Environmental Strategies

Becky Ireland- Higher Education Alcohol Prevention Project

Mary Bourque - Partnership For A Tobacco-Free Maine

We can try to change conditions within each individual to influencetheir decisions

But we also need to change conditions in the environment surrounding the individuals to encourage and supporthealthier/safer decisions

Definition of Environmental Strategies

• Those strategies that alter the legal, social, economic or physical environment in some way to make it more conductive for health and well-being

Policy and Environmental Interventions

• Policy interventions include laws, regulations and rules (formal and informal)

• Environmental interventions include changes to the economic, social, or physical environment.

Policy & Environmental Change –Executive Summary

ASTDHPPHE/CDC,2001

• local / regional / national / global

• natural environment (physical)

• built; architectural environment (physical)• political/policy environment (social)• mass culture/media environment (social) • technological environment (social)

Maine Bureau of Health

ENVIRONMENT

Individual vs. Environmental Strategies

It is difficult to encourage young people to “just say no” when their environment in so many ways shouts “just say yes!”

Research increasingly shows a need for both individual and environmental strategies

Why Environmental Strategies?

• Tobacco, alcohol, and other drugs are not just youth issues – adult attitudes and behavior must change as well if we hope to make progress

• Many people are “fence sitters” – will go either way if they are given a good enough reason and enough support to justify their decision

• It can be difficult to reach all of these fence sitters to convince them each to make healthy/safe decisions, but they are greatly influenced by their environment – rather than trying to convince them to go against the wind, we can sometimes increase our impact by changing the way the wind blows.

In order to better assess and address the environment, prevention uses a social ecological model. This model illustrates the multiple domains, or levels, which make up the overall

environment.

Multiple levels within a social ecology framework

Individuals

Social Networks peers, families, cliques

Organizationspolicies, practices

Communitynorms, cultures, practices

Policy & Environment public policies/regs (local•state•federal)

environment = built or natural

Community Health Program/Bureau of Health/DHS

Using the Framework

• To increase likelihood of effectiveness, prevention needs to use multiple strategies in multiple domains.

• By “attacking” the issue from multiple angles the likelihood of long-term, systemic change is improved.

Effective Prevention: Multiple Strategies in Multiple Domains

Individual

•Knowledge•Attitudes/Beliefs•Social Skills•Personal characteristics•Aspirations•Expectations about effects of substances•Biological risk factors

Multiple Strategies in Multiple Domains

Peers Family

•Friends’ attitudes/behavior•Perceptions of norms•Access to substances•Peer pressure

•Family bonding/rewards•Rules & enforcement•Addiction•Modeling behavior•Access to substances

Social Networks

School

•Academic success•Policies & enforcement•Opportunities/rewards for positive involvement•Adult role models

Youth Organizations

Adult

Organizations•Policies & Enforcement

•Practices

•Role modeling

Multiple Strategies in Multiple Domains

Community

•Norms, culture

•Practices

•Laws & enforcement

•Opportunities/rewards

for positive involvement

•Access to substances

•Adult role models

Multiple Strategies in Multiple Domains

Multiple Strategies in Multiple Domains

Policy &Environment

•Local/State/federal laws•Physical Environment•Mass media•Alcohol advertising•Traditions/expectations•Economic forces/ funding issues

Community Coalitions

• Fit the socio-ecological perspective because they work with multiple domains and promote community change.

Community Coalition

• Coalition - Organization of individuals representing diverse organizations combining to effect a specific change by working together.

– Develop widespread public support– Maximize power through joint action– Minimize duplication– Help mobilize more talent, resources and approaches

to issues

Changing the Environment: Where are the breakdowns in your community?

