September Newsletter
Prevention in Higher Education
Upcoming PTTC Training
Law Enforcement Training - Identifying Drug Endangered Children: A Collaborative Approach
Date:Thursday, September 12, 2019
Time: 8:30 a.m. to 12:00 p.m.
Location: Clinton, IA
Core DEC Awareness - Identifying Drug Endangered Children: A Collaborative Approach
Date:Thursday, September 12, 2019
Time: 1:00 p.m. - 4:30 p.m.
Location: Clinton, IA
Creating Change: Empowering the Leader Within

Date: Thursday, September 26, 2019
Time: 8:30 a.m. - 4:30 p.m.
Location: Kansas City, MO
Mid-America PTTC
The Mid-America Prevention Technology Transfer Center (Mid-America PTTC) is designed to serve as a prevention catalyst, empowering individuals and fostering partnerships to promote safe, healthy, and drug-free communities across Missouri, Iowa, Nebraska and Kansas. Our services are evidence-based, culturally competent, and locally focused. We provide intensive technical assistance to support organizations' and systems' efforts to implement evidence-based prevention strategies. The Mid-America PTTC also forms partnerships with local and regional stakeholders to ensure that the training needs of the region are identified and met.

The Mid-America PTTC goals are to:
  • Accelerate the adoption and implementation of evidence-based and promising substance misuse prevention strategies.
  • Heighten the awareness, knowledge, and skills of the workforce that addresses substance misuse prevention.
  • Foster regional and national alliances among culturally diverse practitioners, researchers, policymakers, funders, and the local communities.
To learn more about our services:  Mid-America PTTC

Event Specific Prevention to Address College Student Drinking

As the fall semester begins for many university students, we’ve focused the newsletter this month on prevention in higher education settings. We’re sharing a summary of the article titled, Event Specific Prevention: Addressing College Student Drinking During Known Windows of Risk 1 that highlights strategies to address drinking during peak-use , high risk events such as new student orientation, homecoming, certain holidays, 21 st birthday celebrations, spring break, and graduation.

When students were asked to keep a diary of their drinking over an academic year, three patterns emerged: (1) drinking varied with time of year and was higher at both the start and end of the academic year (2) drinking varied with day of the week with students drinking four times as much on the weekends as during the week; (3) drinking varied with the event calendar, with consumption at its lowest during exam periods and highest during holidays and special events. Understanding these patterns helps prevention coalition s to identify the best times to implement strategies aimed at reduc ing high risk drinking.
A few interventions that seek to reduce the overall level of drinking by college students have reported some success. However, students will continue to drink at risky levels during events that are culturally or personally significant. Prevention efforts that focus on overall drinking rates should complement event specific strategies that focus on community and personal events.

Other reasons to consider approaching college prevention strategies from this perspective:

  • Community events can spark greater numbers of alcohol related problems off campus which can strain campus-community relations (noise, litter, property damage, alcohol-impaired driving)
  • High profile drinking events may exacerbate students’ misperception of campus drinking norms, which in turn can increase normative pressures to drink heavily on other occasions.
  • Focusing on an alcohol problem tied to a specific event can energize a campus-community coalition, giving it a defined problem to solve. Progress on event-specific prevention can be used as a springboard for a larger prevention effort that leverages the expertise of coalition members in thinking strategically and working together.

A typology matrix introduced by DeJong and Langford (2002) 2 provides a framework for event specific planning that cross walks the social ecological model with key areas of strategic intervention. These key areas include: 1) changing knowledge, attitudes, skills, self-efficacy, and behavioral intentions; 2) eliminating or modifying environmental factors that contribute to problems 3) protecting students from the negative consequences of alcohol consumption (“health protection”); and 4) intervening with students who show evidence of problematic drinking.

