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Intervention Summary

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Training for Intervention ProcedureS (TIPS) for the University

Training for Intervention ProcedureS (TIPS) for the University is a training designed to help college students receiving the training make safe, sound decisions regarding their own high-risk drinking behavior (e.g., underage drinking, drinking to intoxication, drunk driving) and enable them to intervene to prevent this high-risk behavior among their peers and friends. Because these students may be in the best position to understand peer culture related to college drinking, they are encouraged to act as change agents for their peers, both on and off campus. TIPS for the University provides the trained students with specific guidance for detecting when peers have had too much to drink or are getting into trouble with alcohol and teaches them strategies and skills for identifying how and when to intervene in alcohol-related situations.

Following the basic tenets of social learning theory, the intervention consists of three modules: (1) an informational module relying heavily on student and trainer manuals that includes information about alcohol and other drugs, alcohol's effects, and jurisdiction-specific laws related to alcohol; (2) a skills-building module using video vignettes that emphasizes the skills needed to recognize when an intervention is indicated and then implement such an intervention; and (3) a behavioral rehearsal module in which students practice intervention skills they have discussed and observed in the skills-building module. The three modules are delivered over one 2-hour session by trained and certified professionals to a group of up to 30 participants.

Although the program was designed for male and female college students, the study reviewed for this summary involved only male fraternity members. In addition, the study reviewed for this summary assessed the drinking behavior of study participants but did not assess whether study participants influenced the drinking behavior of other students.

Descriptive Information

Areas of Interest Substance abuse prevention
Substance abuse treatment
Outcomes Review Date: April 2011
1: Alcohol consumption
Outcome Categories Alcohol
Ages 18-25 (Young adult)
Genders Male
Races/Ethnicities American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or other Pacific Islander
White
Settings School
Geographic Locations Urban
Suburban
Rural and/or frontier
Implementation History The intervention was first implemented in 1985. More than 1,200 college campuses in all 50 States have implemented the program. In addition, the program has been used by entities outside of higher education, such as branches of the U.S. Armed Forces and high schools. Approximately 10,000 TIPS for the University sessions have taken place, with more than 150,000 students certified.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No
Evaluated in comparative effectiveness research studies: Yes
Adaptations No population- or culture-specific adaptations of the intervention were identified by the developer.
Adverse Effects In Caudill et al. (2007; see Quality of Research), students who participated in the standard intervention (a 3-hour version of TIPS for the University), relative to those who completed assessments only, had a higher rate of increase from baseline to 18-month follow-up in self-reports of total drinks consumed and peak blood alcohol concentration (BAC) in the past 28 days.
IOM Prevention Categories Selective

Quality of Research
Review Date: April 2011

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Caudill, B. D., Luckey, B., Crosse, S. B., Blane, H. T., Ginexi, E. M., & Campbell, B. (2007). Alcohol risk-reduction skills training in a national fraternity: A randomized intervention trial with longitudinal intent-to-treat analysis. Journal of Studies on Alcohol and Drugs, 68(3), 399-409.  Pub Med icon

Outcomes

Outcome 1: Alcohol consumption
Description of Measures Alcohol consumption was assessed using a computerized version of an Alcohol Timeline Followback calendar that focused on drinking behavior during the past 28 days. Participants were given a 28-day calendar with special events (e.g., Halloween) indicated. After reviewing the calendar, they entered any special events, functions, parties, or other activities during this time that were personally unique and estimated the number of drinks they consumed on each day. Students were also asked to identify the length of time they took to consume the specified number of drinks for each drinking occasion. Based on these data, a variety of measures of alcohol use were constructed: (1) number of drinking days (frequency of alcohol consumption), (2) days consumed five or more drinks (frequency of heavy drinking), (3) days consumed eight or more drinks (frequency of drinking to intoxication), (4) consumption of five or more drinks on at least three occasions in the past 2 weeks (frequent heavy drinking), (5) total drinks consumed during the past 28 days, (6) average BAC on drinking days, and (7) peak BAC on any day.

