Despite the expanding use of undergraduate student peer counseling interventions aimed at reducing college student drinking, few programs evaluate peer counselors' competency to conduct these interventions. The present research describes the development and psychometric assessments of the Peer Proficiency Assessment (PEPA), a new tool for examining Motivational Interviewing adherence in undergraduate student peer delivered interventions. Twenty peer delivered sessions were evaluated by master and undergraduate student coders using a cross-validation design to examine peer based alcohol intervention sessions. Assessments revealed high inter-rater reliability between student and master coders and good correlations between previously established fidelity tools. Findings lend support for the use of the PEPA to examine peer counselor competency. The PEPA, training for use, inter-rater reliability information, construct and predictive validity, and tool usefulness are described.
Alcohol use is routinely cited by researchers as a concern at U.S. colleges causing university administrators to invest time and money toward managing and solving problems associated with drinking (Faden and Baskin, 2002 and Johnson et al., 2005). One prevention approach consists of using alcohol intervention programs (e.g., Brief Alcohol Screening in College Students; BASICS) which incorporate Motivational Interviewing (MI) skills developed by Miller and Rollnick, 1991 and Miller and Rollnick, 2002 to facilitate change and reduce college student drinking behaviors. Initial interventions trained professional counselors in MI to meet individually with undergraduate college students with an aim at reducing alcohol use and associated negative consequences but have since expanded to include interventions using undergraduate student peer counselors (Borsari and Carey, 2000, Borsari and Carey, 2005, Larimer et al., 2001, Marlatt et al., 1998 and Turrisi et al., in press). These empirically supported treatments offer tremendous promise towards reducing college student alcohol use and associated negative consequences (Larimer and Cronce, 2002 and Larimer and Cronce, 2007). However, the cost of using professional staff to conduct these interventions may limit implementing such programs on a wide scale.
More recently, there has been a growing body of research examining the efficacy of undergraduate peer-delivered MI feedback sessions for students mandated for alcohol counseling (see Larimer et al., 2001, Larimer and Cronce, 2002 and Larimer and Cronce, 2007). The past empirical studies have evaluated undergraduate student counselors ability to conduct MI interventions with adherence through tools such as the Motivational Interviewing Skills Code (MISC; Miller, 2000), Motivational Interviewing Treatment Integrity (MITI; Moyers, Martin, Manuel, & Miller, 2003), and Motivational Interviewing Supervision and Training Scale (MISTS; Madson, Campbell, Barrett, Brondino, & Melchert, 2005). In contrast, when this intervention approach has been implemented in traditional practice settings across college campuses a lack of consistent peer training and adherence protocols has been observed (Mastroleo, Mallett, Ray, & Turrisi, 2008). Research evaluating undergraduate peer counselor implementation practices have shown that no minimum level of standardized counselor competency has been traditionally employed (Mastroleo et al., 2008).
Although use of these counselor evaluation tools in empirical studies allow researchers to confirm an appropriate intervention has been conducted, they may be less suitable for undergraduate peer counselors. First, there are distinguishable clinical skill differences between highly trained professional counselors and undergraduate student counselors, yet the standards for competency are not weighted by the counselor type. Second, although each tool offers important components of evaluation for MI adherence or skill acquisition, they have been validated when the interventions were delivered by counselors with masters or higher educational training (Tappin et al., 2000) and not with undergraduate student counselors. Third, training for use of the MI evaluation tools vary from 5 h to 3 days while session reviews for intervention integrity range from 20 to 50 min. Student affairs professionals generally have limited time, limited training, varied professional backgrounds, and high staff turnover to be responsible for evaluating undergraduate peer-delivered MI fidelity (Mastroleo, Ray, & Turrisi, 2006). Given these empirical and practical constraints a simple to learn and use, and time efficient tool is needed to evaluate the effectiveness of undergraduate peer intervention evaluations.
The Peer Proficiency Assessment (PEPA) was developed with these issues in mind and requires only 2 h of training time and 15 min of session review to effectively examine undergraduate peer MI skill use. Specifically, the design and training required to effectively use the tool requires minimal time and past experience with MI and coding peer counseling sessions. To establish this we used both individuals highly trained in MI and undergraduate students with both moderate and limited previous exposure to MI principles to test the ability of newly trained coders to successfully identify MI consistent and inconsistent behaviors. The focus of this paper is to document the development and validation of the PEPA for evaluating peer counselor MI adherence and skills that can be used in both research and practice settings.
