Process of Delivering Peer-Based Alcohol Intervention Programs in College Settings, The

Alcohol is routinely cited as the most pervasively misused substance on college campuses (Dawson, Grant, Stinson, & Chou, 2004). To meet the objectives set forth by the U.S. Department of Health and Human Services to reduce binge drinking among college students to 20% by 2010, empirically based selective prevention and intervention programs targeting students who are already drinking are essential.

Individually based motivational interventions have been shown to be able to reduce alcohol use among heavy drinking college students (Borsari & Carey, 2000). To reach more students, peer counselors have been substituted for trained professionals to implement these interventions (Larimer & Cronce, 2007; Salovey & D'Andréa, 1984). Benefits of this approach are supported by Astin (1993) who noted peers influence a variety of topics (social issues, substance use) where changes tend to shift toward the dominant view of the peer group. Ender and Newton (2000) identified peer providers as having the capacity to be as effective, or more effective, than professionals at delivering some services.

Training, supervision, and evaluation serve as key components of successfully implemented peer counseling interventions (Hatcher, 1995; Salovey & D'Andréa, 1984). Studies have shown significant reductions in drinkingrelated outcomes when examining peer based programs in a controlled research environment where rigorous methods are used to train, assess competence, supervise, and evaluate (Larimer et al., 2001). These steps ensure standardization and fidelity of implementation and delivery of the intervention. Despite these documented essential preparation components, no known studies have examined alcohol peer counseling program implementation used in practice on university campuses. The focus of this study is to examine the level of similarity between the controlled research-based peer counseling intervention approaches and interventions conducted in practice on college campuses. The following questions guide the research:

1. What are the training methods?

2. What are the peer competency methods?

3. How are peers supervised?

4. How are program outcomes evaluated?

METHODS

Participants

An email invitation was sent to 878 individuals at Network member institutions (The Network, 2006), and 252 surveys were completed of which 44 respondents (17%) reported using peer alcohol counseling services. The mean student body at the respondents' institutions was 7,577 (SD = 8,073). The majority were 4-year public institutions (54%), followed by private 4-year schools with no religious affiliation (27%), and 4-year religious institutions (14%). Of these 44 institutions, 90% identified using a peer-delivered version of BASICS (BASICS is a skill based curriculum aimed at reducing harmful alcohol consumption and negative consequences for students who drink alcohol; Dimeff, Baer, Kivlahan, & Marlatt, 1999).

Measures

The questionnaire, focusing on assessments of training (intervention model being used and training methods), competency (qualifications to conduct interventions), supervision (types/ time of supervision), and program evaluation (alcohol assessments), is provided in Table 1.

RESULTS

Peer Counselor Training

The reported modal training time for peer counselors was 10 hours which is similar to the 8-12 hours of didactic training peer counselors received in research protocols (Larimer et al., 2001). The range identified was 3 to 100 hours, showing large differences in training time. Over 60% of programs reported conducting training in several sessions over a few weeks, and one third conducted trainings over one weekend.

Specific skill training included practice using open-ended questions (77.3%), reflective listening exercises (75%), and role plays (72.7%). Almost all programs incorporated alcohol content and other drug information (86.4%). Many programs included motivational interviewing skills (47.7%) and stages of change models in training (40.9%).

Competency

Peer counselors were required to meet a threshold level of competency before meeting with clients in 29% of the programs; of these, 52.3% used peer counselor reports, live supervision (43.2%), or review of audio tapes (5%) to gauge adherence to intervention protocol. In contrast, 27.3% reported completion of the training program was sufficient to meet with clients.

Supervision

Supervision of peer counselors was being implemented in just over half of programs (56.8%); of these, 40.9% were conducted weekly, 11.3% monthly, and 11.3% semester/quarterly. The mean time spent per supervision meeting was 45 minutes (SD = 22). The most common approach involved peer counselors providing self-reports of their session to their supervisor (34.1%) followed by review of audio or visual tapes with their supervisor (11%).

Evaluation

Program effectiveness was evaluated most commonly by use of pre/post alcohol knowledge tests of clients (22.7%), followed by tracking participants' alcohol use (15.9%). Approximately 84% of programs did not examine client drinking behaviors post intervention.