Are students drinking hand over fifth? Understanding participant demographics in order to curb a dangerous practice.
Men's periodicals (Marketing)
Drinking of alcoholic beverages
Alcohol and youth
Foster, Holly A.
Bass, Ellen J.
Bruce, Susan E.
|Publication:||Name: Journal of Alcohol & Drug Education Publisher: American Alcohol & Drug Information Foundation Audience: Academic; Professional Format: Magazine/Journal Subject: Health; Psychology and mental health; Social sciences Copyright: COPYRIGHT 2011 American Alcohol & Drug Information Foundation ISSN: 0090-1482|
|Issue:||Date: Dec, 2011 Source Volume: 55 Source Issue: 3|
|Topic:||Event Code: 240 Marketing procedures Computer Subject: Company marketing practices|
|Product:||Product Code: E197500 Students, College; 2721530 Men's Periodicals NAICS Code: 51112 Periodical Publishers|
|Organization:||Organization: University of Virginia; American College Health Association|
High-risk drinking remains an issue on college campuses. Limited research focuses on drinking associated with single events where students are encouraged to drink a predetermined amount of alcohol. Fourth-year undergraduate students (N=1,205) completed a survey about motivation, behaviors and perceptions surrounding participation in a practice where some students attempt to consume a fifth of liquor (750 ml) on the day of the last home football game. Results revealed 18.0% of fourth-year students participated, predominately Greek-affiliated males. Of those who self-reported consuming a fifth, 75.4% consumed at least 6 more drinks than they do on a typical Saturday night. Motivating factors for participation included challenge, tradition, and sociability. As students generally underestimated participation rates, social norms marketing approaches may not be effective.
Celebratory drinking remains a serious issue on college campuses (Glassman, Werch, Jobli & Bian, 2007; Glidenmann, Wiegand & Geller, 2007; Neal & Fromme, 2007). Research on celebratory drinking examines high-risk periods such as fraternity recruitment or spring break (Patrick, Morgan, Maggs & Lefkowitz, 2011; Wechsler, Kuh & Davenport, 2009). Singular events such as Halloween, 21st birthdays, and annual sporting events are important to study, because many students engage in potentially dangerous drinking behaviors on a single day (Hembroff, Atkin, Martell, McCue & Greenamyer, 2007; LaBrie, Migliuri & Carl, 2009; Neighbors, Spieker, Oster-Aaland, Lewis & Bergstrom, 2005), while engaging in lower-risk drinking as a typical pattern (Montealegre, Bass, Bruce & Foster, 2011; Purvis, Odioso, Weaver, White, Bass & Bruce, 2008; White, Odioso, Weaver, Purvis, Bass & Bruce, 2008).
With respect to college sporting events, celebratory drinking has been associated with single events (Glassman et al., 2007) as well as entire seasons (Neal & Fromme, 2007). Drinking before sporting events, commonly called pregaming, includes a range of behaviors including drinking before entering the stadium where alcohol may be expensive or difficult to obtain (Borsari, Boyle, Hustad, Barnett, Tevyaw & Kahler, 2007). This pregaming can lead to hazardous drinking, defined as blood alcohol concentrations (BAC) of 0.08 gram percent and above, typically occurring by consuming five or more drinks (males) or four or more drinks (females) over a two hour period (Sharma & Kanekar, 2008). Primary and secondary negative problems associated with hazardous drinking can range from minor outcomes such as a hangover to major consequences such as physical injury or death (Glindemann et al., 2007; Incerto, Montealegre, Tuttle, Bruce, Foster & Bass, 2011).
