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An Evolution of Environmental Prevention Models. Bob Saltz Richard McGaffigan Prevention Research Center Berkeley, California. Pacific Institute for Research and Evaluation. Prevention Research Center. Presentation Objectives. Planning phase discussion Needs assessment Baseline data

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an evolution of environmental prevention models
An Evolution of Environmental Prevention Models

Bob Saltz

Richard McGaffigan

Prevention Research CenterBerkeley, California

Pacific Institute for Researchand Evaluation

Prevention Research Center

presentation objectives
Presentation Objectives
  • Planning phase discussion
    • Needs assessment
      • Baseline data
      • Strategic partners
      • Resource assessment
  • Model programs vs evidence-based strategies
  • Evaluation strategy
presentation objectives1
Presentation Objectives
  • Outline an evolution of prevention models by:
    • Describing the Community Trials project
    • The Border Project
    • Safer California Universities project
community trials to prevent alcohol involved trauma

COMMUNITY TRIALS TO PREVENT ALCOHOL-INVOLVED TRAUMA

1991-1997

Prevention Research Center

Berkeley, CA

Sponsors:

National Institute on Alcohol Abuse and Alcoholism &

Center for Substance Abuse Prevention

slide5

Up to 50% of fatal car crashes involve alcohol. More than 20,000 people are killed and 650,000 are injured annually.

goal reduce alcohol involved trauma
Goal: Reduce Alcohol-involved Trauma

Traffic Crashes

Injuries

-- burns

-- falls

Drownings

Violence

national community trial to prevent alcohol involved trauma

-

Modesto

Modesto

.

.

Salinas

Salinas

.

.

Orange

Orange

.

Florence

Florence

.

Oceanside

Oceanside

Sumter

Sumter

Experimental

Experimental

Comparison

Comparison

National Community Trial to Prevent Alcohol-involved Trauma
five prevention components
Five Prevention Components

1. Community Mobilization

2. Responsible Beverage Service

3. Risk of Drinking and Driving

4. Underage Drinking

5. Alcohol Access

slide12

Alcohol-involved Trauma at the Community Level: Conceptual Model

MOBILIZATION

DRINKING AND DRIVING

Local News about AlcoholProblems & Enforcement

Perceived

Risk of Arrest

Local Law

Enforcement

RESPONSIBLE BEVERAGE

SERVICE

Driving after

Drinking

Social Access

to Alcohol

Alcohol

Serving and

Sales Practices

UNDERAGE DRINKING

Retail Alcohol Availability

(On and Off-premise)

Local Regulation

of Alcohol

(Density, Hours

of Sale)

Alcohol-involved

Injury and Death

(Traffic and Other)

Alcohol Intoxication

or Impairment

ALCOHOL ACCESS

Non-Traffic Risk Activities

community trials final results
Community Trials Final Results

Heavy Drinking (-6%)

Driving after “Too much to drink” (- 49%)

BAC Positive Drivers (- 44%)

Nighttime Injury Crashes (-10%)

Assaults

-- Hospital Cases (-2%)

-- Emergency Room Cases (- 43%)

the san diego tijuana project to reduce teen and binge drinking

The San Diego-Tijuana Project to Reduce Teen and Binge Drinking

Institute for Public Strategies

www.publicstrategies.org

system functional model for community prevention

Community

Mobilization

Recruitment

Learning

Strategy

Selection

Data Collection

& Evaluation

Strategy

Implementation

System functional model for community prevention
research practice partnership
Pacific Institute

Data collection

Data feedback to programming

Program design

Policy support

Media hook

Institute for Public strategies

Design and implement prevention strategy

Policy

Community organizing

Media

Law enforcement

Research / Practice Partnership
border field laboratory

1.

San Diego

County

Telephone

Survey

2.

4.

South-

bound

border

survey

North-

bound

border

survey

3.

