Heads Up! Men

Introduction

Heads UP! Men is a multi-faceted intervention that combines several empirically validated approaches to problem drinking reduction (i.e., Motivational Interviewing Strategies, Social Norms Strategies, Decisional Balance, and Relapse Prevention) into one comprehensive program. The format is non-confrontational and non-judgmental; allowing students to both assess their drinking and build motivation for changing their behavior.

The goal of Heads UP! Men is to intervene with high-risk men [(1) freshmen males and (2) men sanctioned by Judicial Affairs for drinking-related violations] to reduce their level of drinking and the incidence of resulting problems. This project also seeks to promote a change in the campus culture with respect to alcohol and its impact on healthy development.

Method

The following initiatives are being conducted simultaneously.

1. Group intervention
1. Judicial Offenders: Male students receiving judicial sanctions for violating university alcohol policies are referred to Heads UP! Men.
2. Freshmen males: During the fall semesters of 2003 and 2004, the program recruited approximately 300 freshmen male students to participate in the group intervention. While Heads UP Men freshmen groups are no longer being run, there will be an opportunity for all incoming freshmen students (males and females) to receive the group intervention during orientation (see Model Program description).
2. Campus Outreach:
1. Along with Heads UP! Women, the program is involved in a variety of campus-wide events and initiatives.
   1.   The implementation of social norms and health education programs targeted to specific organizations on campus (e.g., sororities, service organizations).
   2. Foster campus dialogue on health and alcohol issues through monthly Heads UP! events that will include speakers and discussion. These events will be open to faculty, staff, students, and others in the campus community.
   3. The development of a social norms poster campaign to raise awareness of alcohol and health issues and to provide accurate normative information regarding alcohol use among students.

Evaluation

Specific aims of this intervention include: (1) reduce incidence of alcohol violations in male students receiving intervention as compared to peers and previous underclass records; (2) reduce drinking and problems related to drinking in male students; (3) reduce recidivism of alcohol violations and alcohol poisonings among judicial offenders sanctioned to group intervention.

Procedure: Men participate in one 60-90 minute awareness/motivational enhancement group intervention. Each group is led by facilitators trained in Motivational Interviewing and includes 5-10 participants.

The group meeting consists of obtaining informed consent, a Timeline Followback calendaring of drinking, normative feedback, a decisional balance of drinking less alcohol, BAC discussion, alcohol expectancy challenges, and the setting of behavioral goals.

1. Timeline Followback: Participants complete a Timeline Followback (TLFB, Sobell & Sobell, 1992) of drinking behavior for three months pre-intervention. Though addressed as a group, participants are instructed to complete their TLFB individually. The TLFB allows computation of several significant variables and serves as an intervention by fostering awareness of drinking behavior over the past three months.
2. Normative Reeducation: Normative reeducation consists of highlighting discrepancies between perceptions of normative drinking behavior and actual data for their University community. Participants are also provided with feedback regarding the percentage of time alcohol is involved in incidents of regretted sexual experiences, forced sex, vandalism, and physical violence on campus.
3. Decisional Balance: The decisional balance component of the intervention begins with a group exercise in which participants are encouraged to generate a list of reasons for (Pros) and against (Cons) reducing their current levels of drinking. After the group dialogue, participants are asked to document, on a decisional balance worksheet, the Pros and Cons that resonated with them. Each participant then individually rates the personal importance of each Pro and Con on a scale of 0 (not important) to 10 (extremely important).
4. Blood Alcohol Content: The concept of Blood Alcohol Concentration (BAC) is introduced in such a way that is useful in understanding the effects of alcohol on men’s bodies. To facilitate this discussion, gender and weight specific blood alcohol content cards are distributed to give a specific approximation of typical blood alcohol levels.
5. Expectancy Challenges: Evidence is presented that seeks to challenge the social expectancy effects of alcohol use on an individual. Discussions follow this presentation around the supposed social effects of alcohol consumption (i.e. what someone expects to happen during or after consuming alcohol).
6. Motivational Statement/Behavioral Goal: Participants are asked to write down a behavioral goal for how they will drink in the next 30 days and share it with the group.

Follow-up

Weekly Drinking Diaries: Group participants are required to keep a weekly drinking diary for three months post-intervention. They are asked to record for each day they drink: how many drinks they consumed, if the episode met the criteria for binge drinking, whom they drank with, and where they drank.