Schools Use Web to Teach About Booze

11/1/2005

Wall Street Journal

Students Complain About 'AlcoholEdu, ‘But Educators Say the Program Works

By David Kesmodel

As colleges struggle to curb student drinking, they're increasingly turning to a new weapon: a mandatory online class on alcohol for freshmen. 

More than 120 colleges and universities now require first-year students to complete "AlcoholEdu," a three-hour course developed by Outside the Classroom Inc., a closely held Needham, Mass., company. That's up from about 30 schools just two years ago and four schools four years ago.

AlcoholEdu, adopted by schools such as the University of California at Berkeley, the University of Connecticut and Miami University of Ohio, is gaining popularity because administrators can quickly disseminate information about the risks of excessive drinking to thousands of students. Schools pay $5,000 to $50,000 per year to offer the course, depending on the number of students, and receive survey information on the test takers' drinking habits. The makers of AlcoholEdu, meanwhile, are compiling a massive database on college drinking behavior for researchers to probe.

The course has become a staple of the early weeks of college life for many 18-year-olds, and about 250,000 first-year college students are taking it this fall. Some students have groused about the course on blogs, saying the three hours are a waste of time. "Very few people take it seriously," Phoebe Luong, 18, a freshman at the University of Southern California, said of her classmates.

College administrators who have grappled with campus drinking issues for years said any chatter about the Internet class is good. "If they're complaining together, [they're] creating a buzz about it," said Paula Swinford, director of health promotion and prevention services at the University of Southern California, which is requiring its 3,300 freshmen and transfer students to complete the class. 

The course's effectiveness has not been widely studied, and alcohol-prevention experts said such educational approaches must be combined with other strategies to effectively combat abuse. But earlier this year, a University of Illinois researcher found students who had taken AlcoholEdu reported fewer "negative consequences" related to drinking -- such as missed classes and having unprotected sex -- than those who had not. Some college administrators also have reported positive results.

Outside the Classroom, meanwhile, said its surveys showed students who began the course before arriving on campus were about 20% less likely to engage in binge drinking after starting college.

Warning About Alcohol

AlcoholEdu doesn't tell students not to drink -- one part of the course suggests tactics drinkers can use to avoid alcohol poisoning, such as eating a meal before consuming alcohol -- and instead focuses on warning students about what can happen if they drink excessively. In recent years, high-profile deaths from alcohol abuse at schools such as Colorado State University have illuminated the issue. Alcohol contributed to more than 1,700 deaths of U.S. college students between the ages of 18 and 24 in 2001, according to the National Institutes of Health.

Colleges and universities have had alcohol-education programs for decades, though many tactics have faltered. AlcoholEdu is one of a handful of online programs schools are using – others include e-CHUG, a 15-minute "assessment tool" developed by San Diego State University, and Alcohol Wise, a 90-minute course developed by 3rd Millennium Classrooms. Schools have also taken other approaches: Several large universities are working with local governments and liquor-industry businesses to curtail student drinking by bolstering enforcement of alcohol laws and eliminating drink specials at bars.

AlcoholEdu is no "silver bullet," said Brandon Busteed, the 28-year-old who founded Outside the Classroom five years ago. But it represents a prevention strategy that can be broadly implemented and isn't controversial, unlike banning kegs at fraternity parties, he said. He hopes that widespread use of the program will help change campus culture toward drinking. In addition to the schools, more than a dozen fraternities and sororities -- such as the Sigma Nu fraternity and the Alpha Gamma Delta sorority -- require all new members at all chapters to take AlcoholEdu, and can receive discounts on liability insurance for making it compulsory.

Mr. Busteed was a non-drinker as an undergraduate at Duke University, where he studied public policy, represented students on the Board of Trustees and formed a campus panel that planned social events that didn't involve alcohol. Mr. Busteed hired a team of health experts to develop AlcoholEdu, led by Dr. Richard P. Keeling, a former professor of medicine at the University of Wisconsin.

The 25-employee company, which has been financed by venture capitalists, has yet to turn a profit but expects to do so next year, said Mr. Busteed.

You Will Be Tested

AlcoholEdu takes about three hours to finish (the Web-based course doesn't allow skipping ahead) and is not meant to be completed in one sitting. Students begin by submitting confidential survey information about their behavior, then take a pre-test and study three chapters. After that, they take an exam testing their knowledge of such things as blood alcohol concentration, which activities may increase the odds of a blackout (doing shots or chugging drinks) and whether it's possible to cure a hangover by drinking a small amount of alcohol (it's not). 

