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CORK Bibliography: Community Action Initiatives

35 citations. January 2009 to present

Prepared: December 2011

Bagnardi V; Sorini E; Disalvatore D; Assi V; Corrao G; De Stefani R. 'Alcohol, less is better' project: outcomes of an Italian community-based prevention programme on reducing per-capita alcohol consumption. Addiction 106(1): 102-110, 2011. (26 refs.)

Aims: To evaluate differences in the individual alcohol consumption after a community-based prevention programme. Design settings and participants 'Alcohol, less is better' is a controlled intervention trial. The intervention adopted a community approach, based on the active involvement of community leaders and institutional or volunteer organizations. Between 1999 and 2006, 2.5 years of activities aiming at informing and sensitizing the community on the harmful effects of alcohol on social life and health were carried out in 10 selected small Italian communities, involving a total of 123 235 individuals. Eight communities were chosen as control group. Measurements: Changes in self-reported individual alcohol consumption before and after the intervention were assessed on a random sample of intervention (n = 3382) and control (n = 2644) populations, using telephone and mailed surveys. Linear and log-linear models for repeated measures were used to evaluate differences between intervention and control samples. Findings: Overall, a significant reduction (P < 0.001) of individual self-reported alcohol consumption was observed in the intervention sample (-1.1 drinks/week) relative to control sample (+0.3 drinks/week). The reduction was significantly greater in males than in females (P for heterogeneity = 0.016). In the young (15-24-year-olds) intervention and control samples showed opposite trends (-0.4 drinks/week and +1.7 drinks/week, respectively). Conclusions: A coordinated community-based intervention can reduce alcohol consumption in the general population.

Baldwin JA; Johnson JL; Benally CC. Building partnerships between indigenous communities and universities: Lessons learned in HIV/AIDS and substance abuse prevention research. American Journal of Public Health 99(Supplement 1): S77-S82, 2009. (41 refs.)

Many HIV/AIDS and substance abuse prevention studies in American Indian and Alaska Native communities have been directed by academic researchers with little community input. We examined the challenges in conducting HIV/AIDS-related research in American Indian and Alaska Native communities and the benefits of changing the research paradigm to a community-based participatory model. The lessons we learned illustrate that the research process should be a cyclical one with continual involvement by community members. Steps in the process include (1) building and sustaining collaborative relationships, (2) planning the program together, (3) implementing and evaluating the program in culturally acceptable ways, and (4) disseminating research findings from a tribal perspective. These steps can enhance the long-term capacity of the community to conduct HIV/AIDS and substance abuse prevention research.

Bissell K; Fraser T; Bam T. World No Tobacco Day: From an international treaty to country-level action. (editorial). International Journal of Tuberculosis and Lung Disease 15(5): 570- 570, 2011. (5 refs.)

Braine N; Acker CJ; van Sluytman L; Friedman S; Des Jarlais DC. Drug use, community action, and public health: Gay men and crystal meth in NYC. Substance Use & Misuse 46(4): 368-380, 2011. (49 refs.)

In 2004, GLBT and HIV/AIDS service providers in NYC mobilized against use of crystal methamphetamine among gay men. Both drug use and mobilization were shaped by the history of HIV, particularly the institutions, action repertoires, and social networks forged in earlier AIDS work. This paper is based on qualitative research conducted from 2007 to 2009 with advocates, service providers, and men who have sex with men recruited from diverse venues in NYC gay communities. The crystal use epidemic among gay men in NYC indicates the importance of social and historical context in shaping drug use and antidrug mobilization, including the potential for public health responses to drug use.

Buller DB; Young WF; Bettinghaus EP; Borland R; Walther JB; Helme D; Andersen PA et al. Continued benefits of a technical assistance web site to local tobacco control coalitions during a state budget shortfall. Journal of Public Health Management and Practice 17(2): E10-E19, 2011. (54 refs.)

Context: A state budget shortfall defunded 10 local tobacco coalitions during a randomized trial but defunded coalitions continued to have access to 2 technical assistance Web sites. Objective: To test the ability of Web-based technology to provide technical assistance to local tobacco control coalitions. Design: Randomized 2-group trial with local tobacco control coalitions as the unit of randomization. Setting: Local communities (ie, counties) within the State of Colorado. Participants: Leaders and members in 34 local tobacco control coalitions funded by the state health department in Colorado. Intervention: Two technical assistance Web sites: A Basic Web site with text-based information and a multimedia Enhanced Web site containing learning modules, resources, and communication features. Main Outcome Measure(s): Use of the Web sites in minutes, pages, and session and evaluations of coalition functioning on coalition development, conflict resolution, leadership satisfaction, decision-making satisfaction, shared mission, personal involvement, and organization involvement in survey of leaders and members. Results: Coalitions that were defunded but had access to the multimedia Enhanced Web site during the Fully Funded period and after defunding continued to use it (treatment group x funding status x period, F-3,F-714 = 3.18, P =.0234). Coalitions with access to the Basic Web site had low Web site use throughout and use by defunded coalitions was nearly zero when funding ceased. Members in defunded Basic Web site coalitions reported that their coalitions functioned worse than defunded Enhanced Web site coalitions (coalition development: group x status, F1,360 = 4.81, P =.029; conflict resolution: group x status, F1,306 = 5.69, P =.018; leadership satisfaction: group x status, F-1,F-342 = 5.69, P =.023). Conclusions: The Enhanced Web site may have had a protective effect on defunded coalitions. Defunded coalitions may have increased their capacity by using the Enhanced Web site when fully funded or by continuing to use the available online resources after defunding. Web- based technical assistance with online training and resources may be a good investment when future funding is not ensured.

