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CORK Bibliography: Community Action Initiatives

131 citations. January 2003 to present

Prepared: Jaunary 2008

Allamani A; Sani IB; Voller F; Cipriani F; Ammannati P; Centurioni A. Experiences from a community alcohol action research in Scandicci, Florence. Nordic Studies on Alcohol and Drugs 20(English Supplement): 105-109, 2003. (4 refs.)

This is one of 15 papers on particular projects. The Scandicci project began as the result of an agreement between the municipality and Florence Health Agency. The first step was building a promoting group; the second to establish a local coordinating committee. The process of organizing is described and critiqued, including the process of defining goals, and the diverse interests of participants.

Arthur MW; Ayers CD; Graham KA; Hawkins JD. Mobilizing communities to reduce risk for drug abue: A comparison of two strategies. IN: Sloboda Z; Bukoski WJ, eds. Handbook of Drug Abuse Prevention: Theory, Science, and Practice. New York: Kluwer Academic/Plenum Publishers, 2003. pp. 129-144. (44 refs.)

This chapter examines two different efforts to promote drug abuse prevention through community level interventions. These case studies call upon statewide community mobilization efforts in Oregon and Washington. In addition to describing these efforts, the results of process evaluation are summarized.

Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Alcohol policies: A consumer's guide. IN: Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Alcohol: No Ordinary Commodity. Oxford: Oxford University Press, 2003. pp. 263-276. (7 refs.)

This chapter endeavors to provide a useful summary and posit guidance for those concerned about alcohol policy. One of the most difficult elements is to evaluate the evidence supporting different policy approaches. A very useful table has been assembled with is organized according to found major criteria: the evidence of effectiveness, the nature of research support, the extent of testing across diverse countries and cultures, and the relative cost of the intervention in terms of time, resources, and money. Other areas which are addressed within the "comments" section of the table are the target group affected by the intervention strategy, and anticipated costs. Each of the major policy areas highlighted in the book are incorporated. In addition, there are several concluding notes. One is the need to make science more accessible to policy-makers. Another is the adoption of the "precautionary principle", a public health concept that holds that preventive efforts would be undertaken even in the event of uncertainty, that the burden of proof out to be shifted to the proponents of a potentially harmful activity, that alternatives to harmful actions need to be provided, and efforts should be made to increase the level of public involvement in decision-making. There is also attention directed to attend to the needs of developing countries and the responsibilities to address their unique policy concerns and conduct the research required to make wise policy choices.

Barbeau EM; Kelder G; Ahmed S; Mantuefel V; Balbach ED. From strange bedfellows to natural allies: The shifting allegiance of five service organisations in the push for federal fire-safe cigarette legislation. Tobacco Control 14(5): 338-345, 2005. (62 refs.)

Background: Cigarettes are the leading cause of fatal fires in the USA and are associated with one in four fire deaths. Although the technology needed to make fire-safe cigarettes has been available for many years, progress has been slow on legislative and regulatory fronts to require the tobacco industry to manufacture fire-safe cigarettes. Method and results: We conducted a case study, drawing on data from tobacco industry documents, archives, and key informant interviews to investigate tobacco industry strategies for thwarting fire-safe cigarette legislation in the US Congress. We apply a theoretical framework that posits that policymaking is the product of three sets of forces: interests, institutions, and ideas, to examine tobacco industry behaviour, with a special focus on their and others' attempts to court fire service organisations, including firefighters' unions as allies. We discuss the implications of our findings for future policy efforts related to fire-safe cigarettes and other tobacco control issues. Conclusions: Tobacco control advocates ought to: continue efforts to align key interest groups, including the firefighters unions; contest tobacco industry "diversionary'' science tactics; and pursue a state based legislative strategy for fire-safe cigarettes, building towards national legislation.

Biglan A; Brennan PA; Foster SL; Stenius K; Holder HD. Helping Adolescents at Risk: Prevention of Multiple Problem Behaviors. New York: Guilford Press, 2004. (Chapter refs.)

The authors begin with the proposition is that many of problems of youth cluster, and the same individuals engage in multiproblem behaviour. The book focuses on adolescents who display more than one of five of the most costly problems for US society: antisocial behaviour, cigarette smoking, alcohol and drug misuse and sexual behaviour that risks pregnancy and disease. The book begins with discussion of their etiology, followed by discussion of the prevention and treatment methods work on all of these. The book presents extensive data and meta-analyses. In discussing effective interventions, an overview is first given of those interventions that focus on risk-groups during their preteen years. The data thus far shows that such projects have positive outcomes, at least in the short term, but have not been followed only a longer time span. An overview of studies looking at universal measures without regard to level of risk is also presented. These universal interventions usually begin when children enter adolescence. The usefulness of policies that affect the social, economic or geographic environment is highlighted. In the concluding chapter there is consideration of developing partnerships with a shared vision to overcome youth problems, but has little data to draw upon. The authors conclude that the next generation of community interventions will need to use comprehensive approaches to prevention of the entire range of youth problems. So far these studies are rare, although a few examples of projects using a multi-component approach are presented.

Brown RA; Chaloupka M; George AL. Developing the MADD organization. Glasgow: ICADTS, 2004. (0 refs.)

This paper sets forth the history of the organization, Mothers Against Drunk Driving (MADD), its impact on public policy, as well as its related initiatives to reach youth under the legal drinking age. There is an accompanying PowerPoint presentation with 18 slides.

Burkhart G; Matt B. Community-based Drug Prevention Programmes from EDDRA. Lisbon, Portugal: European Monitoring Centre on Drugs and Drug Abuse, 2003. (0 refs.)

This report presents the results of a qualitative analysis on 80 community-based prevention programmes in the EDDRA database. (EDDRA=Exchange on Drug Demand Reduction Action, a database established by the European Union sponsored organization, European Monitoring Centre on Drugs and Drug Abuse. There were 80 programs selected for analysis, drawn from 15 member states of the EU. A variety of approaches were used within these program: school programming, information dissemination, mass media, training, promoting networking, self-help groups, criminal justice based, health service based, and programs for high risk youth. The objectives of the programs are described, as well as the kinds of activities offered. A number of links are provided to enable readers to access specific programs.

Burrus B; Northridge ME; Hund L; Green M; Braithwaite K; Sabol B et al. Perspectives from the front lines of tobacco control. Journal of Health Care for the Poor and Underserved 17(1 Supplement S): 124-142, 2006. (29 refs.)

This research is designed to share valuable experiences and transferable principles from program staff of the Legacy/Community Voices initiative who have been involved in planning, implementing, evaluating, and sustaining tobacco control activities in underserved communities. Interviews were conducted with 13 front line staff from 9 sites: Alameda County, California; Detroit, Michigan; El Paso, Texas; Ingham County, Michigan; Miami, Florida; New Mexico; North Carolina; Northern Manhattan; and West Virginia. A model emerged from these interviews that places the life cycle of a program in a central position, with many of the identified themes (working with local champions, obtaining support from multiple partners, increasing organizational capacity) repeated throughout, albeit in different forms at different stages. Reflecting upon wisdom gained and identifying best processes for such work may help ensure that tobacco control programs are developed that are culturally safe and effective in meeting the needs of diverse communities throughout the United States.

Chapman S. Advocacy for public health: A primer. Journal of Epidemiology and Community Health 58(5): 361-365, 2004. (27 refs.)

Public health advocacy is the strategic use of news media to advance a public policy initiative, often in the face of opposition.

Cochrane Tobacco Addiction Group; Sowden A; Arblaster L; Stead L. Community interventions for preventing smoking in young people. (Cochrane Review). IN: Cochrane Library, Volume 1. Update Software: Oxford, 2003. (85 refs.)

Background: Decisions to smoke are made within a broad social context. Community interventions use co-ordinated, widespread, multi-component programmes to try and influence behaviour. Objectives: To determine the effectiveness of community interventions in preventing the uptake of smoking in young people. Search strategy: The Tobacco Addiction group specialised register, Medline and other health, psychology and public policy electronic databases were searched, the bibliographies of identified studies were checked and contact was made with content area specialists. Searches were updated in September 2002. Selection criteria: Randomised and non randomised 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 using qualitative narrative synthesis. Main results: Seventeen studies were included in the review, 46 studies did not meet all of the inclusion criteria. All studies used a controlled trial design, with six using random allocation of schools or communities. Of thirteen studies which compared community interventions to no intervention controls, two, which were part of cardiovascular disease prevention programmes, reported lower smoking prevalence. Of three studies comparing community interventions to school-based programmes only, one found differences in reported smoking prevalence. One study reported a lower rate of increase in prevalence in a community receiving a multi-component intervention compared to a community exposed to a mass media campaign alone. One study reported a significant difference in smoking prevalence between a group receiving a media, school and homework intervention compared to a group receiving the media component only. Conclusions: There is some limited support for the effectiveness of community interventions in helping prevent the uptake of smoking in young people.

Cochrane Tobacco Addiction Group; Secker-Walker RH; Gnich W; Platt S; Lancaster T. Community interventions for reducing smoking among adults. (Cochrane Review). IN: Cochrane Library, Volume 1. Update Software: Oxford, 2003. (238 refs.)

