC, PHA, NPHC, and Social Greek Organizations). Based on self-reports, 15% of students at Missouri campuses reported involvement in Greek organizations in the 2016 survey. There is quite a range of Greek participation by institution. The campus with the highest Greek participation had a rate of 46%. The campus with the lowest Greek participation, has no students involved in Greek organizations.
Ninety-two percent (92%) of Greek students responded that they have consumed alcohol in the past year compared to 72% of non-Greek students. Forty-nine percent (49%) of Greek students reported “binge” drinking, de ned as having 5 or more drinks in a 2 hour period at least once in the past two weeks, compared to 20% of non-Greek students.
Differences were also observed when comparing students under the legal drinking age of 21. Eighty-nine percent (89%) of underage Greek students reported drinking in the past year compared to 63% of non- Greek students. Additionally, 47% of Greek underage students reported binge drinking in the past year compared to 20% of non-Greek underage students.
The most common ways for underage Greek students to obtain alcohol were from friends of legal drinking age (64 % vs. 43 % non-Greek), fake IDs (23 % vs. 7% non-Greek) or going to places that did not check IDs (15% vs. 7% non-Greek).
While Greek students reported drinking at higher levels and having more access to alcohol, they were also more aware that their campus had alcohol and drug prevention programs and policies.
Greek students also report more marijuana smoking in the past year than non-Greek students. (Greek 40% vs. Non-Greek 22%). However, only 13% of Greek students who reported using marijuana in the past year indicated that they used marijuana at Greek houses.
Greek and non-Greek students reported similar levels of stress, with approximately 28% reporting overwhelming or unbearable stress within the past two weeks. Both groups reported academics as the most common source of stress (93% for Greek students and 87% for non-Greek students). Di erences emerged for other sources of stress based on Greek a liation. Greek students reported a much higher rate of stress from organization involvement and responsibilities (46%) than non-Greek students (17%). Greek students also reported greater levels of stress associated with roommates (23%) than non- Greek students (15%). While Greek students may be experiencing more stress, they stated they were more likely to have someone to talk to about their stress (97%) compared to non-Greek students (88%).
Greek students report having greater levels of connection with campus. Greek students were more likely to see themselves as a member of the campus community (86%) and feel a greater sense of belongingness to campus (80%) than non-Greek students(61% and 58% respectively).
Missouri Partners in Prevention (PIP) implements the Missouri Assessment of College Health Behaviors (MACHB) each year to monitor student behaviors and perceptions on a variety of health and safety topics, including tobacco use and policy. Of the 21 campuses that are part of the PIP consortium, 14 are tobacco-free, 5 are smoke-free, and 2 have somewhat restrictive policies, meaning they may only have indoor policies or designated outdoor smoking areas available on campus.
Across Missouri, use of tobacco products continues to be prevalent among college students. For example, 34% have indicated utilizing a tobacco product within the past year. Among those students, the most popular products are cigarettes (48%), followed by hookah (46%), cigars (37%), and electronic cigarettes (31%). Further, 92% of students whom have used tobacco indicated utilizing multiple tobacco products within the past year.
When referring to frequency of use, a signifcant amount of students whom have smoked in the past year (48%) indicated they have used cigarettes a few times a year. 38% of students reported smoking cigarettes at least once per week, and 26% stated they smoke cigarettes every day. Another widespread tobacco product is electronic cigarettes (E-cigarettes/E-cigs). E-cigs are battery-powered handheld devices that vaporize a flavored aerosol1. They typically contain nicotine, propylene glycol, and a variety of other flavorings (they can come without nicotine as well)1. Due to the novelty of electronic cigarettes, there is limited data about possible short-and long-term health effects1. However, due to the uncertainty of the chemical consumption in each product, the U.S. Surgeon General has determined that e-cigarettes can expose users to several possibly harmful chemicals2. According to the MACHB, electronic cigarette use over the past year was as follows; 59% of students reported using a few times a year, 16% a few times a month, 7% 1-2 times a week, and 14% indicated using electronic cigarettes on a daily basis.
A large majority of students (78%) believe their university should have smoke-free outdoor university areas. This number has typically increased over the years, with only 58% indicating smoke-free outdoor areas in 2012. However, this number was at 80% in 2015, thus has slightly decreased on the 2016 MACHB.
There are several resources across Missouri to address smoking cessation on college campuses. For example, Partners in Prevention (PIP) and the Wellness Resource Center at the University of Missouri, with support from the Department of Mental Health (Division of Alcohol and Drug Abuse), are able to support PIP schools that wish to participate with the following services:
PIP provides a 3-4 hour training for cessation coaches. It covers paperwork, dosing of nicotine replacement therapy, and coaching strategies for cessation consumers. The training also provides a copy of the Tobacco Dependence Treatment handbook if a campus is interested in implementing cessation services.
