JOURNAL OF AMERICAN COLLEGE HEALTH, VOL. 56, NO.

Using Theory-Based Constructs to Explore the Impact of Greek Membership on Alcohol-Related Beliefs and Behaviors: A Systematic Literature Review
Adam E. Barry, PhD

Abstract. By charter, national Greek organizations (ie, fraternities and sororities) place an emphasis on upholding personal integrity, academic scholarship, and development of campus leaders. Recent concerns, however, assert that the drinking behaviors of members of Greek organizations are antithetical to the mission of their universities. Objective: The authors purpose in this review was to systematically examine scientific literature addressing the effect of Greek affiliation on alcohol-related beliefs and behaviors. The internal and external influences affecting Greek members alcohol-related beliefs and behaviors are organized into a framework of various health behavior theories, based on the ecological perspectives levels of influence. Results: Results provide a broad perspective into the individual characteristics, social peer network, and environmental aspects influencing alcohol-related behavior among Greek members. Findings suggest that Greek members comprise a subgroup that consumes alcohol in greater quantities, underscores and misperceives the risks of alcohol abuse, and emulates a social environment and culture in which drinking alcohol is a key part of life. Keywords: alcohol, behaviors, beliefs, fraternity, literature review, sorority

ollege alcohol abuse is considered a major public health concern, as evidenced by the mandate from the US Department of Health and Human Services to reduce the proportion of college students engaging in binge drinking of alcoholic beverages.1 A report of the annual number of 18- to 24-year-old college students engaging in detrimental alcohol-related behavior indicates approximately 1,400 unintentional alcohol-related fatal injuries, 2.1 million students driving while under the influence of alcohol, more than 70,000 victims of alcohol-related sexual assaults
Dr Barry is a lecturer with the Health and Kinesiology Department at Texas A&M University. Copyright 2007 Heldref Publications 307

or date rapes, and more than 3.3 million students engaging in binge drinking within the past 30 days.2 Not all members of the college student population, however, are at equal risk for the negative consequences associated with alcohol abuse. Although the typical college population as a whole is quite heterogeneous, individuals tend to be drawn to and participate in social groups in which others similar to them belong. In addition, Drinking practices frequently reflect the customs and standards of the cultural group.3(p50) Thus, it is conceivable that college students participating in social organizations or student groups containing a large number of alcohol abusers are at an increased risk for alcohol abuse and other alcohol-related concerns themselves. In the 1800s, fraternities and sororities were established as service institutions. National Greek organizations, by charter, place an emphasis on upholding personal integrity, academic scholarship, and the development of campus leaders among their respective members. In the 1953 study, Drinking in College, Straus and Bacon3 examined a multitude of factors influencing alcohol consumption behaviors, including membership in a fraternity. They contend that Greek organizations often are stereotyped or pigeonholed as social drinking clubs motivating drinking along with other undesirable forms of behavior3(p124); however, findings from the study document fraternities impact on the drinking behavior of its members as negligible. More recently, concerns have been raised that these organizations transmit drinking behaviors and standards of membership antithetical to the missions of their respective universities and Greek organization policies.4 Furthermore, Leavy5 described the socialization process linked with fraternity membership as a kind of education in which the subject is drinking and the classroom is the fraternity house. My purpose in this review was to systematically organize and examine scientific literature addressing the impact of

Barry

Greek affiliation (ie, fraternity and sorority membership) on alcohol-related beliefs and behaviors. I analyzed prior research, including Drinking in College3 and various literature reviews,6 in unison with the most recent scientific literature to provide a comprehensive depiction of the alcoholrelated beliefs and behaviors of collegiate Greek members. Last, to provide practitioners and program developers with a theoretically based analysis of alcohol-related concerns among Greek members, I organize my findings into a framework of various health behavior theoretical constructs based on the ecological perspective.7 METHODS Search and Inclusion Criteria I used the electronic database Cambridge Scientific Abstracts to search the fields of education (ERIC), psychology (PsycINFO), medicine (Medline), and sociology (Sociological Abstracts) to locate research-based articles addressing the impact of fraternity and sorority membership on alcohol-related beliefs and behaviors. I used search descriptors to identify relevant English-language studies, including alcohol, fraternity, and sorority. I required studies to meet 1 of the following specifications for inclusion: (1) title explicitly states that the authors examined fraternity and sorority membership as it related to alcoholrelated beliefs or behaviors; (2) the authors primary purpose in the study was to examine fraternity or sorority membership as related to alcohol use or its resulting alcoholrelated personal, organization, and societal impacts; or (3) the authors reported a relationship or nonrelationship between alcohol-related beliefs and behaviors in conjunction with fraternity and sorority membership. Sample I chose research articles using the aforementioned key terms and specified inclusion criteria. The initial search process yielded 31 compatible studies; 18 were cited as references in Examining the Complex Relationship between Greek Life and Alcohol: A Literature Review.6 I analyzed these previously reviewed articles for 2 reasons: (1) to provide a single, comprehensive analysis of the scientific literature assessing how Greek membership affects alcoholrelated beliefs and behaviors and (2) to eliminate assumptions concerning the accuracy of results reported in previous literature reviews. The remaining 13 research articles were not included in past literature reviews. I included these in this systematic review to provide an up-to-date, complete analysis of current scientific literature associated with alcohol-related factors and Greek membership. I found 2 additional articles meeting the inclusion criteria by searching the bibliographies of acquired articles. In all, 33 peer-reviewed journal articles formed the final sample of examined material. I used the Matrix Method8 to organize relevant literature and abstract pertinent findings. The matrix developed for this review contained the following descriptive and method308