Tijuana

bars

Border field laboratory
the problem
The Problem
  • Underage and binge drinking in Mexico
  • Thousands of US teenagers cross into Tijuana on a weekend evening
  • Alcohol related problems are the result
    • DUI Crashes
    • Fights, injuries, crime and arrests
    • Exposure to STD’s
    • Poor school performance
strategic change model
Strategic Change Model

Policy

Community

Organizing

Effective

Advocacy

Campaign

Enforcement

Scientific Data & Research

Media Advocacy

border project multiple interventions

USA

Mexico

Border ProjectMultiple Interventions

Binational

Collaboration

  • Northbound
  • Community
  • Policing
  • DUI
  • checkpoint
  • Southbound
  • Operation Safe Crossing
  • Tijuana
  • RBS training
  • ID training
  • Ban Alcohol Ads
  • Enforcement in Tijuana Bars
slide21

Safer California Colleges and Universities:A risk management approach to college student drinking problems

slide23

Mean Score for 5+ Drinks in a Row in Past 2 Weeks

by 4-year College Student Status

Twice

Once

College

Non-College

None

Wave 1

Wave 2

Wave 3

Wave 4

(18)

(19-20)

(21-22)

(23-24)

Measurement Wave

injury

Injury

500,000 students between the ages of 18 and 24 are unintentionally injured under the influence of alcohol

(Hingson et al., 2002)

assault

Assault

More than 600,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking

(Hingson et al., 2002)

sexual abuse

Sexual Abuse

More than 70,000 students between the ages of 18 and 24 are victims of alcohol-related sexual assault or date rape

(Hingson et al., 2002)

drunk driving

Drunk Driving

2.1 million students between the ages of 18 and 24 drove under the influence of alcohol last year

(Hingson et al., 2002)

academic problems

Academic Problems

About 25 percent of college students report academic consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and receiving lower grades overall

(Engs et al., 1996; Presley et al., 1996a, 1996b; Wechsler et al., 2002)

what are we trying to prevent
What are we trying to prevent?
  • Intoxication
  • Harm related to intoxication
safer california universities project goal

Safer California UniversitiesProject Goal

To evaluate the efficacy of a“Risk Management” approach to alcohol problem prevention

risk management
Risk Management
  • Risk Assessment
  • Risk Reduction
  • Risk Monitoring
risk assessment
Risk Assessment
  • Brief interviews with key personnel
  • Archival data sources
  • Student survey data
risk reduction
Risk Reduction

Matching intervention to risky settings:

  • Fraternity parties
  • Drinking in residence halls
  • Drinking associated with athletic events
  • Drinking at off-campus bars & restaurants
risk monitoring
Risk Monitoring
  • Key role of archival data
  • Iterative process of evaluation….
  • …with improved implementation
how is risk management a unique approach
How is risk management a unique approach?
  • Targets times and places instead of individuals
  • Focus on intoxication
  • Tied to continuous monitoring and improvement - emphasis on “control” rather than “one shot” interventions
anticipated hurdles for prevention strategy
Anticipated Hurdles for Prevention Strategy
  • Implicit assumption that “target” is high-risk drinkers
anticipated hurdles for prevention strategy1
Anticipated Hurdles for Prevention Strategy
  • Implicit assumption that “target” is high-risk drinkers
  • Ambivalence about student drinking
  • Low perceived efficacy of environmental interventions
  • Challenges of coordination and resource allocation
  • Possible fears of “backlash”
hypothesized elements necessary for purposive environmental interventions
Hypothesized Elements Necessary for Purposive Environmental Interventions
  • Organizational Knowledge of Problem
  • Clear Focus
  • Organizational Efficacy
    • Resources
    • Coordination
    • Commitment
  • Perceived Efficacy
  • Continuous Feedback/Evaluation
slide42

For copies of:

  • The full report (readable on-line):

National Academies Press

www.nap.edu

Order by phone: 888-624-7645

  • FACE’s executive summary publication:

www.faceproject.org

task force recommendations
Task Force Recommendations
  • Tier 1:Evidence of Effectiveness Among College Students
  • Tier 2:Evidence of Success With General Populations That Could Be Applied to College Environments
  • Tier 3:Evidence of Logical and Theoretical Promise, But Require More Comprehensive Evaluation
  • Tier 4:Evidence of Ineffectiveness
supplemental slides

Supplemental Slides

These slides were not presented, but are included in case anyone might be interested in seeing a bit more on related topics

slide48

Access: Commercial Availability

  • Strengthen compliance check programs.
  • The federal government should require states to achieve designated rates of retailer compliance.
  • All sellers and servers of alcohol complete state-approved training as a condition of employment.
slide50

Access: Social Availability

  • Implement enforcement programs to deter adults from purchasing alcohol for minors.
  • Establish and implement a system requiring registration of beer kegs.
  • Adopt and publicize policies for detecting and terminating underage drinking parties.
slide51