Nicotine Replacement Therapy
NRT (nicotine gum, lozenges, and patches) can be provided to campuses to assist individuals whom are interested in quitting to sustain a better quit attempt.
There are quitting brochures which can be provided and customized for specific campuses. They include cessation information, locations for services, and contact information for tobacco cessation options on campus. If interested in ordering a brochure, order forms can be found at pip.missouri.edu/brochures.html
Quit kits are utilized to assist clients when attempting to quit. They include sugar-free gum, stress balls, lip balm, sunflower seeds, and come in a nylon drawstring backpack. All items include some type of cessation messaging, such as the 4 D’s of quitting (Delay, Distract, Drink water, and Deep breathing).
The state quitline, 1-800-QUIT-NOW, is a free resource that is currently providing two weeks of free nicotine patches to callers. Additionally, they have phone or text support that they can provide to individuals who would appreciate weekly messages related to cessation.
Partners in Prevention (PIP) is a statewide coalition of 21 public and private colleges in Missouri with the mission of building safe and healthy campuses. PIP gathers data from the Missouri Assessment of College Health Behaviors (MACHB) survey in order to assess high-risk behaviors occurring amongst college students. Data from the MACHB can be utilized to gain an understanding of programs that are currently established to inform individuals about the consequences of impaired driving.
According to the Center for Disease Control (CDC), 2% of Missouri drivers have reported that they have driven while intoxicated.1 In 2014, there were 5,976 alcohol- related crashes in the state of Missouri; 189 of which were fatal; resulting in 205 deaths caused by intoxicated driving.2 Research continues to demonstrate the ongoing issue of impaired driving and the importance of educating individuals about the possible consequences that may occur from their actions.
While the majority of college students in Missouri reported no past impaired driving, the possible consequences of driving while under the influences are severe, which promotes the necessity of eliminating the risk.
According to the 2016 MACHB survey, approximately 21% of students reported driving a motor vehicle after consuming alcohol in the past year. The range of students who reported drinking and driving was from 7% to 34% across all PIP institutions. A small percentage of students reported driving after drinking one (7%) or two (5%) times in the past year. However, 4% of students who reported drinking and driving did so 6 or more times. Of the students who reported drinking and driving, less than 1% of them reported facing consequences such as receiving a DUI/DWI.
A promising approach to lower the incidences of driving under the influence is to utilize designated drivers. The MACHB allows students to identify what they believe it means to be a designated driver. 85% believe it is someone who has not had any alcoholic beverages, 15% define it as someone who has had a couple of alcoholic beverages, and 1% stated it is the least intoxicated person in the group. Further, only 48% of Missouri students reported that they always utilize a designated driver when partying, and 52% of the time that driver is a friend or acquaintance. Several campuses have developed strategies to increase the number of designated drivers for undergraduate students.
CHEERS was designed to increase the number of designated drivers throughout the state of Missouri. The program allows participating bars, restaurants, and nightclubs to provide free non-alcoholic beverages to the designated driver in a group of two or more. Establishment owners across Missouri have been invited to join CHEERS in order to create a safer environment while drinking. Find us online at cheers.missouri.edu or on Facebook @projectcheers.
Drive Safe, Drive Smart
The Missouri Department of Transportation and colleges involved in PIP are working to promote safe driving amid college students in the state of Missouri. DSDS is a campaign that works to reach students through social media, tabling events, and online educational materials. The main goal of DSDS is to encourage students to make smart decisions behind the wheel and to be active bystanders when others are driving. Currently, DSDS has billboard campaigns throughout the state that encourage individuals to designate a responsible texter and a sober driver. Find us online at drivesafedrivesmart.missouri.edu or on Facebook @modrivesafedrivesmart.
SMART and SMART Live
The State of Missouri Alcohol Responsibility Training (SMART) is a free, interactive, web-based responsible beverage service program available to those who own or work for any Missouri establishment licensed to sell alcohol. The training focuses on recognition of fake ID’s, acceptable forms of identification, prevention of service to minors and intoxicated individuals, and more. Users who pass the training exam gain a certification that is valid for 2 years. To access the online training visit smart.missouri.edu.
SMART Live is an in-person version of the training, held in 4 locations throughout Missouri. The next SMART Live training will be held April 5, 2017 in Platte County – registration required, smart.missouri.edu/live.
Law Enforcement Trainings
PIP works with surrounding community law enforcement officers to ensure that they are receiving trainings regarding subjects like alcohol- impaired driving. Trainings are available at this year’s regional conference, Meeting of the Minds, in Kansas City, Missouri. Scholarships for public safety/law enforcement officials who work to prevent impaired driving and underage drinking and enforce underage drinking laws are invited to apply. Registration available at mom.missouri.edu.
Partners in Prevention (PIP) is a statewide coalition of 21 public and private colleges in Missouri with the mission of building safe and healthy campuses. PIP gathers data from the Missouri Assessment of College Health Behaviors (MACHB) survey in order to assess high-risk behaviors occurring among college students. Data from the MACHB can be utilized to gain an understanding of programs that are currently established to inform individuals about the prevalence of underage drinking.
