evidence for community-level prevention interventions
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Evidence for Community-Level Prevention Interventions. Bob Saltz Prevention Research Center Berkeley, California. Pacific Institute for Research and Evaluation. Prevention Research Center. Environmental Policies to Reduce College Drinking: An Update of Research Findings. - PowerPoint PPT PresentationTRANSCRIPT
Prevention Research CenterPRCPacific Institute for Research and Evaluation
Evidence for Community-Evidence for Community-Level Prevention Level Prevention
InterventionsInterventions
Bob SaltzBob SaltzPrevention Research CenterPrevention Research Center
Berkeley, CaliforniaBerkeley, California
Environmental Policies to Environmental Policies to Reduce College Drinking: An Reduce College Drinking: An Update of Research FindingsUpdate of Research Findings
Toomey, Lenk, & Wagenaar (2007) Toomey, Lenk, & Wagenaar (2007) Journal of Studies onJournal of Studies onAlcohol and DrugsAlcohol and Drugs
A Matter of Degree (AMOD)A Matter of Degree (AMOD)Weitzman et al. Weitzman et al. American Journal of Preventive MedicineAmerican Journal of Preventive Medicine. .
20042004
College/ Community PartnershipsCollege/ Community Partnerships Environmental strategies to reduce Environmental strategies to reduce
drinking problems:drinking problems: Keg registrationKeg registration Mandatory responsible beverage serviceMandatory responsible beverage service Police wild party enforcementPolice wild party enforcement Substance free residence hallsSubstance free residence halls Advertising bansAdvertising bans
A Matter of Degree (AMOD)A Matter of Degree (AMOD)Weitzman et al. Weitzman et al. American Journal of Preventive MedicineAmerican Journal of Preventive Medicine. .
20042004
AMOD achieved reductions among AMOD achieved reductions among college students incollege students in Binge drinkingBinge drinking Driving after drinkingDriving after drinking Alcohol related injuriesAlcohol related injuries Being assaulted by other drinking Being assaulted by other drinking
college studentscollege students
Campus Community Strategy Campus Community Strategy to Change the Drinking to Change the Drinking
CultureCulture
Western Washington Western Washington UniversityUniversity
Bellingham, WashingtonBellingham, Washington
Project ComponentsProject Components
Neighborhoods Engaging with Neighborhoods Engaging with Students (NEST) Students (NEST)
EnforcementEnforcement LateNight@WWULateNight@WWU Campus Community Coalition work Campus Community Coalition work
groups were involved in planning, groups were involved in planning, implementation, and process implementation, and process evaluation.evaluation.
Study to Prevent Alcohol Related Consequences:
Using a Community Organizing Approach to Implement Environmental Strategies in and
around the College Campus
Mark Wolfson, et alWake Forrest University
SPARCSPARC
Larger Environment
SPARC Intervention
Interventions
Environmental Strategies•Reduce Availability•Address Price/Marketing•Improve Social Norms•Minimize Harm
Elements: Policy, Enforcement, Awareness
High-risk DrinkingIndicators- Quantity - Social Setting- Frequency - Timing- Physical setting
- Underage use
Consequences- Health - Legal- Social - Academic- Violence - Victimization
Culture / Context
Campus cultures
•Student•AdministrationAlumniFaculty
Campus Policies
Community cultures
•Government•NeighborhoodsLaw enforcementRetail/business
Community Policies
Larger political, socio-economic and historical context
Community Organizing• Hold one-on-one meetings
• Understand self-interest
• Analyze power• Build coalition• Identify actionable issues
• Develop strategies• Plan & implement actions
Intermediate Outcomes
Long-term Outcomes
SPARC Conceptual ModelSPARC Conceptual Model
Environmental StrategiesEnvironmental Strategies
Reduce Alcohol Availability
Address Price/Marketing
Improve Social Norms
Minimize Harm
Expectations of each Intervention School:
Include 3 of the 4 areas in strategic plan
Most strategies should be comprehensive – i.e., include Policy, Awareness, and Enforcement elements
CDSCDS Severe ConsequencesSevere Consequences,, due to own drinking due to own drinking
(p=.02)(p=.02) Alcohol-related Injuries, caused to others Alcohol-related Injuries, caused to others
(p=.03)(p=.03)
RA SurveyRA Survey Consequences: p=.04Consequences: p=.04 Environment: p=.01Environment: p=.01 Aggregate: p=.03Aggregate: p=.03
I & I ReportsI & I Reports Police reports ofPolice reports of alcohol-related incidentsalcohol-related incidents
(p=0.04)(p=0.04) Police reports of # of citations for underage Police reports of # of citations for underage
alcohol use (p=.008)alcohol use (p=.008)
Evidence of Impact: Evidence of Impact: SummarySummary
Safer California UniversitiesSafer California UniversitiesProject Goal:Project Goal:
To evaluate the efficacy of aTo evaluate the efficacy of a“Risk Management” approach “Risk Management” approach to alcohol problem preventionto alcohol problem prevention
NIAAA grant #R01 AA12516with support from CSAP/SAMHSA.
