Due to EVERFI’s unique role as an online education provider, Campus Prevention Network staff want to acknowledge the sensitivity of providing information for this strategy. As we have maintained from the outset of our efforts, our research staff approaches the investigation of online alcohol education–as with any other strategy—with an open mind, reading and interpreting studies cautiously and critically, regardless of the commercial product they may represent. As such, we have adhered strictly and consistently to the scoring model and methodology we developed to assess the impact of programs presented in each of the studies in this analysis, and we report our findings to CPN partners absent of bias with regard to the commercial product they represent.
What is online education?
Many campuses provide online alcohol education to students in order to reduce high-risk drinking on campus. Programs vary from being preventative in nature to interventions intended for problematic drinkers. Online courses may be mandated or offered to broad segments of the student body, such as first-year students, in an attempt to make universal changes that impact not only the individual student, but also the campus culture. Some programs may be implemented in a “selective” fashion, targeting populations determined to be at increased risk for alcohol use, such as athletes or Greek organization members. Other “indicated” programs include brief interventions mandated to students who have violated a campus’s alcohol policies or who have received medical attention for their alcohol consumption. In short, there are a number of online courses and interventions available to campuses to meet a variety of circumstances and needs.
Many online programs do not merely provide students with educational information about alcohol, but present information that is grounded in specific behavior change strategies. For example, many programs utilize cognitive behavioral skills training, intended to change an individual’s beliefs about alcohol use with exercises to address personal alcohol expectancies or to monitor one’s consumption levels. Motivational enhancement may also be employed to provide individual feedback for one’s drinking behavior in a non-confrontational manner and comparing such behavior with data on the norms of a relevant referent group, such as one’s fraternity chapter or other students on campus. Providing students with personalized normative feedback in order to reduce normative misperceptions is another common component to many programs (“Research on Brief Interventions,” n.d.).
There are a number of benefits to providing online education to students. Firstly, online education is a cost-effective means to reach a large number of students. Staff time associated with hiring a facilitator or counselor to lead sessions is not required with online education, however the implementation and tracking of online course usage does require staff oversight. Secondly, with an online format, programs can be adapted to the needs of students. For example, student survey responses to questions about personal alcohol consumption may flag a student as being “high-risk,” offering them a very different online course experience than for students who abstain from alcohol. Additionally, as today’s students are increasingly conversant with online technology and accustomed to learning in an online environment, the use of technology to reach these students becomes increasingly appropriate. Finally, an online course presents an opportunity not present in more traditional educational approaches to gather information on student use and behaviors, which can go a long way to support and inform the work of a prevention practitioner.
Many web-based brief interventions, often mandated to sanctioned students for alcohol-related policy violations, have yielded positive student outcomes. Often times, these web-based sessions for high-risk or problematic drinkers assess student drinking behaviors and provide normative feedback, which has been demonstrated to be an effective approach for reducing negative drinking behaviors. For example, one study compared a Web-based personalized normative feedback (WPNF) session to a Web-based education-only (WE) session for student alcohol policy violators. The WPNF participants had greater reductions in weekly drinking, peak drinking quantity, frequency of drinking to intoxication and peer drinking estimates compared to students who received the WE session (Doumas et al., 2009).
Many web-based brief interventions are based on the Brief Alcohol Screening and Intervention (BASICS) for College Students model. Neighbors et al. (2006) examined the efficacy of a web-delivered program for heavy-drinking students modeled after BASICS and found the program to yield greater reductions in perceived norms and consumption for student participants relative to students in a control group.
Programs that aim to change wider student population alcohol-related behaviors and attitudes have also been demonstrated to have a significant impact. For example, in a study of an online course intended for first-year students, students who took the course experienced fewer negative consequences, fewer heavy alcohol-use days, and fewer incidents of intentional risky behavior relative to a control group of students who did not take the course. Students who took the course also expressed an increased disagreement with positive expectations of consumption relative to control students (Wall, 2007). In another study of a program for first-year students, the program was found to yield reductions in weekly drinking, the frequency of drinking until intoxication, and alcohol-related negative consequences for high-risk students. At the same time, high-risk students in a control condition had increases in all three measures (Doumas, 2007). The success of these online courses may be attributable to the fact that they integrate multiple behavioral components such as motivational enhancement, norms clarification, positive expectancy exercises, and cognitive and behavioral strategies for reducing alcohol use.
Issues and considerations
As with many alcohol prevention strategies, there is wide variability in the options for online education, not only in course components and length, but also their intended use and audience, and cost. It is important that institutions determine their needs and then assess the programs that best meet them, examining the research on these approaches. For example, students who receive medical attention for consumption might benefit from a web-based brief intervention more than a program developed to be used as a universal prevention approach.
Depending upon their audience and intended use, programs may require different levels of student participation. For example, a first year course that requires high participation rates in order to change campus culture might require a mandate or an “implied mandate” for student participation. Web-based brief interventions for alcohol policy violators often mandate student participation without exception. On the other hand, students who self-refer themselves to a health or counseling center for their drinking behaviors ought to be given the opportunity to participate in a brief intervention on a voluntary basis.
The timeframe within which online education courses are offered may play a crucial role in the program’s impact. Programs for first-year students are often offered before or during the beginning of the school year. The goal is to prevent the onset of or increase in high-risk alcohol use often witnessed in the first few weeks of fall semester in freshman year. On the other hand, a web-based brief intervention should be mandated to student policy violators shortly after a student commits a violation to maximize the opportunity to prevent repeat offenses or other high-risk behaviors from occurring.
Finally, it is essential that campuses evaluate their online programming. Assessments of student behaviors ought to be taken before and after students participate in the online experience. Many programs may also provide additional follow-up assessments weeks and even months after a student completes a course in order to evaluate the long-term impact of a program. In addition, a campus may explore other data-collection mechanisms, such as judicial reports (i.e., to track repeat offenses) or ER transports, in order to determine whether a student’s drinking-related behaviors have been modified after completing a web-based intervention.
Doumas, D. (2007). Decreasing Heavy Drinking and Smoking in College Freshman: Evaluation of e-CHUG Administered During Freshman Seminar. Report Prepared for Health, Wellness, and Counseling Services and Advising and Academic Enhancement, Boise State University.
Doumas, D. M., McKinley, L. L., & Book, P. (2009). Evaluation of two web-based alcohol interventions for mandated college students. Journal of Substance Abuse Treatment, 36(1), 65-74.
Neighbors, C., Lewis, M. A., Bergstrom, R. L., & Larimer, M. E. (2006). Being controlled by normative influences: Self-determination as a moderator of a normative feedback alcohol intervention. Health Psychology, 25, 571–579.
Research on Brief Interventions (n.d.) The Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention.
Wall, A. F. (2007). Evaluating a Health Education Website: The Case of AlcoholEdu. NASPA Journal, 44(4), Art. 4. Retrieved April 08, 2008, from http://publications.naspa.org/naspajournal/vol44/iss4/art4