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

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'Andrea, 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'Andrea, 1984). Studies have shown significant reductions in drinking-related 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. 1. What are the training methods?

2. 2. What are the peer competency methods?

3. 3. How are peers supervised?

4. 4. How are program outcomes evaluated?

Table 1.

Survey Questions

Question	Responses
Training
What is the model being used for the alcohol intervention?	BASICS; CHO ICES; Harm-Reduction Model; Stages of Change Model
How many hours of training do peer counselors complete?	Open
What types of training methods are used to train peer counselors?	Role plays; Rolling w/ resistance; Practicing open ended questions; Reflective listening
Competency
Does your institution use a threshold of competency for peer counselors before allowing them to see clients?	Yes; No; Unsure
What is the instrument/evaluation used to gauge this level of competency?	MITI; MISC; Subjective evaluation
What determines if a peer counselor is ready to conduct an intervention?	Open
Supervision
What types of supervision are used in training?	Audiotape; Videotape; Counselor self-reports
What types of counseling skills feedback are provided to peer counselors?	Written; Verbal; Individual while watching/ listening to tapes; Group
On average how long is each supervision session?	Open (minutes)
Evaluation
In what ways is the program evaluated?	Tracking participants' drinking; Participants' satisfaction survey

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...