Assessments were conducted at baseline and at 6-, 12-, and 18-month follow-up. They were timed to occur in the fall at least 30 days after summer break and in the spring at least 30 days after spring break to avoid potential anomalies in student drinking practices (e.g., dips or spikes in drinking) associated with breaks from school.
Key Findings Ninety-eight chapters of a national fraternity were randomly assigned to one of three conditions: the standard intervention consisting of training in a 3-hour version of TIPS for the University, the enhanced intervention consisting of the standard training plus 1.5-hour booster sessions 5 and 11 months after baseline, or an assessment-only control condition consisting of existing university policies and procedures. Analyses controlled for year in school.

From baseline to 6-month follow-up, students receiving the standard intervention, compared with those in the control group, had significantly steeper declines in the frequency of alcohol consumption (p < .05), heavy drinking (p < .05), and drinking to intoxication (p < .05), and in the total number of alcoholic drinks consumed (p < .05). These differences dissipated by the 12- and 18-month follow-ups. Further, students receiving the standard intervention, compared with those in the control group, had a higher rate of increase from baseline to 18-month follow-up in the total number of alcoholic drinks consumed (p < .05).

When comparing students receiving the enhanced intervention with those in the control group, no significant differences were found in the frequency of alcohol consumption at any of the follow-ups. No significant differences between these groups were found in the frequency of heavy drinking, frequency of drinking to intoxication, or number of alcoholic drinks consumed at the 6- and 12-month follow-ups, but students receiving the enhanced intervention had a steeper increase than control group students for all three of these indicators from baseline to 18-month follow-up (p < .05 for frequency of heavy drinking; p < .001 for frequency of drinking to intoxication and number of alcoholic drinks consumed).

The analysis also examined drinking patterns among the 64.2% of students in the sample who self-reported frequent heavy drinking at baseline. Frequent heavy drinkers receiving the standard intervention, compared with those in the control group, had steeper declines in the frequency of alcohol consumption from baseline to 6-month follow-up (p < .05) and baseline to 18-month follow-up (p < .05). Those receiving the standard intervention also had steeper declines in the frequency of heavy drinking (p < .05), frequency of drinking to intoxication (p < .05), and number of alcoholic drinks consumed (p < .05) from baseline to 6-month follow-up, but these differences were no longer significant at the 12- and 18-month follow-ups.

Similar results were found when comparing frequent heavy drinkers receiving the enhanced intervention with those in the control group. Among frequent heavy drinkers, those receiving the enhanced intervention, relative to those in the control group, had steeper declines in the frequency of alcohol consumption (p < .05), heavy drinking (p < .05), and drinking to intoxication (p < .05) from baseline to 6-month follow-up, but these differences were no longer significant at the 12- and 18-month follow-ups. No differences between these groups were found in the number of alcoholic drinks consumed at any of the follow-ups.
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.2 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 18-25 (Young adult) 100% Male 95.3% White
5% Hispanic or Latino
2.1% Asian
1.6% Black or African American
0.6% American Indian or Alaska Native
0.4% Native Hawaiian or other Pacific Islander

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures
Validity
of Measures
Fidelity Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Alcohol consumption 3.2 3.7 2.3 2.9 3.5 4.0 3.2

Study Strengths

The Timeline Followback is widely used and accepted as a reliable and valid measure of alcohol use. Data were collected in a confidential setting using audio-enhanced, computer-assisted self-interviewing procedures, which have been shown in some research to improve the self-disclosure of personal information. To support fidelity, implementation included certification of the trainers in a 1-day train-the-trainers workshop and use of a student and trainer manual and video vignettes. Differential attrition between the groups was handled using advanced multilevel modeling techniques. The randomized block design accounted for fraternity chapter differences in the presence of off-campus housing options and local variations in drinking patterns. The evaluators took steps to reduce the influence of drinking fluctuations by timing the assessment periods 30 days after summer and spring breaks. On the 17 baseline variables examined, no differences were found between the standard intervention and control group; only 2 differences were found between the enhanced intervention and control group, and these variables were included as covariates in analyses. Analyses were comprehensive and used an intent-to-treat design with a very large sample. The use of mixed-effects regression models took into consideration the complexities of the data (e.g., the nested data structure).

