To examine the effects of a multisite environmental prevention initiative, the A Matter of Degree (AMOD) program, on student heavy alcohol consumption and resultant harms at ten colleges. A quasi-experimental longitudinal analysis of alcohol consumption and harms was employed, using repeated cross-sectional survey data from the Harvard School of Public Health College Alcohol Study (CAS). Areas examined included seven measures of alcohol consumption, thirteen measures of alcohol-related harms, and eight measures of secondhand effects of alcohol use by others. Comparisons were conducted on self-reported behavior of students for the ten AMOD sites in aggregate and by level of program implementation, with students at 32 comparison colleges in the CAS, for each outcome. No statistically significant change was found in the overall ten-school AMOD program for outcome measures of interest from baseline (1997) to follow-up (2001). However, there was variation in the degree of environmental program development within AMOD during the intervention period. A pattern of statistically significant decreases in alcohol consumption, alcohol-related harms, and secondhand effects was observed, reflecting minor to more substantial changes across measures among students at the five program colleges that most closely implemented the AMOD model of environmental change. No similar pattern was observed for the low implementation sites or at 32 comparison colleges. While there was no change in the ten AMOD schools in study measures, significant although small improvements in alcohol consumption and related harms at colleges were observed among students at the five AMOD sites that most closely implemented the environmental model. Fidelity to a program model conceptualized around changing alcohol-related policies, marketing, and promotions may reduce college student alcohol consumption and related harms. Further research is needed over the full course of the AMOD program to identify critical intervention components and elucidate pathways by which effects are realized.
Bibliographical noteFunding Information:
The “A Matter of Degree” (AMOD) program, developed and funded by the Robert Wood Johnson Foundation (RWJF) with programmatic support from the American Medical Association, is a coalition-based approach that brings campuses and communities together to change environments that promote heavy alcohol consumption. The community coalition model holds promise for addressing a wide range of social problems. 38 Previous efforts at community-based prevention have demonstrated effectiveness in reducing consumption and alcohol-related harms, 32,39–41 and may be particularly appropriate in addressing college drinking. 42,43
This study was supported by a grant from the Robert Wood Johnson Foundation (RWJF). We gratefully acknowledge that support and assistance from RWJF staff members Mary Ann Scheirer, Dwayne Proctor, Marjorie Gutman, Seth Emont, and Joan Hollendoner. For their support of the program evaluation, we acknowledge Richard Yoast, Sandra Hoover, Donald Zeigler, and Danny Chun, from the American Medical Association, as well as the coalition members at each AMOD site. We acknowledge the assistance of the AMOD site evaluation staff in collecting study data; and Alison Folkman, Jeff Hansen, and Mark Seibring at the Harvard School of Public Health (HSPH), with Anthony Roman and the staff at the Center for Survey Research at the University of Massachusetts-Boston, and Scott Crawford and staff at Market Research Interactive, who helped with data preparation. Karen Powers, Catherine Lewis, Amanda Rudman, and Lisa Irish at HSPH helped with manuscript preparation.
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