According to social learning theory (Bandura, 1977), for which there is extensive empirical support, individuals’ behaviors are strongly influenced by what they perceive to be normative in the culture of the groups to which they belong. During the 1980s, researchers began to recognize that there are substantial misperceptions about the amount of drinking that occurs among college students (Perkins & Berkowitz, 1986). This led to a realization that it might be possible to reduce actual drinking simply by reducing these misperceptions, thereby lowering a strong perceived pressure to drink. Some sophisticated social marketing programs have been developed to help college students understand that, despite all the reports they have heard about student alcohol use, the norm for alcohol use among college students is actually moderation rather than excess (Haines, 1996; Johannessen et al., 1999).
A logical deduction from social learning theory is that approaching a problem by exaggerating its magnitude may backfire. If, in the process of advocating for the need to address a risky behavior, we begin to give the impression that it is more common than is actually the case, we may well contribute to misperceptions about normative behavior. There is a sense among many university health professionals that the heavy media focus on student drinking may have begun to have this effect. Headlines in the national media about student deaths from alcohol poisoning (a tragic, but extremely rare, event) are routinely juxtaposed with findings from questionnaire surveys indicating that a substantial proportion of students report having had four or five drinks on a single occasion. Unfortunately, the phenomenon reported in surveys (usually labeled in the media as "binge drinking") is not synonymous with the kind of behavior that results in alcohol poisoning. What is missed in typical reports and discussions of student alcohol use is that the excessive behaviors that make for good on-air footage and flashy headlines are extremely rare as a proportion of all student behavior and, indeed, of all student drinking behavior.
The social norms approach to reducing excessive drinking focuses on helping individuals (in this case college students) to recognize the reality of student drinking. It is not (directly) prescriptive, but rather is informative. In order to be effective, this approach cannot single out specific groups. It must focus on the entire student body. Because the actual amount of drinking and, therefore, normative drinking are less than believed, simply persuading all students to understand the misperception should reduce pressures to drink for those who are light or non-drinkers. The simple facts about student drinking provide social support for those who don’t drink or who drink occasionally and lightly, since they are in the clear majority. At the same time, this information should help to remove the perceived social support for the behavior of those who drink frequently and heavily, since they are a small minority.
Because of the way this approach works to reduce drinking, neither individuals nor particular groups are singled out directly. Thus, although males were found to drink more than females, they are not treated separately from females on campus. Similarly, although members of Greek social organizations were more likely to drink than non-Greeks, there was no need to focus on them as different. Indirectly, all groups (and individuals) are targeted by virtue of the message. If their drinking behavior is "typical," then the message about what is normative among students on the campus helps to support that behavior. On the other hand, if their drinking behavior is heavier than typical, then the message tends to single them out as just that: atypical. In so doing, it brings implicit social pressure to bear on them to bring their behavior more in line with that which is normative on the campus. Hence, people are implicitly singled out, but the focus is low-key and is based on their behavior rather than their membership in any group or social category.
In view of evidence about the usefulness of the social norms approach, we developed such a program for the UNC-CH campus. Numerous conversations with the developers of two of the best known and most carefully evaluated programs (at Northern Illinois University [Haines, 1996] and the University of Arizona [Johannessen et al., 1999]) helped guide development of the UNC-CH program. The UNC-CH program is distinctive in that data on student drinking norms were drawn from a much larger survey than those at Northern Illinois and the University of Arizona (nearly 2,000 vs. several hundred students) and includes objective data on alcohol use in addition to self-reports of drinking. It also draws heavily on successful elements of programs developed elsewhere.
A central concept of a norms program is to avoid directly telling students what they ‘should’ be doing. Rather, by highlighting and getting students to accurately perceive the true norm, the program relies on their understanding of the norm itself to tell students what they "should" be doing (in this case, moderate or no drinking). Extensive "market-testing" (see below) was done with students as we refined the basic message to ensure that students understood the message to mean what was intended: that drinking among UNC-CH students is not nearly so prevalent as most everyone (including students) seemed to think. As a result, individuals need not feel a pressure to drink.
The most telling single fact that emerged from the BAC survey data is that, on what are considered to be the prime "party nights" (Thursday, Friday and Saturday), fully two-thirds of all students returning home late at night had a zero BAC.