Burris S; Burrows D. Drug policing, harm reduction and health: Directions for advocacy. (editorial). International Journal of Drug Policy 20(4): 293-295, 2009. (20 refs.)

Calhoun JG; Kolker JL; McGowan JM; Sohn W; Ismail AI. Tobacco-free community coalitions: Opportunities for enhancing oral cancer prevention programs. Journal of Cancer Education 24(4): 275-279, 2009. (28 refs.)

Background. This study identified oral cancer (OC) education and tobacco reduction collaboration within tobacco-free community coalitions (TFCC). Methods. Data from 4 TFCC were collected via educational intervention surveys and structured focused group Interviews. Results. Of the 52 participants, 96% were aware that tobacco products are risk factors for OC, yet 33% were unaware of the high OC impact locally. About 90% agreed that primary care providers and dentists should provide OC screenings and tobacco cessation. Conclusion. There is a need for provider endorsement and public demand for OC screenings. Opportunity exists for partnering and collaborative OC prevention with TFCC.

Carson KV; Brinn MP; Labiszewski NA; Esterman AJ; Chang AB; Smith BJ. Community interventions for preventing smoking in young people. (review). Cochrane Database of Systematic Reviews 7(e-article CD001291), 2011. (166 refs.)

Background: Cigarette smoking is one of the leading causes of preventable death in the world. Decisions to smoke are often made within a broad social context and therefore community interventions using coordinated, multi-component programmes may be effective in influencing the smoking behaviour of young people. Objectives: To determine the effectiveness of multi-component community based interventions in influencing smoking behaviour, which includes preventing the uptake of smoking in young people. Search strategy: The Tobacco Addiction group's specialised register, Medline and other health, psychology and public policy electronic databases were searched, the bibliographies of identified studies were checked and raw data was requested from study authors. Searches were updated in August 2010. Selection criteria: Randomized and non randomized controlled trials that assessed the effectiveness of multi-component community interventions compared to no intervention or to single component or school-based programmes only. Reported outcomes had to include smoking behaviour in young people under the age of 25 years. Data collection and analysis: Information relating to the characteristics and the content of community interventions, participants, outcomes and methods of the study was extracted by one reviewer and checked by a second. Studies were combined in a meta-analysis where possible and reported in narrative synthesis in text and table. Main results: Twenty-five studies were included in the review and sixty-eight studies did not meet all of the inclusion criteria. All studies used a controlled trial design, with fifteen using random allocation of schools or communities. One study reported a reduction in short-term smoking prevalence (twelve months or less), while nine studies detected significant long-term effects. Two studies reported significantly lower smoking rates in the control population while the remaining thirteen studies showed no significant difference between groups. Improvements were seen in secondary outcomes for intentions to smoke in six out of eight studies, attitudes in five out of nine studies, perceptions in two out of six studies and knowledge in three out of six studies, while significant differences in favour of the control were seen in one of the nine studies assessing attitudes and one of six studies assessing perceptions. Authors' conclusions: There is some evidence to support the effectiveness of community interventions in reducing the uptake of smoking in young people, but the evidence is not strong and contains a number of methodological flaws.

Crosbie E; Sebrie EM; Glantz SA. Strong advocacy led to successful implementation of smokefree Mexico City. Tobacco Control 20(1): 64-72, 2011. (100 refs.)

Objective To describe the approval process and implementation of the 100% smokefree law in Mexico City and a competing federal law between 2007 and 2010. Methods Reviewed smokefree legislation, published newspaper articles and interviewed key informants. Results Strong efforts by tobacco control advocacy groups and key policymakers in Mexico City in 2008 prompted the approval of a 100% smokefree law following the WHO FCTC. As elsewhere, the tobacco industry utilised the hospitality sector to block smokefree legislation, challenged the City law before the Supreme Court and promoted the passage of a federal law that required designated smoking areas. These tactics disrupted implementation of the City law by causing confusion over which law applied in Mexico City. Despite interference, the City law increased public support for 100% smokefree policies and decreased the social acceptability of smoking. In September 2009, the Supreme Court ruled in favour of the City law, giving it the authority to go beyond the federal law to protect the fundamental right of health for all citizens. Conclusions Early education and enforcement efforts by tobacco control advocates promoted the City law in 2008 but advocates should still anticipate continuing opposition from the tobacco industry, which will require continued pressure on the government. Advocates should utilise the Supreme Court's ruling to promote 100% smokefree policies outside Mexico City. Strong advocacy for the City law could be used as a model of success throughout Mexico and other Latin American countries.