Random AssignmentRandom AssignmentIntervention SitesIntervention Sites
CSU ChicoCSU Chico Sacramento StateSacramento State CSU Long BeachCSU Long Beach UC BerkeleyUC Berkeley UC DavisUC Davis UC RiversideUC Riverside UC Santa CruzUC Santa Cruz
Comparison Comparison SitesSites
Cal Poly SLOCal Poly SLO San Jose StateSan Jose State CSU FullertonCSU Fullerton UC IrvineUC Irvine UC Los AngelesUC Los Angeles UC San DiegoUC San Diego UC Santa BarbaraUC Santa Barbara
How is risk management a How is risk management a unique approach?unique approach?
Targets times and places instead of Targets times and places instead of individualsindividuals
Focus on intoxicationFocus on intoxication
Tied to continuous monitoring and Tied to continuous monitoring and improvement - emphasis on “control” improvement - emphasis on “control” rather than “one shot” interventionsrather than “one shot” interventions
Integrated Intervention Integrated Intervention Strategies for Off-Campus Strategies for Off-Campus
Parties Parties Compliance ChecksCompliance Checks
DUI Check PointsDUI Check Points
Party PatrolsParty Patrols
Pass Social Host “Response Cost” Pass Social Host “Response Cost” OrdinanceOrdinance
A Social Host Safe Party CampaignA Social Host Safe Party Campaign
OutcomesOutcomes
Likelihood of getting drunk at a given Likelihood of getting drunk at a given generic setting (e.g., Greek parties; generic setting (e.g., Greek parties; residence halls) plus additional aggregate residence halls) plus additional aggregate measure across all settingsmeasure across all settings
Two baseline years combined vs. two Two baseline years combined vs. two years post-intervention combinedyears post-intervention combined
Controlling for individual-level variables Controlling for individual-level variables and campus/community variablesand campus/community variables
DUI or RWDD Related to Off-Campus Party
0.00
0.05
0.10
0.15
0.20
2003-04 2004-05
Survey years
Intervention
Control
Practical SignificancePractical Significance At each campus, 900 fewer At each campus, 900 fewer studentsstudents
drinking to intoxication at off-campus drinking to intoxication at off-campus parties and 600 fewer getting drunk at parties and 600 fewer getting drunk at bars/restaurants during the fall semester at bars/restaurants during the fall semester at intervention schools relative to controls. intervention schools relative to controls.
Equivalent to Equivalent to 6,0006,000 fewer fewer incidentsincidents of of intoxication at off-campus parties and intoxication at off-campus parties and 4,0004,000 fewer incidents at bars & restaurants fewer incidents at bars & restaurants during the fall semester at Safer during the fall semester at Safer intervention schools relative to controlsintervention schools relative to controls
In Sum…In Sum… We have the ability to create We have the ability to create
environments that help teens and environments that help teens and young adults make healthy decisions young adults make healthy decisions about alcohol consumptionabout alcohol consumption
We have growing evidence that these We have growing evidence that these strategies are effectivestrategies are effective
Our greatest impact will likely come Our greatest impact will likely come from adopting mutually-reinforcing from adopting mutually-reinforcing policies and practicespolicies and practices
Typical Hurdles for Comprehensive Typical Hurdles for Comprehensive Prevention StrategyPrevention Strategy
Implicit assumption that the only Implicit assumption that the only “target” is high-risk drinkers“target” is high-risk drinkers
Ambivalence about student drinkingAmbivalence about student drinking
Low perceived efficacy of preventive Low perceived efficacy of preventive interventionsinterventions
Challenges of coordination and Challenges of coordination and resource allocationresource allocation
Possible fears of “backlash”Possible fears of “backlash”
Unique Hurdles for College PreventionUnique Hurdles for College Prevention
Too much weight on “process” vs. “outcome”Too much weight on “process” vs. “outcome”
Preference for persuasion over controlPreference for persuasion over control
Universities are complex, diffuse Universities are complex, diffuse organizationsorganizations
Prevention staff trained in education, Prevention staff trained in education, awareness strategiesawareness strategies
Prevention staff usually lacks authority to Prevention staff usually lacks authority to launch initiativeslaunch initiatives