Celebratory drinking events can vary across colleges and universities (Hartford, Weschler & Muthen, 2003; Jones, Oeltmann, Wilson, Brener & Hill, 2001). At a large public research institution in the Southeast, the University of Virginia, one annual hazardous drinking event, called the "Fourth-Year Fifth," involves fourth-year students (college seniors) attempting to consume a fifth of liquor (750 ml) on the day of the last home football game. Although similar to drinking events at other campuses where students plan to drink a targeted quantity for a specific occasion, the Fourth-Year Fifth also focuses on a single sporting event and a very high quantity. The Fourth-Year Fifth practice began about 25 years ago and remains a part of the university culture. The university's Gordie Center for Substance Abuse Prevention found that most fourth-year students (96.6%) are aware of the practice, and participation numbers over the past four years, although low (16.0%-19.8%), have remained relatively stable despite efforts to reduce them (Harris, 2007; Nangle, 2008; Foster & Triplett, 2009, Foster, 2010). While the overall number of students participating is relatively low, this event is cause for great concern due to the volume of alcohol participants consume.
There are many options for addressing hazardous drinking associated with major campus events, and the act of focusing on these events can energize a community to work together on more comprehensive prevention efforts (Neighbors, Walters, Lee, Vader, Vehige, Szigethy & DeJong, 2007). One strategy is to employ a social norms approach, which educates students on healthy drinking norms and the extent of protective behaviors (Haines, 1996; Lee, Geisner, Lewis, Neighbors & Larimer, 2007; Perkins, Meilman, Leichliter, Cashin & Presley, 1999; Purvis et al., 2008).
Social norms marketing applies traditional marketing techniques to support healthy behaviors (Andreasen, 1995; Haines, 1996) and can be an effective way to reach students with messages about the prevalence of healthy behaviors. Effective social norms marketing programs are based on an assessment of students' needs and behaviors and employ standard marketing techniques to increase the likelihood of message retention and behavior change. Successful social norms marketing campaigns follow a multistep process in which an initial step is the collection and analysis of baseline data in order to determine healthy norms, and whether misperceptions exist (Haines, 1996; Linkenbach, 2003).
OVERVIEW OF THE CURRENT STUDY
This study involved collecting and analyzing data in order to understand the extent of the Fourth-Year Fifth practice including participation levels, perceived risks and benefits of participation, and motivations for participating. In quantifying the self-reported alcohol consumption associated with the event, it also provided comparisons with other campus celebratory events. Students at this campus report consuming a mean of 6.85 alcoholic drinks on Halloween, 7.63 drinks at an annual off-campus celebratory event, 4.64 drinks at a typical home football game and 6.74 drinks on a typical Saturday night (White et al., 2008). The following research questions guided our investigations:
1. Why do students participate in this hazardous drinking event? What are their motivations?
2. Is there an identifiable subculture of university students that attempt the Fourth-Year Fifth? For example, are males more likely to participate? Are members of fraternities and sororities more likely to participate?
3. When do students learn about this practice? Is there a relationship between when students learn about the practice and their likelihood of participating?
4. Do perceptions of who engages in this practice affect whether students participate? Do students participate, because their friends plan to participate, or in defiance of marketing campaigns that encourage them not to participate?
5. Are the students who attempt to drink a fifth of alcohol consuming significantly more alcohol than what is typical for them? Are students aware that a fifth contains 17 to 21 standard drinks? Are drinking behaviors surrounding the Fourth-Year Fifth practice different from other events such as Halloween?
A mixed methods approach was employed. Three focus groups of fourth-year students were conducted in the month preceding the last home football game to better understand reasons for participation and reactions to potential educational messages. In addition, a behaviors and perceptions survey was administered to all fourth-year students on the day after the last home football game regarding their behaviors on the day of the last home football game.
The focus group participants were recruited via a message posted to a university listserv with a short explanation about the study, information about incentives for participation (food and $20.00), and a link to provide basic demographics and scheduling availability. These incentives were provided by a grant from the Virginia Department of Alcoholic Beverage Control. A link to the behaviors and perceptions survey was emailed to all 3,122 fourth-year students.
