Evidence for Community-Level Prevention Interventions

1. Evidence for Community-Level Prevention Interventions Bob SaltzPrevention Research CenterBerkeley, California Pacific Institute for Research and Evaluation Prevention Research Center

2. Environmental Policies to Reduce College Drinking: An Update of Research Findings Toomey, Lenk, & Wagenaar (2007) Journal of Studies onAlcohol and Drugs

3. A Matter of Degree (AMOD)Weitzman et al. American Journal of Preventive Medicine. 2004 • College/ Community Partnerships • Environmental strategies to reduce drinking problems: • Keg registration • Mandatory responsible beverage service • Police wild party enforcement • Substance free residence halls • Advertising bans

4. A Matter of Degree (AMOD)Weitzman et al. American Journal of Preventive Medicine. 2004 • AMOD achieved reductions among college students in • Binge drinking • Driving after drinking • Alcohol related injuries • Being assaulted by other drinking college students

5. Campus Community Strategy to Change the Drinking Culture Western Washington University Bellingham, Washington

6. Project Components • Neighborhoods Engaging with Students (NEST) • Enforcement • LateNight@WWU • Campus Community Coalition work groups were involved in planning, implementation, and process evaluation.

7. 2nd Intervention Comparison

8. 2nd Intervention Comparison

9. SPARC Studyto Prevent AlcoholRelated Consequences: Using a Community Organizing Approach to Implement Environmental Strategies in and around the College Campus Mark Wolfson, et alWake Forrest University

10. SPARC Conceptual Model Larger Environment SPARC Intervention • Community Organizing • Hold one-on-one meetings • Understand self-interest • Analyze power • Build coalition • Identify actionable issues • Develop strategies • Plan & implement actions • Environmental Strategies • Reduce Availability • Address Price/Marketing • Improve Social Norms • Minimize Harm Elements: Policy, Enforcement, Awareness Interventions • Culture / Context • Community cultures • Government • Neighborhoods • Law enforcement • Retail/business • Community Policies • Campus cultures • Student • Administration • Alumni • Faculty • Campus Policies Intermediate Outcomes Larger political, socio-economic and historical context • High-risk Drinking • Indicators • Quantity - Social Setting • Frequency - Timing • Physical setting - Underage use • Consequences • - Health - Legal • - Social - Academic • - Violence - Victimization Long-term Outcomes

11. Environmental 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

13. CDS Severe Consequences, due to own drinking (p=.02) Alcohol-related Injuries, caused to others (p=.03) RA Survey Consequences: p=.04 Environment: p=.01 Aggregate: p=.03 I & I Reports Police reports ofalcohol-related incidents(p=0.04) Police reports of # of citations for underage alcohol use (p=.008) Evidence of Impact: Summary

14. Safer California UniversitiesProject Goal: To evaluate the efficacy of a“Risk Management” approach to alcohol problem prevention NIAAA grant #R01 AA12516with support from CSAP/SAMHSA.

15. Intervention Sites CSU Chico Sacramento State CSU Long Beach UC Berkeley UC Davis UC Riverside UC Santa Cruz Comparison Sites Cal Poly SLO San Jose State CSU Fullerton UC Irvine UC Los Angeles UC San Diego UC Santa Barbara Random Assignment

16. 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

17. Integrated Intervention Strategies for Off-Campus Parties • Compliance Checks • DUI Check Points • Party Patrols • Pass Social Host “Response Cost” Ordinance • A Social Host Safe Party Campaign

18. Outcomes • Likelihood of getting drunk at a given generic setting (e.g., Greek parties; residence halls) plus additional aggregate measure across all settings • Two baseline years combined vs. two years post-intervention combined • Controlling for individual-level variables and campus/community variables

23. Practical Significance • At each campus, 900 fewer students drinking to intoxication at off-campus parties and 600 fewer getting drunk at bars/restaurants during the fall semester at intervention schools relative to controls. • Equivalent to 6,000 fewer incidents of intoxication at off-campus parties and 4,000 fewer incidents at bars & restaurants during the fall semester at Safer intervention schools relative to controls

24. In addition…No Displacement

25. In Sum… • We have the ability to create environments that help teens and young adults make healthy decisions about alcohol consumption • We have growing evidence that these strategies are effective • Our greatest impact will likely come from adopting mutually-reinforcing policies and practices

26. …but there are challenges

27. Typical Hurdles for Comprehensive Prevention Strategy • Implicit assumption that the only “target” is high-risk drinkers • Ambivalence about student drinking • Low perceived efficacy of preventive interventions • Challenges of coordination and resource allocation • Possible fears of “backlash”

28. Unique Hurdles for College Prevention • Too much weight on “process” vs. “outcome” • Preference for persuasion over control • Universities are complex, diffuse organizations • Prevention staff trained in education, awareness strategies • Prevention staff usually lacks authority to launch initiatives

29. Thank you!