According to a comprehensive article detailing underage student drinking habits, about half of the alcohol consumed at four year colleges is consumed by students under the legal drinking age of 21.1 It is important to understand why underage students are drinking to create effective prevention efforts, and to lower the overall binge-drinking and alcohol consumption rate. Efforts on campus can also lessen the incidences of students harming themselves and others from the use of alcohol.
According to data from the 2016 MACHB, about 49% of underage students had consumed alcohol least one time in the past 30 days, with 8% of underage drinkers choosing to drink 10-20 of those 30 days. Binge-drinking (consuming 5+ drinks over a two hour period anytime within the previous two weeks) among underage drinkers is also an issue on college campuses. Approximately 24% of underage students in Missouri reported binge-drinking.
The survey identified that underage students consume alcohol most frequently at a social gathering/friend’s house (77%) and where they live (39%). The results are similar when focusing on pre-partying; with 47% indicating pre-partying at a social gathering/friend’s house and 26% indicating drinking at their own residence. Further, students stated they were able to access alcohol most frequently from an over 21 year old friend (46%), using a fake ID (9%), going to a place where they know IDs are not checked (9%), or from fraternity or sorority houses (7%). Of the 9% of underage drinkers whom reported utilizing a fake ID, 59% indicated they have never been denied while purchasing alcohol.
When prompted to indicate reasons for drinking, nearly 84% of underage drinkers chose ‘I want to have fun with friends’. Other popular answers were; ‘I want to relax (49%)’ and ‘I like how it makes me feel (36%)’. As seen in the PIP Social Norm brief (pip.missouri.edu/docs/briefs/PIP_5_5.pdf), there is a large misconception with the frequency of alcohol consumption and the amount of drinks typical students have while they drink. It can be inferred that college students may perceive drinking to be the ‘norm’ and the typical way to meet new people and spend quality time with friends. This may suggest the need for educating college students on safe drinking behaviors and the influence of social norms.
Partners in Prevention (PIP) is a statewide coalition of 21 public and private colleges in Missouri with the mission of building safe and healthy campuses. PIP gathers data from the Missouri Assessment of College and Health Behaviors (MACHB) survey in order to assess high-risk behaviors occurring amongst college students. Data from the MACHB can be utilized to better understand how and why students are contemplating dying by suicide.
According to the Center for Disease Control (CDC), suicide is the second highest cause of death in individuals ages 15-24. This indicates that college students are in a particularly high risk group when it comes to dying by suicide. It is critical for college administrators, faculty, sta , and students to understand how to assist students who are contemplating suicide so that students are able to get the assistance they need.
According to the Missouri Assessment of College Health and Behavior (MACHB), 17% of Missouri college students contemplated suicide in the past year and 2% of students attempted suicide in the past year. Ages of these students ranged from 18-25 years or older, but the most significant ages that students were contemplating suicide were 18 (22%) and 23 (23%). However, the average number of students contemplating suicide that fell into the range of ages 19-22 was approximately 17%.
According to the MACHB, 47% of Missouri college students reported having anxiety in the last year. Of the students who reported having suicidal thoughts, 76% of them also said that they experienced anxiety. 58% of students who reported facing a considerable or great deal of stress concerning their personal lives also experienced suicidal thoughts. This means more than half of students who have contemplated suicide are facing a great deal of stress in their personal lives. 45% of the students who reported having suicidal thoughts also reported facing a considerable or great deal of stress concerning its impact on their academics. Almost half of students who are having suicidal thoughts can also be struggling academically when they may or may not have done so before.
Ask. Listen. Refer.
Ask. Listen. Refer. is an online suicide prevention training tool that is accessible by students, staff, and faculty for free through Partners in Prevention. It is an introductory suicide prevention training program that can help users learn the basics of suicide prevention and provides resources specific to Missouri. The training can be accessed at www.asklistenrefer.org.
While RESPOND training is not offered specifically through Partners in Prevention, it is a recommended training for PIP institutions. It is an 8 hour, in person training empowering participants to recognize and effectively support and refer a person experiencing a mental health challenge or crisis. If you are interested in more information about this training, contact us at pip.missouri.edu.
Partners in Prevention (PIP) is a statewide coalition of 21 public and private colleges and universities in Missouri with the mission of building safe and healthy campuses. PIP tracks e orts to reduce high-risk behaviors with trend data gathered through the annual implementation of the Missouri Assessment of College Health Behaviors (MACHB) survey. It is common on college campuses for students to miscalculate the frequency and severity of other student’s high-risk behaviors. Thus, social norm questions have been added to the MACHB in order to assess perceived versus actual behavior on campus amongst students.
