More than ever before, preventionists on college campuses are called to attend to the needs of a wide range of students, including those from underrepresented or historically marginalized groups. This is because college student populations are diversifying rapidly, as many students who previously would be unable to attend college now are accessing postsecondary education. Given broadening access to college, some undergraduate students arrive on campuses with few resources and little support, which may place them at risk for challenges to their health and well-being, including an increased risk for substance misuse.
From past research, we know that certain groups of college students are more likely to use substances than other groups. For example, studies support higher illicit drug use and misuse among men compared to women, and higher use among White and Latinx college students than among Asian and African American students. Also, students who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ) have been found to use and abuse substances at higher rates than heterosexual, cisgender students. Because certain groups are at risk for problematic use compared to others, college health and prevention professionals can benefit greatly from implementing culturally tailored interventions to effectively reach these at-risk groups.
One-size-fits-all prevention approaches fall short of engaging students equally, evidenced by disparities in use of campus resources among at-risk populations. However, despite calls for culturally tailored, responsive interventions, few exist in the literature and in practice. Making current interventions more culturally tailored or responsive does not necessarily mean reinventing the wheel, and small changes might pave the way toward broader reach to students who are less likely to access prevention programs and initiatives.
Making Our Prevention Efforts More Culturally Responsive: Key Strategies
1. Consider using inclusive language practices by attending to language preferences and differences among students.
Resources printed and presented in languages other than English, such as Mandarin and Spanish, may be more likely to resonate with groups on campus who are less inclined to access traditional prevention resources.
2. Include a representative body of students in programming and marketing efforts.
If posters, flyers, and other media materials advertising campus drug abuse prevention and health and well-being initiatives include students representing diverse backgrounds, some students who might not have considered the resource may give it a second thought when the person advertising it looks like them. For campuses that engage in social norms campaigns, having students who represent varied groups also can create stakeholder engagement among diverse communities who might engage with fellow students on the topic and increase awareness of actual versus perceived norms, as well as the availability of campus resources. When developing media materials focused on prevention, be sure to include students who are representative of the broader student population demographics. When working with student groups with lower rates of drug use, focus on promoting protective behaviors and resilience in messaging and marketing.
3. Invite student groups you are trying to reach to the prevention table.
Inviting student representatives from diverse groups who can tell you how access can be improved for students like them goes a long way toward addressing disparities in service access and the prevention of risk. For example, a focus group of LGBTQ-identified students may expose gaps in reach that were previously not apparent.
Beyond public health interventions inclusive of specific groups, another effective way to intervene with college student health risk behaviors is through the implementation of evidence-based and evidence-informed peer education and peer assistance strategies delivered by students who themselves represent diverse, underrepresented, and marginalized groups. At the University at Albany, the Middle Earth Peer Assistance Program implements culturally responsive models of peer education and prevention across its hotline, peer wellness coaching, and peer wellness ambassador services by actively recruiting and training students from diverse, underrepresented, and historically marginalized backgrounds to deliver services under our professional supervision.
Because we have diverse representation among our peer educators, Middle Earth peers design and present programs using their own rich perspectives informed by their cultures, and the result is inclusive programming that constantly is developing and changing to meet the needs of the widest cross-section of University at Albany students. For example, our campus-based hotline now delivers services in both English and Spanish. Also, a recent workshop developed by Middle Earth students on the mental health needs of students who identify as pansexual, bisexual, or heterofluid included student members from our LGBTQ community in all phases of the program development, implementation, and evaluation process. Normally, traditional prevention models might not reach or resonate with such a group on campus, and yet on our campus, with Middle Earth peer educators leading the charge, we are less likely to leave these groups out, and we make a visible commitment to addressing the health of all students in our campus community. Not only will such inclusion enhance and promote quality programming, but also it will give a clear message to our students that our campus prevention organization offers an understanding and safe home for them.
Greater reach and more access to programs and services that promote health and well-being for our underrepresented and historically marginalized student groups is possible—and the task for us as health professionals and preventionists is to lead with social justice-oriented models that are inclusive and responsive and to learn from our students with humility and openness.
Melissa Ertl is a doctoral candidate in the Counseling Psychology program at the University at Albany-State University of New York. She also serves as the Senior Graduate Assistant within the Middle Earth Peer Assistance Program, where she trains and supervises undergraduate student members in culturally responsive service delivery using a social justice-informed public health framework. Melissa is actively engaged in academic research on how intersectionality of identity relates to health-related quality of life, health risk behaviors, and health disparities among historically marginalized populations.