Three focus groups were conducted with fourth-year students. Each focus group included between six and ten participants and lasted approximately 90 minutes. Participants were provided name tags for ease of discussion facilitation but were encouraged to provide an alias. Focus group discussions were recorded and transcribed with identifying information removed. In the focus groups, participants were asked specifically about the fourth-year fifth to attempt to gain knowledge about the origin, motivation, and other information about the tradition. They were asked how and when they learned about the fourth-year fifth, what kinds of actions they take to protect themselves and their friends from risky behavior due to drinking, and why they choose to participate or not participate in high-risk drinking events.
The focus group transcripts were reviewed for motivating factors for participation. The codes developed included challenge, socializing, and tradition. They were also analyzed with respect to perceptions of participation and demographics such as Greek affiliation and gender.
The behaviors and perceptions survey was co-developed in 2006 by one of the authors and was revised in 2007 and 2008 in conjunction with the other two authors (Harris 2007; Nangle, 2008). Each survey was tested in focus groups to ensure clarity. In order to address validity concerns, a number of survey questions were drawn from national survey instruments including questions about negative consequences from the CORE Alcohol and Drug Survey, questions about protective behaviors from the American College Health's Association's National College Health Assessment, and questions about typical Saturday night drinking from the Daily Drinking Questionnaire (ACHA-NCHA, 2008; Collins, Parks, Marlatt, 1985; CORE, 2006; Presley, Meilman, Cashin & Lyerla, 1996). Further, the consistent results of the behaviors and perceptions survey over all three years indicate reliability in the survey. The survey consisted of 17 questions and was administered using Survey Monkey. Respondents answered questions regarding demographics (gender and fraternity/sorority membership), general drinking behaviors (at typical football game days and at the last home game), and second hand effects of other students' drinking on the day of the last home football game. Those who participated in the Fourth-Year Fifth also answered questions about motivations for participation and any consequences of participation.
Students were asked if they knew about the Fourth-Year Fifth practice. Survey logic prompted the participants who responded positively to having knowledge of the Fourth-Year Fifth practice to indicate when they first learned about it with the following possible responses: Prior to arriving at the university, first year, second year, third year, fourth year.
To assess participation in the Fourth-Year Fifth practice, students could choose from six options regarding drinking behaviors on the day of the last home football game:
* Yes, I drank a fifth of liquor
* Yes, I drank a fifth of champagne/wine
* Yes, I split the fifth with a friend and we finished it together
* Yes, but I did not finish a whole fifth of liquor
* No, but I did drink that day
* No, and I had nothing to drink that day
Based on these responses, those who answered the first three yes choices were considered to have completed the Fourth-Year Fifth. Students who answered the fourth yes choice were considered to have attempted but not completed.
Two questions were designed to determine if students had accurate perceptions about the extent of the Fourth-Year Fifth practice. One question asked, "what percent of fourth-years do you think attempted or completed the Fourth-Year Fifth this year?" and the second asked, "what percent of your friends do you think attempted or completed the Fourth-Year Fifth?"
One derived dependent variable measured the students' perception accuracy. Fourth-Year Fifth participation rates (whether or not the fifth was completed) have fluctuated from as low as 16.0% to as high as 20.0% over the past four years. The students estimating participation within that range were considered to have accurate perceptions. If students estimated less than 16.0% attempted the Fourth-Year Fifth, they were considered to have underestimated participation rates; if students estimated greater than 20.0% of students attempted, they were considered to have overestimated.
Survey Participation Demographics
The initial survey response rate was 42.8% (1,335 responses). Duplicate responses and those who did not answer the question about drinking behaviors on the day of the last home football game were removed. Of the remaining 1,205 respondents, 385 (32%) were male (a smaller percentage than the actual university population, which is 44% male), and 370 students (30.7%) indicated fraternity or sorority membership, nearly matching the university-wide membership rate of 30%.