Deason LM; Adhikari SB; Clopton TM; Oches B; Jensen C. The Ohio Cross-Cultural Tobacco Control Alliance: Understanding and eliminating tobacco-related disparities through the integration of science, practice, and policy. American Journal of Public Health 100(Supplement 1): S240-S245, 2010. (31 refs.)

Objectives. We examined the development of a process designed to eliminate tobacco-related disparities in the state of Ohio and described how a cross-cultural work group used a multicomponent community planning process to develop capacity to address such disparities. Methods. The community development model was used as a guide in the planning process. We employed a case study, focus groups, and telephone interviews to assess the process and collect data on tobacco use and awareness. We also employed the appreciative inquiry framework to create the organizational design for the Ohio Cross-Cultural Tobacco Control Alliance (CCTCA), which was formed from the cross-cultural work group and charged with addressing tobacco-related disparities in the state. Results. Data on tobacco use and awareness were collected from 13 underserved populations. At the end of the planning process, the CCTCA was initiated along with structural capacity to serve as a new program incubator highlighting tobacco use and awareness levels in these populations. Conclusions. The CCTCA appeared to be an effective way to begin mobilizing agencies serving underserved populations by providing an operational structure to address tobacco-related disparities. The alliance also successfully implemented culturally competent community-based programs and policies to help eliminate disparities.

Dickson-Gomez J. Can drug users be effective change agents? Yes, but much still needs to change. Substance Use & Misuse 45(1/2): 154-160, 2010. (54 refs.)

The answer to the question of whether drug users can be effective change agents is yes, although the extent to which they are successful as change agents depends on whether they are acting to change their individual behaviors, the behavior of other drug users, or the laws and policies that negatively impact their health. Drug users have been successful in reducing their individual risk behaviors, and controlling and managing their drug use while still actively using drugs. They have also been successful in advocating risk reduction among their drug using peers. The success of drug users in changing policies that increase their risk for contracting HIV and other diseases, and improving their lives has been more mixed. In spite of these successes, drug use continues to be criminalized and viewed as a moral failure rather than as an illness in the belief that drug users are incapable of change. This essay addresses the major myths still common to misunderstanding drug users and behavior change. These attitudes, in turn, limit drug users' ability to effectively act to improve their lives.

Fagan AA; Brooke-Weiss B; Cady R; Hawkins JD. If at first you don't succeed ... Keep trying: Strategies to enhance coalition/school partnerships to implement school-based prevention programming. Australian and New Zealand Journal of Criminology 42(3, Special Issue): 387-405, 2009. (49 refs.)

Community-based coalitions have been advocated as a promising mechanism to reduce youth involvement in violence, delinquency, and substance use, but coalitions have not always been successful in ensuring widespread adoption of evidence-based prevention strategies. This article describes the strategies used by 12 community coalitions to collaborate with schools to select and implement school-based prevention programs; it includes the barriers to establishing coalition/school partnerships and methods for overcoming these challenges. In this 5-year research project, all communities adopted school-based prevention programs. Coalitions helped achieve this outcome by building relationships with school personnel, fostering champions within the school, creating win/win situations in which schools' needs were addressed, and initiating school-based prevention programs as pilot efforts that were later expanded. While success was achieved in all cases, persistent messaging about the importance of youth problem behaviours was needed to overcome schools' concerns about using academic time to teach prevention messages and replacing current practices with unfamiliar programs. Findings from this study can be used by coalitions and prevention scientists that want to partner with schools to reach a large population of students with effective prevention programming. The results are also of value to researchers and practitioners interested in fostering widespread dissemination of other types of evidence-based programs.

Fagan D; Butler S. 'What are we about?' An organizational study of the Pioneer Total Abstinence Association in present-day Ireland. Drugs: Education, Prevention and Policy 18(4): 261-269, 2011. (19 refs.)

The aim of this study was to explore the current functioning of the Pioneer Total Abstinence Association (PTAA), Ireland's largest and best-known temperance movement which has been in existence since 1898. Although initially intended as a small and relatively elitist organization, the PTAA succeeded in attracting and retaining large numbers of members until the 1960s, when it started to go into decline against the backdrop of incremental but influential changes in both the country's drinking habits and its religious culture. Drawing on qualitative data gathered through semi-structured interviews with the association's leadership, the study looked at how the association understood the concept of religious temperance, how it viewed its adaptation to a radically changed external environment and how clearly it defined its aims and functions. The findings indicate that while individual members still experience membership of the PTAA as spiritually meaningful and a source of support from like-minded Catholics, there is considerable confusion and disagreement at an organizational level as to what the overall goals of the association are. In particular, there is no consensus as to whether or how the PTAA should contribute as a stakeholder or lobbyist in relation to the drafting and implementation of national alcohol policy. It is concluded that, from an organizational perspective, the major task for the association is to clarify its primary aims so as to answer the question in this article's title: ''What are we about''?

Gruenewald PJ; Johnson K; Shamblen SR; Ogilvie KA; Collins D. Reducing adolescent use of harmful legal products: Intermediate effects of a community prevention intervention. Substance Use & Misuse 44(14): 2080-2098, 2009. (55 refs.)