ological categories: author(s), publication year, journal, title, purpose of the study, sample size, methods, instrument(s) used, study design, results/findings, and data analysis. (On request, a detailed table including selective portions of the matrix categories used in this review is available from the author; please see the contact information at the end of the article.) Related research meeting the outlined criteria ranged from 1984 to 2003. Published articles were drawn from a variety of peer-reviewed journals, including Journal of College Student Development, Journal of Alcohol and Drug Education, Journal of Studies on Alcohol, Psychology of Addictive Behaviors, and NASPA Journal. Theoretical Organization and Rationale Using theory can assist practitioners in the development of prevention programming by supplying tools for moving beyond intuition to design and evaluate health behavior and health promotion interventions based on understanding of behavior.9(p4) In their literature review, Danielson, Taylor, and Hartford examined alcohol-related factors associated with Greek membership, acknowledging the insight allotted through the use of a theoretical framework and encouraging research exploring foundational theories that offer perspective on Greek life and alcohol.6(p463) Therefore, to systematically explore and offer theoretical insight into the alcoholrelated beliefs and behaviors among Greek members, as well as the environmental context in which these behaviors occur, I organized research findings from the reviewed studies into applicable health behavior theoretical constructs. Next, I separated the findings into 1 of 3 selected levels of influence outlined in the ecological perspective: intrapersonal level, interpersonal level, and institutional level.7 Intrapersonal factors include internal characteristics of the individual (eg, knowledge, attitude, behavior, selfconception).7 Interpersonal factors are composed of formal and informal family, peer, or work-group social networks.7 Last, institutional factors are the formal and informal policies or regulations for operation among social institutions with organizational characteristics,7 such as Greek organizations. I used the National Cancer Institutes Theory at a Glance: A Guide for Health Promotion Practice9 as a reference tool for the delineation of health behavior theoretical constructs into their respective level of influence. The application of health behavior theories as a framework for the classification and organization of literature review results is not a novel approach. For example, Banduras Social Cognitive Theory (SCT) has been used to systematically examine adolescent female sexual activity.10 Although the aforementioned study applied SCT as a guiding tool to control for the subjective thrust found in most literature reviews,10(p148) I used the ecological perspective for additional reasons: It takes into account that (1) behavior both affects, and is affected by, multiple levels of influence9(p10) and (2) individual behavior both shapes, and is shaped by, the social environment.9(p10) Thus, the ecological perspective addresses both the individual and social environmental factors influencing health behavior.
JOURNAL OF AMERICAN COLLEGE HEALTH

Greek Membership and Alcohol

In other words, both the internal and external factors shaping individual health behavior can be examined using this health promotion model. Table 1 provides operational definitions and descriptions of the various constructs outlined in this review, as well as the overarching level of influence these constructs address. RESULTS Alcohol Consumption Behavior Among Greek Members Overall, this review established that Greek members drank in greater quantities and more frequently than did their non-Greek counterparts.1122 Relative to student drinking behavior, fraternity members had the highest alcohol consumption rates, followed by sorority members, nonfraternity men, and nonsorority women.20 Fraternity men drink in greater quantities than do sorority women19,20,23; however, the level of alcohol consumption by sorority women was not significantly different than that of nonfraternity men.20 In examining female undergraduate drinking patterns, Ozegovic, Bikos, and Szymanski found that 25% of those abstaining from alcohol use were members of a sorority, whereas 75% abstaining from alcohol use were not involved in the Greek system.24

The rates of binge drinking (males consuming 5 or more drinks in a row and females consuming 4 or more drinks in a row) among fraternity and sorority members also were higher than were non-Greek students rates. Weschler et al21 reported that 2 of every 3 individuals involved in either a fraternity or sorority were binge drinkers.21 However, Thombs and Briddick25 asserted that approximately 87.6% of Greek members consumed 5 or more drinks on at least 1 occasion in the past 2 weeks. By their own definition, onethird of Greek members reported having been intoxicated at least once per week.25 Whereas both non-Greek students and Greek members increased their drinking level in college compared with their senior year in high school, Greek members increased their drinking level to significantly higher degrees.17 In their multiyear longitudinal study in which they examined the short- and long-term effects of fraternity and sorority membership on heavy drinking, controlling for prior drinking habits, Sher, Bartholow, and Nanda26 found that Greek membership significantly correlated with future heavy drinking. During the first 2 years of college, Greek members drank more heavily than did their non-Greek peers. During later years of college, however, fraternity men engaged in heavier drinking, whereas sorority members did not. In spite of higher consumption rates compared with

