Efficacy of interventions targeting alcohol, drug and smoking behaviors in university and college students: A review of randomized controlled trials.

OBJECTIVE: To evaluate the effectiveness of interventions targeting alcohol consumption, drug use and smoking for college/university students. PARTICIPANTS: College/University students. METHODS: Studies were eligible if: (1)included students attending universities/colleges; (2)implemented in a university/college setting; (3)aimed to improve at least one of the following behaviors: alcohol and/or drug use and/or smoking; (4)were RCTs. The effect of the interventions on behaviors was determined by the percentage of studies that reported an effect. Due to the heterogeneity of outcomes meta-analysis was not conducted. RESULTS: 88 studies met criteria. University-based interventions were effective for reducing alcohol-related outcomes (drinking patterns, BAC, consequences, problem drinking). Inconsistent findings for drug and smoking were observed. CONCLUSIONS: University-based interventions have the potential to improve health for students. While there is a breadth of research examining the efficacy of interventions to reduce alcohol consumption, further research is needed to determine the best approach for addressing smoking and drug use among students.

Alcohol-related harm minimization practices among university students: Does the type of residence have an impact?

BACKGROUND: The culture of 'risk-related alcohol use' has been identified as an intrinsic part of university life for many students, especially those in residential colleges in English-speaking countries. While the prevailing approach to managing drinking in these countries is harm minimization, little is known about students' uptake of these practices or the relationship of them to students' type of residence. OBJECTIVE: To examine the ways in which type of residence may impact alcohol-related harm minimization practices among university students. DESIGN: A qualitative research design using focus group methodology informed all aspects of the study. METHODS: University students (N = 70) aged 18-24 years and differentiated by their type of residence were recruited from universities in Australia. Nineteen audio-recorded focus groups were conducted. Systematic qualitative analysis was used to identify the main themes. RESULTS: Students reported risk-related alcohol use and alcohol-related harms as either consumers or having witnessed others' consumption through three main themes: (1) The pervasiveness of alcohol use and harms; (2) Perceived safety and physical spaces; and (3) Gender-based alcohol-related harms. Harm minimization practices were talked about in terms of four themes: (1) Policy ineffectiveness; (2) Pre-drinking planning; (3) Friends look after friends; and (4) Help-seeking as a covert activity. CONCLUSIONS: Alcohol use by university students occurs with limited knowledge of harm minimization policies or practices. Students do engage in ad hoc harm minimization practices usually developed during their first year at university through specific 'drinking cultures' that are constituted by various factors including their type of residence. Statement of contribution What is already known on this subject? Previous research has strongly indicated that university students' heavy alcohol consumption is linked with social and environmental factors such as marketing alcohol, low cost, availability, 'wet' environments, and shared accommodation. However, little is known about what, if any, alcohol-related harm minimization practices students employ and if type of residence has an impact on these practices. What does this study add? This study is one of the first to examine alcohol-related harm minimization practices among university students and type of residence demonstrating the impact of social environments on drinking and related practices. Regardless of type of residence, university students were either not aware of university and residential college alcohol policies or found them unclear. Students do engage in ad hoc harm minimization practices usually developed during their first year at university through specific 'drinking cultures' that are constituted by various factors including the type of residence. Two practical recommendations are made in this study to develop alcohol-related harm minimization related to university students.

Australian university smoke-free policy implementation: a staff and student survey.

Issue addressed Universities represent important settings for the implementation of public health initiatives such as smoke-free policies. The study aimed to assess staff and student attitudes towards policy enforcement and compliance as well as the acceptability of the provision of cessation support in this setting. Methods A cross-sectional study was conducted following the introduction of a designated-areas partial smoke-free policy at two campuses of one Australian university in 2014. Staff (n=533) and students (n=3060) completed separate online surveys assessing attitudes towards smoke-free policy enforcement and compliance, and acceptability of university-provided cessation support. Results Students held significantly stronger beliefs than staff that the smoke-free policy required staff enforcement (69% vs 60%) and violation penalties (67% vs 60%; both P's <0.01); however, most staff (66%) did not believe enforcement was part of their role. Only 55% of student smokers were aware that the university provided any cessation support. 'Free or cheap nicotine replacement therapy' (65%) and 'free stop smoking counselling service' (60%) were the most popular strategies student smokers thought the university should provide. Conclusions University staff and students hold conflicting views over the need for policy enforcement and who is responsible for enforcement roles. Students view the university as an acceptable setting for the provision of smoking cessation support. So what? Where staff are expected to enforce smoke-free policies, specific education and training should be provided. Ongoing monitoring of compliance and enforcement behaviour appears necessary to avoid the pervasive kind of non-compliance to smoke-free policies that have been seen in other settings.

A taste of ethical consumption at a slow food festival.

This paper examines the motives and experiences of attendees at a Slow Food festival to gain an understanding of how people engage with ethical consumer projects. Slow Food is a global social movement aimed at promoting food that is regionally, ethically, and sustainably produced, and convivially consumed. The movement uses culinary tourist events, such as food festivals and farmers' markets, to promote its philosophy and attract new members. There have been no empirical studies of ethical consumption using a Slow Food event as a case study. This study uses an ethnographic approach and a framework of virtue ethics to explore the views of people attending a major Slow Food festival in the city of Melbourne, Australia. Semi-structured interviews were conducted in situ with 33 participants (19 consumers and 14 stallholders) to discover their rationales for attending the festival, and their perspectives on ethical consumption. Transcripts were coded and thematically analysed, resulting in three themes reflecting varying degrees of public virtues (altruistic motivations) and private virtues (personal wellbeing): the quest for virtuous lifestyles through ethical consumption, the importance of co-production, and the challenges of putting ethical consumer projects like Slow Food into daily practice. The findings reveal the manner in which virtue ethics affects foodways and highlights the contingent and challenging nature of practising ethical eating.

