Live Long and Live Long and Prosper: Prosper: Using Research to Using Research to Sustain Effective Sustain Effective Strategies Strategies Kathryn Stewart Kathryn Stewart Prevention Research Center Prevention Research Center Underage Drinking Enforcement Underage Drinking Enforcement Training Center Training Center 6 6 th th Annual National Leadership Annual National Leadership Conference Conference
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Live Long and Prosper: Using Research to Sustain Effective Strategies Kathryn Stewart Prevention Research Center Underage Drinking Enforcement Training.
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Live Long and Live Long and Prosper:Prosper:
Using Research to Sustain Using Research to Sustain Effective StrategiesEffective Strategies
Kathryn StewartKathryn StewartPrevention Research CenterPrevention Research CenterUnderage Drinking Enforcement Underage Drinking Enforcement
Training CenterTraining Center
66thth Annual National Leadership Annual National Leadership ConferenceConference
PRC Resource PRC Resource Link: Link: Research in Research in
ActionActionProvides information and Provides information and
practical guidancepractical guidance
Resource Link Goals:Resource Link Goals:
Make PRC research more well Make PRC research more well known and more accessibleknown and more accessible
Translate findings into practical Translate findings into practical guidanceguidance
Facilitate dialogue between Facilitate dialogue between researchers and practitioners, policy researchers and practitioners, policy makers, advocatesmakers, advocates
The Challenge:The Challenge:
How to enhance How to enhance sustainabilitysustainability
The StrategyThe Strategy
Solid research and effective Solid research and effective communication of results can communication of results can enhance sustainabilityenhance sustainability..
How Research can HelpHow Research can Help
Research can guide programs and Research can guide programs and garner community supportgarner community support
Research can demonstrate program Research can demonstrate program effectivenesseffectiveness
Research can support permanent Research can support permanent policy changepolicy change
Research to Research to guide programs guide programs
and garner and garner community community
supportsupport
The Border The Border ProjectProject
Preventing alcohol-Preventing alcohol-related problems at the related problems at the
US/Mexico BorderUS/Mexico Border
Current sitesCurrent sites
San Diego -TijuanaSan Diego -Tijuana El Paso – JuarezEl Paso – Juarez Laredo –Nuevo LaredoLaredo –Nuevo Laredo Brownsville - MatamorosBrownsville - Matamoros
The ProblemThe Problem
Mexico’s drinking age is 18Mexico’s drinking age is 18 Some border towns provided Some border towns provided
plentiful, cheap sources of alcoholplentiful, cheap sources of alcohol
The ProblemThe Problem
Mexico’s drinking age is 18Mexico’s drinking age is 18 Some border towns provided Some border towns provided
plentiful, cheap sources of alcoholplentiful, cheap sources of alcohol Young people traveled to Mexico to Young people traveled to Mexico to
drinkdrink Beverage service not always Beverage service not always
“responsible”“responsible”
The ProblemThe Problem
Mexico’s drinking age is 18Mexico’s drinking age is 18 Some border towns provided plentiful, Some border towns provided plentiful,
cheap sources of alcoholcheap sources of alcohol Young people traveled to Mexico to drinkYoung people traveled to Mexico to drink Beverage service not always Beverage service not always
“responsible”“responsible” Heavy drinking occurredHeavy drinking occurred Sometimes resulted in problems in Sometimes resulted in problems in
MexicoMexico
The ProblemThe Problem Mexico’s drinking age is 18Mexico’s drinking age is 18 Some border towns provided plentiful, Some border towns provided plentiful,
cheap sources of alcoholcheap sources of alcohol Young people traveled to Mexico to drinkYoung people traveled to Mexico to drink Beverage service not always Beverage service not always
“responsible”“responsible” Heavy drinking occurredHeavy drinking occurred Sometimes resulted in problems in Sometimes resulted in problems in
MexicoMexico Impaired young people drove homeImpaired young people drove home
The Research StrategyThe Research Strategy
PIRE studied drinking behavior of PIRE studied drinking behavior of young US residents crossing into young US residents crossing into MexicoMexico
Documented the extent of heavy Documented the extent of heavy drinkingdrinking
Shed light on motivations and Shed light on motivations and behavior of border crossersbehavior of border crossers
The Implementation The Implementation StrategyStrategy
The nature and scope of the problem The nature and scope of the problem were explained to groups and were explained to groups and agencies on both sides of the borderagencies on both sides of the border
