Environmental Strategies CADCA


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Environmental Strategies CADCA

  1. 1. The Coalition Impact: acy Merchant Education Multi-jurisdictional Agreement Outlet Dualitative or Anecdotal Data Quantitative Data Shoulder Tap Social Host Law Social Ma Environmental Prevention Source Investigation Program Synar Checks Teen Party Ordinance Zero Tolerance 24olerance Policy 4 Ps of Marketing Alcohol Purchase Survey Clean Air Laws Community Strategies Beyond the Basics: Topic-Specific Publications for Coalitions Community Anti-Drug Coalitions of America National Community Anti-Drug Coalition Institute
  2. 2. About this Publication CADCA’s National Coalition InstituteCADCA’s National Coalition Institute published a The National Community Anti-Drug Coalitionseries of seven primers that coincide with and Institute (Institute), a part of the Communityhelp coalitions navigate the elements of the Sub- Anti-Drug Coalitions of America (CADCA), servesstance Abuse and Mental Health Services Admin- as a center for training, technical assistance,istration’s Strategic Prevention Framework. This evaluation, research and capacity building foris the first in a new series—Beyond the Basics: community anti-drug coalitions throughout theTopic-Specific Publications for Coalitions—that United States. The Institute was created in 2002work in conjunction with the Primer Series. They by an act of Congress and supports coalitionare meant to assist coalitions expand their development and growth for Drug Free Commu-knowledge about planning for population-level nities Support Program (DFC) grantees and otherchange. As is true with the primers, they work community coalitions.as a set, however, each also can stand alone. The Institute offers an exceptional opportunity toThis publication provides an overview of the envi- move the coalition field forward. Its mission andronmental strategies approach to community objectives are ambitious but achievable. In short,problem solving. It includes real examples of ef- the Institute helps grow new, stronger andforts where environmental strategies aimed at smarter coalitions.preventing and reducing community problemsrelated to alcohol and other drugs were imple- Drug Free Communities Support Programmented. No one approach or set of strategies In 1997, Congress enacted the Drug Free Com-will fix every community problem, but with an munities Act to provide grants to community-appropriate environmental assessment, a coali- based coalitions that serve as catalysts fortion can determine what aspects of environmen- multi-sector participation to reduce local sub-tal prevention will best serve its community. stance abuse problems. As of January 2008,Topics covered in this publication include: more than 1,500 local coalitions have received funding to work on two main goals:WHAT are environmental strategies and why are • Reduce substance abuse among youth coalitions best suited to plan and implement and, over time, among adults by them? addressing the factors in a communityWHAT data collection and analysis is essential in that increase the risk of substance abuse the investigation of environmental conditions and promoting the factors that minimize the of a community to effectively choose and risk of substance abuse. implement strategies? • Establish and strengthen collaborationHOW can a coalition build capacity to commit to among communities, private nonprofit the long-term investment that is necessary agencies and federal, state, local and for environmental strategies to succeed? tribal governments to support the effortsWHERE do environmental strategies fit into a of community coalitions to prevent and comprehensive community plan? reduce substance abuse among youth.HOW will your coalition evaluate the success and impact of environmental strategies?
  3. 3. Table of ContentsCHAPTER 1: INTRODUCTION TO AN ENVIRONMENTAL APPROACH 1 What are Environmental Strategies? 1 The Roots of Environmental Approaches 1 Advantages of Environmental Strategies 1CHAPTER 2: LAYING THE FOUNDATION FOR COMMUNITY CHANGE 4 The Public Health Model 4 Institute of Medicine Model—A Useful Planning Approach for Coalitions 4 A Broader Look at Policy 5 Coalitions: The Organizational Structure for Environmental Strategies 5CHAPTER 3: THE SPF AND ENVIRONMENTAL STRATEGIES 10 Cultural Implications in Assessing the Community and Planning Strategies 10 Environmental Assessment 11 Environmental Scanning 11 Assess Conditions with Marketing’s 4 Ps 12 Geographic Information Systems (GIS) 12 Understanding Problem Environments 13 Involving Youth in Assessment 14 Commitment through Capacity Building 14 Who Do We Need around the Table? 14 Bolstering Coalition Leaders 16 The Planning Process 17CHAPTER 4: ENVIRONMENTAL PREVENTION IN ACTION 19 The Seven Strategies for Community Change: A Brief Explanation 19 Implementing Environmental Approaches Using the Seven Strategies 20 Media and Environmental Approaches 22 Evaluation of Environmental Strategy Implementation 24 Conclusion 26COALITION EXAMPLES Shawnee County Meth Awareness Project 3 North Coastal Prevention Coalition 6 Hood River County Alcohol Tobacco And Other Drug Prevention Coalition 15 Salt Lake City Mayor’s Coalition on Alcohol Tobacco and Other Drugs 25ENDNOTES 29GLOSSARY 29RESOURCES 31
  4. 4. CHAPTER 1: INTRODUCTION TO AN ENVIRONMENTAL APPROACHThis publication launches a new series—Beyond policy dates back to the mid-1970s. In the Unitedthe Basics: Topic-Specific Publications for Coali- States this approach was embraced in the mid-tions—that work in conjunction with the Institute’s 1980s by communities looking for mechanisms topopular Primer Series, based on the Substance address the growing problems of alcohol outlet-Abuse and Mental Health Services Administra- related crime and violence, drinking and driving,tion’s (SAMHSA) Strategic Prevention Framework underage access to alcohol and other community-(SPF). It can help your coaition start planning and based alcohol problems.implementing environmental strategies, but itdoes not provide a set design for any individual Three key publications have attracted attention to,community or coalition. provided a foundation for and offered evidence that by implementing environmental approaches,The publication includes brief case studies from communities and local municipalities develop suf-four local coalitions that have implemented envi- ficient power to reduce alcohol-related problems.ronmental strategies to successfully address theircommunities’ most pressing issues. Each group These publications include:used an environmental approach, but none imple- • Alcohol Control Policies in Public Healthmented identical strategies in the same ways. Perspective2—sponsored by the World HealthEnvironmental strategies must be tailored to local Organization (WHO), was published in 1975community characteristics. Your coalition must ad- and drew the attention of governmentsdress the root causes and local conditions around around the world that sought to rationally ad-the specific problem you are trying to change. dress alcohol availability and consumption. • Alcohol Policy and Public Good3—anotherWhat Are Environmental Strategies? WHO-sponsored book, published in 1994,Grounded in the field of public health, which em- opened the door for increased scientificphasizes the broader physical, social, cultural and research into the approach’s efficacy.institutional forces that contribute to the problems • In 2003, Alcohol: No Ordinary Commodity—that coalitions address, environmental strategies Research and Public Policy,4 provided anoffer well-accepted prevention approaches that updated summary of the significant litera-coalitions use to change the context (environment) ture on the evidential underpinnings ofin which substance use and abuse occur. environmental approaches.Environmental strategies incorporate prevention Today, ample evidence and little doubt exist thatefforts aimed at changing or influencing commu- well-conceived and implemented policies—local,nity conditions, standards, institutions, structures, state and national—can reduce population-basedsystems and policies. Coalitions should select alcohol, tobacco and other drug problems.strategies that lead to long-term outcomes. In-creasing fines for underage drinking, moving to- Advantages of Environmental Strategiesbacco products behind the counter, not selling Environmental strategies can produce quick winscold, single-serving containers of beer in conven- and instill commitment toward long-term impactience stores and increasing access to treatment on practices and policies within a community.services by providing Spanish-speaking counselors But, they also require substantial commitmentare all examples of environmental strategies. from various sectors of the community to con- tribute to sustainable community change. SuchThe Roots of Environmental Approaches1 approaches potentially reach entire populationsInterest in the scientific study of environmental and reduce collective risk. They create lastingstrategies and the corresponding use of alcohol change in community norms and systems,CADCA’s National Coalition Institute 1 The Coalition Impact: Environmental Prevention Strategies