There are several sections on the MACHB that review social norms on campus. Three of the most concerning topics on the MACHB are alcohol consumption on a typical night, illicit drug use, and sexual health due to the large gap between perceived and actual behaviors amid college students. When referring to sexual health, 76% of individuals indicated that they have had 0 or 1 sexual partners in the past year. However, when asked how many sexual partners they believed other students have had; only 16% selected 0 or 1. Conversely, 52% believed their fellow peers had 3 or more partners in the past year, whereas the actual amount reported is 14%.
Further, for marijuana usage, approximately 77% of students did not use over the past year. However, students completing the survey indicated that they believe only 16% of their fellow peers have not used marijuana in the past year. When indicating misuse of prescription drugs, 17% indicating using prescription drugs 1 or more times, whereas participants rated 75% of ‘typical students’ to abuse prescription drugs at least once over the past year.
The MACHB allows students to indicate their average intake of alcohol on a typical night of drinking. Students rated themselves as having around 2.6 drinks in a night, while contrarily rating others on campus much higher; friends at 4 drinks, typical students at 4.4 drinks, and fraternity/sorority members at an overwhelming 6.3 drinks.
Currently, several campaigns across Missouri are speaking out about misperceived social norms on campus, and how they may be impacting the harmful behaviors of college students. Posters and graphics demonstrating accurate data have become a common method of explaining social norms on campus in order to validate the frequent misconceptions that many students have towards fellow peers. For more information, please visit pip.missouri.edu/sn.html.
Partners in Prevention (PIP) is a statewide coalition of 21 public and private colleges in Missouri with the mission of building safe and healthy campuses. PIP gathers data from the Missouri Assessment of College and Health Behaviors (MACHB) survey in order to assess high-risk behaviors occurring amongst college students. Data from the MACHB can be utilized to gain an understanding of programs that are currently established to inform individuals about marijuana use as well as the use of other drugs on college and university campuses.
According to the National Epidemiological Study of Alcohol Use and Related Disorders, it was found that adults who reported marijuana use during the first wave of the survey were more likely than non-users to develop an alcohol use disorder within 3 years. It was also found that marijuana users who already had an alcohol use disorder at the outset were at greater risk of their alcohol use disorder worsening (1). While marijuana is not the only substance that is correlated to users experimenting additionally with other substances, the ability for it to do so makes it critical for college and universities to continue to provide ongoing education about it.
According to data recorded from the 2016 MACHB Survey, 24% of Missouri college students have reported using marijuana at least once in the past year. Most of the students who are using also reported that when they used marijuana it was done at a friend’s house or social gathering (67%), in a car (46%), or in an apartment or house (46%). While campus is not the primary location for marijuana use to take place, it is still important that faculty and staff all play a role in helping to educate students about marijuana use so they can make better informed choices.
Data collected from the 2016 MACHB also notes that 52% of students that have binge drank (5+ drinks in a 2 hour period) in the last year have also used marijuana in the last year as well. 90% of students who have used cocaine in the last year have used marijuana and 66% of students who have used amphetamines in the last year have also used marijuana. However, 55% of students who are using prescription drugs are using marijuana at least once in the past year.
The following links are for brochures and fact sheets that contain more information about marijuana use, side effects, and other material concerning marijuana and drug use. These can be used for educational use by any PIP institution.
As Missouri’s consortium in preventing higher education substance abuse, Partners in Prevention (PIP) promotes healthy behaviors on college campuses. PIP implements the Missouri Assessment of College Health Behaviors (MACHB), previously referred to as the Missouri College Health and Behavior Survey, in order to gain a better understanding of health behaviors and experiences on campuses across Missouri. This brief will focus on alcohol use of students, primarily those whom identify as LGBQQ. Students who identified as transgender are not included in this brief, unless they also reported their sexual orientation as LGBQQ. As sexual orientation and gender are different constructs, the stressors and experiences of the transgender student population cannot be conflated with those of LGBQQ student population.
It is commonly recognized that marginalized groups, such as LGBQQ (Lesbian, Gay, Bisexual, Queer, and Questioning) individuals, tend to have a high rate of substance use and abuse.1 This may be due to chronic stress from discrimination that lead to substance use and other mental and physical health consequences.1 Utilizing data from the MACHB, significant differences amongst alcohol and drug consumption between the LGBQQ population and heteronormative individuals on college campuses are visible. For example, 8% of heterosexual college students across Missouri began drinking at age 14 or before, whereas the rate for LGBQQ individuals is much higher. Individuals that identify as lesbian and bisexual reported 17%, gay individuals reported 11%, and queer students indicated 15%. Further, the MACHB allows students to indicate their reasoning for consuming alcohol on a regular basis. One selection is, “In order to forget my problems”, which is significantly higher in individuals whom are LGBQQ. 12% of heterosexual students reported this as their reasoning, while it is nearly double for all LGBQQ populations (lesbian-23%, gay-22%, bisexual-25%, queer-20%, and questioning-23%).