We had a two-fold objective for the message:
This required working closely with students in the development of potential messages, the refinement of messages and the selection of support information. Six rounds of testing the general concept, the content, the specific wording and the physical layout led finally to the primary message:
"Whether it’s Thursday, Friday or Saturday Night,
2 out of 3 UNC Students Return Home
with a .00 Blood Alcohol Concentration"
and the secondary message:
"Most of those who drink have four or less"
Students were asked to react to "2 out of 3 UNC students return home with a .00 BAC" and "most of those who drink have four or less" as primary messages. Feedback indicated that the "four or less" message meant differing things to students, with some thinking that four represented a low number of drinks and others thinking it was a lot. The .00 BAC message was viewed as a stronger, clearer message. However, special care was needed to ensure that the fact was presented in a believable manner since it was such a departure from the common beliefs about drinking among students.
As a result of student feedback, the ".00 BAC" fact became the primary message. The "four or less" fact was included as a secondary message to dispel the notion that the other one third were ‘drunk.’
This feedback process also provided insight into how individuals might discount the message. For example, some individuals mentioned that students probably lied about their drinking or that we must have collected data at the wrong times or places to reach the drinkers. To deal with this potential scepticism, each message was accompanied with the additional reminder that this was not mere self-report data, but actual BAC data obtained from a breath sample: "It’s not what they say, it’s what they blow." In addition, following the recommendation of Haines (1996), the scientific underpinning for this information was always cited:
"Based on Fall 1997 breathalyzer data
between 10 p.m. and 3 a.m., as students returned home
to fraternities, sororities, residence halls, and off-campus apartments"
A logo was developed (see Figure 3.1) to enhance message recognition and unify program elements. The logo was incorporated into all program materials and displayed during news conferences and presentations.
The program had four main components:
The objective of this component was to present the alcohol fact to all new students at UNC and to make them aware that knowing this fact would enable them to win prizes during the fall semester. All incoming students must attend a summer orientation session known as CTOPS (Carolina Testing and Orientation Program Sessions). Many of these students are accompanied by their parents. Through the efforts of the Vice Chancellor for Student Affairs, this project was incorporated in the opening general session (the best attended session and the only one with both parents and students present). This enabled us to present the message to virtually the entire target population. Crafting a presentation that would maximize this opportunity was crucial for future message recognition. We also remembered the caution students had given us to present the message as credibly as possible.
Methods for enhancing credibility included using young HSRC staff (closer in age to the target audience) to present the message, avoiding any appearance of lecturing or telling the students what to do and incorporating comments from students already attending UNC into the presentation. An unpolished video was produced that was a compilation of comments from students on campus. The amateur nature of the video was important because we did not want students to perceive this to be a slick public relations piece. We wanted it to appear as it was – uncut comments from real students. In the video, randomly stopped students were asked what are the party nights at UNC and their responses were recorded (see Figure 3.2). Then the students were told the .00 BAC fact and asked if it was believable.
Clip from video showing students
being interviewed about drinking at UNC-CH
At the opening general session for each CTOP session, a blue, yellow or pink card was given to each parent and student entering the auditorium. Two-thirds of the people received blue cards. A majority of the rest received yellow cards. Following her welcoming remarks to new students and their parents, the Vice Chancellor for Student Affairs introduced the two young representatives from HSRC. They explained that they wanted to tell the audience one fact about drinking on the UNC-CH campus. They then showed the first half of the video with students reporting that Thursday, Friday and Saturday were prime party nights. Then the video was stopped and all the students and parents holding the blue cards were asked to stand (see Figure 3.3). They were asked to look around the auditorium and were told that they represent the proportion of students returning home on Thursday, Friday or Saturday night with a .00 BAC. Those with yellow cards (representing students who consumed four or fewer drinks) or pink cards (representing heavier drinkers) were then asked to stand. Audience reaction clearly indicated surprise about the small proportion representing drinkers. Next, the second part of the video was shown, presenting student reactions to the fact (most of whom indicated that it sounded about right to them; a few also commented that it was encouraging). Finally students were given a card with the "2 out of 3" fact and told that knowing it would be worth cash during the upcoming semester (see Figure 3.4). The three ways in which students might win or earn a cash reward (poster, sticker, simply knowing the fact) were briefly explained.
Interactive demonstration of the "2 out of 3" fact
at new student orientation session.
Card handed to students and parents
as a reminder of the "2 out of 2" fact.
The full presentation lasted approximately 10 minutes. Ten orientation sessions were held during the summer, beginning in late May. Average attendance at these sessions ranged from approximately 300 to 600; in each case the audience was approximately 60% students and 40% parents.
The concept for the poster campaign was to encourage students to keep the message visible – to themselves and others – by offering cash incentives for students randomly "caught" with posters in their rooms. It was important for the posters to be attractive enough for students to be willing to display them and distinctive enough to break through the visual clutter commonly found in student rooms.
Poster displayed in common areas of residence halls.
