Preventing Underage Drinking

Preventing Underage Drinking: Using Getting To Outcomes(TM) with the SAMHSA Strategic Prevention Framework to Achieve Results

Pamela Imm
Matthew Chinman
Abraham Wandersman
David Rosenbloom
Sarah Guckenburg
Roberta Leis
Copyright Date: 2007
Published by: RAND Corporation
Pages: 308
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  • Book Info
    Preventing Underage Drinking
    Book Description:

    Alcohol is the primary contributor to adolescent deaths in the United States. Structured according to the Substance Abuse and Mental Health Services Administration's (SAMHSA's) Strategic Prevention Framework, a five-step prevention approach, this comprehensive guide to developing, implementing, and evaluating a communitywide plan to prevent underage drinking adopts the Getting To Outcomes model of evaluation, accountability, and improvement.

    eISBN: 978-0-8330-6008-2
    Subjects: Sociology, Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-ii)
    (pp. iii-iv)
  3. Table of Contents
    (pp. v-viii)
    (pp. ix-x)
    (pp. xi-xii)
    (pp. xiii-xiv)
    (pp. xv-xvi)
    (pp. 1-6)

    The story from theCharlotte Observerhighlights tragic circumstances that impact families and communities in ways that are life changing. Cultural norms, policies, and conditions that accept or promote underage drinking exist in most communities in the United States. The purpose of this guide is to help communities through a systematic process of planning, implementation, and evaluation that will improve results in reducing and preventing underage drinking.

    Since research indicates that altering environments where alcohol is used reduces alcohol use (e.g., underage drinking and driving), this guide is focused on the evidence-basedenvironmental approachesto preventing underage drinking that a...

  9. Strategic Prevention Framework Step 1:: Organize the community to profile needs and resources
    • CHAPTER 1: Accountability Question: How can we organize the community to profile community needs and resources regarding underage drinking? (Community Mobilization)
      (pp. 7-12)

      In an environment that encourages or allows youth to engage in unhealthy or risky behavior, such as drinking alcohol, it takes an entire community to enact effective and meaningful change. So how do you get a community mobilized? As Philip H. Cass, former Hope for the Future chairperson of a community policy panel said, “It requires a unique public-private partnership to provide the force and direction needed to realize a vision of a healthy and safe place for all youth” (Franklin County Prevention Institute, 1995).

      One way to mobilize a community is by building coalitions, defined as “inter-organizational, cooperative, and...

    • CHAPTER 2: Accountability Question: What are the underlying needs and conditions that must be addressed in the community to reduce underage drinking? (Assessment)
      (pp. 13-20)

      Here is what can be concluded from this community example:

      • Local merchants need to be educated regarding compliance with alcohol sales laws.

      • Property owners, or whoever owns the land where youth are drinking, need to be informed and action must be taken to stop this from happening in the future.

      • Youth (target population) need to be exposed to prevention programming and made more aware of the laws and dangers of underage drinking.

      • Parents have attitudes favorable toward youth using alcohol.

      • Law enforcement’s attitude toward enforcing underage drinking laws is not a deterrent to youth who choose to drink.

      • Law enforcement...

  10. Strategic Prevention Framework Step 2:: Mobilize and/or build capacity to address needs
    • CHAPTER 3: Accountability Question: What are the goals, target populations, and desired outcomes for the community? (Goals)
      (pp. 21-24)

      To ensure high-quality planning, any organization (e.g., policy panel, community coalition) should first establish goals for its work. When planning environmental strategies, goals should focus on conditions that contribute to or deter underage drinking based on the results of the needs and resources assessments. Once goals are clearly defined, it is much easier to identify specific desired outcomes for any environmental strategy

      Sample goal statements for the components to prevent under-age drinking include

      • Decrease accessibility/availability of alcohol by youth under age 21.

      • Improve merchants’ ability to effectively “card” all under-age youth.

      • Decrease parental approval of underage drinking as a “rite...

    • CHAPTER 4: Accountability Question: What capacities need to be strengthened to develop and implement a plan to reduce underage drinking? (Capacities)
      (pp. 25-28)

      In this step, consider what capacities need to be strengthened to achieve the goals and desired outcomes specified in the previous accountability question on goals. Examine how to strengthen capacities across several areas, such as human capacities, fiscal capacities, technical capacities, and structural capacities, such as collaboration and networking.

      Building capacity to address issues related to underage drinking allows the group to do the following:

      • Identify which additional community members need to be involved in developing the plan (e.g., youth, teachers, membership from various racial/ethnic groups).

      • Examine community resources and what infrastructure (e.g., data systems) and strengths (e.g., data systems)...