During the course, which uses streaming video and audio, students are told that alcohol advertisements on campus "intentionally target underage drinkers" and that beverage companies are "after your money." Students also are told they "don't have to drink to have a good time."

Students are shown several videos of students in drinking situations, such as imbibing the night before an exam, and are asked to consider the consequences. They are also taught to "never leave your drink unattended," because of the risk that someone might slip something into it, such as a date-rape drug.

Schools set their own requirements on how students must score on AlcoholEdu's final exam to pass -- most require students to correctly answer at least 70% of the 40 questions. They also must complete a fourth chapter and another survey about two months after the exam. Schools only know whether a student has completed the class and how he performed on the final exam -- they don't know how individual students have answered survey questions.

Many schools require students to complete the bulk of the course before the first day of classes. Some prevent students from registering for the next semester's classes if they don't finish the course. Others use an "implied mandate:" They tell students they expect them to complete AlcoholEdu but don't necessarily penalize them if they don't. At the University of Southern California, students who haven't taken the class face "much stronger consequences" if they commit an alcohol violation, said Ms. Swinford, the health promotion director. Last year, the first year the school used the class, more than 90% of incoming students finished it.

Extremely Annoyed'

Daniel Medina, 18, a freshman at the University of Southern California, failed the exam the first time and had to retake the course. "Am I the only one who freaking failed the AlcoholEdu? I'm extremely annoyed right now," he wrote on a community blog for USC students. He partly blamed his failure on his browsing of a popular Web site called Facebook, which features profiles of college students, while the audio commentary from AlcoholEdu played in the background.

In an interview, he said he learned important information from the class but found it contradictory at times. "It made a big point that it wasn't trying to judge people and just make you aware of the facts, but I felt it leaned toward abstinence," said Mr. Medina, a business major from Anaheim, Calif. Many students view the class as a chore, and it is frequently panned at campus parties, he said. Students tossing back beers sometimes joke with one another that, "according to AlcoholEdu, I should be having a confrontation with you" by now, he said. 

Jamie Fiorello, 18, a freshman at the University of Scranton in Pennsylvania, said she did not find the course as effective as other education strategies. Far more powerful, she said, were annual talks at her New Jersey high school by a trauma physician who relayed gruesome tales from the emergency room. "No one took AlcoholEdu seriously," Ms. Fiorello said of her classmates. Students are "not going to let an online course influence their decision" about drinking. 

Collecting Data

As part of the AlcoholEdu course, students are surveyed on everything from how much alcohol they had to drink in recent weeks to whether alcohol was used in their households. Students are asked whether in the past two weeks they "skipped a meal to get drunk faster," played "drinking games" or consumed shots. A student who indicates he is a heavy drinker will receive somewhat different information than a student who abstains from alcohol. 

Outside the Classroom aggregates the survey data and sends reports to each school. The company shares its data with academic researchers but has a strict policy of never sharing them with beverage companies. The company asks researchers to sign a "data use" agreement that states they will only use the information for academic studies. The company receives no financial support from the alcohol industry, Mr. Busteed said. (Other approaches to reducing student drinking have been funded by the industry, such as a drink-in-moderation program partly financed by Anheuser-Busch Cos.) 

Thus far, few researchers have explored AlcoholEdu's effectiveness. But there are some signs it may have a positive impact.

Earlier this year, in a study completed for his doctoral dissertation in education at the University of Illinois, Andrew Wall found students who took AlcoholEdu reported 50% fewer "negative consequences" related to drinking than those who had not. The study of 23,000 students analyzed consequences such as missing class, attending class with a hangover, blacking out and vomiting in public.

Dr. Wall, now a researcher at Eastern Illinois University, said the study has yet to be published in a scholarly journal but is under review. He said that while his study showed some positive outcomes, he has been surprised by the rapid adoption rate, given the lack of hard evidence on the program's effectiveness. Still, Dr. Wall said his study showed AlcoholEdu may cause modest changes in drinking behavior. If many schools used such a tool, such changes could add up "to a big change in the campus climate," he said. "That is exciting."

Villanova University, which has required the class for five years as part of a broader program to curb drinking, has seen reductions in the number of fights and instances of abusive behavior related to drinking. In addition, damage to campus residence halls has declined, said Cathy Lovecchio, director of health and wellness education. "I couldn't imagine our program without AlcoholEdu," she said.