  5. 5. producing widespread behavior change and, in telling an individual that substance use/abuse isturn, reducing problems for entire communities. dangerous will not necessarily affect their behav- ior in a significant manner.Individual strategies, such as drug educationclasses, are based on the premise that substance Individuals do not become involved with sub-abuse develops because of deficits in knowledge stances solely on the basis of personal character-about negative consequences, inadequate resist- istics. They are influenced by a complex set ofance skills, poor decision making abilities and low factors, such as institutional rules and regulations,academic achievement. But these efforts, while community norms, mass media messages andimportant in a multiple strategy approach, do little the accessibility of alcohol, tobacco and otherto independently alter the overall environment in drugs (ATOD). When a comprehensive, multi-which people live and work. strategy effort is in place, coalitions contribute to achieving population-level change by focusing onFor example, numerous education campaigns and multiple targets of sufficient scale and scope topublic awareness efforts related to heart disease make a difference communitywide.exist. We are encouraged to avoid certain foods,exercise daily and get regular check-ups. This in- Costs associated with implementation, monitoringformation is familiar and repeated often, yet we and political action within a community can belive in a society where heart disease remains an considerably lower than those associated with on-insidious public health problem. going education, services and therapeutic efforts applied to individuals. The bottom line is environ-Telling individuals what to do is different than mental strategies are effective in modifying thelimiting food options in grocery stores or providing settings where a person lives, which plays a partexercise breaks for employees. Likewise, simply in how that person behaves. Figure 1: Prevention Strategies Attempt to Alter Two Kinds of Environments Strategies Targeting Strategies Targeting the Individualized Environments Shared Environment Socialize, Instruct, Guide, Counsel Support, Thwart Family School Norms Regulations ALL YOUTH INDIVIDUAL YOUTH Faith Health Community Care Availability Providers CSAP’s Centers for the Application of Prevention Technologies (CAPT), West CAPT. Environmental Prevention Strategies: Putting Theory Into Practice Presentation, retrieved from Web, http://captus.samhsa.gov/western/resources/ppt/index.cfm, March 2008.CADCA’s National Coalition Institute 2 The Coalition Impact: Environmental Prevention Strategies
  6. 6. SHAWNEE COUNTY METH AWARENESS PROJECT Residents in Shawnee County, Kansas, mobilized to address The Shawnee County coalition’s broad community reach an increase in the number of methanphetamine (meth) labs resulted in development of new initiatives; one of which grew throughout the county. At the time, Kansas law did not prevent into the Kansas Retail Meth Watch Program, a nationally purchasing large amounts of products containing pseudo- recognized initiative aimed at deterring theft or purchase ephedrine, a substance commonly found in over-the-counter of products used in meth production. cough and cold medicines and used in meth production. When Their local successes led to requests from neighboring counties two local substance abuse prevention professionals entered a that hoped to implement similar strategies. The coalition store and observed a suspicious sale, they reported it to their then began to provide training and technical assistance to Director of Regional Prevention and started to plan a commu- other communities that wanted to address meth production nity mobilization strategy to address the problem. and use. Residents of the county formed a coalition—the Shawnee As the movement grew, it gained significant media attention County Meth Awareness Project—incorporating local and state and opportunities for state-level change emerged. In October government, law enforcement, agriculture, education and busi- 2002, the Kansas Methamphetamine Prevention Project, a ness, and focusing on reducing local meth production. statewide initiative was launched to reduce and prevent pro- The group took advantage of their partnerships and existing duction and use of meth in the state. The initiative developed relationships that those partners brought to the table. These a statewide training program called “Crank it up! Community collaborations ensured the coalition a high level of capacity to Methamphetamine Prevention Training.” reduce meth production locally. The grassroots mobilization success of the Shawnee County Guided by ongoing community assessment, the group concen- project demonstrates how community coalitions can create trated its efforts on limiting access to pseudoephedrine and a “domino effect,” starting at the local level, spreading to anhydrous ammonia—commonly used in meth production. The surrounding counties and ultimately producing state- and coalition’s multiple-strategy approach started with an educa- national-level results. tion campaign, concentrating particularly on retail merchants, The coalition advocated for action from the state legislature residential landlords and hotel/motel managers and the agri- and neighboring states began passing meth precursor laws. In culture community about the issue. 2005, Kansas passed a law limiting the sale of ephedrine and They worked with local farmers to ensure that tanks of anhy- pseudoephedrine in retail stores throughout the state. This drous ammonia—designed for use as a fertilizer—remained local effort has spread throughout the United States and con- locked when not in use. The coalition received funding to sup- tributed to an overall reduction in the number of meth labs. port the farming community by paying for the locks. Lessons Learned: Develop actionable steps to implement. Education is necessary to create awareness and start a movement in your community. However, coalition members and stakeholders need actionable steps to gain momentum. Create and share the basic tools needed to achieve success. For example, the Shawnee County coalition, through the Kansas Methamphetamine Pre- vention Project, provided technical assistance and resources to local communities to address meth production. They developed a kit with ready-to-use information for neighboring counties to implement similar, but not necessarily identical strategies. Avoid placing blame when bringing others on board. Ask for help and support the efforts of community members. The Kansas Meth Prevention Project worked with the farming community to reduce access to anhydrous ammonia tanks, taking care not to blame farmers. The coalition educated farmers on the importance of locking their tanks and obtained funding to pay for locks that they distributed to the local agricultural community. This demonstrated the coalition’s willingness to work with farmers instead of pointing the finger and expecting them to implement a strategy without support. Be creative when presenting to different groups. Present visuals when possible—in Shawnee County, coalition leaders used a map to plot the lab seizures in the community which helped fight denial that the drug problem was permeating everyone’s neighborhoods. Drug seizures were happening throughout the community and did not exclude rural areas, locations near ele- mentary schools or the local shopping mall. Provide small start-up funds to encourage community development. The average funding received in this case was $900 per county. It served as a catalyst to convene the community. Once people mobilize around an issue, the possibilities are endless. With the right resources, support and the proper strategies aligned, people can do much with a little money.CADCA’s National Coalition Institute 3 The Coalition Impact: Environmental Prevention Strategies
  7. 7. CHAPTER 2: LAYING THE FOUNDATION FOR COMMUNITY CHANGEThe Public Health Model Figure 2. The Public Health ModelThe public health model demonstrates that prob-lems arise through relationships and interactionsamong an agent (e.g., the substance, like alcohol Agentor drugs), a host (the individual drinker or druguser) and the environment (the social and physicalcontext of substance use).For example, health risks from smoking becameclear in 1964 with the Surgeon General’s warning.This stepped up efforts to implement tobacco edu- Host Environmentcation and cessation programs. However, signifi-cant reductions in tobacco consumption occurred Alcoholonly when strategies were implemented to changethe settings (e.g., airplanes) where the agent (e.g.,tobacco smoke) and the host (e.g., flight atten-dants, passengers) came together. Groundbreak-ing, smoke-free policies implemented by majorairlines led to passage of similar policies in work-places and public buildings across the country. Physical & IndividualToday, many states and localities have enacted Social Contextand are enforcing Clean Air Laws and pushingsmoking outside of public buildings and spaces.Institute of Medicine Model—A Useful Selective Prevention Interventions target specificPlanning Approach for Coalitions subgroups that are believed to be at greater riskIn 1994, the Institute of Medicine (IOM) proposed for substance abuse than others. Risk groups maya new framework for classifying prevention. The be identified on the basis of biological, psychologi-IOM model divides the continuum of care into cal, social or environmental risk factors known tothree parts: prevention, treatment and mainte- be associated with substance abuse and addic-nance. Prevention interventions are divided into tion. Interventions are designed to address thethree classifications--universal, selective and indi- identified risk indicators of the targeted subgroup.cated. Although the system distinguishes betweenprevention and treatment, intervention in this con- Indicated Prevention Interventions targettext is used in its generic sense. individuals who exhibit early signs of substance use disorders and other problem behaviors associ-Universal Prevention Interventions address the ated with substance use disorders, including earlygeneral population with programs aimed at delay- substance use, school failure, interpersonal socialing substance use and preventing abuse. Partici- problems, delinquency, other anti-social behaviorspants are not specifically recruited for the pre- and psychological problems such as depression.vention activities. Universal prevention activitiesalso can include efforts to bring community mem- Although most environmental strategies arebers together to plan for services and to change aimed at the general population (universal), theynorms and laws reducing risk factors and promot- also can impact a smaller segment of the commu-ing a more protective environment. nity. The IOM model is, therefore, a useful frame- work for classifying environmental efforts. ByCADCA’s National Coalition Institute 4 The Coalition Difference:Environmental Prevention Strategies
