Halloween costumes to scare your health educator: Wellness vs. Not-so-wellness

I've already started looking for a Halloween costume this year (can't resist a costume party). I was going through some websites and immediately started using my wellness lens to group the options into two categories: Wellness vs. Not-so-wellness.

I also used my SciFi lens to group costumes into the categories of ComicCon-worthy vs. Too-obscure-to-be-easily-recognized-in-grad-school-setting. But that's neither here nor there.

My top picks for Wellness costumes certainly don't imply that they need to be conservative, but that they could probably provide an educational component outside of a Halloween setting.

Wellness

1. First up we have healthy food options, including peas in a pod, adult sized carrot, and a nice big yellow banana. That's so wellness!
2. Next, let's learn about sexual health with appearances from a Trojan condom, a giant boob (obviously promoting breast exams), the one-and-only Super Sperm, along with Captain Condom, and of course a giant penis with testicles. All perfectly appropriate wellness costumes!
3. It might be a stretch, but this magazine cover bikini star costume could be an excellent talking point for a presentation on body image.
4. Finally, I might even be willing to look past the strategic placement of the mouthpiece on this breathalyzer costume for the opportunity to discuss BAC levels.

Not-so-wellness

1. It's no surprise costumes themed around alcohol are common. Some simply represent products like Old Milwaukee, a simple bottle of beer, and a Colt 45.
2. Then we move on to the larger quantities of alcohol, including the male beer keg, female beer keg, and a double-fisting beer wench.
3. There are the glorified alcohol super heroes, including Duff Man, Duff Woman, Beer Man, and the party drinking leprechaun.
4. Finally, the top two costumes that make me cringe: Blunt Master and Beer Pong Cup.

So there you have it, my picks for wellness and not so wellness costumes this year! I'm thinking about stocking up on some health foods and Trojan condom costumes - I could staff my own wellness theme park with these!

Bars outnumber grocery stores in areas of high binge drinking

I love GOOD, but I also love being precise, so I felt compelled to acknowledge some of the mis-matched information in a GOOD.is post on Where Bars Outnumber Grocery Stores.



The article presents a map of orange and red dots across the country, with red dots representing areas where bars outnumber grocery stores. The brief post concludes, "Here's the funny thing, though: This doesn't really correspond to where people drink the most."

First of all, the map of drinking across the country that "doesn't really correspond" is from 1996, and shows the Apparent Alcohol Consumption in Gallons of Ethanol for Population 14 Years and Older. Apparent alcohol consumption means the stats report the amount of alcohol purchased, so we can assume it was used for consumption and not for, I don't know, watering plants or something.

Looking back to the number of bars compared to grocery stores, the map's creator (FloatingSheep.org) describes how the data represents the areas where bars outnumber grocery stores in the Google Maps directory as of August 2008 - so I don't know what you'd expect to find when comparing this information to apparent alcohol consumption in 1996.

I went looking for my own consumption maps for comparison, and I found that even the 2008-2009 data for Alcohol Use in Past Month among Persons Aged 12 or Older didn't quite fit. This could be because 12 year olds aren't allowed in bars (hopefully), and many grocery stores sell alcohol - so the number of bars is less relevant.

However, there was a map in the 2008-2009 data that lined up almost perfectly: Binge Alcohol Use in Past Month among Persons Aged 12 or Older. So, it appears binge drinking rates are more closely correlated to the relative number of bars vs. grocery stores than simply the amount of alcohol consumed, or percentage of drinkers in the area.



But which factor is influencing which? Are the number of binge drinkers creating a market for more bars to open, or are the number of bars creating communities with easy access and high visibility of alcohol?

Check out my alcohol article in StudentAdvisor's Freshman Year: Survive & Thrive guide

As I've mentioned before, I'm a big fan of seeing my name in print! That's why I'm so pumped to announce that an article I wrote is appearing in StudentAdvisor's Freshman Year: Survive & Thrive guide. I wrote about alcohol, and tried to poke fun at the awkward (or absent) alcohol talks that parents have with their first-year students - while at the same time providing the kind of information I would include in just such a talk (very sneaky).

