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Report Title:	Anti-Drug Research - Topline Report
*Abstract:*	Past anti-marijuana advertising has faced a challenging audience among teens, who are a naturally skeptical audience given the deluge of advertisements they’ve encountered in their short lifetimes. The purpose of this research was to identify ways to replace past anti-drug advertising strategies with campaigns that are fresh, motivating, and aware of teen’s current impressions of and experiences with drugs.
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Agency:	Other
Date of Report:	6/17/2003

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Report Title:	Addressing Cardiovascular Health in Asian Americans and Pacific Islanders: A Background Report
*Abstract:*	To promote cardiovascular health among AAPIs, the NHLBI has launched the ASPIRE for Healthy Hearts Project. This project seeks to develop model cardiovascular outreach efforts or activities which utilize strategies that are targeted to AAPI cultures, language, and traditional beliefs. As part of the assessment phase, this background report was developed to examine the needs and opportunities for cardiovascular health promotion for AAPIs. It provides an overview of the status of cardiovascular disease among AAPIs and shares knowledge gained from successful community-based projects across the country. Experience from these projects suggests that a family-based approach to health promotion is an important component of effective outreach strategies for AAPIs. In addition, it provides important program planning information (Appendices A-C) for those who are interested in promoting heart health in their communities.
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Agency:	NIH:National Heart, Lung, and Blood Institute
Date of Report:	1/31/2000

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Report Title:	Cardiovascular Risk in the Vietnamese Community
*Abstract:*	Asian Americans and Pacific Islanders (AAPIs) are the fastest growing racial/ethnic group in the United States. They have varying socioeconomic characteristics, levels of acculturation, immigration history, and health profiles. The AAPI population is extremely diverse; its members have ancestral ties to approximately 50 Asian and Pacific Islander nations. Heart disease is the leading cause of death among these groups, but its impact on each group varies. The National Heart, Lung, and Blood Institute (NHLBI) worked in partnership with the Asian & Pacific Islander American Health Forum (Health Forum) to conduct an assessement of the cardiovascular health status of four AAPIs groups nationwide. The Vietnamese community is the second of four Asian American communities studied. Other populations included in this assessment are Filipinos in Daly City and San Francisco, California; Native Hawaiians in Moloka'i, Hawaii; and Cambodians in Lowell, Massachusetts. This report focus on the Vietnamese community in Houston, Texas. Three formative research methods were used to study this community: 1) focus groups with staff and volunteers from a local community service agency; 2) key informant interviews with community leaders; and 3) indepth interviews with community residents conducted by trained bilingual facilitators. This report provides insight into the Vietnamese community's perceptions and knowledge of heart disease, and motivations to making lifestyle changes. Results of this study indicate that while Vietnamese in the United States are concerned about their overall cardiovascular health, they have little to no knowledge about heard disease or its risk factors. Many are new immigrants and do not seek proper health care services because of language barriers, confusion over the American health care system, financial difficulties, and time constraints. Intervention programs need to incorporate the values and traditions of the Vietnamese culture, be community-based, and start with the basics of taking care of one's heart health and mental health, including making good food choices and managing stress.
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Agency:	NIH:National Heart, Lung, and Blood Institute
Date of Report:	3/1/2003

4

Report Title:	Cardiovascular Risk in the Cambodian Community
*Abstract:*	Asian Americans and Pacific Islanders (AAPIs) are the fastest growing racial/ethnic group in the United States. They have varying socioeconomic characteristics, levels of acculturation, immigration history, and health profiles. The AAPI population is extremely diverse; its members have ancestral ties to approximately 50 Asian and Pacific Islander nations. Heart disease is the leading cause of death among these groups, but its impact on each group varies. Although few studies exist on the cardiovascular health of Cambodians in the United States, several studies suggest that they are at high risk for cardiovascular disease (CVD) based on their lifestyle behaviors. The National Heart, Lung, and Blood Institute (NHLBI) worked in partnership with the Asian & Pacific Islander American Health Forum (Health Forum) to conduct an assessement of the cardiovascular health status of AAPIs. The Cambodian community is the third of four AAPI populations studied. The other populations studied are Filipinos, Vietnamese, and Native Hawaiians. This report focus on the Cambodian population. Three formative research methods were used to study the Cambodian communities: 1) focus groups with staff and volunteers from a local community service agency, 2) key informant interviews with community leaders, and 3) indepth interviews with community residents conducted by trained bilingual (English and Khmer) facilitators. This report provides insights into the Cambodian community, its perceptions and knowledge of heart disease, and motivations to making healthy lifestyle changes. Results from this study indicate that Cambodians in the United States are at high risk for developing CVD. Stress from acculturation and financial problems, as well as mental health problems are primary issues that plague this refuree population. Nevertheless, the need for healthy eating habits, regular checkups with a health care professional, physical activity, smoking cessation, and other heart healthy practices are important concerns identified by the community. Health education interventions for Cambodians should focus on primary prevention of heart disease risk factors and behavior modifications.
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Agency:	NIH:National Heart, Lung, and Blood Institute
Date of Report:	4/1/2003