TABLE 1. Definitions of Health Behavior Theory Constructs Construct Intrapersonal level of influence Past behavior Attitude Subjective norm Perceived susceptibility Precontemplation Interpersonal level of influence Observational learning Institutional level of influence Organizational climate Theory Ecological perspective Theory of trying Theory of planned behavior Theory of planned behavior Health belief model Stages of change model Ecological perspective Social cognitive theory Ecological perspective Organizational development theory Organizational development theory Definition Individual characteristics that influence behavior, such as knowledge, attitudes, beliefs and personality traits.10(p11) Frequency of past trying influences both intention to try and trying, and that recency of past trying affects trying.12(p182) Overall evaluation of behavior.11(p69) Belief about whether most people approve or disapprove of the behavior.11(p69) Ones subjective perception of the risk of contracting a health condition.11(p48) Individuals do not intend to take action in the foreseeable future.11(p100) Interpersonal processes and primary groups, including family, friends, and peers that provide social identity, support, and role definition.10(p11) Behavioral acquisition that occurs by watching the actions and outcomes of others behavior.11(p169) Rules, regulations, policies, and informal structures, which may constrain or promote recommended behavior.10(p11) The overall mood or personality of an organization. Characteristics that distinguish an organization from other organizations and that influence the behavior of people in the organization.11(p340) The anthropology of an organization. The deeper level of basic assumptions and beliefs that are shared by members of an organization. Shared assumptions.11(p341) 309

Organizational culture

VOL 56, NOVEMBER/DECEMBER 2007

Barry

non-Greek students, Greek membership during the senior year of college was not found to significantly affect heavy drinking 3 years after graduation.26 Intrapersonal-Level Factors In the following section, I outline the individual characteristics of Greek members that influence their alcohol-related beliefs and behaviors. Examples of these characteristics include personal traits, beliefs, attitudes, or intentions to comply with behavioral norms. See Table 1 for definitions of the theoretical constructs examining these individual characteristics. The intrapersonal factors presented in this section are internal influences specific to the individuals and their own experiences. Past Behavior Students intending to join a Greek organization already consume greater amounts of alcohol than do their peers.27,28 Students intent to join the Greek system also has been significantly associated with frequent binge drinking and high risk scores on both the Perceived-Benefit-of-Drinking scale and the CAGE (Cutting down on drinking, Annoyance by criticism about drinking from others, Guilty feelings, and use of an Eye opener) screening instrument.29 For example, more individuals who identified themselves as heavy drinkers pledged to a Greek organization than did those who identified themselves as light drinkers, those who currently did not drink, and those who never drank.30 In addition, incoming students who experienced alcohol-related problems in high school (eg, physical discomfort, driving after drinking, trouble with law enforcement) were more likely to become members of Greek organizations in college than were those who had no such negative experiences.17 Highquantity high school drinkers currently in the Greek system drank significantly more days per week (M = 4.47) than did both high- (M = 3.13) and low- (M = 1.92) quantity high school drinkers in residence halls (p = .05), even when controlling for prior use.31 Thus, it appears that students with a disposition toward drinking are more likely to join a Greek organization than are those lacking that disposition.27 Attitude Greek members also were significantly more likely than were their non-Greek peers to declare that they drink for the following reasons: to relieve hangovers, because it seemed the thing to do in many activities, to forget about grades, to cope with problems in a romantic relationship, to celebrate special occasions, and because they enjoyed the taste of alcoholic beverages.16 Greek members also believe that alcohol enhances social activities and facilitates peer bonding.11 Furthermore, when compared with non-Greek peers, fraternity and sorority members were much more likely to believe that a real man should be able to hold his liquor, it is easier to meet new people if one has been drinking, or when they are at a gathering together, people who drink have more fun than people who do not.32(p44) A significantly smaller percentage of non-Greek students
310