  8. 8. improving systems to better support a subset of Individual Strategies Environmental Strategiesthe community—for example, individuals return-ing to the community after incarceration—bene- Focus on behavior and Focus on policy and policyfits can be derived for the former inmates, their behavior change changefamilies and the population as a whole. Focus on the relationship Focus on the social, political between the individual and and economic context ofA Broader Look at Policy alcohol/drug-related problems alcohol/drug-related problemsEnvironmental approaches tend to center on Short-term focus on Long-term focus on policypolicy that shapes perception in communities, program development developmenthomes or workplaces in local, state or nationalvenues. Environmental strategies focus on pop- Individual generally does not People gain power byulations and affect large numbers of people participate in decision making acting collectivelythrough the adoption of systems and policy Individual as audience Individual as advocatechange and ongoing effective enforcement.Policies, formal or informal, can be enacted Coalitions: The Organizational Structurelocally. Informal policy change can occur at a for Environmental Strategieshigh school, police department or with local mer- Environmental strategies are carried out mostchants. For example, if local alcohol retailers are effectively in the context of a community problemwilling to attend merchant education sessions solving process conducted by coalitions. Coalitionsvoluntarily, formal policy change is unnecessary. can harness the community’s power to makeHowever, if your community determines that par- change. A well-functioning coalition engagesents and other adults are the main suppliers of residents, law enforcement, schools, nonprofitalcohol to underage drinkers, existing ordinances organizations, the faith community, youth andand laws related to social host issues may require other key groups to work in tandem to addressmore formal policy change. community concerns. Coalitions are well posi- tioned to ensure sustained action on pervasiveDo not immediately head to the state house to community problems that have eluded simpleget laws enacted. In many instances, it is easier solutions. And, coalitions enable residents tofor coalitions to achieve policy success at the local contribute to making a difference and creating thelevel—particularly as they relate to alcohol and un- political will necessary to influence developmentderage drinking. Start at home and learn about ex- and implementation of lasting policy.isting policies that may simply need moreproactive enforcement. Finally, environmental strategies are cost effective given the potential magnitude of change. Commu-Continuing enforcement creates lasting environ- nity mobilization is central to creating population-mental change. For example, if the local school level change. After data have been collected anddistrict enacts a 24/7 Zero Tolerance policy, analyzed, coalitions must assess their capacity toprohibiting students from consuming or posessing effectively address the identified problem(s). Thisalcoholic beverages, enforcement augments the is especially important when using environmentalenvironmental work. Consistent enforcement for approaches. Historically, many coalitions havepolicy violations leads to widespread adoption. consisted largely of members whose focus hasJust passing a policy does not ensure that a com- been working with individuals, families and othermunity will change. Enforcement of a policy that small groups to elicit change in knowledge, skillsresponds to a community problem provides the and attitudes. Implementing environmental strate-greatest impact. The consequences for violating gies requires different skills, such as communitya policy must be appropriate and swift. organizing and/or development, and the involve- ment of different community actors.CADCA’s National Coalition Institute 5 The Coalition Impact: Environmental Prevention Strategies
  9. 9. NORTH COASTAL PREVENTION COALITION The North Coastal Prevention Coalition (NCPC) serving buildings. The city council agreed to the amendment, but North San Diego County, including the cities of Carlsbad, the coalition realized this was only part of the problem. Oceanside and Vista, Calif., developed a comprehensive The original ordinance did not prevent street vendors from plan to address youth marijuana use when assessments selling and displaying items such as t-shirts, jewelry and revealed that more San Diego County youth smoked mari- posters that sent messages to local youth that could be juana than cigarettes. At the time, the community envi- construed as supporting marijuana use. ronment was saturated with pro-drug messages on the The coalition went to the Chamber of Commerce, the radio, in retail stores and at local street fairs. As part of sponsor of “Harbor Days,” an annual festival held at the their plan, the coalition collaborated with a countywide Oceanside Harbor. They believed that if they could compel initiative called HARM (Health Advocates Rejecting Mari- “Harbor Days” to change its policies, others might follow. juana) to eliminate messages portraying marijuana use The coalition worked with the Chamber of Commerce to as “fun” and “harmless.” add language to their vendor policy banning vendors The county holds about 40 public festivals each year, from selling “tobacco products, tobacco/drug parapher- making the problem visible to the general community, nalia or any item that promotes the use of illicit sub- particularly youth. NCPC leaders determined that they stances.” This was a huge success, but many more could have success in eliminating drug paraphernalia festivals remained. The coalition had to be creative. and pro-drug items at local street fairs. Instead of pushing for an ordinance, they decided to get street fair promoters on their side. When a music festival, saturated with pro-marijuana mes- sages came to Oceanside, drawing large crowds of youth One company was responsible for sponsoring most street and young adults, the coalition saw a prime opportunity fairs across North San Diego County. The coalition called to document the problem. Coalition members went to the promoters to seek voluntary adoption of a policy the festival and took a collection of photographs they against the sale of pro-drug items. As they hoped, the used later to advocate for their position and display the change made by “Harbor Days,” led the promoter to magnitude of the problem. voluntarily ban the pro-drug items from other fairs. These efforts led the coalition to successfully produce This visual documentation proved extremely helpful when environmental change at 14 fairs throughout the North the coalition approached the city council to amend an County. They continue to monitor activity, ensuring that existing “headshop” ordinance, to require drug parapher- festivals are positive environments for families and youth. nalia, such as bongs and pipes, to be sold inside licensed Lessons Learned: Focus on local policies first. You do not have to change state laws or create ordinances to make environmental changes. Businesses also have the power to change policies. In this case, the coalition approached street fair promoters, getting them to understand the scope of the problem. They presented pictures and data, helping them to see the value in ban- ning products with pro-drug messages. Monitor enforcement of policy. Once a policy change is made, the work is not over because having a policy in writing, does not guarantee enforcement! The NCPC members continue to be the “eyes and ears” at street festivals to ensure that vendors are following the policy. Your coalition may have to take responsibility for such surveillance to guarantee compliance. Law enforcement in communities is often stretched very thin and they appreciate assistance. Take advantage of windows of opportunity for change. It often is difficult to mobilize people around a particular issue unless a significant event is involved. These events can be great levers for changing community norms and attitudes and to get people on board with your coalition’s proposed strategies. In this case, one festival helped raise visibility of the problem. Document it. Take pictures! Make it easy for partners to get on board. In this case, the coalition went to the street fair promoters with a plan. They told them that the coalition would monitor vendor compliance and would bring this information back to the promoters to address any violations. The promoters only needed to agree to change the policy language. Offer support to partners. Business people will be more willing to agree to your terms if it does not seem like an extra burden for them.CADCA’s National Coalition Institute 6 The Coalition Impact: Environmental Prevention Strategies