Background: Since smoking behaviour is determined by social context, the best way to reduce the prevalence of smoking may be to use community-wide programmes which use multiple channels to provide reinforcement, support and norms for not smoking. Objectives: To assess the effectiveness of community interventions for reducing the prevalence of smoking. Search strategy: We searched the Cochrane Tobacco Addiction Group specialised register, MEDLINE (1966-August 2001) and EMBASE (1980-August 2001) and reference lists of articles. Selection criteria: Controlled trials of community interventions for reducing smoking prevalence in adult smokers. The primary outcome was smoking behaviour. Main results: Thirty two studies were included, of which seventeen included only one intervention and one comparison community. Only four studies used random assignment of communities to either the intervention or comparison group. The population size of the communities ranged from a few thousand to over 100,000 people. Change in smoking prevalence was measured using cross-sectional follow-up data in 27 studies. The estimated net decline ranged from -1.0% to 3.0% for men and women combined (10 studies). For women, the decline ranged from -0.2% to + 3.5% per year (n=11), and for men the decline ranged from -0.4% to +1.6% per year (n=12). Cigarette consumption and quit rates were only reported in a small number of studies. The two most rigorous studies showed limited evidence of an effect on prevalence. In the US COMMIT study there was no differential decline in prevalence between intervention and control communities, and there was no significant difference in the quit rates of heavier smokers who were the target intervention group. In the Australian CART study there was a significantly greater quit rate for men but not women. Conclusions: The failure of the largest and best conducted studies to detect an effect on prevalence of smoking is disappointing. A community approach will remain an important part of health promotion activities, but designers of future programmes will need to take account of this limited effect in determining the scale of projects and the resources devoted to them.

Committee on Developing a Strategy to Reduce and Prevent Underage Drinking; Bonnie RJ; O'Connell ME, eds. Reducing Underage Drinking: A Collective Responsibility. Washington DC: National Academies Press, 2004. (536 book refs.)

This report was prepared in response to a request by the US Congress in 2002 that the Board on Children, Youth, and Families of the National Research Council and the Institute of Medicine form a Committee to review a broad range of federal, state and nongovernmental programs, from environmental interventions to programs focusing on youth attitudes and behaviors, and to develop a cost-effective strategy to reduce and prevent underage drinking. The report is comprised of an Executive Summary outlining the recommendations. It is organized into two parts. Part I defines the extent and consequences of underage drinking. Part II outlines a strategy, with individual chapters devoted to the process of designing an approach, a national media campaign, the alcohol industry, the entertainment industries, access to alcohol, youth-oriented interventions, and efforts a t the community level and by the federal and state governments. The report includes a CD rom with 16 background papers prepared to inform the Committee's efforts. The central goal of the recommended strategy is to create and sustain a broad societal commitment, which will require participation at multiple levels. Recommendations include the following: 1) media campaign directed to adults to build support; 2) involvement of alcohol industry with governmental and private groups, to fund a not-for-profit foundation whose sole mission would be to reducing and preventing underage drinking; 3) to desist advertising with particular appeal of underage youth, and create monitoring mechanisms to assure industry compliance; 4) that the entertainment industry (film and music) take precautions in adverting, strengthen advertising code, and initiate monitoring of compliance; 5) access should be limited via prohibiting and enforcing statutes around provision of alcohol by parents, and other adults, through strengthening compliance checks at package stores and bars; to stet standards for compliance at the state level, training of sellers and servers; and enact or strengthen dram act liability; 6) regulation of internet sales to reduce likelihood of sales to underage purchasers; 7) adoption of graduated driver licenses; 8) strengthen efforts to police use of false IDs, adopt driver's licenses that can be canned electronically; 8) states should adopt administrative and noncriminal penalties for youth; 9) test youth-focused national media campaigns; 10) restrict funding to evidence -based educational initiatives; 11) colleges adopt comprehensive programs of prevention, brief intervention, environmental changes to limit underage access; 12) community assessments to allow programs to be tailored to particular community; 13) at the federal level, increase coordination, develop a training and research Center; 14) revision of federal surveys to elicit more precise information, increase excise taxes; and 15) evaluation of government and private efforts.

Conway K; Casswell S. Riding the waves. The politics and funding context of twentyfive years of research on community action to reduce alcohol harm in New Zealand. Nordic Studies on Alcohol and Drugs 20(English Supplement): 13-24, 2003. (23 refs.)

One of the earliest evaluated community action projects on alcohol took place in New Zealand in the 1980s.This was a demonstration project using a quasi experimental design. In the two decade since, there have been a number of different approaches taken, responding to the political and economic context of the project, but all utilizing community development processes and focused on implementing policy. Six community action projects on alcohol are described and analysed to illustrate how contextual influences can shape a project. Changes in the funding climate after the 1980s meant that subsequent projects had to rely more on existing resources and non-research funds for their implementation and evaluation. Lessons for these projects are discussed and related to a generalisable base about the structure and content of effective community action projects.

Cramer ME; Atwood JR; Stoner JA. A conceptual model for understanding effective coalitions involved in health promotion programing. Public Health Nursing 23(1): 67-73, 2006. (36 refs.)

Funding agencies are increasingly focused on community coalitions as effective entities for promoting public health programs. Yet, there has been no conceptual model for understanding how effective coalition infrastructure works to facilitate a learning environment, wherein coalition members and leaders receive ongoing training and technical assistance needed to accomplish their external programing goals. This article presents a conceptual model for measuring the internal effectiveness of coalitions [Internal Coalition Outcome Hierarchy (ICOH)]. The ICOH model served as the basis for development of the evaluation instrument, Internal Coalition Effectiveness, which measures internal coalition effectiveness based on achievement of organizational outcomes at each of the model's seven hierarchical levels. The ICOH conceptual model has broad application for public health nurses who are frequently called on to serve as evaluators for community coalitions engaged in health programing. The model has implications for evaluators to use in teaching coalition members and leaders about their internal strengths and areas for improvement, so that coalitions can develop more effective internal structures and thereby promote long-term sustainability.

Cramer ME; Mueller KJ; Harrop D. Comprehensive evaluation of a community coalition: A case study of environmental tobacco smoke reduction. Public Health Nursing 20(6): 464-477, 2003. (18 refs.)

Community coalitions have become an increasingly popular means for addressing community health issues, yet evaluating their effectiveness and performance has presented formidable challenges. To meet the community's need for health program evaluation, public health nurses will need to become better prepared to deal with the complexities of evaluating coalitions and their multifaceted organizational structures. This article presents the methodology and conceptual framework, Targeting Outcomes of Programs (TOP), used to evaluate the performance and impact of a local community coalition. The case study offered here focuses on a tobacco-prevention coalition composed of 15 public and private agencies and their 121 activities. The TOP evaluation model provided the coalition with formative evaluation, needed to improve the coalition's on-going program delivery, and summative evaluation, needed for annual reviews of the coalition's effectiveness and impact in the community. The methodological approach and instrument presented here provide the public health nurse with a solid conceptual framework for approaching such a task.

Cuijpers P. Three decades of drug prevention research. Drugs: Education, Prevention and Policy 10(1): 7-20, 2003. (66 refs.)

Dozens of drug prevention programmes have been developed and examined in the past few decades. These interventions are aimed at tobacco, alcohol or all substances. Prevention programmes have different goals, including the following: increasing knowledge about drugs; reducing the use; delaying the onset of first use; reducing abuse; minimizing the harm caused by the use. Most research has been conducted on school-based drug prevention programmes. School-based drug prevention programmes that used interactive methods were found in research to reduce the use of drugs. All school-based drug prevention programmes (interactive and non-interactive) that have examined increase the knowledge about drugs. Although effective school-based prevention programmes are available, the dissemination at schools has not been successful for most programmes. Family-based drug prevention programmes are a promising new area of drug prevention. Most research examining the effects of mass media campaigns about drugs is flawed by major methodological problems. Results suggest that these campaigns cannot reduce the use of substances, but they may increase the effects of community-based interventions. Community interventions (a combined set of activities organized in a specific region or town, with the participation of the residents) are possibly more effective than each of the interventions alone.

Dakota County Public Health Department. Reducing Underage Alcohol Use in Dakota County: 2002 Progress Report. West St. Paul, MN: Dakota County Public Health Department, 2003. (0 refs.)

The purpose of the 2002 Progress Report on Youth Access to Alcohol in Dakota county is to provide an update on alcohol compliance checks conducted by local law enforcement agencies in Dakota County in 2002. The Public Health Department had adopted the following goals for 2002: (1) reduce illegal alcohol sales to underage youth; (2) Increase the number of cities that conduct at least one compliance check per licensed establishment; (3) Increase the number of local law enforcement agencies that complete the standardized data collection forms.; (4) Improve data collection on penalties imposed when there is an illegal sale. It was found that in 2002, 12% of the alcohol compliance checks conducted in Dakota Country resulted in an illegal sale. This rate is slightly higher than the prior year's 9% rate, but lower than the overall rate for the state estimated to be in the range of 15-18%. In respect to meeting other goals, there was an increase in the number of communities that conducted licensees at least once, as well as several additional towns that began to use the standardized data collection forms. Due to issues related to liquor licensing in Minnesota, limited progress was made on Goal 4.

Public Domain

De La Haye W. Community-based prevention of substance abuse. West Indian Medical Journal 53(6): 420-423, 2004. (16 refs.)

