MARYANNE JACONIS, M.S. LENA NEWLIN, M.P.H., C.H.E.S. DAVE COZZENS, PH.D. CHARLIE KSIR, PH.D. MIKE...

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.

Alcohol Screening at the University of Wyoming

Agenda

Background & Context: University of Wyoming

PDSA Cycles

Results

Challenges

Future Directions

University of Wyoming

Public land grant universityOnly 4-year institution of higher education

in Wyoming Approximately 13,000 studentsLocated in southeast corner of Wyoming, in

Laramie, population 31,000.

Alcohol Concerns at UW

Sources: National College Health Assessment, Spring 2001, Spring 2011

Alcohol Concerns at UW

UW Police Department Arrests

Source: Wyoming Association of Sheriffs and Chiefs of Police, 2011

 Average

BAC

Underage Consumption of Alcohol 0.144

DUI 0.131

DUI (minor) 0.101

DUI Crash BAC 0.14

Alcohol, Wellness Alternatives, Research, & Education (AWARE)

Program

Harm Reduction Approach3-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.

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

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

PDSAs for Systematic Campus-Wide Screening

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

University Counseling CenterPDSA Cycles

Act Plan

Study Do

Feedback

Feedback

Feedback

Feedback

PositivesPositives NegativesNegatives

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?

University Counseling Center:Feedback from PDSAs

Academic Year 2011-2012

Academic Year 2011-2012

July 1, 2012 – April 11, 2013July 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%)

AUDIT ResultsUniversity Counseling Center

Spring Semester 2012Spring Semester 2012 July 1, 2012-April 1, 2013

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%)

AUDIT Results Student Health Services

Psychology Training Clinic

Psychology Training Clinic

Counselor Education Training Clinic

Counselor Education Training Clinic

Spring semester 2012 through April 29, 2013

45 AUDITSScore 0-7: 38 (84%)Score 8-18: 5 (11%)Score 19-40: 2 (4%)

Spring semester 2012

32 AUDITSScore 0-7: 23 (72%)Score 8-18: 6 (19%)Score 19-40: 3 (9%)

AUDIT Results Mental Health Training Clinics

Wyoming UnionWyoming Union Athletic DepartmentAthletic Department

March 5, 201238 AUDITSScore 0-7: 25 (66%)Score 8-18: 13

(34%)Score 19-40: 0 (0%)

April 4, 201227 AUDITSScore 0-7: 22 (81%)Score 8-18: 4 (15%)Score 19-40: 1 (4%)

AUDIT Results Peer Education

AUDITAUDIT AUDIT-CAUDIT-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%

Overall Summary of Results

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)

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

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

Questions?

Maryanne Jaconis, M.S. Clinical Psychology Doctoral Student Psychology Department mjaconis@uwyo.eduLena Newlin, M.P.H., C.H.E.S.

AWARE Program Coordinator, Assistant DirectorUniversity Counseling CenterUniversity of WyomingPhone: 307-766-2187lnewlin@uwyo.edu