  10. 10. Think about coalition membership in terms of a projects may mean new employees or an adjust-business. Successful companies recruit and hire ment in positions. Approach coalition work in theemployees only after an analysis of their skills and same way: a company, with a set of leadersabilities. Within a company, leadership strives to (Board of Directors) and divisions (subcommittees)collectively gather the best mix of individuals who, engaged in planning and implementing the work,working together, leverage the breadth of their while keeping common goals and measures ofskills and perform in a cohesive manner. New success in sharp focus. DO YOUR HOMEWORK Coalitions that are planning to implement environmental strategies must do a considerable amount of investiga- tion to learn what formal and informal policies exist that influence environmental factors. Not knowing local ordi- nances related to alcohol and tobacco will hinder forward progress. Coalitions should learn about state and local laws related to the sale of alcohol and tobacco products. In other words, coalitions must do their homework. It be- comes the coalition’s job to know everything that might be helpful. Examples of homework for coalitions: • Locate and read your state’s alcohol/tobacco laws • Locate and read local alcohol/tobacco ordinances/policies • Understand the process for obtaining an alcohol/tobacco retail license • Understand the process for enforcement of alcohol/tobacco retail licenses • Understand the process for creating and modifying local land use regulations, i.e., zoning • Learn about local law enforcement agencies and their roles within your community (i.e., jurisdictions, current efforts) • Learn about the roles and responsibilities of judicial officers (i.e., magistrates, judges) in your community • Learn the political process in your community (i.e., election cycles, who is serving and their agendas, etc.) • Conduct a local/state policy analysis (what already exists) • Conduct a power analysis in your community (who has the power to change policy) • Determine what other local agencies are doing to address the problem your coalition is concerned aboutCADCA’s National Coalition Institute 7 The Coalition Impact: Environmental Prevention Strategies
  11. 11. Table 1. Checklist of Policy Indicators for Alcohol, Tobacco and Other Drugs This checklist can help you to assess the number and types of policies within your community and where you might best extend your efforts. ALCOHOL—Public Policies Yes No Excise taxes (local) Limits on hours or days of sale Restrictions of density, location or types of outlets Mandatory server training and licensing Dram shop and social host liability Restrictions on advertising and promotion Mandatory warning signs and labels Restrictions on consumption in public places Prevention of preemption of local control of alcohol regulation (home rule) Minimum bar entry age Keg registration/tagging ordinances Compulsory compliance checks for minimum purchase age and administrative penalties for violations Establishment of minimum age for sellers ALCOHOL—Organizational Policies Restrictions on alcohol advertisements (media) Restrictions on alcohol use at work and work events (businesses) Restrictions on sponsorship of special events (communities, stadiums) Police walkthroughs at alcohol outlets Undercover outlet compliance checks (law enforcement agencies) Responsible beverage service policies (outlets) Mandatory checks of age identification (businesses) Server training (businesses) Incentives for checking age identification (businesses) Prohibition of alcohol on school grounds or at school events (schools) Enforcement of school policies (schools) Prohibition of beer kegs on campus (colleges) Establishment of enforcement priorities against adults who illegally provide alcohol to youth Sobriety checkpoints (law enforcement agencies) Media campaigns about enforcement efforts (media) Identification of source of alcohol consumed prior to driving-while-intoxicated arrests (law enforcement agencies) Source: Center for Prevention Research and Development, Institute of Government & Public Affairs, University of Illinois at Champaign-Urbana, Retreived from Web at http://www.cprd.uiuc.edu/Pep/docs/Checklist_of_Policy_Indicators.RTF, March 2008.CADCA’s National Coalition Institute 8 The Coalition Impact: Environmental Prevention Strategies
  12. 12. TOBACCO—Public Policies Yes No Excise taxes (local) Tobacco sales licensing system Prohibition of smoking in public places Prevention of preemption of local control of tobacco sales Restrictions on advertising and promotion Ban on vending machines Compulsory compliance checks for minimum purchase age and administrative penalties for violations Minimum age sales of 18 Warning labels Mandatory seller training Ban on self-service sales (all tobacco behind the counter) Minimum age for sellers Penalty for underage use TOBACCO—Organizational Policies Establishment of smoke-free settings (restaurants, workplaces, hospitals, stadiums, malls, day care facilities) Counter advertising (media) Restrictions on sponsorship of special events (communities, colleges, stadiums) Prohibition of tobacco use on school grounds, in buses and at school events Enforcement of school policies (schools) Mandatory checks for age identification (businesses) Seller training (businesses) Incentives for checking age identification (businesses) Undercover shopper or monitoring program (businesses) OTHER DRUGS—Public Policies Control of production and distribution Zoning and building codes that discourage drug activity and penalties for property owners who fail to address known drug activity Mandated school policies OTHER DRUGS—Organizational Policies Employer policies (businesses) Surveillance of high-risk public areas (law enforcement agencies, neighborhood watch groups) Enforcement of zoning and building codes (law enforcement agencies, building authorities) Appropriate design and maintenance of parks, streets and other public places (e.g., lighting, traffic flow) (city agencies, housing authorities) Enforcement of school drug policies (schools)CADCA’s National Coalition Institute 9 The Coalition Impact: Environmental Prevention Strategies
  13. 13. CHAPTER 3: THE SPF AND ENVIRONMENTAL STRATEGIESIn this chapter, we take a look at theelements of the Strategic Prevention Figure 3. SAMHSA’s Strategic Prevention FrameworkFramework (SPF) and how each re-lates to environmental approaches.No “cookie cutter” response to envi-ronmental strategies exists. You can-not select a “model” program andhope it will work in your community.You must do your homework—studyyour community, know the people,the neighborhoods and, yes, the localcontext. Then your coalition can craftenvironmental strategies tailored toyour community characteristics.CADCA utilizes the SPF to assistcommunity coalitions in developingthe infrastructure needed forcommunity-based, public healthapproaches that can lead to effectiveand sustainable reductions in alco-hol, tobacco and other drug (ATOD)use and abuse. The elements shownFigure 3, at right, include: • Assessment. Collect data to de- fine problems, resources and readiness within a geographic area to Cultural Implications in Assessing the address needs and gaps. • Capacity. Mobilize and/or build capacity Community and Planning Strategies within a geographic area to address needs. Coalitions considering implementation of environ- • Planning. Develop a comprehensive strategic mental strategies need to work with diverse popu- approach that includes policies, programs lations within their communities. Representatives and practices creating a logical, data-driven from those communities must be involved as early plan to address problems identified in as possible to avoid miscommunication or percep- the assessment. tions that “outsiders” want to change their norms, • Implementation. Implement evidence-based traditions, policies or environments. Environmen- prevention strategies, programs, policies tal strategies planned without consideration of and practices. cultural impact will not be accepted by the larger • Evaluation. Measure the impact of the SPF community and most likely will not produce the and the implementation of strategies, desired results. Such involvement also requires programs, policies and practices. that the coalition commit to fostering cultural competence at all levels of activity. The Institute’sThe elements of sustainability and cultural compe- Cultural Competence Primer may help yourtence—central to community-based approaches— coalition and is available in PDF format online atare shown in the center of the graphic indicating www.coalitioninstitute.org.their importance to each of the other elements.CADCA’s National Coalition Institute 10 The Coalition Impact: Environmental Prevention Strategies
