Objective:To describe the adoption of public health and improvement methodologies to address college students’ high-risk drinking behaviors and to aid in prevention efforts.Participants:Members of 32 colleges and universities, content experts, and staff members of the National College Health Improvement Program (NCHIP).Methods:A 2-year learning collaborative developed by NCHIP trained individuals from 32 different college and universities in using the Plan–Do–Study–Act cycle as a method to create and implement initiatives aimed at reducing students’ high-risk drinking behaviors and related harms.Results:Participants experienced success ranging from noteworthy increases in type and amount of interventions directed at reducing high-risk drinking, to creating collaboratives across campus, the local community, and stakeholders. Challenges related to data collection and creating lasting cultural change remain.Conclusions:The use of quality improvement methodologies and creation of a national collaborative successfully effected meaningful change in high-risk drinking behaviors on college campuses. [ABSTRACT FROM PUBLISHER]