Transcript Slide 1

Using Data to Guide and
Sustain Community
Interventions
Joel W. Grube, Ph.D.
Prevention Research Center
Pacific Institute for Research and Evaluation
OJJDP UDETC National Leadership Conference
Tucson, AZ
August 18-20, 2005
Preparation of this presentation was supported by
NIAAA grants AA006282 and AA014958
What is Sustainability?
Sustainability addresses three issues:
Maintaining the benefits of a program
Continuing a program
Building the capacity to continue a program
Broadly speaking sustainability refers to:
“The process of ensuring an adaptive preventive
system … can be integrated into ongoing
operations to benefit diverse stakeholders.”
(Johnson, Hayes, Center, & Daley, 2004, p. 137)
Key Issues in Sustainability
Sustainability is an ongoing dynamic process
Sustainability is an adaptive process
Sustainable innovation is integrated into normal
operations and requires adequate infrastructure
capacity
Sustainable innovation should have proven
benefit to diverse stakeholders
Sustainability requires commitment and support:
Champions
Decision-makers
Stakeholders
Workers
Source: Johnson, Hayes, Center, & Daley, 2004
Model of Sustainability
Assess
Plan
Implement
Evaluate
Reassess/Modify
Capacity
Building
Innovation
Integration into
System
Data
Sustainable
Innovation
Continuation
Stakeholder
Benefits
Source: Johnson, Hayes, Center, & Daley, 2004
Some Examples Using Data:
Oregon Youth Alcohol Access Project
Community Trials Project to Reduce Alcohol Trauma
Diadema Project
Assess:
Is there a problem?
What is the problem?
30-Day Drinking
Oregon 11th Graders
Half of Oregon 11th graders
report drinking in the past 30
days….
Oregon
US (YRBS)
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
100
90
80
70
60
50
40
30
20
10
0
Source: Oregon Healthy Teens Survey 2005
http://oregon.gov/DHS/ph/chs/youthsurvey/yrbsdata.shtml
30-Day 5+ Drinks
Oregon 11th Graders
70
60
40
Oregon
US (YRBS)
30
20
10
0
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
Percent
50
Of those Oregon 11th graders who
report drinking in the past 30 days,
60% report having 5+ drinks….
Year
Source: Oregon Healthy Teens Survey 2005
http://oregon.gov/DHS/ph/chs/youthsurvey/yrbsdata.shtml
30-Day Drug Use Among
Oregon 11th Graders
Any Other Illict Drug
Alcohol is by far the most
commonly used and abused drug
among Oregon 11th graders….
Inhalants
Marijuana
5+ Drinks
Alcohol
0
10
20
30
40
50
60
Source: Oregon Healthy Teens Survey 2005
http://oregon.gov/DHS/ph/chs/youthsurvey/yrbsdata.shtml
Annual Costs of Underage
Drinking in Oregon 2001
(Millions of Dollars)
Work Lost and
Other Costs
$139
$130
$428
Medical Costs
Total Costs: $697 million annually
$387 per capita per year
Pain &
Suffering
Source: Enforcing Underage Drinking Laws Website:
http://www.udetc.org/UnderageDrinkingCosts.asp
Annual Costs of Underage
Drinking in Oregon (2001)
Problem
Total Costs (Millions)
Youth Violence
$351.5
Youth Traffic Crashes
$86.1
High Risk Sex
$59.6
Youth Property Crime
$49.1
Youth Injury
$36.7
Poisonings & Psychoses
$11.8
FAS Mothers Age 15-20
$11.7
Youth Alcohol Treatment
$90.5
Total
$697.2
Source: Enforcing Underage Drinking Laws Website:
http://www.udetc.org/UnderageDrinkingCosts.asp
Planning:
Where do we intervene?
How?
