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A Study of the Relationship Between Protective Behaviors

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JOURNAL OF AMERICAN COLLEGE HEALTH, VOL. 53, NO. 1A Study of the Relationship BetweenProtective Behaviors andDrinking Consequences AmongUndergraduate College StudentsJorge Delva, PhD; Michael R Smith, MA; Richard L. Howell, MS;Dianne F. Harrison, PhD; Dina Wilke, PhD; D. Lynn Jackson, MSWAbstract. The authors identified the number, type, and trequencyof protective behaviors that undergraduate college students whoconsume alcohol use to prevent alcohol-related consequences. Theirhypothesis was that students who engage in more types of protectivebehaviors with greater frequency would be less likely to experiencealcohol-related consequences. Participants consisted of a randomlyselected sample of 1.355 undergraduates aged 18 years and older ata large public university. Students completed a mailed questionnaireon alcohol and health behaviors in spring 2002. The findings (afteradjustment for covariates) indicated that self-protective behaviorsare inversely associated with alcohol-related problems for womenbut not for men. The influences of gender and racial and ethnic dif-ferences are considered in relation to prevention and interventionprograms aimed at reducing alcohol-related consequences on col-lege campuses.Key Words: alcohol use, college drinking, heavy drinking, pro-tective factorsA Icohol use and misuse have been documented in anumber of college-specific surveys, including theCollege Alcohol Study (CAS),'- the Center forAlcohol and other Drug Studies (CORE ),' the National Col-lege Health Assessment,6and others,7'8as well as in popula-tion-based surveys such as Monitoring the Future9' 0and theNational Household Survey of Drug Abuse."`13 Findingsfrom these surveys provide substantial evidence that alcoholJorge Delva is an associate professor University oj MichiganSchool of Social Work, Ann Arbor; Michael P. Smith is the execu-tive director, Florida State University Institute Of Science andPublicAffairs, Tallahassee, whereRichard L. Howell is a researchassociate, Dianne E. Harrison is associate vice-president fbr aca-demic affairs and dean oJ'graduate studies, Dina Wilke is an assis-tant pro fessor and D. Lynn Jackson is a research assistant.consumption is prevalent among college students and thatmany students experience a plethora of academic, psyclhoso-cial, and health consequences, some of which are fatal.'4'5Although considerable attention has been given to ideiitify-ing high-risk drinking groups2,41618 and risk factors arniongcollege students,'9-22 scant attention has been paid to icenti-fying the protective behaviors in which students engage toprevent or minimize alcohol-related harm .23As a result of the widespread prevalence of alcohol-related problems among college students, the 1 990s witnessedthe emergence of interventions such as social norms, moitiva-tional, and comprehensive multifaceted programs.'524- Ourpurpose in conducting this study was to (I) identify the typesof protective behaviors in which students engage when theyconsume alcohol, (2) describe the frequency with which stu-dents rely on these behaviors to prevent alcohol-related lharmwhen they consume alcohol, and (3) determine whether stu-dents who report these protective behaviors are less likely toexperience alcohol-related harn compared with students whodo not report such behaviors.METHODSampleWe based this study on cross-sectional data collected inspring 2002 from a random sample of undergraduate stu-dents attending a large public university. The university'sinstitutional review board approved of the study before webegan the survey. The questionnaire, which used items lromthe National College Health Assessment Survey (NCIIA),was administered to a random sample of 4,485 undergradu-ate students aged 18 years and older; we received responsesfrom 1,355 students, a return rate of 31%.3'19DELVA ETALSurvey AdministrationA multidisciplinary team of researchers who followedDillman's32survey principles to increase respondents' par-ticipation administered the survey to a randomly selectedsample of students whose names and addresses wereobtained from the university's registrar's office. We usedEGRET software33to conduct power analyses to obtain asample size that would provide sufficient power to per-form statistical analyses and to provide a representativesample of the undergraduate student population. We sent aletter to 4,485 students informing them they had been ran-domly selected to participate in a survey of health behav-iors, indicating that the questionnaire would be mailedwithin a week, and encouraging them to ask the principalinvestigator (MPS) any questions they had about the study.A week later, we mailed the questionnaires and consentforms to the students.We designed the survey process to assure students thattheir answers were confidential, but we also tracked therespondents so that we could award 10 cash prizes of $50for their participation. The questionnaires were stored in alocked file cabinet in the office of the principal investigator.QuestionnaireThe 7-page, self-administered questionnaire includeditems concerning alcohol, tobacco, and other drug use; per-ceptions of the use of these substances among the general stu-dent body; questions about alcohol-related injury, sexualbehaviors, health-promotion, and health-seeking behaviors;academic performance; and demographic characteristics.MeasuresAlcohol-Related ProblemsWe used a composite score of 7 alcohol-related problemsas a measure of this variable. Students were asked the fol-lowing question, "If you drink alcohol, during the last schoolyear, have you experienced any of the following as a conse-quence of your drinking?" The list consisted of the following:* physically injured yourself* physically injured another person* been involved in a fight* done something you later regretted* forgot where your were or what you did* had someone use force or threaten force to have sexwith you* had unprotected sex?We measured response categories on a yes-no dichoto-mous format. Students who did not drink were excludedfrom the sample.In addition to these 7 items, the questionnaire asked stu-dents whether alcohol use had affected their academic per-formance during the previous school year. We coded stu-dents as having experienced an alcohol-related academicproblem if they reported that they had received a lowergrade (than usual) on an exam, an important project, or in acourse; had received an incomplete; or had dropped acourse. We coded those


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