The posters were designed in an unusual format (white on black, 8" X 22"). Two posters were developed. One, which emulated those developed at Northern Illinois University and the University of Arizona (featuring students depicted in local scenes), was posted in common areas around campus, including residence halls (see Figure 3.5). The other, which shows the "2 out of 3" message on the marquee of a local landmark theater along the strip adjacent to campus (see Figure 3.6), was placed on the bed of each incoming freshman student prior to their arrival. These were accompanied by a note explaining that during the upcoming semester, rooms would be visited randomly and if the poster was displayed in a visible location, the occupants of the room would be given $50 on the spot. The purpose of offering rewards was to ensure that the simple normative information was widely displayed in locations where students would be likely to see it, as opposed to limiting it only to public areas where a plethora of other materials would compete. Again, we used student feedback to determine the incentive. Not surprisingly, cash had the greatest appeal.
While the poster campaign was limited to first year students, the remaining program elements were designed to reach all students. Given the great mixture on campuses, it is not possible to create a belief among first year students if the rest of the students are unaware, or are in disagreement. Hence, although the initial program focus was on first year students, others needed to be addressed as well.
The sticker incentive campaign called "$1 if you know it, $5 if you show it," was another means to make knowledge of the fact valuable to students. Stickers with the "2 out of 3" logo were given out on campus with the explanation that during fall semester a UNC prize patrol would be randomly stopping students on campus. If students could state the alcohol fact to the prize patrol, they would win a dollar on the spot; if they had the sticker somewhere visibly on them (on their book bag, notebook, etc.) they would win five dollars on the spot. Stickers were distributed at the campus bookstore during the beginning of the semester. They were also handed out by the roving prize patrol to students who were stopped and were unfamiliar with the campaign. In addition, a cut-out version of the sticker was included in the ads in the campus newspaper. The sticker is shown in Figure 3.7. Throughout the fall semester, project team members visited various locations on campus where students congregate, stopping randomly selected individuals and groups to ask if they had the sticker or, if not, whether they knew "the Alcohol Fact." Rewards were distributed accordingly. The sticker campaign was designed to generate word-of-mouth dissemination of the "2 out of 3" fact, as well as to increase visibility of the "2 out of 3" fact among students.
at various campus locations
The messages of the program and the winners of the incentive campaigns were publicized through the various media that students use. Media exposure included hard news stories about the results of the data collection, advertisements in the campus newspaper, and the development of a program web site.
News conference. To boost the coverage of the normative message and to reach out to the general public, returning students and their parents, we held a news conference to announce the findings of the survey, focusing on the "2 out of 3" fact (http://www.hsrc.unc.edu/pubinfo/alc_breath.htm). The Vice-Chancellor for Student Affairs, the Student Body President and representatives of the program development team all spoke briefly. This generated widespread coverage in the state and attracted national attention as well. We believe this coverage was particularly important in that it was a way to disseminate information widely to the general public in North Carolina, the population from which most UNC-CH students are drawn. In addition to coverage in the daily print media, the program was also covered in the Carolina Alumni magazine, reaching an important target audience not often thought to be relevant to campaigns concerning student alcohol use.
Newspaper Ads. Large ads were run periodically in the student newspaper to alert students to the fact that the program to reward individuals for carrying the sticker and knowing the "alcohol fact" was under way (see Figures 3.8 through 3.10). Although student newspapers typically have high readership and are a highly cost effective way to reach college students (Johannessen et al., 1999), these ads were used mainly as reinforcers to complement the other channels. However, they were also included as part of the program to help spread the message throughout the entire student body.
First student newspaper advertisement.
Second student newspaper advertisement.
Third student newspaper advertisement.
Web site. A web site was created to provide feedback to students to ensure they realized that we were following up on the promise to reward students for having the poster up in the rooms. Pictures of weekly winners were posted on the site (see Figure 3.11). The web site also provided basic information about the program for those who may not have learned about it elsewhere. The web site address was included on all program materials.
Screen shot from web site showing feedback
made available to students about the "2 out of 3" program
A particular strength of basing the norms program on data from BAC surveys is that they are highly visible to students. In contrast to typical mail questionnaire surveys, which are invisible to nearly everyone except the participants, when BAC survey data are being collected, a large majority of the student population becomes aware of the survey. The first data collection, which provided the facts for the development of the messages, occurred in the Fall of 1997, prior to any program activity. The second round of data was collected in the Fall of 1999, after the majority of the students had been exposed to the alcohol fact. Three teams per night moved around campus to collect data. As a result, a substantial proportion of students actually participated and many more saw interviews in progress. Hence it was more difficult to deny the validity of results from such a survey than it was to question the results from a relatively small mailed questionnaire survey. It is likely that the high visibility of the data collection contributed both to the overall awareness of the program and the credibility of the fact.