5

Report Title:	High-Risk Drinking in College: What We Know and What We Need to Learn -- Final Report of the Panel on Contexts and Consequences
*Abstract:*	In recognition of the serious and sometimes fatal consequences of alcohol consumption among college students, the National Advisory Council on Alcohol Abuse and Alcoholism, National Institutes of Health, established two panels of nongovernment experts to help the Institute develop a national research agenda to better address the problem. The panels included college presidents and administrators, well-known alcohol researchers, and students. The two panels are Contexts and Consequences (Panel 1) and Prevention and Treatment (Panel 2). This report represents the work of the Panel on Contexts and Consequences and is based on 12 commissioned, peer-reviewed papers by experts in the field and extensive discussion among panel members and the authors of the papers. It focuses on what is known about drinking in college and its consequences and on gaps in knowledge that need further study. The report also places a special emphasis on heavy drinking, including binge drinking, because of its potentially serious consequences. High-Risk Drinking in College: What We Know and What We Need To Learn An Entrenched Problem Alcohol use on college campuses is not a new problem; it has been documented in the United States for at least 50 years. However, recent concerns have centered on heavy episodic drinking, a potentially dangerous practice often termed “binge drinking,” and usually defined as consuming five drinks or more in a row for men and four drinks or more in a row for women. According to this definition, about two out of five college students have engaged in binge drinking in the past 2 weeks. An additional two out of five college students drink—but not to excess—while one in five does not use alcohol at all. In recognition of the serious and sometimes fatal consequences of alcohol consumption among college students, the National Advisory Council on Alcohol Abuse and Alcoholism, National Institutes of Health, established two panels of nongovernment experts to help the Institute develop a national research agenda to better address the problem. The panels included college presidents and administrators, well-known alcohol researchers, and students. The two panels are Contexts and Consequences (Panel 1) and Prevention and Treatment (Panel 2). This report represents the work of the Panel on Contexts and Consequences and is based on 12 commissioned, peer-reviewed papers by experts in the field and extensive discussion among panel members and the authors of the papers. It focuses on what is known about drinking in college and its consequences and on gaps in knowledge that need further study. The report also places a special emphasis on heavy drinking, including binge drinking, because of its potentially serious consequences. Because colleges vary widely in their drinking rates, it would be inaccurate to characterize all colleges as having an equally urgent drinking problem. But among college students who do drink heavily, the problem is serious: the two out of five students who engage in binge drinking risk a wide range of alcohol-related consequences, including grave injuries and death. Student Alcohol Consumption: Multiple Influences The Panel found that on many college campuses, heavy drinking is interwoven overtly or subtly throughout the culture of the institution. As a result, students perceive this drinking pattern as the social norm rather than as unhealthy and potentially destructive behavior. Research consistently shows that there is no one cause of excessive alcohol use by college students, and the Panel thought that it would be naive and misleading to adopt a simplistic view of, or approach to, this problem. College student drinking is the product of many factors working together. Among them are: Students’ value systems and personalities; Students’ expectations regarding alcohol’s effects (whether good or bad); Genetic predisposition, often reflected in a family history of alcoholism; Roles and influence of family background and peers; Social integration of drinking into college life; Social context in which drinking takes place (e.g., on- or off-campus parties, on- or off-campus bars); Marketing mechanisms such as reduced-price drink specials and promotional efforts; Economic availability of alcohol, including its retail price and the amount of students’ disposable income; Legal availability of alcohol; Social and institutional structures, including law enforcement; and Public policy. Developmental processes: Drinking problems among college students are also closely tied to developmental processes. Binge drinking rates are lower at younger ages, increase in later adolescence, and drop off in the mid-twenties. The college years are a time of transition, involving challenges and changes in identity, social relationships, and living arrangements. However, these transitions also affect noncollege peers, suggesting that what is often interpreted as a campus-based problem may be attributable, in part, to the broader social and biological processes that characterize late adolescence and early adulthood in general. Factors such as greater personal freedom and independence, greater involvement in social and dating relationships, and freedom from the responsibilities of marriage and family life appear to be intricately linked to greater alcohol involvement. Elevated drinking levels: College drinking occurs at a stage in life when drinking levels are generally elevated. The age period from 19 to 24 is associated with the highest prevalence of periodic heavy alcohol consumption during the life span (Johnston et al., 2001b). Although, on average, college students may drink on fewer occasions than their noncollegiate peers, they drink heavily (e.g., five or more drinks in a sitting) on a more frequent basis than nonstudents, placing them at especially high risk for the consequences of heavy consumption. Preexisting drinking problems: Because colleges and universities are the social institutions that help many youth make the transition from adolescence to adulthood, they often become the playing field on which the developmental problems of this life stage, including alcohol misuse, unfold. Panel members pointed out that the drinking patterns of some college students represent the continuation of behavior that began during high school or even earlier. When these problems emerge at age 18 or 19, they are labeled “college problems,” although they may actually be “high school” or “middle school problems.” Viewed from this perspective, while the college experience may serve to “identify” or, in some cases, amplify excessive drinking, it