maintained similar beliefs about drinking than did those who participated in Greek life.12 Residents of fraternity and sorority houses also are more likely to state that partying and drinking are important.22 Klein contended that fraternity house members are more likely than were non-Greek students living in residence halls to say that it is okay to drink in order to feel more comfortable around others.32(p44) Klein also asserted that fraternity members are less likely than are residence hall members and on-campus apartment-resident peers to believe that a person giving a party always should make nonalcoholic drinks readily available.32 Subjective Norms A perceived drinking pattern among close friends correlates significantly with the extent of ones own drinking.33 Although college students in general view close friends as consuming larger quantities of alcohol than themselves, fraternity members viewed their close friends as drinking significantly more than did the general student population as well.33 Fraternity pledges who believed that drinking led to a high degree of involvement in social activities consumed alcohol in much greater quantities than did those who viewed alcohol as having a low degree of involvement in social activities.34 For example, the more perceived drinking at a fraternity or sorority house, the more a member tended to drink.35 Greek members also are consistently more inclined than are non-Greek students to believe that higher levels of alcohol use are normative and that their peers are more supportive of heavy drinking practices such as binge drinking.26 In addition to overestimating alcohol consumption among their friends and student-body peers, both fraternity and sorority members in houses with campus reputations for alcohol use viewed their houses as being more popular, possessing better-looking members, being more sexually active, and being wealthier than that of average- or low-drinking houses.36 Perceived Susceptibility Greek members also perceive significantly less risk than do non-Greek students in regard to alcohol consumption behaviors.20 Kodman and Sturmak37 documented fraternity representatives reporting that 87% of female students attending chapter social functions drank, whereas 6% of women consuming alcohol became intoxicated at these social functions. This misperception continued in the evaluation of their peer fraternity members drinking behaviors. Representatives contended that 95% of fraternity members were drinkers, whereas 5% were identified as becoming intoxicated as a result of consuming alcohol.36 It is unrealistic to consider that only a small fraction of those engaging in the highrisk drinking behaviors discussed previously would drink in quantities needed to reach intoxication. Compared with non-Greek students, Klein documented Greek members as significantly more likely to sanction the belief that getting drunk is just a harmless way of having some fun and It is okay to drive after one has had a few drinks.32(p44)
JOURNAL OF AMERICAN COLLEGE HEALTH

Greek Membership and Alcohol

Furthermore, Greek members defined excessive alcohol consumption and its related consequences as an indication of problem drinking if the behavior happened to others rather than if the same behavior happened to them, such that Greek students rated other members as drinking more and having more alcohol-related problems than themselves.38 However, some researchers have documented fraternity and sorority members as aware of their consumption patterns. Harrington, Brigham, and Clayton found that as fraternity and sorority members drank greater amounts of alcohol, they grew more afraid of becoming an alcoholic.23 Compared with 14% of nonfraternity men, 18% of nonresident fraternity members and 21% of fraternity house residents believed themselves to have ever had a drinking problem. Nonsorority women and sorority house residents displayed equal belief that they have ever had a drinking problem.22 Precontemplation Thombs and Briddick25 examined the readiness to change among at-risk Greek student drinkers. Approximately 40% of Greek members did not perceive their drinking behavior as problematic. Most of these students did not spend time thinking about their alcohol use and showed little evidence of preparation to change or take action. The investigators also reported that 36% of the study participants were unwilling to identify their drinking behavior as a problem and had virtually no involvement in preparation to change or taking action to change.25 Interpersonal-Level Factors In the following section, I discuss external relationships influencing the alcohol-related beliefs and behaviors of Greek members. These interpersonal factors provide individuals role definitions as well as social identity. Examples include emotional support, information, and aid provided by social contacts such as family, significant others, or peers. See Table 1 for complete definitions of the interpersonal influences outlined in this section. Observational Learning (Modeling) Straus and Bacon asserted that people tend to live near, associate with, and emulate members of their own cultural group. Drinking practices frequently reflect the customs and standards of the cultural group.3(p50) For the purposes of their study, they defined cultural membership by components such as ethnic background, racial origin, and religion. However, when college students joins a Greek organization, they enter a society (ie, a cultural group) with its own set of customs and traditions. Active fraternity members, whether of legal drinking age or underage, have been observed consuming alcohol whenever they wanted and regulating the consumption of alcohol to pledges; thus, alcohol use became a privilege, symbolizing full membership in the group.39(p331) For example, Cashin et al12 assert that increasing levels of involvement in fraternity life corresponded with increasing levels of alcohol use, such that fraternity leaders drank the greatest quantities of alcohol.
VOL 56, NOVEMBER/DECEMBER 2007

It is logical to infer that because Greek members have higher levels of alcohol consumption and, as a whole, are more likely to have friends who approve of heavy drinking,11 they also model a lifestyle that invites increased risk of alcohol-related problems, as compared with their nonGreek peers. Research findings in the available literature support this hypothesis, documenting that Greek students incur considerably more alcohol-related consequences than do students not associated with a Greek organization.12,13,16,18,22,23,31,40 Greek residents also were more likely than were those in other residence arrangements to experience alcohol-related complications throughout the year (eg, driving while or after drinking, attending class while under the influence, having trouble with law enforcement, engaging in aggressive behavior, experiencing nausea or vomiting).13 Compared with non-Greek students, Greek house residents also were more likely to drink and drive or ride with a drunk driver after binge drinking.22 Several researchers also noted gender differences. For example, as sorority members increased their levels of alcohol consumption, they experienced a greater number of alcohol-related problems than did fraternity members.23 Sorority members also were more likely to have experienced hangovers and nausea and to have driven while or after drinking either moderately or in excess.13 In addition to causing physical ailments, school-related problems, and dangerous driving practices, alcohol consumption also affected Greek members sexual practices. Harrington, Brigham, and Clayton23 found that as levels of drinking increased among fraternity and sorority members, so did reports of not using a condom during sexual activity. The researchers also reported a statistically significant correlation between the level of consumption and number of sexual partners. Thus, as Greek members alcohol consumption increased, use of safer sex practices declined and the number of sexual partners increased.23 Institutional-Level Factors In the following section, I describe various institutional factors that influence the alcohol-related beliefs and behaviors of Greek members. These external factors include informal and formal rules/policies that endorse or condone certain health behaviors as well as norms or standards that exist among group members. See Table 1 for specific definitions regarding the institutional factors examined in this section. Organizational Climate In addition to Greek members higher alcohol consumption rates, fraternity and sorority members living in their respective Greek houses drank in greater quantities and more frequently than did other Greek members not living in the house. For example, 57% of sorority house residents were identified as frequent binge drinkers versus 43% of nonresident sorority members. Approximately 86% of fraternity house residents, 71% of nonresident fraternity members, and 45% of nonfraternity men engaged in binge drink311