NORMS AVAILABILITY

REGULATIONSlaws, policies, guidelines, rules

-as designed-as communicated-as understood-as enforced -as perceived to be enforced

-retail-social

-what is acceptable? -actual norms (behavior) -as expressed/communicated - as perceived

Norms

• Occur at all levels of the social ecological model

• There is often a big variance between the “perceived norm” and the “actual norm”

• There is evidence that correcting people’s misperceptions can lead to behavior change

Tobacco Use Perception

• 60% of the high school students surveyed reported they think over 50% of high school students smoke cigarettes once a month or more.(2001 YTS)

• Adults surveyed reported that they think that out of 100 students 49% smoke cigarettes at least once a month. (2001 MATS)

• In reality 24.8% of high school youth smoke cigarettes at least once a month. (2001 YTS)

Social Norm Marketing Example

• PTM “92% Campaign” – (Teaser Campaign)

• Desired outcome -help middle school youth understand that most kids don’t smoke

• 92 % posters throughout participating middle schools – what is this about?

• Answer – 92% is the percent of kids that think smoking is not cool. (youth segmentation tobacco survey)

Researchers have found these misperceptions in every group they have studied, from middle school to college students

Strategies:• Social Norms Theory

– Correcting youth over perceptions of how much/often their peers are drinking

– Highlighting the wide existence of desirable attitudes/beliefs/actions

• Media Campaigns– Correcting adult under

perceptions of how much/often youth are using and other factors such as where they are getting it

How you can get involved:• Know the data – use it

whenever you hear people verbalizing a misperception

• Present data from a positive perspective – what the majority is doing right

• Media advocacy• Use existing materials locally;

communicate needs for additional materials

Changing Norms

Social Norms Theory: Considerations for Implementation

• In your experience, do students suffer from these exaggerated misperceptions?

• Is the real norm that the majority is making healthy choices?

• Does the exaggerated misperception influence people’s decisions?

• Can the misperception be corrected? How?• Who are the “carriers” of the misperceptions?

(people who spread them without even realizing they aren’t true)

• Would it make a difference if people knew the truth and understood the misperceptions? How?

Reducing Retail AvailabilitySample Strategies:• Compliance Checks

– collaborative effort– Nationally one of the most

well-documented strategies for reducing underage retail access to tobacco/alcohol

• Vendor Education – “NO Buts”

• Point of Sale Initiatives• Sticker Shock Campaign

– May & December each year

– Publicizes furnishing laws to deter adults from purchasing alcohol for youth

How you can get involved:

• Be prepared to publicly support the strategy when opposition arises – letters to the editor, legislative contacts if necessary, etc.

• Many different options:– Youth/community group

plans local initiative– Encourage stores to

participate– Use materials in other ways

Regulations & Enforcement

• Includes laws, policies, guidelines, and rules

• Careful and continuous attention needs to be paid to how regulations are written, communicated to people, understood by people, as well as how they are enforced and how people THINK they are enforced

Examples of TobaccoPolicy Initiatives

• Tobacco-Free School Policy (norms, avail., regs)

• Tobacco-Free Playing Field Policy (norms, avail., regs)

• Worksite No Smoking Policy (norms, avail., regs)

• Road map – Working Toward Sustainable Local Policy Change Steps and Examples

(handout)

Examples of Alcohol Policy Initiatives

• Public possession/intoxication

• Minimum Drinking Age

• Providing to a minor

• Operating Under the Influence

• Alcohol Outlet Density

• Keg Registration

• Indirect policy initiatives- parties, noise

Finally…

• Don’t expect change overnight – make it a long-term commitment

• Celebrate small successes often

• Don’t underestimate your power to start an avalanche with a small strategic set of snowballs

Exercise

• Split into groups and read the scenario given to your group

• Answer the questions given to your group based on the scenario

• When all groups are done, we will as 1 or 2 people from the group to share the responses

Environmental Strategies Scenario

• Your community assessment indicates that the most common places youth are drinking alcohol is in a home or other private property with or without an adult’s permission. Within your coalition their has been discussion about how to address this.

• Please discuss how this issue can be addressed in terms of the environmental strategies that reach all of the domains in the social ecological model.