Background:
The True Numbers at VCU and Across the Nation

• What are the True Numbers and why advertise them?
• How are they measured?
• And...how true is True?

What are the True Numbers and why advertise them?

TRUE NUMBERS is the term we at VCU have chosen to refer to survey statistics about college students' health-related behavior. The term is needed and advertised because a large gap exists between what students perceive to be normal behavior and what students report on surveys about their real behavior. The two tables and graphs below provide pictures of the misperception gap for both alcohol use and cigarette smoking.

Perception vs. Reality: Alcohol Use
Drinks	Perception	Reality
0	4%	22%
1-2	6%	14%
3-4	32%	17%
5-6	33%	16%
7-8	7%	8%
9-10	7%	6%
>10	2%	5%

Perception vs. Reality: Frequency of Cigarette Smoking
Days of Smoking	Perception	Reality
0	2%	70%
1-29	35%	15%
Every day	55%	10%

As you can see, the TRUE NUMBERS are much healthier than students think.

So, why does advertizing the truth matter?

Research over several decades suggests that correcting misperceptions by telling people the truth about health “norms” provides valuable support for health. If students know that the true “social norm” for their peers is healthy, then they are more likely to persist in their own healthy choices.

The National Social Norms Resource Center was created to facilitate more interventions and research related to "Social Norms Marketing." This Center awarded VCU’s Office of Health Promotion a grant to create, conduct and evaluate a social norms marketing campaign at VCU.

For a mountain of information about social norms and college students, visit www.socialnorms.org.

How are the True Numbers obtained and measured?

VCU uses a survey tool called the "National College Health Assessment" (NCHA) to gather the numbers. The NCHA was developed by the American College Health Association (ACHA) and an interdisciplinary team of college health professionals. The instrument is a Scantron booklet that contains approximately 300 questions that assess health, including questions on protective behaviors (a fancy way of saying "strategies") and on risk. The survey also assesses perceived norms and a wide variety of health issues including injury prevention, personal safety and violence; alcohol, tobacco, and other drug use; sexual health; weight, nutrition and exercise; and mental health.

To learn about the reliability and validity of the National College Health Assessment (NCHA), please read information provided by the ACHA: www.acha-ncha.org.

How does VCU get its True Numbers?

In 2002, VCU's Office of Health Promotion began the work required by our four-year longitudinal research grant awarded by the National Social Norms Resource Center. This grant pays the cost of our annual NCHA surveys as well as our media campaign. The OHP's research procedure is as follows:

• The sample: Our goal is a random sample of freshmen, sophomore, junior and senior students. Each spring the Registrar's Office provides a list of all undergraduate classes. From the list, we construct a sampling frame that helps ensure a reasonable distribution of 100-, 200-, 300- and 400-level classes. Once a random sample of classes is identified, we contact the instructors, set a date to go into each classrom, and attempt to survey all students enrolled in those classes.
• The response: We aim for a high response rate and have received more than 90 percent of the survey instruments back each year. We attribute our high response rate to the fact that we take the survey into the classrooms. Because faculty must grant permission for us to go into their classrooms, it is possible for the randomness of the final sample to be slightly compromised, but we feel that it produces a more representative sample of undergraduates than other feasible sampling methods.
• Processing the results: Response is completely optional and anonymous. The responses are collected by OHP faculty, not classroom faculty, and sent directly to the American College Health Association for processing.

This study has been approved by the VCU Office of Institutional Research Board.

How do VCU's True Numbers compare to the National Numbers?

Health behavior data collected at VCU is fairly consistent with the national data for other large urban universities. This encourages us to think that our findings are reasonably accurate. The good news at VCU is that over the past two years, our campaign "VCU students are healthier than you think!" and raffles advertising that "It pays to know the True Numbers" appear to be associated with an increase in the number of VCU students who correctly estimate 0-4. This is a 14 percent improvement over the national data for 2003.

How true is True?

(Translation: Do students lie on surveys?)

Good question. We worry about that, too. Every year a handful of surveys (less than a few dozen) are deleted from the data set for silly and bogus answers. For example, a student who responds that he is 99 years old having sex 69 times a day and drinking 100 drinks at a sitting is not included in the data set.

While no one can be certain about the accuracy of any survey data, studies about the validity of self-reported data suggest that if the behavior is legal and if the subjects feel secure that their responses are anonymous, most tell the truth. The VCU students with whom we have discussed this issue say they "tell it like it is." Several students have noted: "Heck, it's too much work to lie on surveys anyway; it's just easier to tell the truth." In addition, it is reassuring that the responses for several large national data sets are consistent.

For more information

If you have additional questions about the NCHA survey at VCU, the validity of self-reported data, or our marketing campaign, you are encouraged to contact Linda Hancock, FNP, PhD, primary investigator, "VCU students are healthier than you think!" Social Norms Project:
Linda Hancock
804-828-7815