Media advocacy brought the Media advocacy brought the problem to the attention of the problem to the attention of the public through compelling news public through compelling news coveragecoverage
The Change StrategiesThe Change Strategies
Earlier bar closingsEarlier bar closings Stepped up DUI enforcement efforts Stepped up DUI enforcement efforts
on the US side of the border on the US side of the border Highly publicized enforcement of Highly publicized enforcement of
laws against crossing by youth under laws against crossing by youth under 1818
New restrictions on Marines from New restrictions on Marines from Camp PendletonCamp Pendleton
The ResultsThe Results
Dramatic decline in number of Dramatic decline in number of nighttime crossings by young peoplenighttime crossings by young people
Reduction in nighttime crashes Reduction in nighttime crashes involving drivers under 18involving drivers under 18
90% reduction in number of Marines 90% reduction in number of Marines driving back from the borderdriving back from the border
The Follow-upThe Follow-up
Results are fed back to the Results are fed back to the communities to sustain actioncommunities to sustain action
The take-home messageThe take-home message
Research can provide motivation for Research can provide motivation for changechange
Research can provide data to guide Research can provide data to guide program strategiesprogram strategies
Research to Research to demonstrate demonstrate
program program effectivenesseffectivenessThe Community Trials The Community Trials
Project to Reduce Project to Reduce Alcohol-Related TraumaAlcohol-Related Trauma
The ProblemThe Problem
Impaired driving crashesImpaired driving crashes
Other unintentional injuriesOther unintentional injuries
Other alcohol-related traumaOther alcohol-related trauma
The Research StrategyThe Research Strategy
Identify strategies with the highest Identify strategies with the highest likelihood of success community-widelikelihood of success community-wide
Implement them vigorously in Implement them vigorously in communitiescommunities
Evaluate changes over time and Evaluate changes over time and compare to non-intervention compare to non-intervention communitiescommunities
The Implementation The Implementation StrategyStrategy
Increased enforcement of drinking and driving lawsIncreased enforcement of drinking and driving laws
Media coverage to enhance perceptions of increased Media coverage to enhance perceptions of increased law enforcementlaw enforcement
Compliance checks to reduce underage access to Compliance checks to reduce underage access to alcoholalcohol
Reduced availability through changes in outlet Reduced availability through changes in outlet densities, planning and zoning laws, and challenges densities, planning and zoning laws, and challenges to license applicationsto license applications
The ResultsThe Results 49% reduction in heavy alcohol consumption 49% reduction in heavy alcohol consumption
51% reduction in impaired driving51% reduction in impaired driving
10% reduction in late night traffic crashes10% reduction in late night traffic crashes
6% reduction in the average amount that people 6% reduction in the average amount that people reported drinkingreported drinking
6% reduction in crashes involving drinking drivers6% reduction in crashes involving drinking drivers
43% reduction in injuries resulting from assaults 43% reduction in injuries resulting from assaults presenting in emergency rooms presenting in emergency rooms
The Follow-upThe Follow-up
Community Trials Project was Community Trials Project was awarded “model program status” by awarded “model program status” by the Center for Substance Abuse the Center for Substance Abuse Prevention. Prevention.
Communities across the country are Communities across the country are adopting this program and receiving adopting this program and receiving federal support under the State federal support under the State Incentive Grants program. Incentive Grants program.
The take-home messageThe take-home message
Research can provide information on Research can provide information on what strategies are likely to be effectivewhat strategies are likely to be effective
Research can provide support for Research can provide support for program effectivenessprogram effectiveness
Research can provide positive feedback Research can provide positive feedback to continue programs and to to continue programs and to disseminate themdisseminate them
Research to support Research to support permanent policy permanent policy
changechange
Alcohol Outlet Density Alcohol Outlet Density and Alcohol Problemsand Alcohol Problems
The ProblemThe Problem
Neighborhoods where bars, restaurants and liquor and other stores that sell alcohol are close together suffer more frequent incidences of violence and other alcohol-related problems.