  11. Strategic Prevention Framework Step 3:: Develop a comprehensive strategic plan
    • CHAPTER 5: Accountability Question: What evidence-based environmental strategies will be useful in helping to achieve the goals? (Environmental Strategies)
      (pp. 29-38)

      Many policies to reduce underage drinking have been researched and evaluated to determine whether they are effective. A policy or strategy is “evidenced-based” if it has shown to reliably produce measurable reductions in underage drinking in communities or research settings (Oregon State University, 2003). Implementing a policy that has already been shown to be successful can help reach the goal of reducing underage drinking. It is also more effective to implement a multicomponent strategy to prevent underage drinking that addresses the family, school, and community (Komro & Toomey, 2002). A number of environmental strategies have been proven effective in reducing...

    • CHAPTER 6: Accountability Question: How will the environmental strategies to reduce underage drinking “fit” within the community context? (Fit)
      (pp. 39-42)

      The concept of “fit” can be thought of in a variety of ways. In this accountability question, the idea is that there should be an assessment of how the proposed environmental strategies (chosen in the previous chapter) will fit with

      1. values and practices of the community

      2. the characteristics (e.g., age, gender, ethnicity, language, rural/urban, level of need) of the target populations

      3. the philosophical mission of the host agency or organization

      4. the culture of the target population, which affects how they can be reached and best served (e.g., college students who would attend alcohol-free tailgate parties if provided, reduced happy hour...

    • CHAPTER 7: Accountability Question: What is the plan for reducing underage drinking? (Plan)
      (pp. 43-48)

      It is important to have an ongoing planning document that specifies who will do what, when, and where. Planning issues can be relevant at a larger level (e.g., county plan) or at a smaller level (e.g., neighborhood plan). This accountability question provides information to consider when planning details of environmental strategies to reduce underage drinking. See the section on Evidence-Based Environmental Strategies in this guide for tools that can be used in planning each of the ten environmental strategies outlined in Chapter 5.

      High-quality planning can improve implementation, which, in turn, can lead to improved outcomes. Just like a to-do...

  12. Strategic Prevention Framework Step 4:: Implement evidence-based prevention strategies and activities
    • CHAPTER 8: Accountability Question: How will the implementation of the plan to reduce underage drinking be assessed? (Process Evaluation)
      (pp. 49-56)

      A process evaluation assesses what activities were implemented, the quality of the implementation, and the strengths and weaknesses of the implementation. This information can help strengthen and improve each environmental strategy. A well-planned process evaluation is developed prior to beginning an environmental strategy and continues throughout its duration.

      How well an environmental strategy is implemented is critical to obtaining positive results. In this question, the process evaluation will identify how well the plan is put into action. Process evaluation data are useful in two primary ways: (1) by highlighting modifications to be made immediately and (2) by facilitating changes...

  13. Strategic Prevention Framework Step 5:: Monitor, evaluate, sustain, and improve or replace those strategies that fail
    • CHAPTER 9: Accountability Question: How well are the strategies working in the comprehensive plan to reduce underage drinking? (Outcome Evaluation)
      (pp. 57-68)

      In this guide, outcomes are changes that occur as a result of an environmental strategy. An outcome evaluation provides data to document whether or not the environmental strategies are effective at making progress toward the longer-term goals in Chapter 3.

      Evaluating the desired outcomes answers important questions such as

      • How well did the environmental strategy work?

      • Should the environmental strategy continue?

      • What evidence proves that funders should continue to spend their money on this environmental strategy?

      There are several steps that need to be taken when conducting an outcome evaluation. First, identify what will be measured. Will it be a...

    • CHAPTER 10: Accountability Question: How will we ensure that the strategies to reduce underage drinking will continuously improve over time? (Continuous Quality Improvement)
      (pp. 69-72)

      In this guide, CQI involves the systematic assessment and feedback of evaluation information about planning, implementation, and evaluation to continuously improve the environmental strategies.

      CQI has gained popularity in industry and is gaining wide acceptance in health and human services agencies (Deming, 1986; Juran, 1989). Evaluation conducted in this manner is not just documentation—it is part of a feedback mechanism that can guide future planning and implementation. In addition, the following illustrates the importance of CQI:

      • Documenting what worked well when conducting environmental strategies helps to ensure that future implementation will also be successful.

      • Assessing what did not work...

    • CHAPTER 11: Accountability Question: If the underage drinking plan is successful, how will it be sustained? (Sustain)
      (pp. 73-76)

      Sustainability is usually thought about as continuing a strategy or program after its initial funding is over. Much of the literature on sustainability has been based on what happens after the initial external (or internal) funding of a program ends (see, e.g., Johnson, et al., 2004; Scheirer, 2005). If a program was begun with external funding, what happens after the funding is over? Does the program end when the funding ends? In this guide, we consider the following questions: How do we sustain an environmental strategy after it has been established?

      Although, by definition, many environmental strategies lead to permanent...

  14. Appendixes
  15. Evidence-Based Environmental Strategies
    (pp. 285-288)
    (pp. 289-292)