Purpose: Preliminary results are presented from a feasibility study of a comprehensive community prevention intervention to reduce the use of inhalants and other harmful legal products (HLPs) among adolescents in three Alaskan frontier communities conducted in 2004-2007. The legal products used to get high include over-the-counter drugs, prescription drugs, and common household products. Community mobilization, environmental and school-based strategies were implemented to reduce access, enhance knowledge of risks, and improve assertiveness and refusal skills. Methods: Pre- and post-intervention survey data were collected from 5-7th grade students from schools in three communities using standardized instruments to assess knowledge, assertiveness, refusal skills, perceived availability, and intent to use. The intervention consisted of community mobilization and environmental strategies to reduce access to HLPs in the home, at school, and through retail establishments. In addition, the ThinkSmart curriculum was implemented in classrooms among 5th grade students to increase the knowledge of harmful effects of HLPs and improve the refusal skills. Data were analyzed using hierarchical linear models that enable corrections for correlated measurement error. Results: Significant increases in knowledge of harms related to HLP use and decreases in perceived availability of HLP products were observed. The environmental strategies were particularly effective in reducing the perceived availability of HLPs among 6th and 7th graders. Discussion: Although limited by the absence of randomized control groups in this preliminary study design, the results of this study provide encouragement to pursue mixed strategies for the reduction of HLP use among young people in Alaskan frontier communities.

Guarino H; Deren S; Mino M; Kang SY; Shedlin MG. Training drug treatment patients to conduct peer-based HIV outreach: An ethnographic perspective on peers' experiences. Substance Use & Misuse 45(3): 414-436, 2010. (23 refs.)

From 2005 to 2008, the Bienvenidos Project trained Puerto Rican patients of New York City and New Jersey Methadone Maintenance Treatment Programs to conduct peer-based community outreach to migrant Puerto Rican drug users to reduce migrants' HIV risk behaviors. Ethnographic research, including focus groups, individual interviews, and observations, was conducted with a subset of the patients trained as peers (n = 49; 67% male; mean age 40.3 years) to evaluate the self-perceived effects of the intervention. Results of the ethnographic component of this study are summarized. The role of ethnographic methods in implementing and evaluating this kind of intervention is also discussed.

Herd D. Community mobilization and the framing of alcohol-related problems. International Journal of Environmental Research andPublic Health 7(3): 1226-1247, 2010. (22 refs.)

The goal of this study was to describe how activists engaged in campaigns to change alcohol policies in inner city areas framed alcohol problems, and whether or not their frameworks reflected major models used in the field, such as the alcoholism as a disease model, an alcohol problems perspective, or a public health approach to alcohol problems. The findings showed that activists' models shared some aspects with dominant approaches which tend to focus on individuals and to a lesser extent on regulating alcohol marketing and sales. However, activists' models differed in significant ways by focusing on community level problems with alcohol; on problems with social norms regarding alcohol use; and on the relationship of alcohol use to illicit drugs.

Holmila M; Karlsson T; Warpenius K. Controlling teenagers' drinking: Effects of a community-based prevention project. Journal of Substance Use 15(3): 201-214, 2010. (45 refs.)

Aims: The study presents the evaluation results of the age-limit component of a community-based prevention project called PARKA. The project aimed to reduce alcohol availability among those under 18, which is the legal age for purchasing alcohol. The interventions consisted of law enforcement, community coalitions and community mobilization. Data and methods: The effects of the interventions were measured in a quasi-experimental research-setting with a matched control area before (2004) and after (2006/7) the interventions. The data included under-age purchase trials, a population survey and a school-based survey. Results: According to the purchase trials, the age limit control in the shops improved between the measuring points, and the young people reported in surveys that it had become more difficult to obtain alcohol. However, changes in the intervention and the control areas were similar. This can partly be explained by increased surveillance in addition to spill-over effects of PAKKA-interventions into the control areas. Conclusions: Local coalitions can be important tools in reducing alcohol availability among minors. The quasi-experimental research-setting has its methodological limitations in assessing the intervention's impact given the overlap in local and national processes seen in the case of the PAKKA project.

Jason LA; Pokorny SB; Adams ML; Topliff A; Harris CC; Hunt Y. Effects of youth tobacco access and possession policy interventions on heavy adolescent smokers. International Journal of Environmental Research and Public Health 6(1): 1-9, 2009. (23 refs.)

This study evaluated the effects of tobacco PUP (purchase, use and possession) laws on tobacco use patterns among students in twenty-four towns, which were randomly assigned into an experimental and a control group. The experimental group involved both PUP law enforcement and reducing minors' access to commercial sources of tobacco, and the condition for the control group involved only efforts to reduce minors' access to commercial sources of tobacco. The present study found that adolescents in the control group had a significantly greater increase in the percentage of youth who smoked 20 or more cigarettes per day when compared to the experimental group.

Lane DC; Simmons J. American Indian youth substance abuse: Community-driven interventions. Mount Sinai Journal of Medicine 78(3): 362-372, 2011. (57 refs.)