Substance abuse is pervasive in a number of countries throughout the world, placing an enormous burden and strain on their healthcare systems. The relationship between crime and illicit drug use increases the significance of the problem facing countries worldwide. Jamaica has not only become a trans-shipment point for cocaine from South America, but recent Drug Enforcement Agency figures show Jamaica being responsible for 30% of cocaine trafficking into the United States of America. Though all segments of society are involved, disadvantaged groups are disproportionately affected Substance use and abuse among adolescents is of particular concern. Supply reduction approaches have not been effective enough in reducing the prevalence of substance use and abuse in many countries throughout the world. Substance abuse prevention research over 25 years has led to the identification of a number of factors differentiating substance abusers from others. The presence of risk factors and the absence of protective facts contribute to an increase potential for drug abuse. The impact that these factors have is also determined by the level of psychological and social development of an individual. The presence of risk factors as well as the absence of protective factors leads to increased "exposure opportunity", exposure to a potential substance of abuse being closely associated with the potential for initial drug use, transition from initiation to regular use and subsequently dependence. One method of reducing "exposure opportunity" is community prevention. The basic aim of community prevention programmes is to decrease the rate of drug use in a population by enhancing protective factors and reversing or reducing risk factors.

D'Onofrio G; Degutis LC; Ahluwalia JS; Samet JH. Physician involvement in community coalitions to prevent substance abuse. (editorial). Substance Abuse 25(2): 1-4, 2004

Donovan R; Henley N. Social Marketing: Principles and Practice. Melbourne: IP Communications, 2003. (Chapter refs.)

This book provides a comprehensive review of the key components of social marketing, their application to health education and health promotion. This volume is not directed exclusively to substance abuse issues. However, many examples are drawn from the alcohol/drug field. The volume is organized into 15 chapters. Of note, efforts are made to avoid a narrow victim-blaming approach, and emphasis is placed on initiating a broad range of changes that promote health and well-being. The author deals with basic principles in marketing as well as the factors which promote change by individuals as well as the larger social spheres. Among the topics convered are theories of change, such as the Stages of Change model, the role of self-efficacy, media advocacy, as well as approaches to systematic planning for social marketing campaigns.

Ellis BH. Mobilizing communities to reduce substance abuse in Indian country. Journal of Psychoactive Drugs 35(1): 89-96, 2003. (35 refs.)

The impact of substance abuse is notable on Indian reservations in the United States and in the border communities surrounding them. One Indian country community, McKinley County, New Mexico, developed and implemented a series of alcohol policy and programmatic reforms beginning in 1989 which have reduced the impact of substance abuse on this community. Learning from the McKinley County experience, Fremont County in Wyoming, home of the Wind River Indian Reservation, has implemented similar reforms. This article introduces the substance abuse reduction efforts and delineates specific innovations implemented in these communities. The influence that these two communities have had on changes in substance abuse policy and programming statewide. in New Mexico and Wyoming is also reviewed.

Embry DD. Community-based prevention using simple, low-cost, evidence-based kernels and behavior vaccines. Journal of Community Psychology 32(5): 575-591, 2004. (61 refs.)

A paradox exists in community prevention of violence and drugs. Good research now exists on evidence-based programs, yet extensive expenditures on prevention have not produced community-level results. Various multiproblems are quite prevalent in the United States, such as violence, Attention Deficit Hyperactivity Disorder (ADHD), conduct problems, learning disabilities, depression, and other mood problems. Various studies have observed that, intuitively appealing community-based coalitions and best practice requirements have not produced prevention gains as hoped for by many. Calls for more money, fidelity, or dose seem unlikely to succeed. Other alternatives may be possible. Most of the best practices aimed at preventing these community problems are composed of evidence-based kernels, which act on core principles of prevention (risk and protective factors). What is not widely known is that the evidence-based kernels are powerful in their own right. Evidence-based kernels are irreducible units of behavior-change technology, and, they can be put together into behavioral vaccines (daily practices) with powerful longitudinal prevention results. Kernels and behavioral vaccines are simple, and they are not programs or curriculum in the conventional sense. This article presents examples of evidence-based kernels and behavioral vaccines that clan be promoted easily across whole communities or states using social marketing principles. Widespread propagation of evidence-based kernels and behavioral vaccines could have a significant impact on. communities and their prevention nouns, providing low-cost alternatives and practical models for community psychology, public health, and policy makers. Behavioral kernels and vaccines can, add needed precision to prevention science and community psychology.

Farquharson K. Influencing policy transnationally: Pro-and anti-tobacco global advocacy networks. Australian Journal of Public Administration 62(4): 80-92, 2003. (45 refs.)

Using the global tobacco advocacy networks as a case study, this article argues that the Advocacy Coalition Framework (Sabatier and Jenkins-Smith 1999), which theorises how advocacy coalitions affect policymaking domestically, and Keck and Sikkink's research into transnational advocacy networks (Keck and Sikkink 1998) can provide insights into the mechanisms of how transnational advocacy networks impact both local and intergovernmental policymaking. I argue that by combining aspects of each of these approaches, all sides of a policy situation can be analysed. I contrast these approaches with the epistemic communities approach (Haas 1992), suggesting that, for the tobacco policy system, the epistemic communities approach provides less insight than the other two.

Fell J. Youth initiatives and efforts to reduce underage drinking. Glasgow: ICADTS, 2004. (25 refs.)

While tremendous progress has been made in reducing alcohol-related traffic deaths since Mother Against Drunk Driving (MASS) was founded in 1980, traffic deaths continue to be the leading cause of death for youth in the US. Alcohol is related to 6.5 times more deaths of youth than all other illicit drugs combined. Underage drinking is America's No. 1 youth drug problem. MADD's mission has always been to stop drunk driving and support the victims of this violent crime, Due to the link between underage drinking and youth traffic fatalities, MADD added the prevention of underage drinking to its mission in 1999. Youth alcohol-related fatalities have been declining since the drinking age was raised to 21 in 1988, saving approximately 1000 lives annually. MADD believes it is important to recruit youth to participate in prevention programs to keep youth alcohol free, and involves a variety of prevention activities. There is an accompanying PowerPoint presentation with 27 slides.

Finney A; Simmonds C. Guidance for Local Partnerships on Alcohol-related Crime and Disorder Data. London: Home Office, 2003. (1 refs.)

This report provides guidance to local Crime and Disorder Reduction Partnerships (CDRPs) on how best to gather and utilize data on alcohol-related crime and disorder. A wide range of data is summarized for measuring alcohol-related crime and disorder at the local level. Different, but complementary, approaches for the measurement of alcohol-related crime are described which link alcohol consumption to crime and disorder. Findings indicate that alcohol consumption is a significant contributory factor with respect to a wide range of offences, in particular, violence and disorderly and anti-social behavior. Guidelines presented include the following. CDRPs are expected to play a role in developing strategies that will minimize the crime and disorder risks, including those posed by alcohol consumption. Building up a picture of local crime and disorder problems through a properly conducted audit is the basis for development of appropriate strategies. CDRPs are expected to take the views of the community into consideration via processes of consultation. A range of relevant and useful alcohol-related crime and disorder data is available. Auditing crime and disorder is complex and there are problems associated with data sources. Progress for understanding local alcohol-related crime and disorder problems can only be based on what data are available, and CDRPs are only expected to work to a realistic, rather than scientific, standard of proof. Developments in the nighttime economy are of key importance for understanding one context in which crime and disorder often occur.

Public Domain

Flewelling RL; Austin D; Hale K; LaPlante M; Liebig M; Piasecki et al. Implementing research-based substance abuse prevention in communities: Effects of a coalition-based prevention initiative in Vermont. Journal of Community Psychology 33(3): 333-353, 2005. (29 refs.)

Despite the popularity and perceived potential effectiveness of community-based coalitions in helping to prevent and reduce adolescent substance use, empirical evidence supporting this approach is sparse. Many reasons have been suggested for why coalition-based prevention initiatives, and community-level interventions in general, have not demonstrated stronger and more consistent results. Among these explanations are lack of uniformity and control over activities implemented by coalitions and inadequate numbers of communities used in evaluative studies. This article reports findings from the evaluation of a nonrandomized community trial in Vermont in which 23 community coalitions were funded for 3 years to select and implement a comprehensive mix of research-based prevention strategies designed to reduce substance use prevalence among adolescents. Data from three successive biennial administrations of the statewide Youth Risk Behavior Survey were used to assess this goal. Across the communities served by these coalitions, greater reductions in student substance use prevalence were achieved, relative to the remainder of the state, for all nine substance use measures examined. The greatest relative reductions were observed for past-30-day use of marijuana and cigarettes (both p < .05). These findings suggest that collaborative community-based efforts implemented within a supportive framework such as Vermont's New Directions project can have a meaningful impact on the prevalence of substance use behaviors among youth.

Ford JM; Beveridge AA. Varieties of substance use and visible drug problems: Individual and neighborhood factors. Journal of Drug Issues 36(2): 377-391, 2006. (11 refs.)

This paper examines whether the individual and neighborhood factors associated with visible drug problems are also related to drug use. It also looks at how the relationship between individual and neighborhood characteristics and substance use may vary depending upon type of substance under consideration (e.g., marijuana versus cocaine). Using data from the evaluation of the "Fighting Back" national demonstration program, our findings indicate that while neighborhood disadvantage, minority concentration, and density are strongly related to increased levels of visible drug problems, these characteristics are not significantly related to drug use. One implication of these findings is that law enforcement tactics aimed at reducing drug-related "incivilities" in a neighborhood are unlikely to have a substantial impact on residents'rates of drug use. The results also suggest that intervention programs targeting demand reduction among residents in a given neighborhood are likely to have little impact on visible drug problems in that area.