The original title was "That Awkward Alcohol Talk: It's All About Plane Crashes" but it got changed to "Beer Pong is a Tool of the Devil?" in the actual publication. The new title is very eye-catching because beer pong and devil are definitely two loaded terms, and refers to the exaggerated perspective of an abstinence-only parent that I mention in the opening paragraph.

Now that I think about it, there are some potential concerns about releasing an article with "it's all about plane crashes" in the title in the same week as the 10th anniversary of 9/11... so yeah, probably for the best!

Here's an excerpt from the article (p.19):

Has it happened yet? If not, you’re in for a real treat. I’m talking about that awkward alcohol talk between you and your parents that is bound to happen sometime before or during your first year in college. The talks are usually quite short, and come in different styles ranging from the vague, “be responsible, honey,” to threats of corporal punishment, “I’ll beat the living daylights out of you," and even appeals to a higher power: “beer pong is a tool of the devil!”

I really like how the StudentAdvisor guide includes diagrams of the different alcohol serving sizes, and highlighted the top 4 risk-reduction techniques in a nice table. The stats and survey come from the Fall 2010 American College Health Association National College Health Assessment (ACHA - NCHA II), which is linked directly from the electronic guide.

I just did an interview with the BG News yesterday morning on the topic of Wine vs. Beer, which I hope will illustrate the differences in alcohol concentrations, among other things.

I'm on a roll!

Playing beer pong with water doesn't make it an educational activity [comic]

I received an email asking if our office would be willing to provide handouts for an alcohol awareness event during Homecoming. I was told the event would have water pong and flip-cup with soda instead of beer, "to go along the whole safe way to having fun." Oh, is that not a good idea?

Are alcohol-alternative events getting students out of the bars, or preaching to the choir?

This year, I'm putting three questions about alcohol use on all of our Late Night event evaluations in an attempt to answer the age-old question: Are we providing alternative events for students who would normally be drinking, or are we providing entertainment for students who don't drink?

We were able to purchase some pretty trendy incentives for under 50¢ each. Combined with an aggressive evaluation table, we were able to get the highest response (n=234) since I've been working here.

The three questions I added to our normal evaluation are:

1. How many days in a typical week do you drink? (circle 0-7)
2. How many days in a typical week do you get drunk? (circle 0-7)
3. How many drinks did you have the last time you partied? (open response)

The questions are rather subjective (what do you mean by 'get drunk'?), but in previous research, subjective questions like these have strongly correlated with AUDIT scores - so we are able to get a rough snapshot of possible alcohol-related negative consequences in a single question rather than listing all 18 questions.

It's important to note that our evaluation table was staffed with student volunteers to try to make students feel more comfortable answering questions about their drinking behavior.

So what were the results? We appear to be preaching to the choir - at least at this Late Night event, which was on the very first night the first-year students were on campus. 69% of the respondents indicated that they drink 0 days in a typical week, 82% said they never get drunk in a typical week, and 49% said they had 0 drinks the last time they partied.

Of the students who filled out evaluations (which was a convenience sample of students in attendance at our event), 82% said they had 4 or fewer drinks the last time they partied. If we knock out the 49% who had 0 drinks at their last party, we get 33% of students having between 1-4 drinks. This is disproportionally high compared to our Fall 2010 NCHA data (random sample) which indicates that only 26.5% of the general student body consumed 1-4 drinks the last time they partied.

Looking at gender differences (female=67%, male=32%), the women drank more frequently (0.60 days/wk vs. 0.40 days/wk) and got drunk more frequently (0.27 days/wk vs. 0.22 days/wk) but had fewer drinks at their last party (2.20 vs. 3.11).

Overall, we appear to be attracting a disproportional number of abstainers and moderate drinkers to our Late Night event. So we might not be pulling students out of the bars, but we're providing entertainment and positive reinforcement for the students who are not heavy drinkers.

And there is something to be said for the 18% of student respondents who admitted to heavy drinking the last time they partied (5+ drinks in a single drinking event). If our sample were representative of the entire event attendance, it would mean we were able to host an alcohol-free night for around 300 at-risk users.

However, this event was the very first event of the year, which means a lot of these first-year students have yet to establish their "typical" college drinking behaviors. I want to continue asking these questions at our five remaining Late Night events to see what type of crowd we bring in.