Substance abuse among American Indians has a long history that dates back to the colonial era. American Indian youth today continue to have one of the highest substance abuse rates when compared with other groups. Researchers have implemented American Indian youth substance abuse interventions that previously have worked in the general population, but studies have found that they are generally unprepared and poorly designed for American Indian populations. The lack of inclusion of American Indian populations in the interventional studies, poor understanding of American Indian I diversity and cultures, and lack of consideration for the unique historical and sociopolitical context of each tribe were cited as reasons the interventions failed. It has been suggested that historical trauma plays a considerable role in American Indian youth substance abuse; however, much of this theoretical framework has yet to be rigorously tested. Contemporary trauma appears to contribute significantly more to American Indian youth substance abuse. The data on American Indian substance abuse are limited, but what is currently available appears to show a vast heterogeneity in the level of substance abuse among American Indian youth that varies across different American Indian tribes and geographical distribution. In summary, this article seeks to describe the special relationship American Indian tribes have with the federal government, review historical and contemporary trauma, review American Indian youth substance abuse and interventions today, and finally describe a unique intervention strategy that tribes in the Pacific Northwest are implementing in order to combat American Indian youth substance abuse.

Little J; Franskoviak P. So glad you came! Harm reduction therapy in community settings. Journal of Clinical Psychology 66(2): 175-188, 2010. (23 refs.)

Harm reduction therapy was originally developed as a nonabstinence-based method of treating people with drug and alcohol problems. In this article, we describe and apply the principles and practices of harm reduction therapy in community settings, places where people congregate for nontherapeutic reasons -- street corners, community drop-in centers, needle exchanges, and primary care clinics. Low-threshold welcome and flexible session arrangements are defining characteristics of this community-based approach. We have been instrumental in developing several programs, three of which are described here. These programs work with more than 1,000 clients per year, with varying levels of intensity. The programs offer drop-in or sidewalk sessions, drop-in support groups, regular therapy appointments, and psychiatric medications. Many impressive outcomes, such as reduction of harmful drug use, stabilization of psychiatric problems, and permanent housing are found each year.

Luke DA; Harris JK; Shelton S; Allen P; Carothers BJ; Mueller NB. Systems analysis of collaboration in 5 national tobacco control networks. American Journal of Public Health 100(7): 1290-1297, 2010. (38 refs.)

Objectives. We studied 5 members of the National Network Consortium on Tobacco Control in Priority Populations. These networks, which consist of governmental and nongovernmental organizations, targeted lesbian, gay, bisexual, and transgender persons; Asian Americans, Native Hawaiians, and Pacific Islanders; American Indians and Alaska Natives; African Americans; and persons with low socioeconomic status, respectively. Methods. We used statistical network analysis modeling to examine collaboration among these national networks in 2007. Results. Network size and composition varied, but all 5 networks had extensive interorganizational collaboration. Location and work area were significant predictors of collaboration among network members in all 5 networks. Organizations were more likely to collaborate with their network's lead agency; collaborations with other agencies were more likely if they were geographically close. Collaboration was perceived to be important for achieving the goals of the national network. Conclusions. The similarity of collaboration patterns across the 5 networks suggests common underlying partnership formation processes. Statistical network modeling promises to be a useful tool for understanding how public health systems such as networks and coalitions can be used to improve the nation's health.

Luke DA; Ribisl KM; Smith C; Sorg AA. Family Smoking Prevention and Tobacco Control Act banning outdoor tobacco advertising near schools and playgrounds. American Journal of Preventive Medicine 40(3): 295-302, 2011. (15 refs.)

Background: The tobacco industry has challenged new FDA rules restricting outdoor tobacco advertising near schools and playgrounds on First Amendment grounds, arguing that they would lead to a near complete ban on tobacco advertising in dense urban areas. Purpose: To examine how the 2009 Family Smoking Prevention and Tobacco Control Act (FSPTCA) rules banning outdoor tobacco advertising near schools and playgrounds would affect tobacco retailers. Methods: GIS spatial analyses of two different states (Missouri, New York), along with more detailed analyses of two urban areas within those states (St. Louis, New York City), were conducted in 2010. The percentage of tobacco retailers falling within 350-, 500-, and 1000-foot buffer zones was then calculated. Results: 22% of retailers in Missouri and 51% in New York fall within 1000-foot buffers around schools. In urban settings, more retailers are affected, 29% in St. Louis and 79% in New York City. Sensitivity analyses demonstrate that smaller buffers decrease the proportion of affected retailers. That is, 350-foot buffers affect only 6.7% of retailers in St. Louis and 29% in New York City. Conclusions: The effects of new outdoor tobacco advertising restrictions vary by location and population density. In Missouri and New York, outdoor tobacco advertising would still be permitted in many locations if such advertising was prohibited in a 1000-foot buffer zone around schools and playgrounds. Much smaller buffer zones of 350 feet may result in almost no reduction of outdoor advertising in many parts of the country.

Miller PG; de Groot F; McKenzie S; Droste N. Vested interests in addiction research and policy: Alcohol industry use of social aspect public relations organizations against preventative health measures. Addiction 106(9): 1560-1567, 2011. (40 refs.)