This matrix shows that alcohol prevention activities can be addressed at different levels simultaneously. Campus-community coalitions can examine their existing prevention efforts by utilizing the matrix to determine other areas for intervention. The example below demonstrates this:

  • Spring Break – At the institutional level, college administrators organize alternative trips that feature volunteer work. For students remaining on campus they could offer substance-free social events, special one-week courses and tutoring services for students needing additional help. Faculty could be encouraged to schedule exams or papers for the week after spring break. Private institutions could look at banning spring break advertising. At the individual level, administrators could sponsor a social norms campaign to raise awareness of the norms around spring break and parents could be encouraged to visit their children on campus during the vacation week.

As you consider this intervention for your campus, two attributes are important:

  • Perceived drinking norms are likely to be different for specific events than for general drinking
  • Approaches found to be effective for addressing one specific event might be readily modified to address other events that present a similar problem.

We know that college students tend to drink more on the weekends, at the beginning of the year and during special events. In prevention this means we can target these high-risk windows and, recognize both the overlap among specific events as well as each event’s unique features in order to determine the best strategies.
1 U.S. National Library of Medicine National Institutes of Health (2007). Retrieved from
2 DeJong W, Langford LM. A typology for campus-based alcohol prevention: Moving toward environmental management strategies. Journal of Studies on Alcohol. 2002:140–147.
Resources - Prevention in Higher Education
Partners in Prevention

Partners in Prevention is Missouri’s higher education substance misuse consortium dedicated to creating healthy and safe college campuses. This website is filled with research, training and fact sheets.

Read more
AOD in Higher Education Knowledge Community

NASPA’s Alcohol and Other Drug (AOD) Knowledge Community provides an institutionalized and ongoing structure within NASPA to discuss issues around alcohol and other drugs on campus.

Read more
CollegeAIM NIAAA's Alcohol Intervention Matrix

CollegeAIM-the College Alcohol Intervention Matrix-is a new resource to help schools address harmful and underage student drinking. Developed with leading college alcohol researchers and staff, it is an easy-to-use and comprehensive tool to...

Read more
College - Generation Rx

Resources for College Students The Generation Rx University resources were created by college students, for college students, to help prevent prescription drug misuse on college campuses. These materials are designed for use in courses, student...

Read more
More Helpful Links

Nebraska Collegiate Consortium to Reduce High Risk Drinking
Providing support for campuses across Nebraska who are committed to reduce high-risk drinking, the NCC Currently includes 27 institutions of higher education in Nebraska, including private and public colleges and universities as well as community colleges and proprietary colleges. NCC members use strategic and comprehensive environmental approaches to reduce high-risk drinking and the negative effects of excessive alcohol use.

NIAAA College Drinking Resources
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) is one of the 27 institutes and centers that comprise the National Institutes of Health (NIH). NIAAA provides a variety of resources on harmful and underage college drinking, including:   -- a one-stop resource for comprehensive research-based information on issues related to alcohol abuse and binge drinking among college students; a college drinking fact sheet ; and a fact sheet titled  Fall Semester—Time for Parents to Discuss the Risks of College Drinking

Association of Recovery in Higher Education
The Association of Recovery in Higher Education (ARHE) is the only association exclusively representing collegiate recovery programs (CRPs) and collegiate recovery communities (CRCs), the faculty and staff who support them, and the students who represent them. ARHE provides the education, resources, and community connection needed to help change the trajectory of recovering student’s lives. We are a network of professionals, administrators, faculty, staff, students, parents and policy makers.

Prevention Profiles: Take Five - Dr. Amelia M. Arria (University of Maryland)
Dr. Amelia M. Arria, Director of the Center on Young Adult Health and Development and the Office of Planning and Evaluation at the University of Maryland School of Public Health discusses the research on college stimulant use, the connection between students 'stopping out' and drug use, parenting style and its effect on prevention, and much more.

Booklet: Rethinking Drinking: Alcohol and Your Health
This 16-page booklet is available for free download from the National Institute on Alcohol Abuse and Alcoholism for young people about alcohol use. It includes a questionnaire that helps young people to learn about their drinking patterns, symptoms of alcohol use disorder, deciding whether to change and how to make a plan to change. It includes drinking tracker cards and several resources for support.
What's Happening Around the Region?

Regional Podcast Series

Check out the Mid-America PTTC podcast series where you will find a mix of interviews, case studies, and prevention topics geared to help improve your efforts and move you toward success. You can listen and subscribe on any of your favorite podcast platforms.