  14. 14. Note: in many communities across the country,problem environments tend to be concentrated in Community Assessmenteconomically disadvantaged, minority neighbor- Issues may be considered “pressing” when:hoods. These areas often have a high concentra- a. The problem occurs frequently (FREQUENCY)tion of liquor outlets, liquor and tobacco billboards b. The problem has lasted for a while (DURATION)and advertisements, as well as abandoned hous- c. The problem affects many people (SCOPE)ing that foster illicit drug use. These communities d. The problem is intense (SEVERITY)often are marginalized and disenfranchised and e. The problem deprives people of legal or human rights (SOCIAL IMPORTANCE)high-risk conditions exist that would not be toler- f. The problem is perceived to be important (PERCEPTION).ated in more affluent neighborhoods. Communitycoalitions must involve formal and informal lead- University of Kansas Community Tool Box, retrieved from the In-ers from such communities to bring about mean- ternet at ctb.ku.edu, March 2008. Used with permission.ingful environmental change that will lead to im-proved community health in areas that are dispro-portionally impacted by a myriad of problems. them at the smallest level necessary to thoroughly understand the issues in the target population orCarefully consider how your coalition will address community. It may be necessary to dig deeper asissues of cultural diversity and competence as you your data investigation progresses. If the countywork through the elements of the SPF. For exam- has been chosen as the targeted area, then col-ple, how will you conduct an accurate assessment lecting county-level data is a good place to start.of diverse sectors of your community? How willyou ensure broad representation of minority popu- Such an approach reflects the beginnings of envi-lations in your coalition? How will you build capac- ronmental approaches more than 150 years agoity in economically disadvantaged communities? when Dr. John Snow—a pioneer in the science ofHow your coalition responds to these issues likely epidemiology—was able to stem an outbreak ofwill determine your ultimate success in imple- Asiatic cholera in South London by tracing it to amenting environmental strategies and reducing single source of polluted water.substance abuse rates in your community. By interviewing families of victims where the out-Environmental Assessment break occurred, he was able to identify a single pump as the epicenter of the outbreak. And, byCoalitions should take the necessary time to creating a map that showed all the pumps in thecomplete an assessment that includes key factors South London area in relation to cholera deaths,to determine the most appropriate environmental he convinced authorities to remove the pump han-strategies for a community. Create a picture of dle, stopping the spread of cholera immediately.the state of affairs locally and surface problemsthe community sees as its most pressing issues. This example of the benefits of well-researchedMove beyond just collecting student consumption epidemiology forms the foundation for environ-and attitudinal data for a more detailed under- mental assessments being conducted by coali-standing of the deep-rooted causes in the commu- tions today. Snow used both qualitative datanity. The Institute’s Assessment Primer provides (personal interviews) and quantitative datain-depth information on how to complete a com- (mapping locations of deaths) to make his case.munity assessment and is available in PDF format Further, he looked at where the deaths wereonline at www.coalitioninstitute.org. most concentrated to pinpoint the source of the infection and compel skeptical policymakersData collection can present challenges. Coalitions to take action.should seek data on their targeted geographicarea and/or create data that are aggregated downto the level they need (i.e., zip codes, a town, etc.). Environmental ScanningWhen searching for data, remember to collect Environmental scanning is a useful assessment method coalitions can employ to gather visible in-CADCA’s National Coalition Institute 11 The Coalition Impact: Environmental Prevention Strategies
  15. 15. formation on local conditions surrounding alcohol, munity festivals that revolve around alcoholtobacco and other drugs. In determining the envi- use? What are the regulations related to freeronmental strategies that best fit your community, samples of wine at the grocery store or chewingcoalitions may find it valuable to physically assess tobacco on a military base?the landscape. Using the context of substance Place: Is beer next to soda in the cooler of localuse/abuse as a starting point, coalitions can convenience stores? Do “beer caves” makebecome sensitive to environmental cues evident large amounts of cold beer available? Are prod-when viewing the community context. ucts displayed where they can be stolen easily?To conduct an environmental scan, your coalitionmust first develop a methodology to document Figure 4. Marketing’s Four Psthe information. This includes questions you wantanswered and the ability to collect additional infor-mation that comes to the forefront during thescanning process. Recruit coalition members andenlist other community residents (i.e., law enforce-ment officers, youth, etc.) who will complete the Product Pricescans and bring back the information.While conducting a scan, visit local alcohol out-lets, other retail and commercial properties, resi- TARGETdential neighborhoods, parks and recreation areas MARKET(rivers, streams, wooded areas, etc.). Collect infor-mation about what you see, including the numberof billboards, advertising, lighting, signage, loca-tion of police and fire stations, schools, day care Place Promotioncenters, churches and other physical elements ofthe community. Use the data gathered to furtherinform your assessment process and alert yourcoalition membership of environmental elementsthat were not previously discovered. The marketing mix, or 4 Ps of marketing, can help coalitions determine where in the community change needs to occur. ForAssess Conditions with Marketing’s 4 Ps a community environmental approach, the target market seenWhen engaging in environmental scanning, work above informs initiative planning and implementation. Graphicto find conditions that make illegal or excessive adapted from NetMBA.com.substance use and abuse easier. A concept knownas the marketing mix, or marketing’s four Ps, canhelp identify issues your coalition may need to Geographic Information Systems (GIS)address. Consider: In addition to the data sources already listed, thePrice: How much does a 22-ounce beer cost when prevention field has sophisticated technology that compared to a 12-ounce can of soda? Is alcohol can further illustrate the context of the environ- less expensive in certain settings or time of day? ment and its current conditions. What is the excise tax on tobacco?Product: Do specific products appeal to certain Through Geographic Information Systems (GIS), populations (i.e., alcopops or flavored ciga- information can be digitally mapped, creating vi- rettes)? Is beer provided in single cans with a sual displays that indicate problem environments high alcohol content? or “hot spots” of activity. For example, GIS map-Promotion: What Happy Hour regulations exist ping can have one layer that shows the locations (i.e., time, price of alcohol, etc.)? Does the com- of alcohol outlets across a county; a second that munity allow “2 for 1” specials? Are there com- indicates areas where underage drinking viola-CADCA’s National Coalition Institute 12 The Coalition Impact: Environmental Prevention Strategies
  16. 16. tions have occurred and a third illustrat- Figure 5: Sample GIS Maping crimes including vandalism, publicintoxication and loitering. In areas wherethe data are concentrated, a coalitioncan pinpoint an area of high activitywhere the environmental factors shouldbe investigated further. Where are alco-hol retail outlets and crime rates mostconcentrated? GIS mapping provides cor-relations among data sets, so communi-ties can determine problem settings andmove toward addressing the environmen-tal factors that create opportunities forhigh-risk behaviors and related crime.Learn more about GIS mapping on theHelping America’s Youth Web site,http://www.helpingamericasyouth.gov.Many law enforcement and military agen-cies also utilize GIS mapping in their day-to-day operations. Check with your local The map illustrates a GIS map indicating the correlation in the crime ratepolice or National Guard Bureau for help (including loitering, vandalism, noise ordinance violations, drug dealing,in compiling GIS maps for your commu- public drunkenness and robbery) and alcohol outlet density in a five-countynity. See the Resources Section on page area. Crime rates are shown by color (with darker color indicating higher31 for more information. crime rates), while alcohol outlets are illustrated by pins in the map.Understanding Problem Consider demographic and geographic featuresEnvironments within the environmental context. Pay close atten-For success in planning environmental strategies, tion to the following:determine what specific locations in