Ease of Obtaining Alcohol
by Oregon 11th Graders
…Over 81% of Oregon 11th graders say it
would be very easy or sort of easy to get
alcohol if they wanted…
7.5%
11.1%
53.0%
28.4%
Very Easy
Sort of Easy
Sort of Hard
Very Hard
Source: Oregon Healthy Teens Survey 2005
http://oregon.gov/DHS/ph/chs/youthsurvey/yrbsdata.shtml
Sources of Alcohol
Past 30 Days by Oregon 11th
Graders
100
90
Commercial
Social
80
73
Oregon teens use
multiple sources to
obtain alcohol…
60
50
40
20
10
55
46
30
30
16
21
16
4
20
10
Pa
re
A
ny nt
So
ci
al
e
om
H
C
Fr
ie
nd
>2
Fr
1
ie
nd
<
21
ro
on cer
y
ve
ni
en
D
ce
ru
g
St
or
G
as
e
A
S
ny
ta
t
C
om ion
m
er
ci
al
0
G
Percent
70
Source: Dent, Grube, & Biglan, 2005
Indicated Points of Intervention
Commercial Availability
Reward and Reminder
Compliance Checks
Social Availability
Shoulder Taps
Party Dispersal
MIP
Targeted Media
Monitor Implementation
What is being done?
What dosage?
Underage Access Activities
Community Trials Project
Q2
Q3
Q4
Q1
Q2
160
140
COMPLIANCE
CHECKS
120
100
CITATIONS
ISSUED
80
60
OUTLETS
TRAINED
(RBS)
40
20
0
Pre-intervention
Intervention Period
Source: Grube, 1997
Evaluate/Assess
What effects?
What benefits?
Effects of Reward and
Reminder on Tobacco Sales
100
90
80
Baseline
Post Intervention
70
60
50
40
30
20
10
0
T1
T2
T3
T4
T5
T6
T7
T8
T9
T10 T11 T12 T13 T14
Biglan, Ary, Smolkowski, Duncan, & Black, 2000
Effects of Reward and Reminder
on Weekly Alcohol Use
20
Percent
15
R & R + SchoolBased
School-Based Only
10
5
0
T1
T2
T3
T4
T5
Biglan, Ary, Smolkowski, Duncan, & Black, 2000
Homicides per 1,000 Residents:
Diadema,
Brazil
0.14
0.12
Before Sales Hours Restriction
After
Restriction
0.08
0.06
0.04
0.02
There were an average of 301.3 homicides
per year before the sales restrictions and
169.6 per year afterward
0.00
Ja
nJu 95
Ja l-9
n- 5
Ju 96
Ja l-9
n- 6
Ju 97
Ja l-9
n- 7
Ju 98
Ja l-9
n- 8
Ju 99
Ja l-9
n- 9
Ju 00
Ja l-0
n- 0
Ju 01
Ja l-0
n- 1
Ju 02
Ja l-0
n- 2
Ju 03
Ja l-0
n- 3
Ju 04
l-0
4
Rate
0.10
Duailibi, Laranjeira, Ponicki, Grube, & Lacey, 2005
Estimated Effects of Reducing
Hours of Sales
Number of Lives Saved
95% CI
% Reduction in Homicides
Number of Assaults Prevented
95% CI
% Reduction in Assaults
273
208-338
46.1%
224
-66 – 514
25.8%
Duailibi, Laranjeira, Ponicki, Grube, & Lacey, 2005
Reassess/Modify
What is not working?
What should be changed?
Where are more resources needed?
Effects of Compliance Checks and
RBS on Underage Sales
Percent of Outlets Selling
60
50
40
53
47
45
Comparison (No
Treatment)
35
30
Compliance
Checks
20
19
10
16
Compliance
Checks + RBS
0
Pretest
Posttest
Source: Grube, 1997
Conclusion
Data can guide and sustain programs:
Define the problem and the solution
Plan and target interventions
Monitor implementation
Evaluate outcomes
Reassess and modify interventions
Marshall support for increased allocation
of resources and infrastructure capacity
Key reference:
Johnson, K., Hays, C., Center, H., & Daley,
C. (2004). Building capacity and
sustainable prevention innovations: A
sustainability planning model. Evaluation
and Program Planning, 27, 135-149.