Alcohol and Other Drug Prevention on College Campuses: Using Staff and Student Perspectives to Improve our Services

College staff member and student

Alcohol and Other Drug Prevention on College Campuses: Using Staff and Student Perspectives to Improve our Services

-Ashley Helle, Ph.D.

Ashley HelleRecent data shows college student drinking rates and binge drinking remains high, and cannabis use is on the rise in recent years. Given this, alcohol and other drug misuse prevention on college campuses remains a top priority for many student affairs professionals. However, even with the best intentions and strong efforts from our student affairs professionals on campus, many students do not seek or receive services for their alcohol and substance misuse, and there are real-life barriers to the implementation of prevention, treatment, and recovery programs.

In partnership with one statewide higher education prevention coalition, our research team sought to understand the barriers faced by student affairs professionals working in these spaces. Over the past four years, we have worked alongside implementers and administrators who provide alcohol and other drug misuse prevention, treatment, and recovery services for college students. We have also heard from college students about their perceptions and hypothetical openness to these services. Collectively, we have gained knowledge in some important domains that inform recommendations for the field.

Barriers to Implementing Evidence-Based AOD Misuse Prevention Strategies

Our work with prevention professionals and their leaders has culminated in six key drivers of effective implementation of evidence-based alcohol prevention.

1.      Adequate Resources: Access to sufficient resources and staff capacity to carry on the prevention work is essential and is often lacking given larger contextual barriers (e.g., funding climate, workforce shortages).

2.      Evidence for Programs: An important consideration when selecting evidence-based programs for AOD misuse prevention is the evidence base for the approach. Additionally, campus staff indicated another important form of evidence from their perspective comes in the form of hearing what has worked well for other campuses.

3.      Student Needs and Preferences: Understanding student body needs through annual assessments and using effective student engagement approaches were identified as key determinants of selecting successful AOD misuse prevention programming.

4.      Collaboration: Working with other departments on campus, as well as partners at other campuses and within their larger communities can advance effective implementation through sharing of resources, tasks, and ideas.

5.      Institutional Priorities: The tension between proactive and reactive responses to AOD-related events and prevention needs on campus was identified as a primary driver in the implementation process. Campus responses to large events as well as general messaging through longstanding traditions and networks (e.g., athletics, alumni) play a role in the program selection and implementation process.

6.      Leadership Readiness, Engagement, and Buy-In: Our findings supported the idea that leadership buy-in and support is important to program adoption, implementation, and sustainment over time; however, our assessment of tangible leadership support for the implementation process was “lukewarm” from the perspective of the staff members. For example, one-third of the professionals surveyed indicated their leadership recognition of the high-risk alcohol problem on campus was in the preplanning or vague awareness phase, indicating early stages of readiness to implement alcohol misuse prevention. Specific implementation leadership domains were also rated moderately, with the domain for leadership planning and addressing implementation barriers rated the lowest relative to other leadership domains (e.g., supportive leadership). Concurrent to some of these gaps in leadership support, fewer than half of those surveyed indicated they feel as though they have the autonomy to make choices in the space of implementation of alcohol misuse prevention programs. These findings highlight the need for additional leadership support specifically in the implementation process and alcohol misuse prevention realm.

Student Perspectives on AOD Services on Campus

Consideration of staff barriers and needs related to leadership development is important to the “behind the scenes” work of AOD misuse prevention. However, as our partners in higher education prevention have pointed out – understanding and applying our student perspectives is a vital part of the AOD misuse prevention process. Recent work from our group indicated that students are generally open to talking with informal sources (e.g., friends, family) and individual therapy about their alcohol use compared with other options such as medication or group therapy. Students who used alcohol and/or alcohol and cannabis reported past treatment-related services with mental health professionals as opposed to substance-specific professionals. This points to the need for integration of services across offices on campus, rather than only offering these services from substance prevention or treatment staff. Among students that used both alcohol and cannabis, there was more openness to alcohol-focused interventions, pointing to a potential open door to meeting students where they are at while also having opportunities to discuss the use of multiple substances and risk reduction strategies.

Recommendations For Your AOD Misuse Prevention Team

Collectively, our work to understand the barriers and facilitators for our staff and the perspectives of our students have shaped several relevant recommendations for campuses to consider:

1.      Consider your staff needs and perspectives when conducting your campus needs assessments: Inclusion of student behavior and needs around alcohol and other drug use is important. Another critical evaluation is the capacity of your staff to select and deliver the best fitting evidence-based programs. A team and implementation climate assessment can highlight key areas for building capacity to hone your efforts in a resource-limited environment (e.g., Are more staff members needed? Does your team need training on a new approach?).

2.      Build capacity around your unique barriers on campus: With more information about your team needs, planning for your AOD misuse prevention approaches with an intentional focus on your implementation process and team can set you up for success and sustainability.

3.      Engage your leaders in the implementation process: Going beyond leadership support toward having a leader who is a champion for the work can make a big difference in your program implementation. Engaging leaders early and often and keeping an eye on alignment between the staff and leadership can be one way to work toward this goal.

4.      Select evidence-based practices for AOD programming: Although staff value the evidence-basis behind AOD programs, most staff surveyed in our work did not use existing tools that could be useful in selecting effective programs and many campuses implement ineffective programs. Consider use of the College Alcohol Intervention Matrix (CollegeAIM), for example, to identify best practices that can work for your campus.

5.      Continually consider student perspectives in your program and planning implementation: Engaging students across the process of selecting and delivering programs can provide important insight and buy-in from the “end-user” perspective. Our programs aim to serve students, and they should be at the table. Engaging our students and subject matter experts in evidence-based alcohol and other drug misuse prevention can be an optimal way to ensure program fidelity while also meeting our students where they are at.

This work was funded by the National Institutes of Health, Award K08AA028543; PI: Helle). The funder had no influence on the findings of this work.

The work summarized in this View from the Field is from:

Helle, A. C., Masters, J., Washington, K. T., Sher, K. J., Cronce, J. M., Kilmer, J. R., & Hawley, K. M. (2025). Adoption and Perceptions of the College Alcohol Intervention Matrix (CollegeAIM) Among Professionals in a Higher Education Statewide Prevention Coalition. Prevention Science, 1-13.

Helle, A. C., Washington, K. T., Masters, J., Sher, K. J., Aarons, G. A., & Hawley, K. M. (2025). Implementation science in higher education: Identifying key determinants in the selection of evidence-based alcohol and substance prevention and treatment. Journal of Substance Use and Addiction Treatment, 170, 209617.

Helle, A. C., Boness, C. L., Masters, J., & Sher, K. J. (2024). Alcohol and cannabis co-use: Receptiveness to treatments and application to intervention planning. Journal of student affairs research and practice, 61(1), 86-102.

Helle, A. C., Boness, C. L., & Sher, K. J. (2022). College students’ receptiveness to intervention approaches for alcohol and cannabis use. Psychology of Addictive Behaviors, 36(2), 157.

Dr. Ashley Helle is an Assistant Research Professor at the University of Missouri, licensed clinical psychologist, and Director for Engagement at the Missouri Center for Addiction Research and Engagement. Dr. Helle's work applies implementation science approaches to understand and reduce barriers for student health professionals working in substance misuse prevention in higher education settings. She does this work in close collaboration with campus professionals and the Missouri Partners in Prevention statewide coalition. Dr. Helle also works as an evaluator and implementation specialist for the SAMHSA Addiction Technology Transfer Center Mid-America Region and Network Coordinating Office. In addition to her research and evaluation work, Dr. Helle provides training and tailored support to health providers and educators in evidence-based practices for substance prevention and early intervention.