the commu- • Lakes and rivers: Are youth allowed to usenity might be considered high-risk or problematic. their parents’ boats on the water with little orFor example, during the course of a community no supervision? Are boat patrols a regularassessment that includes environmental investiga- part of enforcement activities?tion (i.e., environmental scanning and GIS map- • Homes with large land areas: Are theseping), a community discovers that there is a high areas ideal for underage drinking parties?density of alcohol outlets within a two-block area • Homes with basements: Can youth easilyof the downtown district. In that area, crime, such conceal a party from negligent adults?as vandalism, noise ordinance violations and drug • Youth with working parents: Is supervisiondealing, also are significant. Understanding this, a an issue?coalition may identify environmental factors—i.e., • Rural communities: Are the driving distancesovergrown vacant lots or bars that allow underage long and do they contribute to driving underpatrons to drink—that must be addressed. the influence? Are open fields common gathering spots for youth?In some instances, a single outlet can wreak • Economically disadvantaged communities:havoc on an entire community. GIS mapping can Are abandoned buildings used for drugshow how one “bad apple” can affect the commu- sales or use?nity. Dealing with that one location might improveconditions in the entire community.CADCA’s National Coalition Institute 13 The Coalition Impact: Environmental Prevention Strategies
  17. 17. • Major highways/ports: Does your city have a Coalition members DFC Requirements major highway or port that becomes part of should become the trafficking issue and increases the local savvy agents of DFC coalitions must include a supply of illegal drugs? change to modify minimum of one member/ risky environments representative from each ofAgain, communities must consider ALL salient these 12 community sectors: and affect improve-factors when determining where problem environ- • Youth (persons less than or ments in systems to equal to 18 years of age)ments are and how to most appropriately plan to discourage alcohol, • Parentsaddress them. drug and tobacco • Business community use. Remember, the • MediaInvolving Youth in Assessment strategies and tac- • SchoolsYouth involvement in coalitions is essential and tics needed to bring • Youth-serving organizationyoung people can become great “data detectives.” about environmen- • Law enforcement agenciesThey may see the community through a different tal change differ • Religious or fraternallens than most adult coalition members. Youth from those required organizationscan be recruited and organized to carry out inter- to select and imple- • Civic and volunteer groups • Healthcare professionalsviews with neighborhood residents, count and ment programs for • State, local, or tribalmap alcohol and tobacco outlets and locate and individuals. governmental agenciesphotograph settings to further illustrate local con- • Other organizations involvedditions. They can create and administer surveys, Coalitions that em- in reducing substance abusepresent data in easy-to-understand reports, coordi- ploy environmentalnate town hall meetings and recruit participants. approaches mustSee the case study on page 15 to learn about how learn to generate political capital and garner sup-the Hood River Coalition engaged youth in the en- port from those in positions of authority. Electedvironmental assessment process. officials, school and hospital administrators, busi- ness and labor union leaders, faith and culturalThe context in which a young person lives certainly organizations and media all have the power toinfluences his/her behavior and how that context shape policies and deploy resources. When suchbecomes an influence is different than that of an leaders also are coalition members, they can actadult. With adult support and guidance, youth as catalysts for change by enlisting support fromhave the skills and ability to go out into the com- others in their sphere of influence. Encouragemunity and collect information. And, their knowl- them as “champions for change” for the coali-edge of technology can be invaluable. Involving tion’s policies and practices.and utilizing their skills in GIS mapping is not onlyan effective way to get this type of data collection Who Do We Need around the Table?underway, but also to educate youth on the princi- Determine whether your coalition includes all theples of environmental strategies and how physical stakeholder groups it needs to improve the likeli-design can be modified. hood that your initiatives will succeed. Using the problem(s) identified from your communityCommitment through Capacity Building assessment data as a starting point, ask the fol-Successful implementation of environmental lowing questions to begin to analyze if your coali-strategies does not happen overnight. Results tion membership is comprehensive:take long-term commitment from coalition • Who is directly affected by the problem(s)?members and membership must be adapted and • Who else cares enough to want to solve theadjusted as implementation progresses. Imple- problem(s)?menting environmental strategies requires more • Who benefits if the problem is resolved?community involvement than individual strategies • What individuals or groups can resolve theand requires participation of those most affected problem?for crafting and carrying out solutions.CADCA’s National Coalition Institute 14 The Coalition Impact: Environmental Prevention Strategies
  18. 18. HOOD RIVER COUNTY ALCOHOL TOBACCO AND OTHER DRUG PREVENTION COALITION From 1992 to 1999, the Hood River County Alcohol Tobacco administrators and presented to the school board fact-filled and Other Drug Prevention Coalition, in partnership with the and persuasive arguments supporting a tobacco-free campus. Oregon Research Institute in Eugene, Oregon, implemented These efforts led to adoption of policies restricting tobacco Project SixTeen, to prevent and reduce tobacco use by adults advertising, paraphernalia, use and possession in the schools, and youth in their community. The project was comprehensive, on campus and at school events. The policies applied to all involving multiple strategies to reduce access and sales of students, employees and visitors to the school and banned to- tobacco to underage youth, increase perception of harm and bacco use on campus outside of regular school hours. parental disapproval of tobacco and increase tobacco-free places and events. The success of these efforts empowered youth to address the tobacco issue beyond school grounds. They worked to extend What is unique about Hood River’s strategies is they involve- the school policy to include local restaurants, bars, motels and ment of youth in every step of the coalition process. The businesses; advocating for a Smoke-Free Workplace Law in coalition engages youth as agents of change in its action plan Hood River County. They presented in front of city council because of the receptive environment toward youth in the members, county commissioners and individual businesses, overall community. Involving youth in coalition work empowers among others to influence change. Youth created petitions at them, builds their leadership skills and bonds them to the the high school and surveyed peers to demonstrate to local community. They also can show the community youth’s role in business owners that banning smoking in their facility was a positive community change. profitable decision. To recruit youth members to assist in developing coalition As a result of their hard work, 87 percent of local restaurants activities, coalition leaders began in the local high school. and bars voluntarily adopted tobacco-free policies before the They identified interested youth in classrooms and student first state laws were passed in 1998. In addition, three local clubs to help implement strategies and activities to mobilize businesses removed vending machines from their bars and the community to reduce exposure to tobacco smoke, de- eight Quick Stop groceries put tobacco products behind the crease exposure to tobacco advertising and create barriers to counter. Once these local businesses were on board, the tobacco sales to underage youth. By first engaging youth in coalition youth were prepared to present their successes at poster contests, t-shirt exchanges and strategy development, the state level. These efforts helped lead to the passage of the coalition strategically planned ways to achieve the goals of Oregon’s Smoke-Free Workplace Law in 1999. The coalition their initiative. continues to engage about 30 youth in prevention work each year, through youth-led education, media and testimony to Youth passionately expressed their desires for stronger school local and state policy makers on the impact of second-hand policies prohibiting tobacco use on school grounds, at commu- smoke and the need to increase the tobacco tax as an nity events and in local restaurants, retail outlets and other effective reduction tool. venues where youth gathered. They worked closely with school Lessons Learned: Involve youth in your coalition work. Youth are powerful and persuasive advocates that can speak on behalf of the coalition to key leaders and stakeholders in the community. Youth can push the coalition to do the work because they are anxious for results. Involve them in the assessment and evaluation process to help paint a picture of the environment, using methods such as GIS mapping, photography and video. Build capacity through training opportunities. The coalition’s affiliation to the Oregon Research Institute was a key component to their success because of the training provided. Never underestimate the power of training. It can greatly increase a coalition’s chances for success. The coalition leader was taught community mobilization; focusing on specific skills including working with the media, networking with key leaders, sharing data and motivating and engaging commu- nity members. Active youth members also received training that built their capacity to reach their goals. Work with your community. The Hood River Coalition had little pushback from the community because of their overall approach and their deep roots in the community. It is best if you can keep the coalition from being the “bad guy.” Work with businesses, not against them. Provide incentives and reminders to keep community members involved.CADCA’s National Coalition Institute 15 The Coalition Impact: Environmental Prevention Strategies