Bonus data! Using the right incentive to survey alcohol use with student evaluations

I knew our late-night event would draw a large crowd of first-year students (because they are the only ones moved-in on campus so far), so I wanted to add some survey questions about alcohol quantity and frequency usage in addition to our regular evaluation questions. We also wanted to get a more attractive incentive for the evaluation table, because compared to all the other freebies we were giving out, stickers wouldn't get much attention.



We normally give out temporary tattoos, stickers, or candy as an incentive at our evaluation table. This time, however, we got some trendy silicone sport watches. These incentives look very impressive - some companies are selling them for $21.99 each, pretending they are infused with negative ions to give you extra balance and strength (don't get me started) - but they're actually around $0.39 to $0.48 per unit depending on the quantity, if you buy wholesale. Just Google "silicone sport watch" and see what comes up.

The evaluation was a great success, and we got a stack of responses (I'm guessing around 250, but I haven't counted yet).



What's even more exciting, students actually filled out the alcohol quantity and frequency questions! This means we have "bonus" survey data on the first night these students were on campus. When we ask the same questions on future evaluations, we can compare trends. We'll also be able to answer the age-old question: Are we providing alternative events for students who would normally be drinking, or are we providing entertainment for students who don't drink?

I intentionally included a subjective question: "How many days in a typical week do you get drunk?" that I got from an interesting study called "Single Question about Drunkenness to Detect College Students at Risk for Injury" in the journal of Academic Emergency Medicine. Although this question is subjective, it positively correlates with typical measures of alcohol-related negative consequences. Basically, it's a quick and dirty approach when you just don't have room for the entire AUDIT survey.

I'm excited to get into the office on Monday to really dig into this data. Exciting start to the year!

Ideas for an alcohol talk with a college athletic team during Fall Semester

I was recently asked for some ideas for a pre-season alcohol / responsibility talk with an intercollegiate athletic team. I thought I'd share what I wrote in that email with the interwebs in case someone out there is looking for that same information...

For a talk with a college athletic team, I would emphasize how they should watch out for each other like a family. They should also respect each other if they choose not to drink. A divided team runs the risk of splitting social activities into the group of drinkers and group of non-drinkers.

Also, emphasize how the seniors and captains should be role models. On teams with a drinking culture, the seniors and captains usually drink the MOST which is counter-intuitive - but this also shows how they have the ability to influence team behavior. Even if members choose to drink during the season, see if they are willing to have weekly alcohol-free activities (like Movie Night every Friday). This will not only increase their bonding and communication, but will at least take one night of drinking out of the equation.

Tell them how long alcohol can stay in their system the day after drinking, and can have a huge impact on their muscle recovery - so every time they drink after a workout, they are throwing away hours in the gym or on the field! Paint the picture that excessive drinking is what teams do when they aren't serious about their sport. Challenge them to rise above what the typical college social scene might include, because they aren't typical college students. They have elite status, they are here for a reason, and they are better than that.

The easiest way to change drinking habits is to not develop them in the first place, so they should start in with alcohol-free group activities right away when the school year starts. Individual choices become the team's business, especially on team sports. They should get on each others' cases about things they are not OK with, and it shouldn't be the coach's job to regulate their choices. The team is a family and a machine that only works as well as its weakest member.

This is the kind of stuff I would talk about, hope this helps! Go ahead and challenge them. They are likely competitive individuals, and will be very optimistic about taking the sport seriously right at the start of the year - so try to sustain that optimism!

Drunk support is a new twist on bystander intervention for alcohol prevention

I just finished reading the article "Drunk Support" on Inside Higher Ed, and I was intrigued by this new term and its implications for tweaking our existing alcohol prevention programs. The term "drunk support" was coined by Thomas Vander Ven, an Ohio University associate professor of sociology, and refers to the social aspect of the college drinking scene in which students might coerce each other to drink more in one instance, and later offer help or assistance in the form of water, an escort home, or even emergency assistance.

I haven't read Mr. Vander Ven's book, but from the description in the article it sounds like this is a silver lining to drinking circles with strong social influences. On one hand, they might be egging each other on, and on the other they are more willing or likely to assist during a crisis.

I might have to pick up a copy of the book so I don't continue putting words in his mouth, but I'll continue this post for the sake of finishing my thoughts.