Freisthler B; Gruenewald PJ. Social ecology and the invention of new regulatory strategies for preventing drug and alcohol problems. IN: Stockwell T; Gruenewald PJ; Toumbourou JW; Loxley W, eds. Preventing Harmful Substance Use: The Evidence Base for Policy and Practice. New York: John Wiley & Sons, Ltd, 2005. pp. 291-306. (31 refs.)

Community-based prevention programs are one effective means of reducing alcohol- and drug-related harm. But there is little information on how policy and regulatory change in communities interact with local conditions to moderate reductions in harm. Understanding the differential effectiveness of policies across different neighborhoods will enable focused preventive interventions to reduce alcohol and drug problems. In order to understand the impact of community-wide global policies on local neighborhood problems, prevention researchers must understand the local correlates of problem outcomes. The current chapter uses social disorganization and routine activities theories to explain how different characteristics of neighborhoods (population and place characteristics) are related to a variety of problem outcomes (assaults, motor vehicle crashes, drug sales, drug possession, and drug overdoses). An ecological model is developed which describes how neighborhood conditions may be related to outcomes across areas of one community. An important facet of this model is that it assumes the movement of populations within and across neighborhood areas and interactions between local and neighboring populations are important components of a full explanation of the geographic distribution of alcohol and drug problems. Results from statistical analyses of community-based data show: (1) population and place characteristics both make important contributions to problem rates; (2) spatial interactions of populations between neighborhood areas affect drag and alcohol problems; and (3) risk and protective factors are heterogeneously related to problem outcomes across community areas. Policies that continue global efforts to reduce poverty, improve education, and eliminate poor housing will generally act to reduce alcohol- and drug-related problems. Furthermore, regulatory efforts to change rates of drag and alcohol problems using other mechanisms (i.e., reductions in outlet densities) would benefit from some local focus. Until the mechanisms that relate these characteristics of regulation to problem outcomes are better understood, blanket regulation of these aspects of drag and alcohol markets will have to be undertaken with considerable care. Consequently, the local effects of preventive interventions will be moderated by the larger social contexts of community settings, contexts that, once recognized, may be used to enhance the effectiveness of these programs.

Freudenberg N. Public health advocacy to change corporate practices: Implications for health education practice and research. Health Education & Behavior 32(3): 298-319, 2005. (109 refs.)

Corporate practices, such as advertising, public relations, lobbying, litigation, and sponsoring scientific research, have a significant impact on the health of the people in the United States. Recently, health professionals and advocates have created a new scope of practice that aims to modify corporate practices that harm health. This article describes how corporate policies influence health and reviews recent health campaigns aimed at changing corporate behavior in six industries selected for their central role in the U.S. economy and their influence on major causes of mortality and morbidity. These are the alcohol, automobile, food, gun, pharmaceutical, and tobacco industries. The article defines corporate disease promotion and illustrates the range of public health activities that have emerged to counter such corporate behaviors. It analyzes the role of health professionals, government, and advocacy groups in these campaigns and assesses the implications of this domain for health education practice and research.

Gabrielson KR. Prevention program planning. IN: Hogan J; Gabrielsen K; Luna N; Grothaus, eds. Substance Abuse Prevention: The Intersection of Science and Practice. New York: Allyn & Bacon, 2003. pp. 42-67. (20 refs.)

This chapter articulates a comprehensive seven step program planning and evaluation process. These include assessing communicty readiness to mobilize for change; assessing the levels of reisk and protective factors in the community; establishing priorities based on the data available; examination of community resources that reduce risk; selecting a target population; applying "best practices" and guiding prinicples drawing upon the research literature; and also evaluation strategies to assess outcome. Two of the appendices include instruments to assist in this process: a community readiness survey, and validated archival indicators.

Gabrielson KR. The logic model and evaluation. IN: Hogan J; Gabrielsen K; Luna N; Grothaus, eds. Substance Abuse Prevention: The Intersection of Science and Practice. Needham Heights MA: Allyn & Bacon, 2003. pp. 210-232. (5 refs.)

This chapter considers the area of evaluation, describing the common scientific methods available to measure program effectiveness. It highlights the issues to be consider in planning evaluation, designing a method to answer evaluation questions, analysis of data, and how to use the information gathered to promote the prevention efforts.

Giesbrecht N. Alcohol, tobacco and local control. A comparison of several community-based prevention trials. Nordic Studies on Alcohol and Drugs 20(English Supplement): 25-40, 2003. (42 refs.)

In North America there are significant similarities and differences in attitudes with regard to alcohol and tobacco on several dimensions, including the view taken of produces, suppliers and retailers, the products, and in the patterns of use. There are also contrasting as well as overlapping t3endencies with regard to perceived problems associated with alcohol versus tobacco consumption, intervention initiatives and the resources available. These secular developments and forces provide a contest for examining 10 community-based prevention trials which have sought to reduce harm from alcohol or tobacco using a range of strategies. These have included education and information campaigns, media advocacy,, counter-averting an health promotion, controls on selling and consumption venues and other regulations reduce access to alcohol or tobacco, enhanced low enforcement and surveillance, and community organizing and coalition development. This paper outlines the challenges of undertaking community-based trials and interpreting their findings. It notes that interventions which show promise are those that pay particular attention to controls on access, include the environmental context of where the products are sold and distributed and involve enforcement of public health policies. Controlling tobacco use may be made somewhat easier, than is the case for alcohol, with the vilification of the tobacco industry and marginalization and victimization of smokers. Nevertheless, the community trial provides opportunities for reducing harm related to alcohol and tobacco, particularly if resources are oriented in a coordinated way to those control measures and policies with the widest scope and greatest effectiveness.

Greenberg MT; Feinberg ME; Gomez BJ; Osgood DW. Testing a community prevention focused model of coalition functioning and sustainability: A comprehensive study of Communities that Care in Pennsylvania. IN: Stockwell T; Gruenewald PJ; Toumbourou JW; Loxley W, eds. Preventing Harmful Substance Use: The Evidence Base for Policy and Practice. New York: John Wiley & Sons, Ltd, 2005. pp. 129-142. (35 refs.)

There is evidence that community action approaches can reduce problems related to alcohol use and youth substance use. However, to date there has been little attention to the processes underlying successful community approaches. Coalitions and partnerships have become a popular vehicle for community action to reduce adolescent substance abuse and promote positive youth development. This chapter provides a broad overview of results of a detailed study of the Communities That Care (CTC) initiative in the state of Pennsylvania. CTC is a systematic approach to community action that includes the formation and training of a local coalition to identify factors underlying child and youth development in order to redress adverse influences through empirically supported programs. Findings emphasize the importance of community organizational and motivational readiness, initial training and ongoing technical assistance (TA) for the effective functioning of coalitions. Further, the prevention knowledge of coalition members, the quality of coalition functioning, and their fidelity to the CTC model all are predictive of sustainability of effort. Finally, coalitions that function more effectively showed greater changes in the rate of youth delinquency in their communities. Data on youth substance abuse changes were not available. These findings have clear implications for practitioners and policy-makers who can focus resources and attention early in the coalition lifecycle. Important areas of focus include adequate early training of key leaders and ongoing, high quality TA that helps the coalition's local committee (board) maintain fidelity to the model and effective internal board functioning. Maintaining a critical mass of knowledgeable board members is crucial and this requires orientation for new board members as well as ongoing TA to help community leaders sustain a sense of direction. Finally, it is important to note that while coalitions in themselves do not ensure positive outcomes in addressing adolescent problem behaviors, such outcomes are more likely to be achieved when communities are better poised for effectively developing, managing and sustaining coalition preventive efforts.

Gruenewald PJ. Introduction to prevention in the community. IN: Stockwell T; Gruenewald PJ; Toumbourou JW; Loxley W, eds. Preventing Harmful Substance Use: The Evidence Base for Policy and Practice. New York: John Wiley & Sons, Ltd, 2005. pp. 145-147. (5 refs.)

In this chapter, the author provides an introduction to the section presents examples of applications of community-based preventive interventions to different populations and sub-populations of users.

Hamilton WJ; George AL. Current MADD priorities. Glasgow: ICADTS, 2004. (0 refs.)

Mothers Against Drunk Driving (MADD) uses scientific research to advance its cause and change social attitudes. In 2004 its legislative priorities included: increasing alcohol-related law enforcement, especially through the use of highly-visible sobriety checkpoints; enacting primary enforcement seat belt laws in all 50 states; and enacting tougher, more comprehensive sanctions toward "higher risk" drivers. These are defined as repeat offenders, those who drive with a .15 percent blood alcohol concentration or higher or those who drive with suspended license, as a result of a prior alcohol-related driving offense. There is an accompanying PowerPoint presentation with 17 slides.

Hammett TM; Norton GD; Kling R; Liu W; Chen Y; Ngu D et al. Community attitudes toward HIV prevention for injection drug users: Findings from a cross-border project in southern China and northern Vietnam. Journal of Urban Health 82(33 (Supplement 4)): IV34-IV42, 2005. (19 refs.)

