maryanne jaconis, m.s. lena newlin, m.p.h., c.h.e.s. dave cozzens, ph.d. charlie ksir, ph.d. mike...
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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
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Agenda
Background & Context: University of Wyoming
PDSA Cycles
Results
Challenges
Future Directions
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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.
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Alcohol Concerns at UW
Sources: National College Health Assessment, Spring 2001, Spring 2011
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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
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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.
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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
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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
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PDSAs for Systematic Campus-Wide Screening
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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
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University Counseling CenterPDSA Cycles
Act Plan
Study Do
Feedback
Feedback
Feedback
Feedback
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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
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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
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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
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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
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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
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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
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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)
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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
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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
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Questions?
Maryanne Jaconis, M.S. Clinical Psychology Doctoral Student Psychology Department [email protected] Newlin, M.P.H., C.H.E.S.
AWARE Program Coordinator, Assistant DirectorUniversity Counseling CenterUniversity of WyomingPhone: [email protected]