Barry

ing.22 Greek house residents drank in greater quantities than did non-Greek students22,40 and individuals living on and off campus.13 One in 5 individuals who lived in a fraternity or sorority house were heavy drinkers, compared with slightly more than 1 in 10 individuals who lived in university housing or off-campus.15 Thus, living in the Greek system was associated with higher binge drinking rates21 and more drinking days per week for both men and women.39 However, researchers suggest that alcohol consumption may be a normative experience among students who are active on campus, whether they are members of a Greek organization or a non-Greek volunteer organization. Pace and McGrath18 compared the drinking habits of students active in Greek organizations with students active in on-campus, primarily volunteer organizations. Individuals involved in Greek and volunteer organizations had higher occurrences of 30-day alcohol use, use within the past year, and binge drinking than did non-Greek students and nonvolunteer organization members.18 In this study, heavier drinking was linked with students who were involved in campus organizations, whether they were socially or volunteer-based. Organizational Culture Fraternity members also are less likely to accept someone who does not drinksomeone who is not considered one of the boys. In other words, fraternity members are documented as less likely to accept someone who does not consume alcohol versus someone who readily drinks alcohol.27 Larimer et al31 found that fraternity house residents also were significantly (p < .05) more likely to report alcoholrelated problems than were sorority members and male and female residence hall members. Reported problems among fraternity men included blackouts (83.6%), physical fights when drinking (49.1%), guilty feelings about drinking (49.1%), arrest for drunken behavior (16.4%), arrest for driving under the influence (5.5%), and physical symptoms, such as delirium tremens and the inability to stop drinking (9.1%).31 Compared with nonfraternity men, nearly twice as many fraternity house residents reported they were behind in school work, argued with friends, engaged in unplanned sexual activity, damaged property, experienced injury, or did not use protection during intercourse.22 Goodwin14 reported that fraternities and sororities do not cause alcohol consumption; however, because parties take place at fraternities, alcohol is regularly provided in a social setting. Thereby, Greek students have little incentive to develop alternative social activities.14 In addition, expectations regarding alcohol consumption among fraternity and sorority members are positively associated with chapter culture, which glorifies alcohol use.41 Faulkner, Alcorn, and Garver said, Alcohol consumption appears to have a strong utilitarian value for fraternity students, serving a functional role in the socialization process.34(p18) Furthermore, the Greek system provides a social environment that facilitates a heavy drinking lifestyle among its membersin which binge drinking is considered standard practice.22
312

Although a number of investigators documented the relationship between Greek membership, heavy drinking, and its associated negative consequences, Sher et al26 found that this association did not appear to have a long-term effect on Greek members drinking behaviors. Analysis indicated that Greek members drank more heavily than did non-Greek students during college years but that this difference was no longer apparent 3 years after college. Also, having been a Greek member during the fourth year of college did not significantly affect heavy drinking 3 years later.26 COMMENT In 1953, Straus and Bacon stated, The fraternity nonfraternity dichotomy is not particularly meaningful with respect to the drinking customs of college students.3(p125) However, my review provides a broad perspective into the individual characteristics, social peer network, and environmental aspects influencing alcohol-related behavior among Greek members. Compared with their non-Greek peers, findings suggest that fraternity and sorority members are a subgroup of college-aged individuals who consume alcohol in greater quantities, underscore and misperceive the risk associated with their alcohol abuse, and emulate a social environment and culture in which drinking alcohol is a key part of life. Furthermore, results reveal that Greek members also are at an elevated risk for bodily injury and physical depreciation. In addition to negative alcohol-related consequences, researchers also expressed concerns regarding the effect of Greek affiliation on adverse, self-destructive behaviors, such as bulimia.42 Sher et al26 argue that once Greek members leave the college campus, they are presumably no longer engrossed in a social environment that supports heavy drinking and that, in turn, their alcohol involvement appears to decrease. Thus, the Greek system provides a social environment facilitating a heavy drinking lifestyle among its members.26 The effect of this alcohol-supportive environment is evident in the significant effect fraternity or sorority house residence has on current alcohol consumption. For example, Wechsler et al22 documented that 65% of sorority house members had abstained from binge drinking in high school. Yet a high proportion (76%) of sorority house residents who did not binge drink in high school did so in college. In comparison, 48% of nonresident sorority members and 25% of nonsorority women started binge drinking after arriving at college.22 Of note, however, is that researchers document alcohol consumption as a normative experience among students who are active on campus, including those in Greek organizations. Students involved in campus organizations that are both volunteer- and socially based may be more alike in drinking habits than are those not involved in organizations at all.18 The commitment to alcohol-related bonding among Greek members is apparent in that alcohol has been clearly shown to be the drug of choice among Greek members. Goodwin documented that 53% of Greek members reported no use of illicit drugs (eg, marijuana, cocaine, LSD, heroin) within the 30 days prior, whereas 2% of respondents reported no
JOURNAL OF AMERICAN COLLEGE HEALTH