The article continues by describing a variety of bystander intervention programs that seem to be quite effective beyond the traditional social norming or educational poster campaigns that are more commonplace. The programs listed include the Red Watch Band program, the Quaker Bouncers, and the Green Team.

The Haverford Quaker Bouncers, in addition to being trained in bystander intervention techniques, are actually paid $10.25 an hour to monitor parties in teams of two. Likewise, Dartmouth's Green Team members are paid $44.00 per night to monitor parties.

This is a fairly bold move, and hey if you've got the funding why not give it a try! My only concern would be intentionally placing students at parties they wouldn't otherwise attend. Maybe I'm just being overly cautious, but training students to be more safety-consious in their everyday life is one thing. But having them attend raucous parties as paid lifeguards seems risky somehow. I suppose since they're the sober ones, they have less to worry about.

The quotes in the article were very positive, and anecdotes in the comments were also very telling. It sounds like students understand that these party monitors are not paid snitches, and are there for their benefit.

Jeff Millman, the creator of both the Quaker Bouncers and Green Team, is now president of his own start-up company SOTEER that "creates and supports a professionally-trained, non-threatening peer monitoring system for parties and acts as a liaison between students and college administrators" (source).

Drinking culture Prezi presentation for RA Diversity Day adds some unexpected wellness

On Wednesday, I presented a Prezi titled Drinking Culture and the Beliefs Your Students Bring to Campus to a group of RA's for RA Diversity Day. I know, normally we don't get to sneak alcohol education into diversity training - but this went over rather well! The entire thing took an hour and 15 minutes. I took the lead, and was followed with sections presented by our Drug and Alcohol Prevention Specialist at the Counseling Center, and our Director of Wellness.

I started with a hook: Some interesting alcohol facts about traditional beverages from Egypt and Kenya. I got my information from the 2004 WHO report on alcohol, which is quite a hefty document!

I talked about different minimum drinking ages in different countries, which led into a discussion of countries where alcohol is forbidden (for citizens) with a reference to Sharia customs. I think this religious component was really interesting, and mirrored it later by talking about the Mormon "Word of Wisdom" which also explicitly prohibits alcohol.

The quilt activity in the middle was probably the RAs' favorite part. We had them each draw pictures or words that represent the direct and indirect influences of their own family or community. We had some pretty creative quilt squares! The students really enjoyed sharing with each other, which drove home the point that everyone brings different experiences and influences with them to campus.



It took me forever to find vector world maps to use on Prezi. Then I found out Prezi supplies a vector world map template presentation that was way better than the maps I found, and I felt silly. So make life easy, and just re-use the Vector Maps in Prezi template.

What I learned: Don't reinvent the wheel, especially when the wheel is a vector map.

The checkout is the last checkpoint [comic]

Since my post about Finish Line supplying ping pong balls for "Shoe Pong," I was made aware of a display of College Essentials in Target, and I've been thinking more about the role of the cashier as the last arbiter leading up to risky decisions (especially risky decisions involving large quantities of alcohol and alcohol, um, accessories).

It reminded me of teenagers buying large amounts of toilet paper and eggs, and the cashier all but calling their parents in an attempt to stop them. Why is there not a similar protest in an attempt to avoid potentially destructive situations later in life?



I labeled this post [comic] because I'm thinking about making more of these Photoshop college collages. Ooooh, zippy!

Ping-pong balls are the new free t-shirt

I remember when I would do anything for a free t-shirt. Sign up for a credit card? Sure! Hand out alcohol information at tailgates? Why not! However, considering these economic times, the free t-shirt is reserved for special occasions. Based on a piece of junk mail I recently received, it looks like Finish Line is opting for a much cheaper alternative: ping-pong balls.

Ok, that might seem like an odd promotion - if not for the immediate association between ping-pong balls and drinking games. But Finish Line didn't want to take any chances, so they went the extra mile to imply what you might do with these free ping-pong balls. Shoe Pong!

Wait, is that like beer pong? Noooo, beer doesn't have anything to do with this. The good people at Finish Line just want to encourage college aged shoe-buyers to be creative and come up with something to do with these ping-pong balls. You know, maybe like standing in teams of two throwing the balls into something - maybe even in a tournament in someone's basement. Who said anything about drinking?

What I learned: Finish Line is using beer pong to sell shoes, and they're not very sneaky about it.