Aim: It has been proposed that alcohol industry 'social aspects/public relations' organizations (SAPROs) serve the agenda of lending credibility to industry claims of corporate responsibility while promoting ineffective industry-friendly interventions (such as school-based education or TV advertising campaigns) and creating doubt about interventions which have a strong evidence base (such as higher taxes on alcoholic beverages). This paper investigated whether submissions to Australia's National Preventative Health Taskforce (NPHT) from alcohol industry bodies regarding the Australian SAPRO, Drinkwise, have used this organization to demonstrate corporate responsibility while promoting industry-friendly interventions. Method: Submissions to the Australian National Preventative Health Taskforce (NPHT) discussion paper Australia, the healthiest country by 2020 (n = 375) were examined to identify those with primary alcohol content. A thematic analysis of the resulting 33 submissions was conducted to determine which organization, institution or individual discussed Drinkwise. Setting: Australia. Findings Nine of the 33 submissions discussed Drinkwise; all were submitted by the alcohol industry or its affiliates. Every industry submission referred to Drinkwise either as providing evidence of social responsibility or by suggesting the industry-friendly actions of Drinkwise as alternatives to those recommended by the NPHT report. Conclusions: Drinkwise has been used by the alcohol industry to create an impression of social responsibility while promoting interventions that maintain profits and campaigning against effective interventions such as higher taxes on alcohol.

Modayil MV; Cowling DW; Tang H; Roeseler A. An evaluation of the California community intervention. Tobacco Control 19(Supplement 1): I30-I36, 2010. (29 refs.)

Aim We conducted this study to determine key community-level factors associated with higher tobacco control programme performance. Methods: A combination of surveys, administrative and fiscal data were collected to measure local county-level health department performance over a 7-year period. Longitudinal analyses were performed using generalised estimating equations to examine whether counties that exerted higher effort were successful in creating more tobacco retail licensing (TRL) and secondhand smoke policies. Several social, political and contextual factors were examined as confounders. Results: Local county health departments (CHDs) that demonstrated high effort on their work plans increased the proportion of residents covered by TRL policies (7.2%; 95% CI - 1.7 to 16.1%) compared to CHDs with lower levels of effort. Having legislators who voted in favour of tobacco control bills was found to significantly increase the passage of local TRL policies. CHDs demonstrating higher efforts also increased the proportion of residents covered by secondhand smoke policies (9.2%; 95% CI - 3.5 to 21.9%). Conclusion: There was strong evidence that higher county-level efforts predicted an increasing number of local tobacco control policies. Evaluations using integrated designs are recommended as effective strategies to provide a more accurate assessment of how well community-level interventions catalyse community-wide change.

Nygaard P; Saltz RF. Communication between researchers and practitioners: Findings from a qualitative evaluation of a large-scale college intervention. Substance Use & Misuse 45(1/2): 77-97, 2010. (16 refs.)

Many community-based intervention studies experience problems with collaboration between researchers and practitioners. A preferred strategy appears to be to form community coalitions to carry out the proposed interventions in the community, but doing so risks shifting the focus from intervention objectives to coalition process. As a by-product, coalitions often lack understanding of the project goals and are not given specific instructions on how to implement the intervention. In contrast to conventional wisdom, the Safer California Universities study implemented a very directive approach in collaboration with local liaisons on the participating campuses, even though this approach is seen to risk cooperation or commitment from collaborators. This paper reports on the findings of a qualitative study based on interviews with campus liaisons of how the directive approach was perceived on the participating campuses. Findings indicate that the strategy was successful in terms of "getting things done" but could have been improved in terms of liaison involvement in selling objectives, and in finding the optimal level of specificity.

Okamoto SK; Helm S; Delp JA; Stone K; Dinson AL; Stetkiewicz J. A community stakeholder analysis of drug resistance strategies of rural native Hawaiian youth. Journal of Primary Prevention 32(3-4): 185-193, 2011. (30 refs.)

This study examines and validates the drug resistance strategies identified by rural Hawaiian youth from prior research with a sample of community stakeholders on the Island of Hawai'i. One hundred thirty-eight stakeholders with a vested interest in reducing youth substance use (i.e., teachers, principals, social service agency providers, and older youth) completed a web-based survey comprised of 15 drug-related problem situations and 413 responses developed by Hawaiian youth. The findings corroborated the youth-focused findings from prior research. Differences in the endorsement of different strategies were examined based on gender, ethnicity, and age of the stakeholders. Implications for culturally grounded drug prevention in rural Hawaiian communities are discussed.

Redmond C; Spoth RL; Shin C; Schainker LM; Greenberg MT; Feinberg M. Long-term protective factor outcomes of evidence-based interventions implemented by community teams through a community-university partnership. Journal of Primary Prevention 30(5): 513-530, 2009. (45 refs.)