Greek Membership and Alcohol

use of alcohol within the past month.43 In addition, Kuh and Arnold39 documented fraternity members readily identifying places where kegs and other alcohol containers could be hidden from institutional agents. Heavy-drinking fraternity men rejected the idea of an external control over drinking, whether at the university level or in national panhellenic organizations.35 Further reiterating the importance of alcohol to Greek members, Kodman and Sturmak37 documented Greek members average estimate of annual monetary expenditures by their respective chapters for alcoholic beverages as $1,200. Institutions not taking positive intervention steps with fraternities and sororities leave campus chapters and individual students at heightened risk for negative consequences of alcohol use, as well as increased legal liability.44 Elkins, Helms, and Pierson examined state and federal cases involving college Greek organizations and negligence resulting from the use of alcohol by university students.40 Of the 43 cases examined, nearly a third (n = 16) involved wrongful death claims. These deaths resulted from drunk driving, alcohol poisoning, injuries sustained from falls, and in one case, murder. Courts ruled against fraternity or sorority chapters, in cases where they were named as a defendant, 33% of the time. Results from this study also indicated that fraternity chapters and Greek members were more vulnerable than were colleges and universities to alcohol-related litigation.40 In general, the Greek population consumes alcohol more intensely and, as a group, perceives less risk to be associated with drinking than an otherwise demographically similar group on the same campus.20 Fraternity and sorority membership provides frequent opportunities to party, and binge drinking has become standard practice.22 In contrast to Greek organizations value basis, Kuh and Arnold39 observed women being relegated to instrumental roles in organized fraternity functions when alcohol was available. The researchers also found that fraternities included in the study were characterized by hedonistic, anti-intellectual behaviors and attitudes.39(p331) These results seem to dispute Straus and Bacons original conclusions3 declaring the stereotype of fraternities encouraging drinking as well as other undesirable forms of behavior to be false. Implications I examined studies of Greek organizations that seem a far cry from those historically based on academics and leadership qualities. My findings enforce and strengthen other reviews6 and dispute those originally reported by Straus and Bacon.3 Comparison of these 2 prior studies, in unison with the current systematic review, reveals that the culture of Greek organizations has placed an increasing importance on alcohol use among its members. The identified differences among Greek members and non-Greek students discussed throughout this study alert college health practitioners and policymakers to a notably different subculture of students, even though they reside and participate in activities on the same campus. To fully understand the scope of internal and external influences affecting Greek members alcohol-related beliefs
VOL 56, NOVEMBER/DECEMBER 2007

and behaviors, I organized research findings in a framework of health behavior theoretical constructs. By using a framework based on the levels of influence designated by the ecological perspective, I was able to address prior literature reviews request for foundational theories that offer perspective on Greek life and alcohol.6(p463) In addition, my findings are an updated and comprehensive depiction of the individual and social environmental factors influencing Greek members alcohol-related beliefs and behaviors. As such, this article equips practitioners and researchers with a theoretically based foundation to inform the development of interventions aimed at countering these findings. Limitations There is a direct association between the limitations of this systematic review and the research methodology of the included studies. Thus, to identify the limitations in my study, I must discuss some of the methodological characteristics of the research I examined. I found that researchers in less than one-third (27%) of the examined studies used a random systematic sample in their research. Investigators in the overwhelming majority (72.7%) of reviewed studies examined a Greek population specific to their own campus, 15.1% analyzed a multiuniversity Greek cohort, and the remaining 12.1% achieved a nationally representative sample. Because findings from many of the reviewed studies were specific to one campus or a certain geographic region, my ability to generalize its findings to the entire college population is limited. Therefore, it is necessary for future researchers to attain generalizability (external validity) by focusing on random, systematic sampling and the acquisition of multiuniversity samples, preferably those that are nationally representative. Although lacking multiuniversity or nationally representative samples, 31 of the 33 studies were composed of a large sample sizebetween 100499 participants (42.4%) or 500 or more participants (51.5%). Of the instruments used to explore these samples, the majority (57.6%) were previously referenced from the literature; however, 42.4% failed to document their datas specific reliability (Cronbach alpha levels). In addition, researchers in 18.2% of the studies I reviewed created their own instrument through pilot testing and provided specific alpha levels, whereas 24.2% created a novel instrument but failed to pilot test or cite alpha levels. To limit the introduction of bias, researchers interested in further examining the relationship between alcohol and Greek affiliation would benefit from using tested instruments from the literature or ensuring that the instruments to be instituted have been properly examined and the data adequately tested for validity and reliability (eg, pilot test and report alpha levels). A future focus on strengthening methodological procedures will assist college health practitioners and policy makers in determining whether effective interventions can be used across different university settings. In addition, because of the nature of this article and the inclusion/exclusion criteria used to identify relevant research articles, I did not include alcohol prevention or
313

