As college students exhibit higher rates of risky drinking and substance use than their non-college counterparts, government agencies and research institutions have sought to identify and disseminate evidence-based strategies (EBSs) for alcohol and other drug (AOD) prevention and treatment. Nonetheless, there remains a paucity of empirical investigation into how such strategies are selected, adopted, and implemented within higher education. To address this gap, implementation science frameworks, notably EPIS (Exploration, Preparation, Implementation, Sustainment), have garnered heightened attention. Anchored in the EPIS model, this study aims to examine how higher education institutions—particularly those located within student affairs units—select and adopt AOD prevention and treatment strategies, emphasizing the influence of organizational factors. Moreover, it elucidates the barriers and facilitators encountered during the ‘Exploration’ and ‘Preparation’ phases, ultimately offering practical implications for introducing and disseminating EBS in the higher education context.
The study collected both quantitative (survey) and qualitative (interview) data from student affairs professionals at 23 university campuses. A total of 142 individuals completed the survey, which employed various measures—including the Implementation Climate Scale (ICS), a readiness tool adapted from an existing higher education center, the Organizational Readiness for Implementing Change (ORIC), and the Implementation Leadership Scale (ILS)—to gather comprehensive data. Subsequently, 16 semi-structured interviews were conducted to gain an in-depth understanding of the processes by which AOD prevention and treatment strategies are selected and adopted, as well as the barriers and facilitators that shape these processes. The interview data were then analyzed through a content-analysis approach, and a hybrid inductive–deductive coding procedure grounded in the EPIS model produced 21 final codes.
The findings indicated that student affairs professionals largely perceived an organizational climate conducive to implementing EBSs, especially in terms of “absorptive capacity” (i.e., their institution’s ability to acquire and utilize new knowledge). Leadership support for AOD initiatives was rated at a moderate level, highlighting its presence but also opportunities for enhancement. Concurrently, qualitative interviews identified six primary determinants: collaboration, evidence supporting the initiative, leadership, institutional priorities, available resources, and student needs/perspectives—that influence the selection and adoption of AOD prevention and treatment strategies. Integrating both qualitative and quantitative results revealed that these factors act as pivotal facilitators in devising implementation strategies, thereby underscoring the need for additional support across campuses to effectively prepare for implementation. These findings underscore the significance of organizational and individual-level factors during the EPIS framework’s “exploration” and “preparation” phases, thereby illuminating a need for more targeted implementation supports to promote the effective initiation and sustainability of EBSs related to AOD across college campuses.
Takeaway: Effective EBS adoption for AOD prevention in higher education requires balanced support for both organizational and individual-level factors during the EPIS model’s Exploration and Preparation phases.