  19. 19. Resist the urge to respond to these questions with Take the opportunity to learn and cultivate yourthe common answer, “Everyone!” Identify specific community members’ skills, talents, abilities,environmental conditions that underlie problems interests and resources. Your members willand clearly identify those groups and individuals remain active when they are called to contributewho can enhance your efforts—human resources, to the cause. Remember that coalition memberscommunity resources, political power, etc. need to feel as though there is purpose and definition to their role within the coalition.In the environmental approach, the community isnot simply the site for the intervention, but the ve- Bolstering Coalition Leadershicle for change. To truly reflect community needs Coalition leaders set the tone for their coalition’sand solutions, coalitions must include residents capacity to engage the community from grass-and others who experience the alcohol and other roots to policymakers. As a coalition leader, yourdrug-related problems directly, on a regular basis. main role is as a community mobilizer. IndividualsThese might include residents living near a park in leadership positions must be able to clearlywhere drugs are sold and consumed; teenagers convey what environmental strategies are and whywith direct knowledge of underage drinking par- they should be a focus of the coalition. Relation-ties and the effects on their friends and class- ship building and collaboration are vital to sustain-mates; or persons recovering from addiction who ability and must correspond to the coalition’sunderstand how relapse and recovery are affected collective vision for long-term commitment andby high-risk environments where alcohol and other measurable community change.drugs are easily available. Coalitions that provide direct services or whosePeople who directly experience a problem are membership consists predominantly of servicemore invested in finding solutions. In the final providing organizations may find environmentalanalysis, community members can help sustain strategies difficult to implement. Thus, grassrootsenvironmental change strategies by overseeing mobilization that includes residents, parents,the implementation of efforts over the long term. Engaging Law Enforcement and Judicial Officers Environmental strategies that require law enforcement agencies can be part of a comprehensive, multi-strategy approach. The coalition’s role is to investigate existing policies and procedures that can benefit the community. Learn how your coalition can help local law enforcement in analyzing gaps and enforcing current laws. Consider tapping into non-traditional law enforcement agencies (i.e., game wardens, natural resource officers, code enforcement, animal protection, fraud investigators, etc.). These agencies face the same problems as the city police or county sheriff’s departments, but in a different environment or context. Coalitions in rural communities should consider these agencies valuable partners in addressing environments that are more difficult to reach. Judicial officers and systems are a large part of policy enforcement. Without their support, violators may not be convicted or consequences may not be enforced. Consider how the coalition can make their job easier. Failure to engage local judicial officers may hinder the forward progression of enforcement operations and create tension among local law enforcement and the judges they stand before in court. Coalitions can seek Attorney Generals’ opinions to support law enforcement and help them effectively defend cases. In doing your homework, coalitions should: • Investigate current arrangements among local law enforcement agencies regarding enforcement (multi-juris- dictional agreements, multi-aid agreements, etc.) • Work to improve and bolster relationships between law enforcement agencies • Involve local judicial officers and systems prior to an increase in enforcement operations (i.e., Compliance Checks, Shoulder Taps, DUI Enforcement)CADCA’s National Coalition Institute 16 The Coalition Impact: Environmental Prevention Strategies
  20. 20. neighborhood associations, formal and informal Your coalition must continue to build its benchleaders is essential. These individuals can become strength, planning for growth and change overthe voice of change without the fear of repercus- time. Good leaders move coalition partners andsion from an employer or appearing to be acting other stakeholders from the simple to the com-solely in their employers’ interests. plex, mediate disagreements and coach members to represent and articulate coalition positions.Informal leaders can be as effective and influen-tial as formal leaders. For example, residents are The Planning Processthe “eyes and ears” of the community and can Like the processes of community assessment andhold policy makers and other institutions account- capacity building, coalition planning works bestable for ensuring that system changes and poli- when it incorporates multiple sectors of the com-cies are enforced on an ongoing basis. munity. Coalition leaders must make planning an inclusive process, beginning with the prioritizationLeaders—formal and informal—can benefit from of the root causes identified in the communitytraining that develops the the skills required to assessment and acknowledgement of underlyingplan and implement environmental strategies. conditions, such as high crime locations.Some examples include, but are not limited to: • Community mobilization including relationship The choice of how to name and frame issues building skills; should reflect what works for your community, • Training on environmental strategies and their the language that motivates citizens into action effects; and sets the stage for a comprehensive response • Analyzing and developing effective, enforce- to shared problems. Listening to community able policies, including the process for develop- members–beginning with assessment–and ing local land use restrictions; involving them throughout the planning process • Appropriate engagement of media; lays the strong foundation a coalition needs to • Knowledge of how local, state and federal gov- change environments. Refer to the Institute’s ernment processes operate; Assessment and Planning Primers for more • Knowledge of community policing; information on data collection and developing a • Knowledge of alcohol and other drug-related logic model to inform your coalition’s process for community problems; selecting interventions and activities. • Knowledge of how local decisions are made and who makes them; Choosing environmental strategies and planning • Strong communication and facilitation skills; for their implementation should be carefully and mapped out by the coalition. Again, no single • Comfort working in environments with much strategy will provide the desired results and local- community dialogue and disparate opinions. izing strategies is allowable and encouraged. A carbon copy of what was done in another commu-These are skills generally associated with commu- nity will not be the best solution for your commu-nity mobilizers—people who motivate others into nity. To achieve real, long-term success, take theaction, fade into the background and share credit time to think through what is viable and what willfor success. Emphasize the community process to create the identified changes. See page 18 for aengage residents and key stakeholders in defining chart that illustrates examples of environmentalissues and participating in the development and strategies aimed at specific problems.implementation of environmental solutions.CADCA’s National Coalition Institute 17 The Coalition Impact: Environmental Prevention Strategies