As seen in the August PIP brief, students in recovery account for approximately 7% of the Missouri college campus population. When considering LGBQQ individuals, this number is higher for bisexual (10%), questioning (9%), and queer (8%) individuals. The number for gay and lesbian students is around 6%, which is still slightly higher than heterosexual (5%) college students in Missouri. This information allows campuses to recognize the importance of providing treatment options for students in recovery, with a special focus on marginalized groups on campus.
Due to the consistently higher rates of alcohol consumption from individuals who identify as LGBQQ, campuses across Missouri should develop programs that address responsible drinking behaviors. Further, based on the sense of belonging questions on the MACHB, LGBQQ students indicated that they do not feel like a member of the campus at the same level as heterosexual individuals. For instance, 65% of heterosexual students reported feeling as though they are a member of campus, whereas lesbian (54%), bisexual (60%), and questioning (50%) students reported far lower rates of belonging. In response to the large number of students who report drinking in order to forget their problems, programs could focus on appropriate coping skills and other ways to allow LGBQQ individuals to feel a higher sense of belonging on campus.
As Missouri’s consortium in preventing higher education substance abuse, Partners in Prevention (PIP) promotes healthy behaviors on college campuses. PIP implements the Missouri Assessment of College Health Behaviors (MACHB) survey, previously referred to as the Missouri College Health and Behavior Survey, in order to gain a better understanding of health behaviors and experiences on campuses across Missouri. Several questions were added to the 2016 MACHB that target students whom identify themselves as sober and in recovery.
Approximately 4% of students across Missouri identify themselves as sober and in recovery, with an additional 3% reporting “prefer not to respond” (PNR). PNR may take on a different significance with the tradition or anonymity philosophies practiced by some recovery approaches. Thus, between 4% to 7% of Missouri college students report being in recovery from an alcohol or drug addiction.
This year the MACHB included additional questions for students in recovery focusing on the recovery resources available and the general campus environment. Initial findings indicate that students who are sober and in recovery were less likely to choose ‘friends’, and more likely to select ‘no one’ than the general student population when seeking help and support. Conversely, students who have experienced substance abuse or dependency have a higher rate of seeking assistance from the University Counseling Center (15%) or an inpatient psychiatric facility (4%) for treatment. Students in recovery also had significantly lower stress levels in the past two weeks (67%) compared to the general population (74%) when choices of stressed /overwhelmed/stress is unbearable are listed.
Currently, there are seven active recovery programs at PIP campuses. Most of the programs have begun within the past two years. State-wide, individuals that indicated they are sober and in recovery had a low participation rate in collegiate recovery programs. When assessing campuses that have established on-campus recovery programs, only 21% of students who identify as sober and in recovery have utilized these services. This may be due to the novelty of recovery programs and lack of awareness across campus. For students who participated in the on-campus recovery program, the levels of stress in the past two weeks was lower (53%) compared to individuals in recovery that were not participating (69%). Further, when indicating a sense of belonging on campus, students in recovery who participating in the on-campus recovery program had higher selections of ‘agree’ and ‘strongly agree’ (52%) than individuals who did not participate (43%).
There are a variety of popular treatment modalities that are utilized for substance dependency. The results were varying for students who identified as sober and in recovery about which method they preferred, with 30% indicating moderation management, 28% indicating 12 Step approaches, and 13% selecting treatment based. A large portion of students (29%) selected ‘Other’ with open text responses indicating a majority of students utilizing religion or religious- based treatments for their recovery process.
The Missouri Alliance of Collegiate Recovery Organization (MACRO), works with several Missouri colleges and universities to establish recovery programs for college students. MACRO’s mission is to unite collegiate recovery efforts across the state, and to be a top resource for Missouri schools as they build their own recovery support organizations. In doing so, MACRO, hopes to increase the capacity of colleges and universities to support recovery in their communities and on their campus. To date, seven schools have implemented recovery programs on campus. Over the last year, one new collegiate recovery organization was added to MACRO, and there are two other campuses currently working to establish a program. For more information about MACRO’s services, visit macro.missouri.edu.
As Missouri’s consortium dedicated to preventing higher education substance abuse, Partners in Prevention (PIP) promotes healthy behaviors on college campuses. PIP implements the Missouri Assessment of College Health and Behaviors (MACHB), previously referred to as the Missouri College Health and Behavior Survey, in order to gain a better understanding of health behaviors and experiences on campuses across Missouri. The survey also gathers information on bystanders that witness sexually coercive and abusive behaviors on Missouri college campuses. A bystander can be described as someone who witnesses or is aware of a harmful situation that is happening to someone else. They can either choose to intervene (helpful bystander) or ignore the problem (hurtful bystander)1. The MACHB includes questions that allow students to report their own experiences with bystander interventions, whether or not they choose to intervene, and resources they may utilize to help the situation. Further, bystander interventions have been reported as one of the most promising prevention strategies to reduce violence on college campuses.2
In the MACHB, which gathers comprehensive data from 21 colleges and universities across Missouri, three questions were utilized to gather information about the likelihood of student bystander intervention on campus (How likely are you to: Tell someone if I heard what sounded like yelling or fighting through my residence hall/apartment walls, speak up and express concern if I heard a stranger talking about coercing someone to have sex, or speak up and express concern if I heard a friend talking about coercing someone to have sex). Approximately 48% of surveyed individuals would tell someone about fighting overheard through apartment/residential hall walls. Further, 78% of individuals would intervene if they witnessed their friend coercing an individual to have sex, and 62% if someone was coercing a stranger.