Access: Youth Use

  • Facilitate enforcement of zero tolerance laws.
  • Enact graduated driver licensing laws.
  • Implement sobriety checkpoints.
  • Strengthen efforts to prevent and detect use of false identification.
  • Establish administrative procedures and noncriminal penalties for alcohol infractions by minors.
slide52

Youth Interventions

  • Insufficient evidence to support youth-oriented media campaign now: intensive research and development needed.
  • Fund only evidence-based programs.
  • Information-only interventions, scare tactics, and “delay” messages are not effective.
  • Expand the availability of effective clinical services for treating alcohol abuse.
slide53

College Interventions

Campuses should adopt comprehensive evidence based approaches:

  • Universal educational approaches as well as selective and indicated approaches
  • Screening and brief interventions
  • Limit alcohol availability and access for underage students
  • Consistent enforcement of laws and policies

NIAAA and SAMHSA should continue to fund evaluation of college-based programs and should maintain list of evidence-based programs.

slide54

Community Interventions

  • Community coalitions can increase the effectiveness of interventions.
  • Assess problem locally
  • Develop comprehensive community-based initiative.
  • Implement strategies tailored to the specific problems and resources in the community.
slide55

Community Interventions

  • Involve gatekeepers, businesses, key community leaders, and colleges.
  • Consider strategies such as: community organizing, public education, strategic use of mass media, and partnerships with faith-based organizations.
slide56

Community Interventions

Resources are essential:

  • Public and Private partners should support community mobilization to reduce underage drinking
  • Federal funding should be available under a national program dedicated to community-level approaches modeled after the Drug-Free Communities Act
slide57

Summary

  • Alcohol use by young people is dangerous.
  • Committee calls for a deep, unequivocal societal commitment to curtail underage drinking.
  • Need to dedicate the resources commensurate with the magnitude of the problem.
  • Commit to a comprehensive strategy that involves multiple partners (National, State, Campuses, Local) to achieve long-term results.
summary
Summary
  • Develop national adult-oriented media campaign
  • Create national partnership, including industry
  • Reduce youth exposure, both advertising and entertainment
  • Government Assistance and Coordination
  • Increase compliance, including enforcement on- and off-campus
  • Implement evidence-based efforts aimed at youth
  • Implement effective college campus interventions
  • Develop community-specific responses, including campus collaborations
  • Increase excise taxes
  • Conduct ongoing monitoring and R& E
safer california universities survey
Safer California Universities Survey
  • Fall 2003
  • Internet and Mail Surveys
  • Random Samples of Students
  • 14 Campuses
  • N = 28,000Range 738 - 1291
  • Response rate 51%

Source: SaferCalifornia Universities Survey, 2003

safer california universities survey1
Safer California Universities Survey
  • Class: Freshman 21.1% Sophomore 17.9% Junior 28.5% Senior 32% Other .5%
  • Ethnicity White 52.1% Black 3.3% Asian Amer. 33.5%

Latino 17.4% Other 17.4%

  • Gender: Male 41% Female 59%
  • Ages: 18 19.6% 19 18.3% 20 16.2% 21 16.2% >21 28.8%

Source: SaferCalifornia Universities Survey, 2003

percentage of safer students drinking in past semester quarter
Percentage of Safer Students Drinking in Past Semester/Quarter

Source: SaferCalifornia Universities Survey, 2003

percentage of drinkers getting drunk in past semester quarter
Percentage of Drinkers Getting Drunk in Past Semester/Quarter

Source: SaferCalifornia Universities Survey, 2003

percent of students binge drinking past two weeks
Percent of Students “Binge” Drinking Past Two Weeks

Source: SaferCalifornia Universities Survey, 2003

drinking problems in past semester quarter uc
Drinking Problems in Past Semester/Quarter (UC)

Source: SaferCalifornia Universities Survey, 2003

drinking problems in past semester quarter csu
Drinking Problems in Past Semester/Quarter (CSU)

Source: SaferCalifornia Universities Survey, 2003

secondary drinking problems in past semester quarter uc
Secondary Drinking Problems in Past Semester/Quarter (UC)

Source: SaferCalifornia Universities Survey, 2003

secondary drinking problems in past semester csu
Secondary Drinking Problems in Past Semester (CSU)

Source: SaferCalifornia Universities Survey, 2003