Study Weaknesses

Test-retest reliability of the Timeline Followback instrument was not measured with study participants. Because the self-administered Timeline Followback instrument may have lacked the level of probing commonly used with the interviewer-administered version, unreliable reporting may have resulted. No collateral data sources (e.g., records of infractions, reports from fraternity staff) were used to verify data on self-reported drinking behavior. The presentation of information and rehearsal of behavioral skills could have varied across trainers, and no systematic efforts were made to monitor the fidelity of the training conducted by the numerous trainers at the 57 standard and enhanced intervention sites. Between baseline and the follow-up assessments, researchers did not document student participation in other interventions, which could have occurred, in particular, with high-risk drinkers who may have committed infractions or enrolled in alcohol counseling.

Readiness for Dissemination
Review Date: April 2011

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Chafetz, M. E., Bellack, A., Donovan, M. C., Constantine, L. M., Chafetz, M. E., Barkan, A., et al. (2009). TIPS for the University: Trainer supplement. Arlington, VA: Health Communications.

Chafetz, M. E., Bellack, A., Donovan, M. C., Constantine, L. M., Chafetz, M. E., Barkan, A., et al. (2010). TIPS for the University: Participant manual. Arlington, VA: Health Communications.

Health Communications, Inc. (2009). TIPS for the University [DVD]. Arlington, VA: Author.

Health Communications, Inc. (n.d.). TIPS: Equip, educate, empower. Reduce alcohol-related incidents on your campus by providing students with the skills they need [brochure]. Arlington, VA: Author.

Program Web site, http://www.gettips.com

Other materials:

  • Hosting a TIPS Workshop
  • Multiple Site Information Form--University Sites
  • Obtaining and Using TIPS Participant Exams
  • Sign-in sheet for TIPS workshops
  • TIPS Customer Support Contacts
  • TIPS for the University Closed Workshop--Requirements and Agreement
  • TIPS for the University: Program Syllabus
  • TIPS Product Order Form
  • TIPS: Trainer Policies
  • TIPS: Trainer Procedures
  • TIPS Training Portal: Manage and Monitor Your TIPS Training
  • TIPS University Program: University Participant Exam
  • TIPS University Trainer Workshop Exam
  • TIPS: University Train-the-Trainer Workshop Agenda
  • TIPS Workshop Registration Form

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
3.3 4.0 3.5 3.6

Dissemination Strengths

Implementation materials clearly explain the program's components. The program content is engaging, and the training session allows students to practice new skills. The program Web site provides implementation resources, training information, and a training management tool for implementers. Certified master trainers deliver all implementer training workshops, and on- and off-site training is available. Each implementer is assigned to an account manager who assists and coaches him or her with content, procedures, policies, and general customer service inquiries. An outcome tool for both implementers and students is provided to support quality assurance. Implementers are required to obtain annual recertification, a process that can be completed online.

Dissemination Weaknesses

While the materials describe how the program would fit into certain campus organizations, it does not give guidance on how to implement the program at a campus-wide level that includes all students. The characteristics of a successful implementer, including communication and interpersonal skills, are not discussed. No system is in place to monitor students' interactions with peers.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description Cost Required by Developer
Student participant manual (includes grading and processing of certification exam and evaluation as well as a certification card valid for 3 years) $13 each Yes
1-day, on- or off-site train-the-trainer workshop (includes trainer kit with trainer supplement and student DVD, processing of certification exam, and trainer certification card valid for 1 year) $225 per participant, with a minimum of seven participants Yes
Trainer recertification via online exam $75 per participant Yes, one recertification option is required
Trainer recertification via paper exam $100 per participant Yes, one recertification option is required
Trainer recertification via trainer workshop $125 per participant Yes, one recertification option is required
Training and support documents and resources Free Yes
Web-based training management tool Free Yes
Access to account manager (includes phone consultation and email support) Free Yes
Trainer policies and procedures documents Free Yes

Additional Information

Implementation sites hosting an on-site workshop may permit participants from other institutions to attend. Discounts are available for on-site workshops and bulk purchases.

Replications

No replications were identified by the developer.

Contact Information

To learn more about implementation or research, contact:
Trevor Estelle
(800) 438-8477 ext 357
estellet@gettips.com

Consider these Questions to Ask (PDF, 54KB) as you explore the possible use of this intervention.

Web Site(s):