Attempting the Fourth- Year Fifth
A total of 217 of the 1,205 (18.0%) respondents reported attempting or completing the Fourth-Year Fifth (Table 1). Those who attempted or completed the Fourth-Year Fifth were analyzed as a single group and are described as attempters. The associations between attempting and gender and attempting and sorority/ fraternity membership were both significant. In particular, males were more likely to attempt than females and sorority/fraternity students were more likely to attempt than non-sorority/fraternity students ([chi square] = 49.3, p < .001; [chi square]= 56.8, p < .001, respectively).
When Students Learned About the Fourth-Year Fifth
Most students learned about the Fourth-Year Fifth practice during their first year in college (59.6%), followed by in their second year (16.7%), and then prior to arriving at the university (Table 2). A Chi-Square test of association indicates a significant relationship ([chi square]=29.802, df=4, p<0.001) between whether a respondent self-reported participating and when that person learned about the practice. Thus participation rates decrease the later students learn about the Fourth-Year Fifth. While only 9.0% of students learned about this practice prior to arriving at college, that group comprised 27.8% of those who attempted. While 14.8% of all students learned about the practice during their third and fourth years, they comprised only 13.5% of those who attempted. 68.6% of all attempters learned about the practice either before arriving at the university or during their first year of attendance, and 85.3% of all attempters learned before their third year.
Perceptions of Participation
Fourth-year students tended to underestimate how many of their classmates participate in the Fourth-Year Fifth (Table 3). Overall, 48.1% underestimated and 34.0% overestimated participation rates. Of students who attempted the Fourth-Year Fifth, 53.5% underestimated the actual number of participants, while only 26.7% overestimated participation. Of students who did not attempt the Fourth-Year Fifth, 47.0% underestimated participation, while only 35.6% overestimated participation rates.
When asked about friends' behaviors, of those who attempted the Fourth-Year Fifth, 26.7% believed a greater percentage of their friends participated compared to the actual norm, while 65.9% believed a lower percentage of their friends participated compared to the actual norm. Among those who did not attempt the Fourth-Year Fifth, 30.5% believed a greater percentage of their friends participated compared to the actual norm, while 63.9% believed a lower percentage of their friends participated compared to the actual norm (Table 4). Thus, fourth-year students underestimate actual participation numbers, both among their friends and all fourth-year students, at approximately the same level regardless of whether they did or did not participate in the Fourth-Year Fifth.
Comparing Fourth-Year Fifth Drinking Patterns to a Typical Saturday Night
For students who reported completing the Fourth-Year Fifth, most students (75.4%) reported consuming at least six standard drinks more than they do on a typical Saturday night, including 26.3% who reported consuming at least 12 standard drinks more than on a typical Saturday night. A few students report consuming as many as 15 to 17 drinks more than on a typical Saturday night (See Table 5).
Motivations for Participating in the Practice
Several themes emerged from focus group data regarding reasons for participation. These included challenge, sense of accomplishment, wanting to participate in a tradition, and socialability (having friends who were participating). Students noted that there is a distinct challenge associated with attempting the Fourth-Year Fifth. Concurrent with that challenge comes a great sense of accomplishment for students who complete it. One student said, "It's an 'earn your stripes' type thing. It's your last year and you've gone to football games and done drinking, but this is the apex of drinking at a football game." Students at this institution participate in and respect a wide range of campus traditions. Students in every focus group cited "tradition" as a major driving force behind the Fourth-Year Fifth. Students said, "we love tradition" and "[this] is a big tradition school." Friends encouraged participation in the Fourth-Year Fifth both directly in the weeks leading up to the event, and also indirectly, since many students indicated they first learned about the practice from their friends.
All students who reported attempting the Fourth-Year Fifth indicated experiencing at least one negative consequence ranging from minor to serious. In particular, 48.1% of attempters reported experiencing a memory loss, 7.5% reported being injured or hurt, and 6.2% felt they might have a drinking problem. While all participants reported experiencing at least one negative consequence, 26.3% reported experiencing at least three negative consequences, and 5.5% reported experiencing at least five consequences.