Success of HIV prevention projects for injection drug users (IDUs) depends on the support of the communities in which they are implemented. This article presents data from cross-sectional community surveys of HIV knowledge and attitudes toward peer-based HIV prevention interventions for injection drug users in a border area of Lang Son Province, Vietnam and Ning Ming County, Guangxi Province, China. Analysis of these surveys at baseline and 18 months reveals generally high or improving levels of HIV knowledge and positive attitudes toward the interventions in both Vietnam and China. Levels of knowledge and positive attitudes tended to be higher in Vietnam than in China. Interviews with staff and peer educators suggest that the project's community education efforts have increased support for the interventions and contributed to their smooth implementation. However, the community surveys also reveal some continuing deficits in HIV knowledge and understanding of the interventions, including perceptions that provision of new needles/syringes will result in increased drug use. Additional education, including dissemination of countervailing project data, is necessary to address these deficits and further increase community support for the interventions.

Heminger JD. Big abortion: What the antiabortion movement can learn from big tobacco. Catholic University Law Review 54(4): 1273-1311, 2005. (280 legal refs.)

The author is concerned that the US courts continued to find that women have a constitutional right to abortion although there have been cases which have weakened strict standard of scrutiny, and allowed legislatures to introduce restrictions as long as they do not place an "undue burden" on women seeking an abortion. The author suggests that antiabortion advocates adopt the strategy used by the anti-tobacco advocates: mass tort class action litigation. this Comment proposes that this be used against abortion providers to reform social policy. The comment begins by surveying the historical and legal framework for the three waves of Big Tobacco litigation. It then outlines how the constitutional right to an abortion developed. After outlining the supreme Court's abortion jurisprudence, the Comment examines the potential psychological and physical harms that face women who have abortions. It then evaluates recent attempts to use litigation and legislation to restrict abortion After establishing this foundation, the comment analyzes abortion from the perspective of (1) the people involved; (2) the legal principles at issue; and (3) strategic conditions necessary for success. Finally it articulates why antiabortion advocates should pursue this litigation.

Hingson RW; Zakocs RC; Heeren T; Winter MR; Rosenbloom D; DeJong W. Effects on alcohol related fatal crashes of a community based initiative to increase substance abuse treatment and reduce alcohol availability. Injury Prevention 11(2): 84-90, 2005. (27 refs.)

Objective: This analysis tested whether comprehensive community interventions that focus on reducing alcohol availability and increasing substance abuse treatment can reduce alcohol related fatal traffic crashes. Intervention: Five of 14 communities awarded Fighting Back grants by The Robert Wood Johnson Foundation to reduce substance abuse and related problems attempted to reduce availability of alcohol and expand substance abuse treatment programs (FBAT communities). Program implementation began on 1 January 1992. Design: A quasi- experimental Design: matched each program community to two or three other communities of similar demographic composition in the same state. Main outcome measures: The ratio of fatal crashes involving a driver or pedestrian with a blood alcohol concentration of 0.01% or higher, 0.08% or higher, or 0.15% or higher were examined relative to fatal crashes where no alcohol was involved for 10 years preceding and 10 years following program initiation. Results: Relative to their comparison communities, the five FBAT communities experienced significant declines of 22% in alcohol related fatal crashes at 0.01% BAC or higher, 20% at 0.08% or higher, and 17% at 0.15% or higher relative to fatal crashes not involving alcohol. Conclusions: Community interventions to reduce alcohol availability and increase substance abuse treatment can reduce alcohol related fatal traffic crashes.

Hoek J. Tobacco promotion restrictions: Ironies and unintended consequences. Journal of Business Research 57(11): 1250-1257, 2004. (34 refs.)

As the health consequences of tobacco smoking have become more apparent, governments have regulated the types of promotion available to cigarette manufacturers. Yet despite these efforts, the tobacco industry has continued to develop highly visible promotions that make greater use of youth role models and of new media known to have high penetration among youth. Attempts to reduce the impact of the tobacco industry's promotions seem unintentionally to have stimulated the development of more subtle initiatives that are harder to regulate and that reach and influence young people even more effectively. Alternative means of controlling the health-related consequences of smoking include further promotion restrictions and tighter controls on the sale and distribution of tobacco. Social marketing programmes based on techniques developed by the tobacco industry may yet provide the richest irony: use of the industry's own tactics to counter its messages.

Hogan JA; Gabrielsen KR; Luna N; Grothaus D. Substance Abuse Prevention: The Intersection of Science and Practice. Boston: Allyn & Bacon, 2003. (234 refs.)

This is text directed to substance abuse prevention. The authors view it as a volume that can assist those preparing for licensur and certification. Chapter headings and some subheadings in this volume include: (1) introduction: evolution and training of the prevention discipline; attitudes about alcohol, tobacco, and other drugs (ATOD); definitions of use, misuse, abuse, and dependence/addition; justification for theory; building blocks for the prevention profession; (2) prevention research; (3) prevention program planning: assess the readiness of the community and mobilize for action; assess the levels of risk factors and protective factors in the community; translate data into priorities; examine the resources in the community that are reducing risk factors and increasing protective factors; select a target population; apply "guiding principles" and "best practices;" evaluate; (4) facts about drugs; (5) the cultural context and ethics of prevention; (6) incorporating human development theory into prevention; (7) the media and prevention; (8) the logic model and evaluation; (9) communication strategies; (10) grant writing; and (11) bringing it all together. Appendices provide additonal resource materials as well as four case studies in prevention, which address ethics and the gap between research and practice.

Public Domain

Holder HD. Community prevention of young adult drinking and associated problems. Alcohol Research & Health 28(4): 245-249, 2004. (21 refs.)

This article briefly summarizes three evidence-based community intervention trials sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Designed to reduce alcohol use among youth and young adults, these trials demonstrate the potency of community interventions that can influence the price, availability, drinking context, and perceived risks of heavy drinking among young people. The effectiveness of comprehensive, research-based local prevention efforts is confirmed by research examining other programs to reduce alcohol sales to youth as well as the harm caused by alcohol use among youth and young adults, including alcohol-related traffic accidents and assaults. By restructuring the total alcohol environment in a way that can be self-sustaining, these interventions are more likely to be effective than one-time interventions.

Public Domain

Holder HD; Treno A; Levy D. Community systems and ecologies of drug and alcohol problems. IN: Stockwell T; Gruenewald PJ; Toumbourou JW; Loxley W, eds. Preventing Harmful Substance Use: The Evidence Base for Policy and Practice. New York: John Wiley & Sons, Ltd, 2005. pp. 149-161. (17 refs.)

This chapter outlines the theoretical bases underlying the "community systems approach" to alcohol and other substance-related problems. It begins by contrasting this approach with more individual-based approaches and argues for its application to these problems on both practical and theoretical grounds. It then presents an illustration of how this approach may be applied using "computer systems modeling" as an illustration. It is argued that such modeling reflects the complexity of the use/abuse system, provides a means to integrate existing prevention and epidemiological studies, can be used to assist prevention planning by projecting potential outcomes for various prevention strategies, and ultimately provides a prevention planning tool that can be utilized in a variety of settings. Three simulation programs (i.e., SimCom, SimSmoke and SimPot) are presented. Finally, the chapter discusses two types of modeling strategies which fit within this broader approach: (1) the mean field approach; and (2) the network approach. While the former attempts to reduce complex ecological interactions to their root dynamics, the latter creates a higher-resolution, graph-based model that describes spatial and temporal interactions between individuals and community systems. Thus, while the former provides the advantage of characterizing complex problems simply, the latter more accurately captures the dynamics underlying them. It is argued that both techniques should be used in parallel, and with reference to statistical assessment of goodness-of-fit to available data that will provide measures of optimal performance at various scales. It is concluded that the effective prevention of alcohol, tobacco, and drug problems must be based upon an approach mat provides the greatest possible potential return for research and prevention interventions.

Ivers RG; Castro A; Parfitt D; Ballie RS; D'Abbs PH; Richmond RL. Evaluation of a multi-component community tobacco intervention in three remote Australian Aboriginal communities. Australian and New Zealand Journal of Public Health 30(2): 132-136, 2006. (12 refs.)

Objectives: To assess the effect of community tobacco interventions in Aboriginal communities. Methods: The study consisted of a pre- and post-study of the effect of a multicomponent tobacco intervention conducted in six Aboriginal communities in the Northern Territory (NT). The intervention included sports sponsorship, health promotion campaigns, training health professionals in the delivery of smoking cessation advice, school education about tobacco, and policy on smoke-free public places. The study was conducted in three intervention communities and three matched control communities. Surveys were used to measure changes in prevalence of tobacco use, changes in knowledge, and attitudes to cessation in intervention communities. Results: Tobacco consumption decreased in one intervention community compared with the matched control community; the trends of consumption (as measured by tobacco ordered through points of sale) in these communities were significantly different (t=-4.5, 95% CI -33.6 - -12.5, p <= 0.01). Community samples in intervention communities included 920 participants. There was no significant change in the prevalence of tobacco use, although knowledge of the health effects of tobacco and readiness to quit increased. Conclusions: Although it is difficult to demonstrate a reduction in tobacco consumption or in the prevalence of tobacco use as a result of multi-component community tobacco interventions delivered in Aboriginal communities, such interventions can increase awareness of the health effects of tobacco and increase reported readiness to cease tobacco use.

Jacobson PD; Banerjee A. Social movements and human rights rhetoric in tobacco control. Tobacco Control 14(Supplement 2): 1145-1149, 2005. (18 refs.)