Barry

education programs enacted by national Greek organizations. Although the reporting on these programs may be lacking in the peer-reviewed scientific literature, this does not mean they are nonexistent. The North American Interfraternity Conference discusses one such program, Alcohol Summit, on its Web site. The Alcohol Summit Program consists of a 2-day curriculum designed to spark open dialogue among Greek leaders about high-risk drinking within their communities. The overall goal of the program is the development of an action plan outlining initiatives to confront high-risk drinking and the behaviors associated with the misuse of alcohol.45 It also should be noted that umbrella organizations, such as the North American Interfraternity Conference and the National Panhellenic Conference, set forth basic standards and expectations requiring member fraternities and sororities to refrain from the misuse of alcohol.46,47 Furthermore, these organizations maintain the ability to revoke the charter of affiliated fraternities or sororities failing to meet the standards or expectations established. Unfortunately, systematic evaluations of these initiatives have not been published in either the social sciences or public health literatures and were thus not included in this review. Last, although I attempted to include all articles relative to alcohol-related beliefs and behaviors as influenced by fraternity and sorority membership, it is conceivable that the sources referenced are not an exhaustive list of all related scientific literature.
ACKNOWLEDGMENT

The author thanks Dr James Eddy and Dr Patricia Goodson for their editorial contributions.
NOTE

For comments and further information, address correspondence to Dr Adam E. Barry, Texas A&M University, Health and Kinesiology Dept., 159 Read Bldg, Mail Stop 4243, College Station, TX 77843-4243, USA (e-mail: aebucs@hlkn.tamu.edu).
REFERENCES 1. US Department of Health and Human Services. Healthy People 2010. Vols. 1,2. Sudbury, MA: Jones and Bartlett; 2000. 2. Hingson RW, Heeren T, Zakocs RC, Kopstein A, Wechsler H. Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 1824. J Stud Alcohol. 2002;63:136144. 3. Straus R, Bacon S. Drinking in College. New Haven, CT: Yale University Press; 1953. 4. Horowitz H. College Life: Undergraduate Cultures From the End of the 18th Century to the Present. New York, NY: Knopf; 1987. 5. Leavy RL. An alternative source of information on a popular topic: a course on drinking. Teach Psychol. 1979;6:97100. 6. Danielson C, Taylor SH, Hartford M. Examining the complex relationship between Greek life and alcohol: a literature review. NASPA J. 2001;38:451465. 7. McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Q. 1988;15:351377. 314