An important goal of substance abuse prevention efforts is to reduce the adverse consequences of drinking. Celebratory drinking events are, by their nature, prone to encouraging hazardous drinking. The Fourth-Year Fifth is a celebratory drinking event that, while unique to one university, is similar to drinking events at other campuses where students plan to drink for a specific occasion and with a target quantity in mind (e.g. 21st birthday celebrations). Surveys from 2007, 2008 and 2009 (Harris, 2007; Foster & Triplett, 2009; Foster, 2010; Nangle, 2008) indicate a stable level of participation in the practice from 16% to 20%. This is cause for concern because participants attempt to drink a specific hazardous amount, a fifth of liquor in one day, with some completing the target in only a few hours.
Some students drink significantly more than what is typical for them, creating the potential for serious adverse consequences, including alcohol overdose. While alcohol overdose is less common, students self-reported more common negative consequences including hangover, memory loss, engaging in behaviors later regretted, engaging in sexual activity they would not have otherwise engaged in, and being injured or hurt. Given that all participants experienced at least one negative consequence, and over a quarter of participants experienced at least three negative consequences, messaging on protective behaviors could be effective at reducing harm.
Others who attempt the Fourth-Year Fifth are already hazardous drinkers, with self- reported drinking levels of 15 to 17 drinks on a typical Saturday night. These students are probably experiencing many negative consequences of hazardous drinking and may minimize the potential risks of consuming a fifth of liquor. In fact, several students remarked in focus groups that in hindsight, consuming a fifth of liquor was less alcohol than what they typically consumed before and during a football game.
Participation rates vary across the student body. Fraternity members represented the majority of attempters (with 50% attempting) while non-sorority females were the least likely to attempt (with 9.1% attempting). This pattern has been consistent across the last few years (Harris, 2007; Foster & Triplett, 2009; Foster, 2010; Nangle, 2008). Although there are long-standing healthy traditions to celebrate the last home football game (e.g., the Fourth-Year 5K race), these events do not appear to resonate with the heavy drinking population. Students who attempted the Fourth-Year Fifth were primarily motivated by a sense of tradition and felt a sense of accomplishment afterwards. The earlier students learn about the practice, the more likely they are to attempt it. Thus, anticipation may lead to a sense of accomplishment in completing the Fourth-Year Fifth. This anticipation is similar to the special circumstances surrounding other high-risk celebratory drinking events such as weddings, game days, and other culturally associated drinking events (Glassman, Dodd, Sheu, Rienzo, & Weagenaar, 2010).
Social norms marketing is a strategy that has seen positive results (Andreason, 1995; Carter & Kahnweiler, 2000; Haines, 1996), and has resulted in reduced negative consequences on this campus (Turner, Perkins & Bauerle, 2008). However, without a clear misperception to correct, a social norms campaign would not be indicated. While some students may anticipate the event for several years, a large percentage of fourth-year students actually underestimate the number of students who participate in the Fourth-Year Fifth. The low-risk groups overwhelmingly underestimated the overall rates of participation among all fourth-year students. Therefore, a social norms campaign to market the low participation rate may not be effective for the students who do not have a perception gap, or for whom the misperception is in a positive direction. In addition, publicizing the campus-wide social norm of 18-20% attempting the Fourth-Year Fifth may be dismissed by those in high-risk groups and might exaggerate participation rates among the lowest risk groups.
Another issue surrounding message selection and intervention is that campus-wide marketing efforts may have the unintended effect of educating younger students about the existence of the practice and may drive participation rates up due to the sense of anticipation and tradition. Given the high level of typical drinking reported by students who attempt the Fourth-Year Fifth, and the fact that they are generally underestimating participation rates, educational efforts may need to focus on harm reduction messages targeted to those groups most likely to participate. Since students who are typically low-risk drinkers are unlikely to consider participation, campus-wide messages could encourage bystander intervention and describe how to effectively assist an intoxicated friend.