After achieving breathtaking successes in securing state and local restrictions on smoking in public places and restricting youth access to tobacco products, the tobacco movement faces difficult decisions on its future strategic directions. The thesis of this article is that the tobacco control movement is at a point of needing to secure its recent successes and avoiding any public retrenchment. To do so requires rethinking the movement's strategic direction. We use the familiar trans-theoretical model of change to describe where the movement is currently and the threats it faces. The new tobacco control strategy should encompass a focus on voluntary non-smoking strategies, use human rights rhetoric to its advantage, and strengthen the public health voice to be more effective in political battles. In developing a new strategy, tobacco control advocates need to build a social movement based on a more forceful public health voice, along with the strategic use of human rights rhetoric, to focus on the power of voluntary non-smoking efforts. Using human rights rhetoric can help frame the movement in ways that have traditionally appealed to the American public. Perhaps more importantly, doing so can help infuse the tobacco control movement with a broader sense of purpose and mission.

Jos PH; Perlmutter M; Marshall MF. Substance abuse during pregnancy: Clinical and public health approaches. Journal of Law, Medicine & Ethics 31(3): 340-350, 2003. (74 refs.)

The authors explore the issues related to interventions involving drug-using women during pregnancy. Currently there are thirty-five states that have criminally proscuted women for substance abuse or alcohol use during pregnancy. In addition involuntary commitment has been used to protect fetus. There have also been mandatory reporting mechanisms for health care professionals that has generated concerns. This essay acknowledges the concerns about need to protect the clinical encounter from intrusion by government, HMOs, or insurers. This essay approaches the issues of maternal addiction through a public health model. It presents what the authors view as inherent limits is the clinical encounter, and the problems which arise from the intrusion in the clinical encounter. The key elements of a public health approach is described which includes attention to macro-level policy and programs rooted in the community.

Karel T. The failure of Ohio's drug treatment initiative. Cleveland State Law Review 51: 203-234, 2004. (240 refs.)

Summary: In the summer of 2002, proponents of Issue 1 "The Ohio Drug Treatment Initiative," (hereafter referred to as the Initiative) succeeded in getting the proposal on the November ballot. With so much emphasis being placed on the need for treatment and prevention why did Ohioans reject The Ohio Drug Treatment Initiative? ... There are two basic forms to the initiative process: the direct initiative and the indirect initiative. ... A direct initiative is a proposed constitutional amendment that qualifies for the ballot by citizen petition and is submitted directly to the people for a vote. ... The Drug Treatment Initiative has itself sparked moral debates. An Overview of the Ohio Drug Treatment Initiative: The coalition "Ohioans for New Drug Policies" was the main proponent for the Initiative. The Initiative provided that upon receiving a request for treatment the court shall stay the proceedings and determine whether the offender meets eligibility requirements. The Initiative did not reject offenders who had prior records or who had received prior drug treatment. Although Ohio does not require the ballot to state the effect of a yes or no vote, which generates voter confusion, this was not the case with the Initiative.

Karlsson T; Torronen J. Local authorities views on changes in alcohol- and drug prevention in three Finnish cities. Nordic Studies on Alcohol and Drugs 20(English Supplement): 120-124, 2003. (7 refs.)

This is one of a group of papers dealing with specific projects. In this article the authors analyze how local authorities understand the purpose of community-based preventive work against alcohol and drug problems in their communites and the significant of multi-agency or interagency co-operation in a decentralized system. Relevant changes in the public sector administration are described, particularly minicipaliites refor to promote greater autonomy of municipalities to allocate state subsidies. A change in alcohol legislation in 1968, increasing availability of alcohol and the impact of joining the EU are described. This article describes and discusss community based programs to reduce alcohol consumption and implement the national alcohol action plan, intended for implementation at the local level. One of the programs was initiated by the police to reduce public drinking and promote public safey, another addressed youth drinking and drug use, another endeavoring to promote traditional values.

Kerr T; Small W; Peeace W; Douglas D; Pierre A; Wood E. Harm reduction by a "user-run" organization: A case study of the Vancouver Area Network of Drug Users (VANDU). International Journal of Drug Policy 17(2): 61-69, 2006. (30 refs.)

The Downtown Eastside of Vancouver has experienced ongoing epidemics of HIV infection and illicit drug overdoses since the mid 1990s. In 1997, in response to the emerging health crisis among injection drug users (IDU) and government inaction, individuals gathered in Vancouver to Form a drug user-run organization. This group eventually became known as the Vancouver Area Network of Drug Users (VANDU). Because of the growing interest in drug user organizations, this case study was conducted to document the genesis, structure, and activities of VANDU. In accordance with VANDU's philosophy of "user involvement and empowerment," we employed a community-based case study methodology to achieve these aims. The findings demonstrate that through years of activism, advocacy, and public education, VANDU has repeatedly voiced the concerns of drugs users in public and political arenas. VANDU has also performed a critical public health function by providing care and support programmes that are responsive to immediate needs of their peers. This study indicates that greater efforts should be made to promote the formation of drug user organizations, and that health authorities and policy makers should explore novel methods for incorporating the activities of drug user organizations within existing public health, education, and policy making frameworks.

Kibel BM; Holder HD. Community-focused drug abuse prevention. IN: Sloboda Z; Bukoski WJ, eds. Handbook of Drug Abuse Prevention: Theory, Science, and Practice. New York: Kluwer Academic/Plenum Publishers, 2003. pp. 145-264. (30 refs.)

This chapter provides a theoretical approach to community-based initiatives. The basic premises are that substance use problems are multicausal, programs however well conducted, if only directed at a single sphere can have only a limited impact, and effective responses required coordinated multi-system initiatives The chapter considers the emergence of community coalitions and their role in prevention efforts. It also considers the role of environmental strategies, and what factors are important for successful programs.

Knickman JR. "Fighting back": A funder's perspective. Journal of Drug Issues 36(2): 469-484, 2006. (20 refs.)

This article is authored by a member of the Robert Wood Johnson Foundation that funded the Fighting Back initiative, an effort to address to address neighbor substance use problems through the activities of community coalition. The evaluation of this initiative is the theme of this issue. Overall the results indicate the initiative was not effective. The author describes the origins of the initiative, its key elements, as well as the governmental policies that were then being followed. Different topics addressed are the Foundation's management of what was a very large-scale multi-site program, including the creation and role of a national program office, and the roles of a national advisory council and foundation staff. Also addressed are the impacts of environmental changes, changes within the Foundation staffing, the emergence of differing expectations across the life of the initiative, and the challenges that confronted the evaluation efforts. Some of the factors that may have contributed to the lack of positive findings are noted, including from the possibly too narrow focus of the evaluation design.

Lavery SH; Smith ML; Esparza AA; Hrushow A; Moore M; Reed DF. The community action model: A community-driven model designed to address disparities in health. American Journal of Public Health 95(4): 611-616, 2005. (18 refs.)

The community action model is a 5-step, community-driven model designed to build communities' capacity to address health disparities through mobilization. Fundamental to the model is a critical analysis identifying the underlying social, economic, and environmental forces that create health and social inequities in a community. The goal is to provide communities with the framework necessary to acquire the skills and resources to plan, implement, and evaluate health-related actions and policies. The model was developed in the context of tobacco-related health disparities. Concrete policy outcomes demonstrate the model's potential application to a wide variety of grassroots policy development efforts.

Leonard A. Building the right environment for legislative change and public awareness. Glasgow: ICADTS, 2004. (0 refs.)

This paper chronicles efforts to inform the public about penalties and sanctions on drinking and driving. Often new sanctions with the accompanying publicity leads to a reduction in drinking and driving; the challenge is to maintain the decline. This paper discusses the activities of the Ontario Community Council on Impaired Driving as a means of providing a ground for those concerned with drinking and driving to maintain attention to the topic. There is an accompanying PowerPoint presentation with 22 slides.

Lindholm ML. Establishing program legitimacy in multiethnic settings: The Robert Wood Johnson Foundation's "Fighting Back" program. Journal of Drug Issues 36(2): 351-375, 2006. (27 refs.)

While there is a plethora of literature on program models, evaluation strategies, evaluation outcomes, and lessons learned regarding anti-alcohol and drug community coalitions, case studies of implementation are rare. This paper analyzes multiple case histories of implementation of the Robert Wood Johnson Foundation's (RWJF) "Fighting Back"(FB) program with particular attention to issues in multiethnic sites. A common theme in the case histories was minority challenge to the legitimacy of local grantees'(lead agency) leadership in addressing local alcohol and other drug (A OD) problems facing minorities. The local projects adopted a range of strategies to increase their legitimacy with minorities: sharing policy making with or turning it over to minority leadership, recruiting minorities forpositions on staff and committees, and subcontracting or making grants to minority-run organizations to implement project activities. These responses reduced challenges to the local projects'legitimacy but also produced unanticipated consequences; most significantly, the nature of project activity expanded well beyond the original scope of FBs mission to reduce demand for AOD. The discussion addresses the implications of legitimacy issues related to political control of FB, allocation of the grant's resources, and how AOD problems and solutions were framed in the context of urban multiethnic U.S. settings.

Lindholm M; Ryan D; Kadushin C; Saxe L; Brodsky A. "Fighting Back" against substance abuse: The structure and function of community coalitions. Human Organization 63(3): 265-276, 2004. (23 refs.)