National research indicates students consistently perceived that helpful bystander intentions of others is lower than it actually is. Students perceived 55% of peers would choose to intervene; whereas 81% of students report they would be a helpful bystander1. These misperceptions can create barriers towards bystander interventions due to fears of violating social norms.
The majority of students (64%) who would intervene stated they would reach out to another student for help with the situation, 19% would go to the police, and 5% would choose the Health/Wellness/Counseling Center for support.
Individuals that choose not to intervene in hostile situations most commonly attribute it to their inherent personality traits, such as being shy or disliking conflict. In order to encourage these individuals to become involved, several programs have been developed to promote bystander intervention, such as Green Dot, Step UP!, and STOP SV. One in particular, Green Dot, has developed methods to intervene if one is shy or nervous to approach the situation directly. This training suggest3 different means to be a helpful bystander; Direct, Delegate or Distract. Taking individual action to intervene and prevent or stop the harm would be considered a Direct approach. Another option would be to Delegate3. Delegate differs from directly approaching a situation by requesting or assisting other individuals to diffuse a situation. An example would be finding friends of the individual in danger or by contacting the authorities for assistance. Finally, students can also use the Distract method, which entails redirecting focus away from the situation in a manner that stops or reduces chances of harm. A common example is telling the individual causing harmed that their car is being towed in order for the situation to be averted3. Many college campuses around the country are beginning to encourage students to complete bystander intervention training. The intervention programs may be a key role in reducing violence on campus and creating a safe environment for students2. For more information on Green Dot, please refer to their website: www.livethegreendot.com.
Missouri Partners in Prevention (PIP) is a higher education substance abuse consortium dedicated to creating healthy and safe college campuses. The PIP Coalition is comprised of 21 public and private college and university campuses across the state. First implemented in 2007, the Missouri Assessment of College Health Behaviors (formerly referred to as the Missouri College Health Behavior Survey or MCHBS) is designed to understand the role of alcohol, drugs (illegal and prescription), mental health issues, and power-based personal violence on student health and wellness. The survey also assesses individual’s attitudes towards campus and community policies, other student’s behavior, and bystander interventions. The MACHB is administered online every spring to undergraduate students at Coalition campuses across the state. The PIP Coalition analyzes the data collected from the survey in order to implement a variety of beneficial programs at participating colleges and universities. Please note that in 2017, the MCHBS survey will change its name to the Missouri Assessment of College Health Behaviors (MACHB).
Do students use a designated driver or other protective strategies? Have they encountered legal problems or trouble with campus administrators? Questions in this section of the survey focus on the frequency of student’s alcohol use, where they drink, the direct and indirect consequences of their drinking on academic and social life, how they obtain alcohol (if they are minors), recovery options on campus, and reasons for drinking or abstaining. This section also includes information regarding binge drinking behavior and protective behavior strategies, such as utilizing a designated driver or taxi service. Roughly 80 questions on the MACHB focus on alcohol use and abuse on campus.
How often do you think the typical student on your campus uses marijuana?
It is common on college campuses for students to miscalculate the frequency and severity of other student’s high-risk behaviors. Information is collected on student perceptions regarding the incidence of other student’s high-risk behaviors.
How often have students used or abused illicit substances and prescription drugs? Where do they commonly engage in substance abuse?
The survey seeks to understand the abuse of illicit substances in the context of social behavior and determine the consequences of substance abuse as they relate to social, personal, and academic concerns. This section analyzes which substances are being abused, how often, by whom, and where such abuse occurs.
What types of tobacco products do students use? How often do students use them?
Questions in this section identify what type of tobacco products are being used, how often, and in what settings. These questions also seek to identify the age of first use, the role of tobacco as a social behavior, and perceptions of health consequences. This section focuses not only on cigarette use, but a range of tobacco products, including smokeless tobacco, hookah, and E-cigarettes.
Have student’s experienced major depression, anxiety, panic attacks, etc.? In the past year, have students had suicidal thoughts?
This portion examines varying aspects of mental health, including what resources students would use when mental health concerns arise.
Have students experienced non-consensual sexual contact against their will? Would students speak up and express concern if they witnessed a stranger coercing someone to have sex?