  21. 21. Table 2. Examples of Environmental Policies for Alcohol, Tobacco and Illicit Drugs Strategy Alcohol Tobacco Illicit Drugs Environmental policies to limit access Compliance checks: Laws prohibiting sale, Removal of cigarette Purchase laws Minimum purchase age possession and machines laws actively enforced distribution Excise tax; Excise tax; Increase supply reduction to Price controls Ban on “2 for 1” drink No free tobacco samples raise prices specials on military bases Land use ordinances enforced on blighted/ abandoned properties; Synar checks; physical design changes Restrictions on retail Limit number of sales Limit number of sales (increase lighting; plant sales or sellers licenses with in a licenses; shrubs, etc.); county/city/town Fines for selling to youth restrictions on sale of pseudoephedrine and ephedrine and other meth precursor chemicals Environmental policies to influence norms Zero Tolerance laws for youth under 21 years; You Use/You Lose laws; Fines for selling tobacco Workplace initiatives; Legal deterrence Social Host laws to youth Asset forfeiture laws Source Investigation Programs Surgeon General’s warning/The Truth National Anti-Drug Youth Counteradvertising Ban alcohol sponsorship; Campaign; Media Campaign ads/ Advertising restrictions Restriction on samples and Web sites coupons; Ban television advertising Adapted from Environmental Prevention Strategies: An Introduction and Overview, Deborah A. Fisher, Ph.D., used with permission.CADCA’s National Coalition Institute 18 The Coalition Impact: Environmental Prevention Strategies
  22. 22. CHAPTER 4: ENVIRONMENTAL PREVENTION IN ACTIONThe environmental strategies approach recognizes The Seven Strategies for Communitythat risks associated with substance use are, in Change: A Brief Explanationpart, a function of the interplay between the envi- Seven methods that can bring about communityronments where an individual uses and the sub- change have been adopted as a useful frameworkstances he/she uses (agent). In the environmental by CADCA’s Institute. Each of these strategies rep-approach, place matters. We recognize that man- resents a key element to build and maintain aaging the availability of alcohol and other drugs in healthy community. In the planning process, utilizespecific environments impacts the substances in- all seven strategies to be as comprehensive asdividuals choose and the amount they use. These possible to achieve population-level change. Whendecisions determine the level of risk individuals focusing on implementation of environmentaland communities experience. The ability to shape strategies, consider the types of information, skill-an individual’s behavior by structuring what is ex- building and support activities necessary to movepected or permitted in specific environments can your interventions forward. You will see that thereduce alcohol- and other drug-related problems. strategies overlap and reinforce each other. Seven Strategies to Affect Community Change 1. Provide information—Educational presentations, workshops or seminars, and data or media presentations (e.g., public service announcements, brochures, billboard campaigns, community meetings, town halls, forums, Web-based communication). 2. Enhance skills—Workshops, seminars or activities designed to increase the skills of participants, members and staff (e.g., training, technical assistance, distance learning, strategic planning retreats, parenting classes, model programs in schools). 3. Provide support—Creating opportunities to support people to participate in activities that reduce risk or enhance protection (e.g., providing alternative activities, mentoring, referrals for services, support groups, youth clubs, parenting groups, Alcoholics or Narcotics Anonymous). 4. Enhance access/reduce barriers**—Improving systems and processes to increase the ease, ability and opportunity to utilize systems and services (e.g., access to treatment, childcare, transportation, housing, education, special needs, cultural and language sensitivity). 5. Change consequences (incentives/disincentives)—Increasing or decreasing the probability of a specific behavior that reduces risk or enhances protection by altering the consequences for performing that behavior (e.g., increasing public recognition for deserved behavior, individual and business rewards, taxes, citations, fines, revocations/loss of privileges). 6. Change physical design—Changing the physical design or structure of the environment to reduce risk or enhance protection (e.g., parks, landscapes, signage, lighting, outlet density). 7. Modify/change policies—Formal change in written procedures, by-laws, proclamations, rules or laws with written documentation and/or voting procedures (e.g., workplace initiatives, law enforcement procedures and practices, public policy actions, systems change within government, communities and organizations). ** Note: This strategy also can be utilized when it is turned around to reducing access/enhancing barriers. When community coalitions establish barriers to underage drinking or other illegal drug use, they decrease its accessibility. Prevention science tells us that when more resources (money, time, etc.) are required to obtain illegal substances, use declines. When many states began to mandate the placement of pseudoephedrine-based products behind the pharmacy counter, communities experienced a significant decrease in local clandestine methamphetamine labs. Barriers were put into place that led to a decrease in the accessibility of the precursor materials for meth production. The list of strategies were distilled by the University of Kansas Work Group on Health Promotion and Community Development— a World Health Organization Collaborating Centre. Research cited in selection of the strategies is documented on the Environmental Strategies page of the Institute’s Web site, www.coalitioninstitute.org. The Institute uses this list by permission of the University.CADCA’s National Coalition Institute 19 The Coalition Impact: Environmental Prevention Strategies
  23. 23. The first three strategies—provide Common Environmental Strategies for Coalitionsinformation, enhance skills andprovide support—assist in educating the Hours/Days of Sale Outlet Density Reductionpublic, raising awareness and helping Clean Air Laws Open Container Ordinanceindividuals make healthy choices. Gen- Happy Hour Ordinance/Laws Festivalserally they affect small numbers of indi- • Beer Gardensviduals and are too weak to impact the Advertising Ordinance/Lawscommunity at large. These strategies Third-Party Transaction Land Use Ordinancesoften are necessary if you are working • Shoulder Taps Responsible Beverage Server • Social Hostin a community where denial of and lim- Training • Source Investigationited knowledge about the current prob- Fake ID Enforcement Programslem is prevalent. But, they can provideinitial information necessary to bring a Party Patrol/Controlled Party Compliance Checkscommunity together around an issue. DispersalSince the first three of the seven strategies focus around the holidays. This adds to the community’son impacting individuals, they have obvious limita- knowledge of local efforts, but in isolation wouldtions and probably will not, by themselves, achieve not create long-term change.measurable change in substance abuse rates inyour community. However, the last four strategies Enhance skills: Tactics include media advocacy,are environmental in nature and, when utilized in youth training on refusal skills, parenting classesa multi-strategy plan, can form the basis of a com- and training local treatment professionals in pre-prehensive approach along with the first three. vention concepts. Parenting classes can comple- ment environmental strategies when social hostImplementing Environmental Approaches issues are uncovered, presenting the opportunity to educate parents about laws related to providingUsing the Seven Strategies alcohol to underage youth on private property.Moving through assessment, naming and framingthe existing problem, identifying root causes and Provide support: Support includes substance-freelinking them to strategies that directly address activities for youth, support groups and clubs. Iflocal conditions requires broad-based community a community determines through its assessmentinvolvement. Environmental strategies appear process that many youth are cited for underagedaunting, but can lead to powerful results. Be- drinking during certain hours, substance-freecause of their impact, they are worth the effort activities can be offered during those times. Con-and attention to continual maintenance over time. currently, local law enforcement can carry out proactive community policing efforts.On page 23, we include a portion of a samplelogic model with specific examples for comprehen- Enhance Access/Reduce Barriers: Environmentalsive environmental strategies to help reduce youth strategies often are associated with modifying set-tobacco use. As we address each of the strategies tings to reduce risk through the implementation ofin this section, we will illustrate additional sample policy, however, systems change to increase theactivities that might be used to plan and imple- ease of utilization also can be viewed as a popula-ment a comprehensive environmental approach. tion-focused approach. Make access to the basic services community members require to leadProvide information: This strategy includes town healthy and productive lives a priority. For exam-hall meetings, Web sites, billboard campaigns, ple, increase accessibility to services for individu-and Public Service Announcements (PSA). Com- als who do not speak English or where English ismunities may air PSAs to provide information not the first language by providing parentingabout campaigns to reduce to drinking and driving classes in the language most appropriate for theCADCA’s National Coalition Institute 20 The Coalition Impact: Environmental Prevention Strategies