The Robert Wood Johnson Foundation's Fighting Back (FB) program was one of the first efforts to develop "community coalitions" to reduce drug and alcohol problems. The challenges of coalition building are described and analyzed based on fieldwork from 10 of the 14 urban communities where the program operated. The possibilities and limits of broad-based participation in decision making and interagency collaboration are described. The program triggered a vertical dynamic in its effort to integrate grassroots and elite participation. This dynamic involved negotiation for control within the local program. Structures that encouraged more grassroots-elite integration in the local programs were: 1) relative cohesion and political strength among grassroots leadership; and 2) a grantee agency with resources to distribute and relative freedom from constraints imposed by having to compete in the local political arena and with other service providers. The program initiated a horizontal dynamic in its effort to rationalize the delivery of services. Competition, segmentation, and the mandate to be broadly inclusive were barriers to effective collaboration. Short-term collaboration among agencies emerged around concretely defined, shared goals. Longer-term collaboration was infrequent but emerged on a smaller scale around grant writing, legislative advocacy, and educational events for professionals. Coordination proved difficult because relevant policies were typically set by state legislatures rather than in local communities.

Livert D; Winick C. Changes in the number of methadone maintenance slots as measures of "Fighting Back" program effectiveness. Journal of Drug Issues 36(2): 313-330, 2006. (32 refs.)

This study examined trends in the number of available methadone maintenance treatment (MMT) slots to evaluate a community-based drug prevention program. In the 1990s, the "Fighting Back" (FB) initiative sought to reduce substance use and harm through community-based coalitions in 14 sites across the U.S. Nine state agencies provided MMT data for 28 FB and control communities for a 10-year period prior to and -during the program. Opioid use data from a general population survey conducted in the same communities by the national evaluation team were also examined. Counter to expectation, implementation of the FB program was associated with significantly less expansion of MMTslots when compared to control communities. This trend was not attributable to opioid use in those communities, which did not change during the same period. The implication of the findings as well as the historical context of methadone maintenance treatment since the 1990s is also discussed.

Luna N. The media and prevention. IN: Hogan J; Gabrielsen K; Luna N; Grothaus, eds. Substance Abuse Prevention: The Intersection of Science and Practice. Needham Heights MA: Allyn & Bacon, 2003. pp. 170-209. (60 refs.)

An understanding of the media is central to prevention efforts in several prespects. It is frequently a tool in prevention programming. Simultaneously an understanding of the media is important in education, as media is a significant influence in the formation of attitudes towards substance use. The chapter considers media advoacy; media literacy; and social marketing.

May PA; Miller JH; Gossage JP. Measuring community readiness for change in the prevention of fetal alcohol syndrome. (meeting abstract). Alcoholism: Clinical and Experimental Research 28(5 Supplement): 125A-125A, 2004. (0 refs.)

McLintock B. Smoke-free: How One City Successfully Banned Smoking in All Indoor Public Places. Vancouver, British Columbia: Granville Island Publishing, 2004

The author is an award-winning journalist who describes the efforts to enact smoke-free legislation. The city is Victoria, the capital of British Columbia, and this is a case study showing how a region can not only pass legislation, but implement it, and enforce it with such effectiveness that the compliance rate now exceeds 99 per cent. The story is a dramatic narrative in its own right, replete with details of harrowing public meetings, widespread early defiance of the law in drinking establishments, an often-hostile media climate and even death threats to those responsible for implementation and enforcement. But it also shows the benefits of enacting such a law, not just through improved air quality for patrons and workers but also how such a bylaw results in a reduced smoking rate in the population and growing popularity for the measure, even amongst smokers.

Midford R; Cooper M; Jaeger JA. The Partysafe Project: Working with an Australian rural community to reduce alcohol harm. Nordic Studies on Alcohol and Drugs 20(English Supplement): 69-80, 2003. (12 refs.)

This is one of 15 papers on individual projects. The program, Partysafe Project, was a community mobilization initiative, conducted in the remote Northwest town of Carnarvon in Western Australia over a period of 18 months. The initial goal was to reduce alcohol-related harm associated with drinking in private settings. However, subsequent to the pre-intervention community survey, gtreater emphasis was placed on influencing males in the age range 25-45 years, because of the high risk drinking bnehaviour identified in this group. The intervention comprised a number of components, including local media advertising and advocacy; participation in high profile community collaborative campaigns and the use of peer character cartoon strip to highlight alcohol issues and model behaviour change. Use of local media content was particularly effective in raising community awareness as to the project's message and obtaining support for its aims. On completion of the intervention phases, process and impact data were gathered from a number of community sources. The major impact of Partysafe project in its own right was heightened awareness of alcohol issues in the community. However, the project also contributed in a major way to institutionalizing a collaborative Christmas alcohol harm prevention campaign.

Midford R; Wayte K; Catalano P; Gupta R; Chikritzhs T. The legacy of a community mobilisation project to reduce alcohol related harm. Drug and Alcohol Review 24(1): 3-11, 2005. (24 refs.)

The Community Mobilisation for the Prevention of Alcohol Related Injury (COMPARI) project was established to investigate how alcohol related harm could be reduced within the Geraldton community through community action. Twenty-two major component activities were carried out over three years. On completion of the demonstration phase the project was taken over by the community and evolved into the region's main alcohol and drug service provider. This research seeks to identify the legacy of COMPARI from interviews with 23 key informants and from serial measures of alcohol consumption and harm. Key informants indicated that the original community prevention focus of the project has been diluted and there is more emphasis on individual prevention through education and training. A culture of intersectoral collaboration on alcohol issues has endured and this contributes to better use of resources and higher levels of treatment referral. There was also strong acknowledgement that the local committee was crucial in sustaining the project. Since the inception of COMPARI, local alcohol consumption has decreased and a proxy measure of alcohol harm, weekend, night, hospital accident and emergency occasions of service, also indicates better outcomes in Geraldton. The original project initiated cultural and structural change in the way alcohol problems are dealt with in Geraldton and this has produced on-going benefit for the community.

Mistral W; Velleman R; Templeton L; Mastache C. Local action to prevent alcohol problems: Is the UK Community Alcohol Prevention Programme the best solution? International Journal of Drug Policy 17(4, Special Issue): 278-284, 2006. (21 refs.)

Increasing evidence indicates that the UK has a serious alcohol problem. This crosses many patterns of drinking and all ages, whereas the public debate about alcohol tends to focus almost exclusively on binge drinking and on young people's alcohol-related anti-social behaviour. This paper addresses the interventions and policy developments currently implemented in the UK to reduce alcohol-related anti-social behaviour. There are two main approaches: a national (England) change in the licensing laws; and local harm reduction projects seeking to effect change independently of central Government initiatives. This paper describes the critique currently mounted against the expected efficacy of new licensing laws and describes the theoretical and practical developments of some local prevention initiatives that are part of the United Kingdom Alcohol Prevention Programme (UKCAPP), funded by the Alcohol Education and Research Council (AERC). Although it is too early to draw conclusions as to the effects of either of these developments, initial reports suggest that changes in the licensing regime have not yet created the increase in alcohol-related problems some commentators have argued would occur; and the local prevention initiatives have led to the formation of extremely strong community partnerships, with a range of innovative and integrated actions to tackle alcohol-related anti-social behaviour. Fundamental criticisms of both the new licensing laws and the National Alcohol Strategy remain, however. Even if the above interventions lead to reductions in alcohol-related anti-social behaviour, it is not clear how they might deal with the rising levels of alcohol-related health harms reported within the UK. Nevertheless, the community partnership approach may be the best possibility for dealing with at least some of the alcohol-related problems caused by the rise in availability and accessibility of alcohol within the UK.

Mohatt GV; Rasmus SM; Thomas L; Allen JA; Hazel K; Hensel C. "Tied together like a woven hat:" Protective pathways to Alaska native sobriety. Harm Reduction Journal 1: e-article 10, 2004. (56 refs.)

Background: The People Awakening Project (1RO1 AA 11446-03) had two purposes, completed in Phase I and Phase II of the project. The purpose of Phase I was to complete a qualitative study; the research objective was discovery oriented with the specific aim of identification of protective and recovery factors in Alaska Native sobriety. Results were used to develop a heuristic model of protective and recovery factors, and measures based on these factors. The research objective of Phase II was to pilot these measures and provide initial validity data. Methods: Phase I utilized a life history methodology. People Awakening interviewed a convenience sample of 101 Alaska Natives who had either recovered from alcoholism (n = 58) or never had a drinking problem (n = 43). This later group included both lifetime abstainers (LAs) and non-problem drinkers (NPs). Life histories were transcribed and analyzed using grounded theory and consensual data analytic procedures within a participatory action research framework. Analyses were utilized to generate heuristic models of protection and recovery from alcohol abuse among Alaska Natives. Results: Analyses generated a heuristic model of protective factors from alcohol abuse. The resulting multilevel and multi-factorial model describes interactive and reciprocal influences of (a) individual, family, and community characteristics; (b) trauma and the individual and contextual response to trauma, (c) experimental substance use and the person's social environment; and (d) reflective processes associated with a turning point, or a life decision regarding sobriety. The importance of cultural factors mediating all these protective processes is emphasized. For NPs, the resilience process drew from personal stores of self-confidence, self-efficacy, and self-mastery that derived from ability to successfully maneuver within stressful or potentially traumatizing environments. In contrast, for many LAs, efficacy was instead described in more socially embedded terms better understood as communal mastery. One style of mastery is more associated with individualistic orientations, the other with more collectivistic. Future research is needed regarding the generalizeability of this group difference. Conclusions: Results suggest that preventative interventions should focus on intervening simultaneously at the community, family, and individual levels to build resilience and protective factors at each level. Of particular importance is the building of reflexivity along with other cognitive processes that allow the individual to think through problems and to reach a life decision to not abuse alcohol.

