| For most students, college is a learning experience | | | | scheduling two 20-minute sessions and using a |
| that goes well beyond the classroom. More | | | | behavioral change counseling approach. This type |
| freedom and responsibility means more risk, | | | | of counseling is based on motivational interviewing |
| which is borne out in the statistics surroundings | | | | but requires less time to be effective. Most |
| students' use of alcohol. According to the National | | | | students fall into the category of at-risk |
| Institute on Alcohol Abuse and Alcoholism | | | | consumption, which brief interventions are |
| (NIAAA), one in three 18 to 24 year olds | | | | effective at tackling. According to Schaus, |
| admitted to the emergency room is intoxicated, | | | | traditional, longer-term counseling is more |
| and about half of all fatal traffic crashes amongst | | | | appropriate for alcohol use disorders, alcohol abuse |
| this age group involve alcohol. College health | | | | or alcohol dependency. However, usually only five |
| professionals are charged with a duty of care for | | | | to 10 percent of college students fall into these |
| students' health and wellbeing; the somewhat | | | | categories. The challenge, of course, is to |
| daunting task of keeping them safe from | | | | incorporate this into the schedule of a busy |
| alcohol-related injury and death can be seen as | | | | student health center. One tactic for doing this is |
| part of that responsibility. The question is, how | | | | known as the "teachable moment". Schaus |
| can an already-stretched college health center | | | | explains, "If a student presents with a sprained |
| best tackle the continuing problem of harm | | | | ankle because they fell over when drunk, or if |
| related to binge drinking? An increasing number of | | | | they're being tested for an STD because they |
| health professionals, including Dr. James Schaus, | | | | had a high-risk sexual encounter while intoxicated, |
| assistant director for clinical services at the | | | | you can use these incidents as a starting point to |
| University of Central Florida, and principal | | | | talk about alcohol." Additionally, Schaus advises |
| investigator in the NIAAA-funded study entititled | | | | that there should be a dedicated formal screen at |
| "Alcohol Screening and Intervention in a College | | | | initial patient registration at the health center. |
| Clinic", believe the answer lies in a | | | | Making sure that all students have participated can |
| well-implemented program of alcohol screening | | | | be a simple process if your health center has a |
| followed by brief interventions for high-risk | | | | practice management system such as Nuesoft |
| students. The goal of a brief intervention is to | | | | Xpress (TM) . With the click of a button, a list can |
| reduce harm and effect a change in behavior. This | | | | be compiled of all students who have not yet |
| is particularly important for this age group, | | | | been screened, and a follow up letter sent to |
| explains Schaus. "Students are at a pivotal time in | | | | each one. Students can even schedule their own |
| their life," he said. "If you can connect with a | | | | screenings via Nuesoft Xpress' student Web |
| college student on the topic of alcohol and other | | | | portal. Schaus' screening and intervention |
| social and preventative health issues, and get | | | | recommendations seem to be practical ones. Yet |
| them to recognize that there is a problem and | | | | a 2004 article by Foote in Journal of American |
| maybe even do something to change it, you're | | | | College Health indicated that only 32 percent of |
| likely to be affecting their behavior for life." The | | | | college health centers routinely screen and only 12 |
| first step, however, is to screen students for | | | | percent use a standardized, approved screen. |
| high-risk drinking. There are several ways to do | | | | What's more, says Schaus, the majority of these |
| this. The AUDIT or Alcohol Use Disorders | | | | health centers use the CAGE screen (so called |
| Identification Test is a 10 question screen | | | | because it is a mnemonic of the key words from |
| developed and validated by the World Health | | | | each question) which is a screen primarily used to |
| Organization, but there are other, even simpler | | | | detect alcohol dependency rather than at-risk |
| screens also available. Schaus recommends a | | | | consumption. "Apart from the lack of time and |
| single question screen that includes the "5/4" | | | | money, many college health centers feel their |
| definition of high-risk drinking. "If the student is | | | | staff hasn't had adequate training to deliver an |
| male, the question is 'In the last two weeks, have | | | | intervention," says Schaus. "But only eight hours |
| you had five or more drinks in a row?' If the | | | | of training are required for staff to be able to |
| student is female, the figure changes to four or | | | | deliver an effective brief intervention." Educational |
| more drinks in a row." Schaus believes that the | | | | resources are accessible either through the |
| key to successful screening is to take a | | | | BASICS program or the College Drinking |
| non-judgmental, student-centered approach. | | | | Prevention Curriculum developed by the NIAAA. |
| "Alcohol can be a sensitive topic with students. If | | | | This combination of screening and brief |
| you ask them straight out about their | | | | interventions appears to be effective at |
| consumption of alcohol or drugs, you're not likely | | | | identifying at-risk students and changing their |
| to get an honest answer," he said. "But if you use | | | | behavior significantly. "At 12 months out from our |
| a motivational interview style and approach the | | | | initial study, we're seeing a lasting effect," said |
| subject on their terms, making sure you're | | | | Schaus. Not only did the study show statistically |
| non-judgmental in the way you deal with it, they | | | | significant reductions in all eight alcohol |
| feel more comfortable." This style of interviewing | | | | consumption outcomes (including peak blood |
| can be applied to substance abuse, eating | | | | alcohol count and number of drinks consumed in |
| disorders and a range of other problems. In fact, | | | | one sitting); it also showed reductions in alcohol |
| claims Schaus, when you use this approach, you | | | | related harms including driving after three or more |
| can often end up discussing other important | | | | drinks, taking foolish risks and physical injuries. |
| problems that the student didn't initially plan on | | | | Those college health centers with Nuesoft Xpress |
| broaching. If the student has a positive experience | | | | can use the clinical study feature to track the |
| talking about these sensitive topics, it also makes | | | | effectiveness of their own alcohol prevention |
| it more likely that they will return to the health | | | | program over time. As the results of studies such |
| center if they have a problem in the future. Once | | | | as Schaus' become publicized, more college health |
| you've identified the high-risk students, the next | | | | centers will find a way to implement these types |
| step is to conduct a brief intervention. As the | | | | of screenings and brief interventions, making |
| name suggests, it doesn't have to be time | | | | high-risk drinking on campus less prevalent and |
| consuming. There have been a number of studies | | | | helping to safeguard students. |
| delivered by counselors suggesting that even | | | | Cassie Harman writes for NueMD ( ), a provider |
| very brief sessions - as little as five minutes - can | | | | of medical billing software. This article previously |
| reduce harm. Schaus suggests, if possible, | | | | appeared in the Nuesoft Xpress e-nues . |