Podcast: Missouri Partners in Preventio n

Listen here to Mid-America Podcast Episode 6 where we interview Joan Masters, the Senior Coordinator of Missouri’s Partners in Prevention!
2019 Substance Abuse Prevention Conference

November 18-20, 2019
Lodge of Four Seasons
Lake Ozark, Missouri

Make plans now to join us for the 10 th Annual Substance Use Prevention Conference!

ACT Missouri invites preventionists, community coalition members, counselors, law enforcement officers, educators, school nurses, and anyone that works with, or cares for, youth to attend. It will be an information-packed opportunity to enhance prevention efforts, motivate volunteers, share ideas, network with others in the field, and get the latest updates and resources to keep Missouri’s kids safe and substance free!

For more information and to register online please visit our website:
Question to the Field
Each month a question to the field will be posted to generate feedback that will be shared in the following month’s newsletter. The purpose of this section is to share ideas and the work in your tribe, state, or community that would be helpful to others. Please send responses to the question to . These responses will be shared in next month’s newsletter.

What Event Specific Prevention strategies have you implemented in the college-community setting?
Epi Corner

Beverly Triana-Tremain, PhD
Mid-America Prevention Technology Transfer Center
Understanding College-Age Suicidality Through the Incidence-Prevelance Bucket Model

In a study of over 67,000 college students, over 20% indicated such a high amount of stress that they have contemplated suicide. The study was conducted by the American College Health Association and is called the National College Health Assessment (2018). 1
The Centers for Disease Control and Prevention through CDC Wonder 2 analyzes the underlying cause of death by geographic area and age cohorts. CDC Wonder uses the International Diagnostic Classification (ICD) 10 System as a method of organizing etiological mechanisms or causes of why and how people die. Intentional self-harm is one of those classifications and has ICD Codes of X60 to X84.
For this issue, we analyzed data for Intentional Self-Harm for Region 7, consisting of Nebraska, Iowa, Kansas, and Missouri, for 18 to 22-year olds, 3 for the years 2012 to 2017 using these ICD 10 Codes. The results of this analysis for these states is provided in Table 1.
We can understand the results of this analysis using a very simple illustration, the Incidence-Prevalence Bucket. Prevalence is the number of existing cases of a disease or condition during a specified point in time divided by the total population at risk at a given time. It is the existing water in a bucket. (Morton, Hebel, McCarter, 1996) 4 . Table 1 represents the prevalence of death by suicide in Region 7 states.

Incidence is the number of new cases of a disease or condition during a specified point in time divided by the total population at risk at a given time, that is, the raindrops falling into the bucket. If we look at suicide rates for each individual year, we can see new cases (incidence) adding to the overall prevalence of suicide like raindrops falling into the bucket (Figure 1) 5 . Calculating incidence rates is helpful because it allows us to see how the disease changes from year to year, while prevalence rates allow us to compare current conditions across counties, states, regions, sub populations, or other groups.
Figure 1
Expressing incidence and prevalence as rates is important. In Table 1. Nebraska, with 124 suicides and a population of 690,913, has a suicide prevalence rate of 1.8 per 10,000 18 to 22-year olds. Missouri has 374 deaths by suicide but a larger population than Nebraska at 2,062,361, so Missouri has the same prevalence Crude Rate of 1.8 per 10,000.
The idea that anyone, regardless of age, is considering suicide is disheartening. Data is a powerful tool for programs, coalitions, and organizations working to prevent death by suicide.
1 American College Health Association. (2018). National College Health Assessment. Retrieved from
2 Centers for Disease Control and Prevention. CDC Wonder. Retrieved from
3 The age-cohort used is college-age but does not necessarily mean they are enrolled in college.
4 Morton, R., Hebel, J., & McCarter, R. (1996). A study guide to epidemiology and biostatistics. Gaithersburg, MD: Aspen Publications.
5 American Foundation for Suicide Prevention.(2017). Centers for Disease Control and Prevention. Retrieved from