The Research StrategyThe Research Strategy
Demonstrate the link between outlet Demonstrate the link between outlet location and density and problemslocation and density and problems
Analyze the nature of the linkAnalyze the nature of the link
The Implementation The Implementation StrategyStrategy
Make communities aware of the Make communities aware of the problems created by alcohol outletsproblems created by alcohol outlets
Make communities aware of the Make communities aware of the policy strategies that can control policy strategies that can control outlet location and densityoutlet location and density Licensing policiesLicensing policies Land use policiesLand use policies
The ResultsThe ResultsCommunities can:Communities can:
Set minimum distances between alcohol outlets
Limit new licenses for areas that already have outlets too close together;
Not issue a new license when an outlet goes out of business
Permanently close outlets that repeatedly violate liquor laws
The Follow-upThe Follow-up
Policy changes can permanently Policy changes can permanently change the environmentchange the environment
Reductions in alcohol problems can Reductions in alcohol problems can be sustainedbe sustained
Communities are empowered to take Communities are empowered to take control of the alcohol environmentcontrol of the alcohol environment
The take-home messageThe take-home message
Research can provide support for Research can provide support for policy and environmental changespolicy and environmental changes
Once a law or policy has been Once a law or policy has been changed, it is difficult to undo itchanged, it is difficult to undo it
Once an environment has been Once an environment has been changed, the effects are likely to be changed, the effects are likely to be long-lastinglong-lasting
www.resources.prev.orgwww.resources.prev.org
More ExamplesMore Examples
Using Data to Guide and Sustain Using Data to Guide and Sustain Community InterventionsCommunity Interventions
Using research to identify settings Using research to identify settings and prevention strategies at and prevention strategies at California Universities California Universities
Using Data to Using Data to Guide and Sustain Guide and Sustain
Community Community InterventionsInterventionsJoel W. Grube, Ph.DJoel W. Grube, Ph.D..
Prevention Research CenterPrevention Research CenterPacific Institute for Research and EvaluationPacific Institute for Research and Evaluation
OJJDP UDETC National Leadership ConferenceOJJDP UDETC National Leadership ConferenceTucson, AZTucson, AZ
August 18-20, 2005August 18-20, 2005
Preparation of this presentation was supported byNIAAA grants AA006282 and AA014958
What is Sustainability?What is Sustainability?Sustainability addresses three issues:Sustainability addresses three issues:
Maintaining the benefits of a programMaintaining the benefits of a program
Continuing a programContinuing a program
Building the capacity to continue a programBuilding the capacity to continue a program
Broadly speaking sustainability refers to:Broadly speaking sustainability refers to:
““The process of ensuring an adaptive The process of ensuring an adaptive preventive system … can be integrated into preventive system … can be integrated into ongoing operations to benefit diverse ongoing operations to benefit diverse stakeholders.”stakeholders.”
((Johnson, Hayes, Center, & Daley, 2004, p. 137))
Key Issues in Key Issues in SustainabilitySustainability Sustainability is an Sustainability is an ongoingongoing dynamic process dynamic process
Sustainability is an Sustainability is an adaptiveadaptive process process
Sustainable innovation is Sustainable innovation is integratedintegrated into normal into normal operations and requires operations and requires adequate infrastructureadequate infrastructure capacitycapacity
Sustainable innovation should have proven Sustainable innovation should have proven benefitbenefit to diverse stakeholders to diverse stakeholders
Sustainability requires Sustainability requires commitmentcommitment and support: and support:ChampionsChampionsDecision-makersDecision-makersStakeholdersStakeholdersWorkersWorkers
Source: Johnson, Hayes, Center, & Daley, 2004
Model of SustainabilityModel of Sustainability
Sustainable Sustainable Innovation Innovation
ContinuationContinuation
Sustainable Sustainable Innovation Innovation
ContinuationContinuation
Innovation Innovation Integration into Integration into
SystemSystem
Innovation Innovation Integration into Integration into
SystemSystem
Source: Johnson, Hayes, Center, & Daley, 2004
AssessAssessPlanPlan
ImplementImplementEvaluateEvaluate
Reassess/ModifyReassess/Modify
AssessAssessPlanPlan
ImplementImplementEvaluateEvaluate
Reassess/ModifyReassess/Modify
DataDataDataData
CapacityCapacityBuildingBuilding
CapacityCapacityBuildingBuilding
Stakeholder Stakeholder BenefitsBenefits
Stakeholder Stakeholder BenefitsBenefits
Some Examples Using Data:Some Examples Using Data:
Oregon Youth Alcohol Access ProjectOregon Youth Alcohol Access ProjectCommunity Trials Project to Reduce Community Trials Project to Reduce
Of those Oregon 11Of those Oregon 11thth graders who graders who report drinking in the past 30 days, report drinking in the past 30 days, 60% report having 5+ drinks….60% report having 5+ drinks….