does not necessarily cause it. Aspects of campus life supporting drinking: Research does, however, suggest that there are aspects of certain college environments that may support or facilitate drinking among students. These factors include commingling of students under the legal drinking age of 21 with those who can drink legally, substantial amounts of unstructured time, and student-oriented alcohol advertising. College student drinkers: Research shows that: Male college students tend to drink more than female college students; White college students tend to drink more than their African-American and Hispanic peers; Members of fraternities and sororities tend to drink more than students who do not participate in the Greek system; College athletes tend to drink more than peers who are not involved with campus-based sports; and As a group, college students are less likely to use drugs than their noncollege peers. College students vary greatly in their use of alcohol and their beliefs about its positive and negative effects. Studies show that two major drinking patterns appear dominant among college students: (1) drinking related to impulsivity, disinhibition, and sensation-seeking; and (2) drinking to manage negative emotional states, such as depression. Multiple Negative Consequences The negative consequences of excessive drinking can be severe for both those college students who drink and those around them. Personal consequences: Students who drink heavily may experience a range of personal consequences that include missing class, academic difficulties, dropping out of school, problems with friends, health problems, and unprotected or unwanted sex. Excessive use of alcohol can also increase the likelihood that students will engage in high-risk sex, behave aggressively, or perpetrate or experience sexual assault. These consequences are highlighted because they can have severe, long-term repercussions including contracting a sexually transmitted disease, becoming pregnant unintentionally, developing an arrest record, or living with the emotional devastation caused by rape. Research clearly demonstrates that heavy alcohol use by college students is associated with high-risk sexual behavior. Alcohol impairs information processing and reasoning and heightens the salience of simple cues to action (such as sexual arousal) while blunting the more distal consequences of behavior (such as the risk of HIV infection). Students who drink excessively are two to three times more likely to have had multiple sexual partners in the past month than those who drink responsibly. Similarly, drinking on a first date is associated with a twofold to threefold increase in the probability of having sex on that date. Data also show that alcohol and physical and sexual aggression are linked. Aggressive college students tend to drink more, but it may also be that heavier use increases the likelihood of aggression. At least 50 percent of college student sexual assaults are associated with alcohol use. Typically, both parties in such situations have been drinking when the sexual assault occurs. Alcohol-related sexual assault is underreported, primarily because of the misplaced shame and stigma that surround this violent and personal crime. In addition, approximately one in three 18- to 24-year-olds admitted to emergency rooms for serious injuries is intoxicated. Heavy alcohol use is also associated with homicides, suicides, and drownings. The link between excessive alcohol consumption and unsafe driving is well known. About one-half of all fatal traffic crashes among those aged 18 to 24 involve alcohol; many of those killed in this age group are college students. Alcohol can slow a driver’s reaction time, affect concentration, interfere with steering, and impair response to pedestrians and traffic signs and signals. Secondhand effects: Noise and property damage, vomit, and unsightly litter are common byproducts of a night of binge drinking on campus. Some researchers term these consequences “secondhand effects,” because they are similar to the secondhand smoke from tobacco use (Wechsler et al., 1998). More than one-half of college administrators from schools with high levels of excessive drinking report problems with vandalism and property damage. In addition, students who drink excessively are more likely to physically or sexually assault other students. The College Scene Today, there is much heterogeneity in college experiences; only about 13 percent of all undergraduate students live on campus, and 35 percent are enrolled part-time. Some first-year students who live on campus may be at particular risk for alcohol misuse. Anecdotal evidence suggests that the first 6 weeks of enrollment are critical to first-year student success. Because many students initiate heavy drinking during these early days of college, the potential exists for excessive alcohol consumption to interfere with successful adaptation to campus life. Unfortunately, many alcohol prevention programs do not target this early, critical, high-risk situation. College organizational factors are also related to student drinking. For example, historically Black colleges and women’s colleges tend to have lower rates of alcohol use, while colleges with a Greek system and colleges that place a heavy emphasis on athletics tend to have higher rates of alcohol use. Commuter colleges and 2-year institutions tend to have lower alcohol consumption rates than noncommuter schools and 4-year institutions. In terms of size, students at smaller colleges tend to drink more than students at larger schools. U.S. laws require that colleges and universities that receive Federal funding develop an alcohol and drug education policy. In addition to laws, ethical and social obligations dictate that college administrators develop an alcohol policy that is consistent with the institution’s own culture, mission, and values. The Panel noted that once drafted and adopted, an institution’s alcohol policy should be respected and consistently enforced; it should be wholly supported by the college president, students, faculty and staff, and the neighboring community, including law enforcement officers. Factors that may be external to the campus can also affect college student drinking. For example, alcohol pricing and the density of liquor outlets have been shown to influence consumption by college students. Generally, the lower the price and the higher the concentration of bars and retail outlets near campus, the higher the alcohol consumption by college students.
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Agency:	NIH:National Institute on Alcohol Abuse and Alcoholism
Date of Report:	4/1/2002

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