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Discussion and analysis of attempts in utilizing evidence-based alcohol use screening

Discussion and analysis of attempts in utilizing evidence-based alcohol use screening. American College Health Association Conference Boston, MA May 30, 2013. Presenters:

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Discussion and analysis of attempts in utilizing evidence-based alcohol use screening

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  1. Discussion and analysis of attempts in utilizing evidence-based alcohol use screening American College Health Association Conference Boston, MA May 30, 2013 Presenters: Lara Hunter, LCSW Coordinator of Alcohol and Other Drug Clinical Services and National Coordinator of the Red Watch program Ahmed Belazi, MPH Program Evaluator Center for Prevention and Outreach and Counseling and Psychological services

  2. Describe the rational for and implementation of alcohol screening in college counseling setting • Discuss the use of small tests of change to facilitate the implementation of screening across multiple college departments. • Discuss challenges and barriers to implementation Session Learning Objectives

  3. We Are Here Set among 1,100 wooded acres on Long Island, NY

  4. Publically funded state university • 24,000 students and 2,100 faculty • Culturally Diverse Student Body • Approximately 15% of students report severe alcohol problems • 30% of students drank more than 4 drinks in a sitting in the past two weeks. Stony Brook Fast Facts

  5. Deaths Injuries Sexual Assaults Suicides Vandalism Property Damage Drunk Driving Unsafe sex Alcohol as a Public Health Crisis

  6. About 25 percent of college students report academic consequences of their drinking • Relationship between alcohol, sleepiness, and GPA exists in college. • Heavy drinking associated with lower GPA, Frequency of binge drinking associated with lower grades in college setting. Academics and Alcohol

  7. Identification Intervention / Prevention Screening

  8. Strategic Intervention

  9. Brief interventions by primary care clinicians in efficacy trials resulted in 40% of hazardous drinkers reducing their alcohol consumption to safe levels compared with 20% of the control group. • Students who receive brief, personalized motivational enhancement sessions, whether delivered individually or in small groups, reduce alcohol consumption. Intervention works

  10. Incorporate high-risk alcohol use screening within student support services framework, beginning with center for Counseling and Psychological Services • Move towards the establishment of a "community of practice" among all relevant campus stakeholders Aims

  11. Increase frequency of high-risk alcohol use screening • Integrate the implicit message that there is a connection between alcohol-related behaviors and student success and wellness • Hold professional staff Alcohol BMI Training to stakeholders Ideas

  12. Academic Advising • Student Health • University Counseling Center • Sanctioning Officers Points of Intervention

  13. Implementation

  14. AIM MEASURES IDEAS Model for Improvement

  15. Act Plan PDSA also known as: • Shewhart Cycle • Deming Cycle • Learning & Improvement Cycle • Continuous Scientific Method Do Study NCHIP Model for Improvement

  16. Summary

  17. When to Screen

  18. When to Screen

  19. Clinician’s Feedback

  20. Interns Screening

  21. Interns Screening

  22. Client Feedback

  23. Client Feedback

  24. PDSAs in Action

  25. PDSAs in Action

  26. Resistance to Change

  27. Student Health “What if ?....” • Clinical staff “interrupts flow of therapy” • Academic Advisors “It will turn students off” • Fear of disrupting the system Barriers to Implementation

  28. Maintaining fidelity: • Solicitation of investment across staff segments • Varied mechanisms of screening specific to context of the screening environment • Feedback of findings to staff Creating a Community of Practice: • Irrespective of success or failure, the PDSA activity communicates momentum towards an institutional focus on high-risk alcohol use Lessons Learned

  29. Future Directions

  30. Consistent screening • Eliminates staff bias • Immediate BMI intervention • Student friendly Future Directions

  31. Questions / Comments

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