30-Day Drug Use Among 30-Day Drug Use Among Oregon 11Oregon 11thth Graders Graders
0 10 20 30 40 50 60
Alcohol
5+ Drinks
Marijuana
Inhalants
Any Other Illict Drug Alcohol is by far the most Alcohol is by far the most commonly used and abused drug commonly used and abused drug among Oregon 11among Oregon 11thth graders…. graders….
Where are more resources needed?Where are more resources needed?
Effects of Compliance Checks and Effects of Compliance Checks and RBS on Underage SalesRBS on Underage Sales
4753
45
35
1916
0
10
20
30
40
50
60
Per
cen
t o
f O
utl
ets
Sel
lin
g
Pretest Posttest
Comparison (NoTreatment)
ComplianceChecks
ComplianceChecks + RBS
Source: Grube, 1997
ConclusionConclusionData can guide and sustain programs:Data can guide and sustain programs:
Define the problem and the solutionDefine the problem and the solution
Plan and target interventionsPlan and target interventions
Monitor implementationMonitor implementation
Evaluate outcomesEvaluate outcomes
Reassess and modify interventionsReassess and modify interventions
Marshall support for increased allocation Marshall support for increased allocation of resources and infrastructure capacityof resources and infrastructure capacity
Key reference:Key reference:
Johnson, K., Hays, C., Center, H., & Johnson, K., Hays, C., Center, H., & Daley, C. (2004). Building capacity Daley, C. (2004). Building capacity and sustainable prevention and sustainable prevention innovations: A sustainability innovations: A sustainability planning model. planning model. Evaluation and Evaluation and Program Planning, 27Program Planning, 27, 135-149., 135-149.
Using Research Data to Using Research Data to Identify, Evaluate, and Identify, Evaluate, and Sustain Environmental Sustain Environmental
Alcohol Prevention Alcohol Prevention Strategies in College Strategies in College
SettingsSettings
Safer California Universities:Safer California Universities:A risk management approach A risk management approach to college student drinking to college student drinking
problemsproblems
Robert F. Saltz, Ph.D.Robert F. Saltz, Ph.D.Principal InvestigatorPrincipal Investigator
Prevention Research Center, Prevention Research Center, Pacific Institute for Research and Pacific Institute for Research and
EvaluationEvaluation
Funded by the National Institute on Funded by the National Institute on Alcohol Abuse and AlcoholismAlcohol Abuse and Alcoholism
Safer California Safer California UniversitiesUniversitiesProject GoalProject Goal
To evaluate the efficacy of aTo evaluate the efficacy of a“Risk Management” approach “Risk Management” approach
to alcohol problem to alcohol problem preventionprevention
Risk ManagementRisk Management Risk Assessment – using data to identify Risk Assessment – using data to identify
Risk Reduction – interventions aimed at Risk Reduction – interventions aimed at reducing alcohol-related problemsreducing alcohol-related problems
Risk Monitoring – using data to assess Risk Monitoring – using data to assess intervention effectiveness and modify intervention effectiveness and modify interventions if necessaryinterventions if necessary
Risk Assessment and Risk Assessment and Monitoring Data SourcesMonitoring Data Sources
Brief interviews with key Brief interviews with key personnelpersonnel
Archival data sourcesArchival data sources
Student survey dataStudent survey data
What are we trying to What are we trying to prevent?prevent?