It is becoming increasingly common for community teams or coalitions to implement programming for children and families designed to promote positive youth development and prevent adolescent problem behaviors. However, there has been only limited rigorous study of the effectiveness of community teams' programming efforts to produce positive outcomes. This study employed a community-level randomized control design to examine protective parent and youth skills outcomes of evidence-based preventive interventions selected from a menu and delivered by community teams supported by a community-university partnership model called PROSPER. Twenty-eight rural communities in two states were randomized across intervention and control conditions. Data were collected through written questionnaires that were completed by approximately 12,000 middle school students in the fall of the 6th grade, prior to intervention delivery, and again in the spring of the 7th, 8th, and 9th grades. Positive intervention effects were found for youth, parent, and family outcomes (e. g., association with antisocial peers, child management, parent-child affective quality) at each post-intervention assessment point. Improvements in these family and youth skill outcomes are expected to support long-term reductions of adolescent problem behaviors, such as substance abuse. Editors' Strategic Implications: In this important and well controlled trial, the authors demonstrate that university partnership-supported community teams, especially when supported with ongoing technical assistance, can continue to produce positive outcomes even after much of the control over delivery of programs is turned over to representatives of the communities in which they are implemented.

Roeseler A; Burns D. The quarter that changed the world. Tobacco Control 19(Supplement 1): I3-I15, 2010. (65 refs.)

Background:The California Department of Public Health (CDPH), California Tobacco Control Program (CTCP) is one of the longest-running comprehensive tobacco control programmes in the USA, resulting from a 1988 ballot initiative that added a 25-cent tax on each pack of cigarettes and a proportional tax increase on other tobacco products. This programme used a social norm change approach to reduce tobacco use. Methods: The operation, structure, evolution, programme dissemination and results are reviewed. Results: The sustained programme implementation has reduced adult per capita cigarette consumption by over 60% and adult smoking prevalence by 35%, from 22.7% in 1988 to 13.8% in 2007. From 1988 to 2004, lung and bronchus cancer rates in California declined at nearly four times the rate of decline seen in the rest of the USA and the programme is associated with an $86 billion savings in healthcare costs. Youth smoking rates among 12-17 years olds are the second lowest in the nation. Conclusions: The social norm change approach is effective at reducing tobacco consumption, adult smoking and youth uptake. This approach resulted in declines in tobacco-related diseases and is associated with savings in healthcare expenditures. In considering CTCP's effectiveness, the takeaway message is that it should be viewed as a unified programme rather than a collection of independent interventions. The programme was designed and implemented as one where the parts complement and reinforce each other. Its effectiveness is dependent on its comprehensive strategy rather than any one part of the intervention.

Ross L. Sustaining youth participation in a long-term tobacco control initiative: Consideration of a social justice perspective. Youth & Society 43(2, special issue): 681- 704, 2011. (45 refs.)

This article presents an in-depth case study of the Healthy Options for Prevention and Education Coalition's Teens Tackle Tobacco initiative, a 3-year community-based participatory research (CBPR) project about the distribution of tobacco vendors and tobacco advertising in Worcester, Massachusetts. Using two theoretical frameworks, positive youth development (PYD) and social justice youth development (SJYD), the case reveals personal and community conditions that drove youth to get engaged in this project, how CBPR guided the group's research and action strategy, and results of the work to date. Analysis of this case highlights factors that facilitate and pose barriers to active youth involvement in a long-term, tobacco-related community change initiative. Specifically, to affect oppressive community conditions, a blend of PYD's focus on individual skill building, participation, and empowerment-joined with SJYD emphasis on community organizing and building youth's self-awareness of how race, class, and other dimensions of power affect their lives on a daily basis-is needed.

Satterlund TD; Cassady D; Treiber J; Lemp C. Barriers to adopting and implementing local-level tobacco control policies. Journal of Community Health 36(4): 616-623, 2011. (18 refs.)

Although California communities have been relatively successful in adopting and implementing a wide range of local tobacco control policies, the process has not been without its setbacks and barriers. Little is known about local policy adoption, and this paper examines these processes related to adopting and implementing outdoor smoke-free policies, focusing on the major barriers faced by local-level tobacco control organizations in this process. Ninety-six projects funded by the California Tobacco Control Program submitted final evaluation reports pertaining to an outdoor smoking objective, and the reports from these projects were analyzed. The barriers were grouped in three primary areas: politically polarizing barriers, organizational barriers, and local political orientation. The barriers identified in this study underscore the need for an organized action plan in adopting local tobacco policy. The authors also suggest potential strategies to offset the barriers, including: (1) having a "champion" who helps to carry an objective forward; (2) tapping into a pool of youth volunteers; (3) collecting and using local data as a persuasive tool; (4) educating the community in smoke-free policy efforts; (5) working strategically within the local political climate; and (6) demonstrating to policymakers the constituent support for proposed policy.

Sterling KL; Curry SJ; Emery S; Sporer AK; Mermelstein RJ; Berbaum M et al. Internally-developed teen smoking cessation programs: Characterizing the unique features of programs developed by community-based organizations. International Journal of Environmental Research and Public Health 6(3): 1026-1040, 2009. (18 refs.)