8. Garrard J. Health Sciences Literature Review Made Easy. Gaithersburg, MD: Aspen; 1999. 9. National Cancer Institute. Theory at a Glance: A Guide for Health Promotion Practice. 2nd ed. US Dept of Health & Human Services: National Institutes of Health; 2005. NIH Publication No. 05-3896. 10. Goodson P, Evans A, Edmundson E. Female adolescents and onset of sexual intercourse: a theory-based review of research from 19841994. J Adolesc Health. 1997;21:147156. 11. Alva SA. Self-reported alcohol use of college fraternity and sorority members. J Coll Stud Devel. 1998;39:310. 12. Cashin JR, Presley C, Meilman PW. Alcohol use in the Greek system: follow the leader? J Stud Alcohol. 1998;59:6370. 13. Globetti G, Stem JT, Marasco F, Haworth-Hoeppner S. Student residence arrangements and alcohol use and abuse: a research note. J Coll University Stud Housing. 1988;18:2833. 14. Goodwin L. Social psychological bases for college alcohol consumption. J Alcohol Drug Educ. 1990;36:8395. 15. Haworth-Hoeppner S, Globetti G, Stem J, Morasco F. The quantity and frequency of drinking among undergraduates at a southern university. Int J Addict. 1989;24:829857. 16. Klein H. Self-reported reasons for why college students drink. J Alcohol Drug Educ. 1992;37:1428. 17. Lo CC, Globetti G. The facilitating and enhancing roles Greek associations play in college drinking. Int J Addict. 1995;30:13111322. 18. Pace D, McGrath PB. A comparison of drinking behaviors of students in Greek organizations and students active in a campus volunteer organization. NASPA J. 2002;39:217232. 19. Sher KJ, Bartholow BD, Nanda S. Short- and long-term effects of fraternity and sorority membership on heavy drinking: a social norms perspective. Psychol Addict Behav. 2001;15:4251. 20. Tampke DR. Alcohol behavior, risk perception, and fraternity and sorority membership. NASPA J. 1990;28:7177. 21. Wechsler H, Downdall GW, Maenner G, Gledhill-Hoyt J, Lee H. Changes in binge drinking and related problems among American college students between 19931997. J Am Coll Health. 1998;47:5768. 22. Wechsler H, Kuh G, Davenport AE. Fraternities, sororities, and binge drinking: results from a national study of American colleges. NASPA J. 1996;33:260279. 23. Harrington NG, Brigham N, Clayton RR. Differences in alcohol use and alcohol-related problems among fraternity and sorority members. Drug Alcohol Depend. 1997;47:237246. 24. Ozegovic JJ, Bikos LH, Szymanski DM. Trends and predictors of alcohol use among undergraduate female students. J Coll Stud Devel. 2001;42:447455. 25. Thombs D, Briddick WC. Readiness to change among atrisk Greek student drinkers. J Coll Stud Devel. 2000;41:313322. 26. Sher KJ, Bartholow BD, Nanda S. Short- and long-term effects of fraternity and sorority membership on heavy drinking: a social norms perspective. Psychol Addict Behav. 2001;15:4251. 27. Schall M, Kemeny A, Maltzman I. Factors associated with alcohol use in university students. J Stud Alcohol. 1992;53:122 136. 28. Cantebury RJ, Gressard CF, Vieweg WVR, Grossman SJ, Westerman PS, McKelway RB. Psychological inventory among first-year college students and patterns of alcohol use. Adv Alcohol Subst Abuse. 1990;9:111. 29. Werner MJ, Greene JW. Problem drinking among college freshmen. J Adolesc Health. 1992;13:487492. 30. OConnor RM, Cooper SE, Thiel WS. Alcohol use as a predictor of potential fraternity membership. J Coll Stud Devel. 1996;37:669675. 31. Larimer ME, Anderson BK, Baer JS, Marlatt GA. An individual in context: predictors of alcohol use and drinking problems among Greek and residence hall students. J Subst Abuse. 2000;11:5368. JOURNAL OF AMERICAN COLLEGE HEALTH

Greek Membership and Alcohol 32. Klein H. College students attitudes toward the use of alcoholic beverages. J Alcohol Drug Educ. 1992;37:3552. 33. Baer JS, Stacy A, Larimer M. Biases in the perception of drinking norms among college students. J Stud Alcohol. 1991;52:580586. 34. Faulkner KK, Alcorn JD, Garver RB. Prediction of alcohol consumption among fraternity pledges. J Alcohol Drug Educ. 1989;34:1220. 35. Goodwin L. Explaining alcohol consumption and related experiences among fraternity and sorority members. J Coll Stud Devel. 1989;30:448458. 36. Larimer ME, Irvine DL, Kilmer JR, Marlatt GA. College drinking and the Greek system: examining the role of perceived norms of high risk behavior. J Coll Stud Devel. 1997;38:587 598. 37. Kodman F, Sturmak M. Drinking patterns among college fraternities: a report. J Alcohol Drug Educ. 1984;29:6569. 38. Baer JS, Carney MM. Biases in the perceptions of consequences of alcohol use among college students. J Stud Alcohol. 1993;54:5460. 39. Kuh GD, Arnold JC. Liquid bonding: a cultural analysis of the role of alcohol in fraternity pledgeship. J Coll Stud Devel. 1993;34:327334. 40. Elkins B, Helms L, Pierson C. Greek-letter organizations, alcohol and the courts: a risky mix? J Coll Stud Devel. 2003;44:6780. 41. Lichtenfeld M, Kayson WA. Factors in college students drinking. Psychol Rep. 1994;74:927930. 42. Meilman PW, von Hippel FA, Gaylor MS. Self-induced vomiting in college women: its relation to eating, alcohol use, and Greek life. J Am Coll Health. 1991;40:3941. 43. Goodwin L. Alcohol and drug use in fraternities and sororities. J Alcohol Drug Educ. 1992;37:5263. 44. Reis J, Trockel M. An empirical analysis of fraternity and sorority individual-environmental interactions with alcohol. J Appl Social Psychol. 2003;33:25362552. 45. North American Interfraternity Conference. Alcohol Education Initiative: Alcohol Summit. Available at: http://nicindy.org. Accessed August 29, 2006. 46. North American Interfraternity Conference. Nine Basic Expectations for Fraternal Members: A Statement of Fraternal Values and Ethics. Available at: http://nicindy.org. Accessed August 30, 2006. 47. National Panhellenic Conference. Standards. Available at: http://www.npcwomen.org/pdf/0502_standards_booklet.pdf. Accessed August 30, 2006.

VOL 56, NOVEMBER/DECEMBER 2007

315