Effectiveness of interventions targeting physical activity, nutrition and healthy weight for university and college students: a systematic review and meta-analysis.

To examine the effectiveness of interventions aimed at improving physical activity, diet, and/or weight-related behaviors amongst university/college students. Five online databases were searched (January 1970 to April 2014). Experimental study designs were eligible for inclusion. Data extraction was performed by one reviewer using a standardized form developed by the researchers and checked by a second reviewer. Data were described in a narrative synthesis and meta-analyses were conducted when appropriate. Study quality was also established. Forty-one studies were included; of these, 34 reported significant improvements in one of the key outcomes. Of the studies examining physical activity 18/29 yielded significant results, with meta-analysis demonstrating significant increases in moderate physical activity in intervention groups compared to control. Of the studies examining nutrition, 12/24 reported significantly improved outcomes; only 4/12 assessing weight loss outcomes found significant weight reduction. This appears to be the first systematic review of physical activity, diet and weight loss interventions targeting university and college students. Tertiary institutions are appropriate settings for implementing and evaluating lifestyle interventions, however more research is needed to improve such strategies.

Effectiveness of interventions targeting health behaviors in university and college staff: a systematic review.

OBJECTIVE: Evaluate the literature on interventions targeting tertiary education staff within colleges and universities for improvements in health behaviors such as physical activity, dietary intake, and weight loss. DATA SOURCE: One online database, Medline, was searched for literature published between January 1970 and February 2013. STUDY INCLUSION AND EXCLUSION CRITERIA: All quantitative study designs, including but not limited to randomized controlled trials, quasi-experimental studies, nonrandomized experimental trials, cohort studies, and case-control studies, were eligible. DATA EXTRACTION: Data extraction was performed by one reviewer using a standardized form developed by the researchers. Extraction was checked for accuracy and consistency by a second reviewer. DATA SYNTHESIS: Data in relation to the above objective were extracted and described in a narrative synthesis. RESULTS: Seventeen studies were identified that focused on staff within the tertiary education setting. The review yielded overall positive results with 13 reporting significant health-related improvements. Weight loss, physical activity and fitness, and/or nutrition were the focus in more than half (n = 9) of the studies. CONCLUSION: This appears to be the first review to examine health interventions for tertiary education staff. There is scope to enhance cross-disciplinary collaboration in the development and implementation of a "Healthy University" settings-based approach to health promotion in tertiary education workplaces. Universities or colleges could serve as a research platform to evaluate such intervention strategies.

Indonesian men's perceptions of violence against women.

This article explores male perceptions and attitudes toward violence against women in Indonesia. It analyzes interview data from Indonesian men collected as part of a large multimethod Australian government-funded project on masculinities and violence in two Asian countries. Reluctance to talk about violence against women was evident, and the accounts of those men who did respond referred to three justificatory discourses: denial, blaming the victim, and exonerating the male perpetrator. The findings support continuation of government and nongovernmental organization (NGO) projects aimed at both empowering women and reeducating men.

The effect of social class on mid-age women's weight control practices and weight gain.

The prevalence of obesity and weight gain is higher in the working class, but we know little about class differences in practices used to control weight. This study examined associations between self-reported measures of social class (upper, middle, or working class), weight control practices, and weight among a cohort of 11,589 mid-aged women (aged 47-52) participating in the Australian Longitudinal Study on Women's Health (ALSWH). A multivariate model tested whether mean weight change over a two-year period differed by social class after adjusting for area of residence, age, education, baseline BMI, and smoking. Working-class women gained significantly more weight at 1.27 (0.07) kg (95% CI: 1.12-1.42) over 2 years, compared with middle/upper-class women at 1.01 (0.07) kg (95% CI: 0.88-1.15). They were significantly more likely to use potentially harmful weight control practices than middle/upper-class women (8.9%) (Chi-squared test=30.65, p<0.0001), and less likely to meet physical activity recommendations. The study provides longitudinal evidence from a nationally representative sample of women that social class is related to weight gain, and to certain weight control practices. The findings have implications for the development of weight gain prevention programs for socially disadvantaged groups.

Managerialism in the Australian public health sector: towards the hyper-rationalisation of professional bureaucracies.

This paper draws on qualitative case-study research to discuss the impact of managerialism on the work organisation of public sector health professionals in Australia. The case studies included 71 semi-structured interviews with a broad range of public sector health professionals (predominantly nursing and allied health professionals, with some doctors and managers). The data are used to examine the implications of managerialism for the organisation of professional (public) bureaucracies. The findings show that while health professionals were able to exert their agency to influence managerial processes, the incorporation of managerial strategies into professional practice placed constraints upon professional autonomy. The impact of managerialism on professional bureaucracies is examined using the neo-Weberian framework of hyper-rationality, an ideal type derived from a combination of four forms of rationality identified in Weber's work: practical, formal, substantive and theoretical rationality. Applied to the social organisation of health-care work, this paper critically examines the utility of the hyper-rationality ideal type, noting its limitations and the insights it provides in conceptualising the impact of managerialism on professional (public) bureaucracies.