This section gathers information about non- consensual sexual contact that students have experienced while attending college. There also have been recently added questions to the survey detailing stalking behaviors and bystander interventions.
What role do drugs and alcohol play in student’s sexual behavior and experience?
This section inquiries about sexual activity in the past year and perceptions of other students’ sexual activity. The information is helping in identifying misperceptions of sexual behavior amid students. This portion also identifies the role of substances in sexual behavior and their effect on frequency of occurrence and attitude towards sexual encounters.
Do students text or wear their seatbelt while they drive? Do they often speed or drive while they are drowsy?
Questions seek to understand the frequency of engagement in a variety of hazardous behaviors, including texting, speeding, and other forms of distracted driving.
Do students feel the campus is concerned about alcohol and drug prevention? Do they feel such policies are enforced effectively and consistently?
This portion helps to understand the awareness of the prevention efforts on campus.
Do you wish you were more connected on campus?
This section focuses on student’s feelings of interconnectedness with other students on campus, and how these feelings impact overall behavior.
Missouri Partners in Prevention (PIP) is a higher education substance abuse consortium dedicated to creating healthy and safe college campuses. The PIP Coalition is comprised of 21 public and private college and university campuses across the state. First implemented in 2007, the Missouri Assessment of College Health Behaviors (formerly referred to as the Missouri College Health Behavior Survey or MCHBS) is designed to understand the role of alcohol, drugs (illegal and prescription), mental health issues, and power-based personal violence on student health and wellness. The survey also assesses individual’s attitudes towards campus and community policies, other student’s behavior, and bystander interventions. The MACHB is administered online every spring to undergraduate students at Coalition campuses across the state. The PIP Coalition analyzes the data collected from the survey in order to implement a variety of beneficial programs at participating colleges and universities.
Implement: Construct a comprehensive survey for students at participating PIP colleges and universities across Missouri.
Identify: Identify high-risk behaviors occurring amongst undergraduate students on college campuses.
Inform: Write monthly briefs utilizing data from the Missouri College Health Behavior Survey to update administrators and students about possible health risks on campus.
First implemented in 2007, the Missouri Assessment of College Health Behaviors (formerly referred to as the Missouri College Health Behavior Survey or MCHBS) is designed to understand the role of alcohol, drugs (illegal and prescription), mental health issues, and power-based personal violence on student health and wellness. The survey also assesses individual’s attitudes towards campus and community policies, other student’s behavior, and bystander interventions. The MACHB is administered online every spring to undergraduate students at Coalition campuses across the state.
First implemented in 2012, the Missouri College Student Veteran Assessment (MCSVA) was designed to better understand the role of health and wellness of student veterans in the campus community. The survey also provides information regarding perceptions of campus and community resources allocated for veterans, as well as analyzing the ease of transition from military service to academic andstudent life The MCSVA is currently administered online every fall semester to student veterans at participating coalition campuses across the state.
The Carnegie Classification system is a framework for categorizing institutional diversity in the United States. Formed by the Carnegie Commission on Higher Education in 1970, the Carnegie Foundation has published six updates to their original 1973 publication. These categorizations have been used to help policy analysts and researchers classify the wide variety of institutions represented in higher education. As institutions of higher education have evolved, the classification system has morphed to accurately reflect the categories of institutions.
First implemented in 2007 by Partners in Prevention, the Missouri College Health Behavior Survey (MCHBS) is designed to understand the role of alcohol, drugs (illegal and prescription), mental health issues, and gambling on student health and wellness. The survey also provides information regarding attitudes, perceptions of other student’s behaviors, campus and community laws, and policies. The MCHBS is administered online every Spring semester to undergraduate students at all coalition campuses across the state. The Partners in Prevention Coalition helps to implement and analyze the data collected from the survey, which in turn is used to design a variety of programming at participating colleges and universities.
SAMHSA’s Center for the Application of Prevention Technologies (CAPT) has recently released a new resources on drinking and substance abuse: Youth Marijuana Use: Consumption, Consequence, and Risk and Protective Factor Data Resources, which offers prevention practitioners a comprehensive listing of available data resources and surveys developed by and for a range of federal agencies.