We have compared the unique features of teen tobacco cessation programs developed internally by community-based organizations (N=75) to prepackaged programs disseminated nationally (N=234) to expand our knowledge of treatment options for teen smokers. Internally-developed programs were more likely offered in response to the sponsoring organization's initiative (OR=2.16, p<0.05); had fewer trained cessation counselors (OR=0.31, p<0.01); and were more likely found in urban areas (OR=2.89, p=0.01). Internally-developed programs more often provided other substance-abuse treatment services than prepackaged programs and addressed other youth-specific problem behaviors (p <= 0.05). Studies that examine the effectiveness of internally-developed programs in reducing smoking and maintaining cessation for teen smokers are warranted.

Van Vleck VNL; Brinkley GL. Alert eyes and DWIs: An indirect evaluation of a DWI witness reward program in Stockton, CA. Accident Analysis and Prevention 41(3): 581-587, 2009. (35 refs.)

We evaluate a "grassroots" anonymous reward program targeting drunken driving in Stockton, CA. The time-series cross-sectional data covers 19 years for Stockton and six other California cities. Exploiting interrupted time-series regression, Zellner's seemingly unrelated regression (SUR) framework, and boot-strapped standard errors, we test for an impact of this program on alcohol-related injury or fatality accidents, the proportion of all accidents involving alcohol, and the number of DWI arrests. In its first decade, the citizen reward program appears to have averted some 275 alcohol-related accidents for social cost savings of between $21,000 and $5.6 million. Further, possibly 4495 arrests were precluded, saving some $1-3 million in arrest-related costs. Incentivized public monitoring of driving-after-drinking may be an effective drunken driving abatement program though our exploratory findings need further confirmation.

Villadsen K. The 'human' touch: Voluntary organizations as rescuers of social policy? Public Management Review 11(2): 217-234, 2009. (49 refs.)

This article critically discusses the almost mythical conception of voluntary and 'grass-roots' organizations as problem solvers in current welfare policy-a myth, which over the last twenty years has become increasingly dominant in social policy programmes in advanced liberal welfare states. In particular, the article examines the assumption that voluntary and local organizations are permeated by a different rationality that enables human beings to act as 'real humans' rather than as professionals and clients-a rationality which is, however, permanently at risk of being contaminated by bureaucratic influence. It is demonstrated that among the conditions of possibility for this discourse are explanatory models and concepts in modern organizational theory and in voluntary sector studies. The article argues that the conceptualizations of power, rationality and social change dominant in these studies are unsatisfactory. Instead, it applies a Foucauldian approach to the domain of drug addiction treatment, analysing a social work 'regime' that transgresses the traditional boundaries between state and voluntary sector.

Wolfson M; Champion H; Rogers T; Neiberg RH; Barker DC; Talton JW et al. Evaluation of Free to Grow: Head Start partnerships to promote substance-free communities. Evaluation Review 35(2): 153- 188, 2011. (41 refs.)

Free to Grow: Head Start Partnerships to Promote Substance-free Communities (FTG) was a national initiative in which local Head Start (HS) agencies, in partnership with other community organizations, implemented a mix of evidence-based family-strengthening and community-strengthening strategies. The evaluation of FTG used a quasi-experimental design to compare 14 communities that participated in the FTG intervention with 14 matched comparison communities. Telephone surveys were conducted with two cohorts of the primary caregivers of children in HS at baseline and then annually for 2 years. The survey was also administered to repeated cross-sectional samples of primary caregivers of young children who were not enrolled in HS. No consistent evidence was found in changes in family functioning or neighborhood conditions when the 14 FTG sites were compared to 14 matched sites. However, caregivers of young children who were not in HS in three high-implementing FTG sites showed evidence of improvements in neighborhood organization, neighborhood norms against substance abuse, and child disciplinary practices. Results provide highly limited support for the concept that family and neighborhood conditions that are likely to affect child development and well-being can be changed through organized efforts implemented by local HS programs.

Wusthoff LE; Waal H; Ruud T; Grawe RW. A cross-sectional study of patients with and without substance use disorders in community mental health centres. BMC Psychiatry 11(e-article 93), 2011. (44 refs.)

Background: Epidemiological studies have consistently established high comorbidity between psychiatric disorders and substance use disorders (SUD). This comorbidity is even more prominent when psychiatric populations are studied. Previous studies have focused on inpatient populations dominated by psychotic disorders, whereas this paper presents findings on patients in Community Mental Health Centres (CMHCs) where affective and anxiety disorders are most prominent. The purpose of this study is to compare patients in CMHCs with and without SUD in regard to differences in socio-demographic characteristics, level of morbidity, prevalence of different diagnostic categories, health services provided and the level of improvement in psychiatric symptoms. Methods: As part of the evaluation of the National Plan for Mental Health, all patients seen in eight CMHCs during a 4-week period in 2007 were studied (n = 2154). The CMHCs were located in rural and urban areas of Norway. The patients were diagnosed according to the ICD 10 diagnoses and assessed with the Health of the Nation Outcome Scales, the Alcohol Use Scale and the Drug Use Scale. Results: Patients with SUD in CMHCs are more frequently male, single and living alone, have more severe morbidity, less anxiety and mood disorders, less outpatient treatment and less improvement in regard to recovery from psychological symptoms compared to patients with no SUD. Conclusion: CMHCs need to implement systematic screening and diagnostic procedures in order to detect the special needs of these patients and improve their treatment.