Alcohol Screening at the University of Wyoming

1. Alcohol Screening at the University of Wyoming Maryanne Jaconis, m.s. Lena Newlin, M.P.H., C.H.E.S. Dave Cozzens, Ph.D. Charlie Ksir, Ph.D. Mike Dorssom, M.A.

2. Agenda • Background & Context: University of Wyoming • PDSA Cycles • Results • Challenges • Future Directions

3. University of Wyoming • Public land grant university • Only 4-year institution of higher education in Wyoming • Approximately 13,000 students • Located in southeast corner of Wyoming, in Laramie, population 31,000.

4. Alcohol Concerns at UW Sources: National College Health Assessment, Spring 2001, Spring 2011

5. Alcohol Concerns at UW UW Police Department Arrests Source: Wyoming Association of Sheriffs and Chiefs of Police, 2011

6. Alcohol, Wellness Alternatives, Research, & Education (AWARE) Program • Harm Reduction Approach • 3-in-1 Framework: Educational Services at 3 levels • Individual student • Mandated education for policy violators • Evidence Based Approach: BASICS, ASTP, Motivational Interviewing, Alcohol EDU • Student population as a whole • Alcohol EDU for all freshmen, freshmen/parent orientation, peer education, Safe Ride, alternative late night programming, etc. • Campus and surrounding community • Coalitions (A-team, CoPSA), alcohol policies and ordinances, Summit, NCHIP, TiPS training for local distributors, etc.

7. National College Health Improvement Project (NCHIP) • Teams from 32 colleges and universities form a Learning Collaborative on High-Risk Drinking • 18 months focused on evaluation and measurement techniques to identify and implement the most effective ways to reduce high-risk drinking • “Plan-Do-Study-Act (PDSA)” Cycles

8. Alcohol Screening at UW • No systematic campus-wide screening as primary prevention • Individual-based interventions occurred only after an alcohol violation • Aim: To reach students where they are already receiving services

9. PDSAs for Systematic Campus-Wide Screening

10. Screening Measures • AUDIT • 10 questions • Score 0-7: Low risk drinking • Score 8-18: May be experiencing or at risk of experiencing health consequences as a result of drinking • Score 19-40: Possible alcohol dependence • AUDIT-C • 3 questions • Scale of 0-12 • Positive for alcohol misuse (men) 4+ • Positive for alcohol misuse (women) 3+ • Administered by: • Licensed mental health providers, graduate student trainees, medical staff, peer educators

11. Act Plan Study Do University Counseling CenterPDSA Cycles Feedback Feedback Feedback Feedback

12. University Counseling Center:Feedback from PDSAs Positives Negatives • Easy for front office to hand out • Feasible to incorporate into UCC’s electronic medical records system • Picked up information that clinicians may not have caught (e.g., drinking & driving) • Able to supplement conversation • Gives more comprehensive picture of what’s going on with student • One more form for clients to fill out • Limited time • How to do referrals?

13. AUDIT ResultsUniversity Counseling Center Academic Year 2011-2012 July 1, 2012 – April 11, 2013 • 400 AUDITS • Scored 0-7: 306 (76%) • Scored 8-18: 79 (20%) • Scored 19-40: 15 (4%) • 565 AUDITS • Score 0-7: 440 (78%) • Score 8-18: 95 (17%) • Score 19-40: 30 (5%)

14. AUDIT Results Student Health Services Spring Semester 2012 July 1, 2012-April 1, 2013 • 261 AUDIT-Cs • Scored 0-3: 187 (72%) • Scored 4-12: 74 (28%) • 448 AUDIT-Cs • Score 0-3: 448 (73%) • Score 4-12: 164 (27%)

15. AUDIT Results Mental Health Training Clinics Psychology Training Clinic Counselor Education Training Clinic • Spring semester 2012 through April 29, 2013 • 45 AUDITS • Score 0-7: 38 (84%) • Score 8-18: 5 (11%) • Score 19-40: 2 (4%) • Spring semester 2012 • 32 AUDITS • Score 0-7: 23 (72%) • Score 8-18: 6 (19%) • Score 19-40: 3 (9%)

16. AUDIT Results Peer Education Wyoming Union Athletic Department • March 5, 2012 • 38 AUDITS • Score 0-7: 25 (66%) • Score 8-18: 13 (34%) • Score 19-40: 0 (0%) • April 4, 2012 • 27 AUDITS • Score 0-7: 22 (81%) • Score 8-18: 4 (15%) • Score 19-40: 1 (4%)

17. Overall Summary of Results AUDIT AUDIT-C • Score 0-7: 76% • Score 8-18: 19.3% • Score 19-40: 4.3% • Score 0-3: 72.5% • Score 4-12: 27.5%

18. Following Up • No follow-up (608) • Advised talking with health provider (100) • Advised to reduce drinking (37) • Advised to stop drinking (1) • Out-patient referral (2) • Inpatient referral (4) • Referral to AWARE (8)

19. General Challenges • Extra time for clinicians • More forms for clients to fill out • Training of screeners • Personalized feedback • Referrals out • Poor fit within the system (Center for Advising and Career Services) • Inconsistent completion of recommendations by screeners • Changes to AWARE referral system necessary

20. Future Directions • Determine what are the next steps • Increase screening locations • Institutionalization of AUDIT and AUDIT-C screenings across campus • More screenings by peer educators across campus • Continue to integrate screening as part of comprehensive approach

21. Questions? • Maryanne Jaconis, M.S. Clinical Psychology Doctoral Student Psychology Department mjaconis@uwyo.edu • Lena Newlin, M.P.H., C.H.E.S.AWARE Program Coordinator, Assistant DirectorUniversity Counseling CenterUniversity of WyomingPhone: 307-766-2187lnewlin@uwyo.edu