CAPT has also revised three tools to highlight current research on college/campus populations:
The Nature and Correlates of Young Women's Peer-Directed Protective Behavioral Strategies
Armstrong, K., Watling, H., Buckley, L. (February 2014) Addictive Behaviors
The Burden of Alcohol Use: Excessive Alcohol Consumption and Related Consequences among College Students
White, A., Hingson, R. (2014) Alcohol Research, The Journal of the National Institute on Alcohol Abuse and Alcoholism
Dating Violence among College Students: The Risk and Protective Factors
Kaukinen, C. (February 2014) Trauma, Violence & Abuse
Improving College Campus-Based Prevention of Violence against Women: A Strategic Plan for Research Built on Multipronged Practices and Policies
Banyard, V. L. (February 2014) Trauma, Violence & Abuse
Focus On: Women and the Costs of Alcohol Use
Wilsnack, S. C., Wilsnack, R.W.(2014) Alcohol Research, The Journal of the National Institute on Alcohol Abuse and Alcoholism
Feminist Self-Defense and Resistance Training for College Students: A Critical Review and Recommendations for the Future
Gidycz, C.A., Dardis, C.M (February 2014) Trauma, Violence & Abuse
Measuring the Burden: Alcohol's Evolving Impact
Hingson, R. (2014) Alcohol Research, The Journal of the National Institute on Alcohol Abuse and Alcoholism
Campus and College Victim Responses to Sexual Assault and Dating Violence: Disclosure, Service Utilization, and Service Provision
Sabina, C., Ho, L.Y. (February 2014) Trauma, Violence & Abuse
Academic Advising via Facebook: Examining Student Help Seeking
Amador, P. & Amador, J. (April 2014) The Internet and Higher Education
College Student Drinking Research From the 1940s to the Future: Where We Have Been and Where We Are Going
Kilmer, J.R., Cronce, J.M. & Larimer, M.E. (March 2014) Journal of Studies on Alcohol and Drugs
Special Issue: Substance Use Problems and Issues in Recovery among College Students (February 2014)
Journal of Social Work Practice in the Addictions
Case Closed: Research Evidence on the Positive Public Health Impact of the Age 21 Minimum Legal Drinking Age in the United States
DeJong, W., Blanchette, J. (March 2014) Journal of Studies on Alcohol and Drugs
Dangerous Climates: Factors Associated With Variation in Racist Hate Crimes on College Campuses
Dyke, N. (July 2014) Journal of Contemporary Criminal Justice
Response of Heavy-drinking Voluntary and Mandated College Students to a Peer-led Brief Motivational Intervention Addressing Alcohol Use
Mastroleo, N.R., Oakley, W., Eaton, E.M. & Borsani, B. (June 2014) The Journal of Substance Abuse Treatment
College Student Perceptions of Victim Action: Will Targets of Stalking Report to Police?
Cass, A.I. & Mallicoat, S., L. (June 2014) American Journal of Criminal Justice
Randomized Controlled Trial of a Web-Delivered Personalized Normative Feedback Intervention to Reduce Alcohol-Related Risky Sexual Behavior Among College Students
Lewis, M.A., Patrick, M.E., Litt, D.M., Atkins, D.C., Kim, T., Blayney, J.A., Norris, J., George, W.H. & Larimer, M.E. (June 2014) Journal of Consulting and Clinical Psychology
Protective Behavioral Strategies Mediate Problem-Focused Coping and Alcohol Use in College Students
Walker, R. & Stephens, R.S. (June 2014) Addictive Behaviors
Developing Public Health Regulations for Marijuana: Lessons from Alcohol and Tobacco
Pacula, R. L., Kilmer, B., Wagenaar, A.C., Chaloupka, F. & Caulkins, J.P. (June 2014) American Journal of Public Health
Administrators' Perceptions of College Campus Protocols, Response, and Student Prevention Efforts for Sexual Assault
Amar, A.F., Strout,T.D., Simpson, S., Cardiello, M. & Beckford, S. (August 2014) Violence and Victims
The Effect of Enrolling in a Minority-Serving Institution for Black and Hispanic Students in Texas
Flores, S.M. & Park, T.J. (July 2014) Research in Higher Education
Effects of the Campus Watch Intervention on Alcohol Consumption and Related Harm in a University Population
Cousins, K., Connor, J.L. & Kypros, K. (July 2014) Drug and Alcohol Dependence
Local Support for Alcohol Control Policies and Perceptions of Neighborhood Issues in Two College Communities
Fairlie, A.M., DeJong, W. & Wood, M.D. (July 2014) Substance Abuse
The Effect of Enrolling in a Minority-Serving Institution for Black and Hispanic Students in Texas
Flores, S.M. & Park, T.J. (July 2014) Research in Higher Education
Are Female College Students Who are Diagnosed with Depression at Greater Risk of Experiencing Sexual Violence on College Campus?
Hossain, M.B., Memiah, P. & Adeyinka A. (August 2014) Journal of Healthcare for the Poor and Underserved
Perceptions of, and Assistance Provided to, a Hypothetical Rape Victim: Differences Between Rape Disclosure Recipients and Nonrecipients
Paul, L.P., Kehn, K., Gray, M.J. & Salapska-Gelleri, J. (August 2014) Journal of American College Health
The Role of Positive Alcohol Expectancies in Underage Binge Drinking Among College Students
McBride, N.M., Barrett, B., Moore, K.A. & Schonfeld, L. (August 2014) Journal of American College Health
Psychological Factors in Community College Student Retention
Lukea, C., Redekopb, F. & Burgina C. (August 2014) Community College Journal of Research and Practice