The first step in curbing hazardous celebratory drinking events is to conduct research as was completed here to identify which student populations participate, learn about student perceptions of participation rates, and understand participant motivations. This information can aid in determining what type of educational approach will be most effective to reduce participation and encourage safer drinking practices. Additional research should be conducted on the motivations of students who do not participate. These may provide additional information to support the development of effective messages to reduce participation.
This study provides insight into how best to reduce the numbers of students who participate in a time-specific celebratory drinking practice by targeting limited resources to the specific populations most likely to participate. While the research was initially undertaken to evaluate behaviors in preparation for a social norms marketing campaign, the results are indicative of a case where reporting low participation rates would not be an appropriate strategy since students were not likely to underestimate their peers' behaviors.
More effective messages may be ones that include healthy social norms of protective drinking behaviors and intervention behaviors that are part of a broader campaign. Additional research should be conducted to determine the reasons why students do not participate and to learn if positive injunctive norms (i.e., whether students disapprove of those who participate) exist. While changing the culture surrounding a hazardous drinking practice can be difficult, it is important to understand the many motivations for student participation in order to create targeted educational programs that have the greatest chance of success.
This study was funded in part by a grant from the Virginia Department of Alcoholic Beverage Control. We would like to thank the Virginia ABC and the students who participated in the survey and in the focus groups.
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Holly A. Foster, M.Ed., Ellen J. Bass, Ph.D. & Susan E. Bruce, M.Ed.
University of Virginia
Correspondence concerning this article should be addressed to: Holly A. Foster, Doctoral Intern, Gordie Center for Substance Abuse Prevention, Department of Student Health, 170 Rugby Road, Madison House, Lower Level, PO box 800139, Charlottesville, VA 22908-0139, Phone: (434) 924-5276; Fax: (434) 982-3671; email: firstname.lastname@example.org.
TABLE 1 Attempting the Fourth-Year Fifth Based on Gender and Greek Affiliation Attempted by % attempted by Total respondents demographic demographic by demographic Greek Male 61 50.0% 122 Non-Greek Male 52 19.8% 263 Greek Female 52 21.0% 248 Non-Greek Female 52 9.1% 572 Totals 217 18.0% 1205 TABLE 2 Attempting the Fourth-Year Fifth as a Function of when Students Learn About it % of when learned of When learned % of when total Year when learned Attempted totals learned responses Prior to arrival 30 108 27.8% 9.0% First-year 148 718 20.6% 59.6% Second-year 27 201 13.4% 16.7% Third-year 9 89 10.1% 7.4% Fourth-yea 3 89 3.4% 7.4% Total 217 1205 N/A 100% TABLE 3 Accuracy of Overall Participation Estimates as a Function of Participation Estimation of Participation Participation Underestimate Accurate Overestimate Total Attempters n=116 53.5% n=43 19.8% n= 58 26.7% n=217 Non-attempters 464 47.0% 172 17.4% 352 35.6% 988 Total 580 48.1% 215 17.8% 410 34.0% 1205 TABLE 4 Accuracy of Friends' Participation Estimates as a Function of Participation Estimation of Participation Participation Underestimate Accurate Overestimate Attempters n=143 65.9% 16 7.4% 58 26.7% Non-Attempters 631 63.9% 56 5.7% 301 30.5% Total 774 64.2% 72 6.0% 359 29.8% Estimation of Participation Participation Total Attempters 217 Non-Attempters 988 Total 1205 TABLE 5 Drinking Patterns of Completers; N = 110 (completers whose typical Saturday drinking behaviors were reported). Drinking Pattern n Percent consumed less than 3 drinks more 14 12.7% than typical consumed 3 - 5 drinks more than 13 11.8% typical consumed 6 - 8 drinks more than 29 26.4% typical consumed 9 - 11 drinks more than 25 22.7% typical consumed 12 - 14 drinks more than 25 22.7% typical consumed 15 - 17 drinks more than 4 3.6% typical
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