Intoxication at particular Intoxication at particular settings/eventssettings/events
Harm related to intoxication at Harm related to intoxication at particular settings/eventsparticular settings/events
Selecting A Selecting A Problem SettingProblem Setting
Using assessment data to Using assessment data to target prevention effortstarget prevention efforts
Web-based Student Survey, Web-based Student Survey, Fall 2003Fall 2003
Administered to ~14,000 students at Administered to ~14,000 students at 14 California universities14 California universities
Established baseline levels of Established baseline levels of student drinking and alcohol-related student drinking and alcohol-related problemsproblems
Identified settings where the Identified settings where the majority of alcohol-related problems majority of alcohol-related problems are occurringare occurring
Survey Modules for Specific Survey Modules for Specific SettingsSettings
Residence hall partiesResidence hall parties Greek partiesGreek parties Campus events (e.g., concerts, Campus events (e.g., concerts,
Questions About Each Questions About Each SettingSetting
Frequency of going to setting during Frequency of going to setting during semestersemester
Frequency of alcohol useFrequency of alcohol use Frequency of intoxicationFrequency of intoxication Frequency of alcohol-related problemsFrequency of alcohol-related problems Last time at setting:Last time at setting:
How long at settingHow long at setting How much alcohol consumed before, during, How much alcohol consumed before, during,
afterafter Number of people, underage drinking, system for Number of people, underage drinking, system for
Prevalence of Student Intoxication Last Time at Each Setting
0
10
20
30
40
50
60
70
Dorm party Greek party Campus event Off-campusparty
Bar/restaurant Outdoor setting
Source: Safer CA Univerisities Fall 2003 Survey
Per
cen
t
Drinking Problems in Past Drinking Problems in Past Semester/QuarterSemester/Quarter
51
21
24
4
17
9
6
10
12
38
26
23
0 10 20 30 40 50 60
Percentage
HangoverMissed Class
Got Behind in WorkTaken Advatage of Sexually
Had Unplanned SexNot Used ProtectionDamaged PropertyGot Hurt or InjuredDid Poorly on Test
Got SickDUI
RWDD
Source: Safer California Universities Survey, 2003
Secondary Drinking Problems Secondary Drinking Problems in Past Semesterin Past Semester
15
4
12
6
2
9
34
26
12
13
1
0 10 20 30 40
Percentage
Insulted
Harassed
Argument
Pushed, Hit, Assaulted
Physical ViolenceProperty Damaged
Take Care of Other
Studies or Sleep Disrupted
Unwanted Sexual AdvanceFound Vomit
Sexual Assault
Source: Safer California Universities Survey, 2003
Percentage of Alcohol Problems by Setting
Fall 2003
.8%
5.6%
57.2%
14.6%
3.7%
18.0%
Outdoor settings
Bars/restaurants
Off campus parties
Greek parties
Campus events
Dorm parties
Why Off-Campus Parties are Why Off-Campus Parties are
Causing the Most ProblemsCausing the Most Problems Over 9,000 students in survey Over 9,000 students in survey
sample went to at least one off-sample went to at least one off-campus party, 3-4 times as many as campus party, 3-4 times as many as other settingsother settings
Statistical analyses indicate that off-Statistical analyses indicate that off-campus parties carry a higher risk campus parties carry a higher risk for frequent intoxication and alcohol-for frequent intoxication and alcohol-related problems than other settingsrelated problems than other settings
Effects of Survey Data on Effects of Survey Data on Decision MakingDecision Making
Consensus among members of Consensus among members of campus-community task forces to campus-community task forces to target interventions to off-campus target interventions to off-campus settings (e.g., house parties)settings (e.g., house parties)
Strong support for initiation and Strong support for initiation and long-term implementation of long-term implementation of interventionsinterventions
Great interest in continuing surveys Great interest in continuing surveys to assess intervention effectsto assess intervention effects
Interventions for Off-Campus SettingsInterventions for Off-Campus Settings Educational campaign that helps students Educational campaign that helps students
and others host safe social gatherings and and others host safe social gatherings and to know their responsibility as a host for to know their responsibility as a host for the safety and well-being of their guests the safety and well-being of their guests and neighbors;and neighbors;
Fair but firm enforcement of existing laws Fair but firm enforcement of existing laws that protect the community from alcohol-that protect the community from alcohol-related harm:related harm: DUI enforcementDUI enforcement Party patrols to disperse dangerous crowdsParty patrols to disperse dangerous crowds Enforce laws prohibiting alcohol sales or Enforce laws prohibiting alcohol sales or
informal provision of alcohol to minorsinformal provision of alcohol to minors Placing the burden of costs to those who Placing the burden of costs to those who
repeatedly require community or police repeatedly require community or police response – a “response cost” ordinance.response – a “response cost” ordinance.
SummarySummary Student survey, archival and key informant Student survey, archival and key informant
data provide an assessment of where and data provide an assessment of where and when alcohol-related problems are when alcohol-related problems are occurringoccurring
These data can be used to help college These data can be used to help college prevention specialists, administrators, prevention specialists, administrators, campus police and others to focus campus police and others to focus intervention efforts on a particular setting intervention efforts on a particular setting and sustain those effortsand sustain those efforts
Data can also be used to monitor the effects Data can also be used to monitor the effects of interventions targeted to specific settingsof interventions targeted to specific settings
For More Info. About the For More Info. About the Safer CA Universities Safer CA Universities
Project…Project…
Michelle Blackston and Richard Michelle Blackston and Richard McGaffiganMcGaffigan
Data-driven Strategic Planning and Data-driven Strategic Planning and Implementation ProcessImplementation Process