Mostashari F; Kerker BD; Hajat A; Miller N; Frieden TR. Smoking practices in New York City: The use of a population-based survey to guide policy-making and programming. Journal of Urban Health 82(1): 58-70, 2005. (26 refs.)

To inform New York City's (NYC's) tobacco control program, we identified the neighborhoods with the highest smoking rates, estimated the burden of second-band smoke exposure, assessed the early response to state taxation, and examined cessation practices. We used a stratified random Design: to conduct a digit-dialed telephone survey in 2002 among 9,674 New York City adults. Our main outcome measures included prevalence of cigarette smoking, exposure to second-hand smoke, the response of smokers to state tax increases, and cessation practices. Even after controlling for sociodemographic factors (age, race/ethnicity, income, education, marital status, employment status, and foreign-born status) smoking rates were highest in Central Harlem and in the South Bronx. Sixteen percent of nonsmokers reported frequent exposure to second-hand smoke at home or in a workplace. Among smokers with a child with asthma, only 33% reported having a no-smoking policy in their homes. More than one fifth of smokers reported reducing the number of cigarettes they smoked in response to the state tax increase. Of current smokers who tried to quit, 65% used no cessation aid. These data were used to inform New York City's smoke-free legislation, taxation, public education, and a free nicotine patch giveaway program. In conclusion, large, local surveys can provide essential data to effectively advocate for, plan, implement, and evaluate a comprehensive tobacco control program.

Moulden J. SoberRide: A community-based impaired driving prevention program. Glasgow: ICADTS, 2004. (1 refs.)

On the average day, 48 people die in alcohol related traffic deaths in the US. In the year 2002 the number of alcohol-related deaths rose to its highest level in four years, ending an almost 20-year downward trend. To respond to this pubic health and safety issue a program was create by the National Commission Against Drug Driving (NCADD) and AT&T Wireless. A program, SoberRide was introduced to provide complimentary cab rides on holidays associated with high levels of drinking -- such as New Year's Eve, Halloween, Independence Day, and St. Patrick's Day. It was first introduced in 1993 and by 2002 had been extended to 5 cities. Data has been assembled on the demographics of those using SoberRide, transportation choices, drinking behavior, and program awareness. There is an accompanying PowerPoint presentation with 26 slides.

Munro G. Drinks industry organizations should carry warning labels: A brief reply to commentaries. Addiction 99(11): 1380, 2004. (7 refs.)

This is a response to commentaries on the author's article published in this issue: An addiction agency's collaboration with the drinks industry, Moo Joose as a case study. The case study highlights the tensions inherent in collaborations between the beverage industry and community substance abuse agencies.

Murie A. Mixing grassroot volunteerism with empirical research: Rating the provinces report card. Glasgow: ICADTS, 2004. (0 refs.)

This presentation deals with the effectiveness of Canada's response to impaired driving and the interaction between community action initiatives and empirical services in Canada. The presentation begins with an explanation of the divisions between federal and provincial governmental responsibilities. It then presents a case study of the efforts of MADD in Canada to influence government policy. Central to this was the reliance on empirical data in selecting its policy goals. An example used is MADD's Rating the Provinces Project, the Report Card initiative. This involved a rating scale, summaries of provincial legislation, the use of external raters, and a series of public presentations highlighting the data. Among the initiatives supported by these efforts was ignition interlock, graduated licensing, impoundment programs, and vehicle seizures. This presentation is summarized in a PowerPoint presentation with 14 slides.

Murie A; Solomon R. The alcohol industry: Friend or foe in the fight against impaired driving. "A MADD Perspective". Glasgow: ICADTS, 2004. (26 refs.)

The alcohol industry has been a major obstacle to making significant progress in fighting drinking and driving. While MADD has no problems with the industry's focus on pursuing profits or sponsoring bonafide research. MADD Canada's perspective changes when the alcohol industry purports to be committed to reducing impaired driving and yet offers "solutions" that will have little positive impact and when it opposes measures that research indicates would have major traffic safety benefits. As with the tobacco industry, the alcohol industry provides little research in support of its proposals. This paper illustrates the industry's approach by reference to its support for social norming and its opposition to lowering the BAC limit for driving. MADD is not opposed to working with the industry, but only if it is willing to tackle real problems in the impaired driving field. There is no accompanying PowerPoint presentation.

Newburn VH; Remington PL; Peppard PE. A method to guide community planning and evaluation efforts in tobacco control using data on smoking during pregnancy. Tobacco Control 12(2): 161-167, 2003. (37 refs.)

Background: Effective community based tobacco control programmes are critical for state and nationwide impact. However, there is little discussion in the literature of methods for setting local objectives which use locally collected data and account for historical variation in progress. Objectives: To develop and illustrate a method that uses locally available birth certificate data to model trends in tobacco use during pregnancy among women giving birth, predict future prevalence, and use predictions to set community specific tobacco control objectives. Data source: Vital statistics. Wisconsin standard birth certificates, 1990-2000, which record the smoking status of the mother during pregnancy. Data analysis: Trends in the prevalence of smoking during pregnancy in Wisconsin statewide and in all counties (n = 72) were modelled using linear regression of log prevalence on year. Model fit was assessed using R-2. Regression slopes, indicating estimated relative annual percentage change in prevalence, were used to predict prevalence in 2005, and objectives were calculated as a 20% reduction from the predicted prevalence in 2005. Conclusions: Modelling trends in the prevalence of smoking using locally collected data enables communities to set reasonable future tobacco control objectives that account for historical trends in progress.

Noe T; Fleming C; Manson S. Healthy nations: Reducing substance abuse in American Indian and Alaska Native communities. Journal of Psychoactive Drugs 35(1): 15-25, 2003. (42 refs.)

Since 1993, 14 American Indian and Alaska Native (AIAN) communities have worked diligently to reduce the harm due to substance abuse in their communities: Funded by the Robert Wood Johnson Foundation's Healthy Nations Initiative 1, these communities implemented creative strategies that span the continuum from community-wide prevention, early identification and treatment to aftercare. Drawing upon the unique strengths of their own cultural traditions to find solutions to local substance abuse problems, these efforts have identified important and useful lessons for not only other AIAN communities, but also for sponsors of substance abuse programming in Indian country and elsewhere. Described here are successful strategies for developing and sustaining substance abuse programs in AIAN communities and an assessment of their impacts and accomplishments.

Northridge ME. Building coalitions for tobacco control and prevention in the 21st century. (editorial). American Journal of Public Health 94(2): 178-180, 2004. (13 refs.)

Offen N; Smith EA; Malone RE. From adversary to target market: The ACT-UP boycott of Philip Morris. Tobacco Control 12(2): 203-207, 2003. (67 refs.)

Background: In 1990, the AIDS Coalition to Unleash Power (ACT-UP) sparked a year long boycott of Philip Morris's Marlboro cigarettes and Miller beer. The boycott protested the company's support of Senator Jesse Helms (R-North Carolina), a leading opponent of AIDS funding and civil rights for lesbian, gay, bisexual and transgender (LGBT) people. ACT-UP demanded that Philip Morris sever its ties with Helms and acknowledge its responsibility to the LGBT community and to people with AIDS. Objective: To assess the impact of the boycott on the LGBT community, the tobacco industry, and the tobacco control movement; and to determine what lessons tobacco control advocates can extract from this case. Data sources: Internal tobacco industry documents and newspaper archives. Methods: Search of tobacco industry documents websites using "boycott", "ACT-UP", "gay", and other terms. Results: Philip Morris used the boycott to its own advantage. It exploited differences within the community and settled the boycott by pledging large donations to combat AIDS. Through corporate philanthropy, Philip Morris gained entree to the LGBT market without appearing gay friendly. Many LGBT organisations, thirsty for recognition and funding from mainstream corporations, welcomed Philip Morris's overtures without considering the health hazards of tobacco. Conclusions: Unless the goal of a boycott is to convince the tobacco industry to abandon tobacco altogether, such actions invite the industry to expand its marketing under the guise of philanthropy. Tobacco control advocates should be clear about goals and acceptable settlement terms before participating in a boycott of a tobacco company.

Offen N; Smith EA; Malone RE. The perimetric boycott: A tool for tobacco control advocacy. Tobacco Control 14(4): 272-277, 2005. (53 refs.)

Objectives: To propose criteria to help advocates: (1) determine when tobacco related boycotts may be useful; (2) select appropriate targets; and (3) predict and measure boycott success. Methods: Analysis of tobacco focused boycotts retrieved from internal tobacco industry documents websites and other scholarship on boycotts. Results: Tobacco related boycotts may be characterised by boycott target and reason undertaken. Most boycotts targeted the industry itself and were called for political or economic reasons unrelated to tobacco disease, often resulting in settlements that gave the industry marketing and public relations advantages. Even a lengthy health focused boycott of tobacco industry food subsidiaries accomplished little, making demands the industry was unlikely to meet. In contrast, a perimetric boycott (targeting institutions at the perimeter of the core target) of an organisation that was taking tobacco money mobilised its constituency and convinced the organisation to end the practice. Conclusions: Direct boycotts of the industry have rarely advanced tobacco control. Perimetric boycotts of industry allies offer advocates a promising tool for further marginalising the industry. Successful boycotts include a focus on the public health consequences of tobacco use; an accessible point of pressure; a mutual interest between the target and the boycotters; realistic goals; and clear and measurable demands.

Osborn B; Small W. "Speaking truth to power": The role of drug users in influencing municipal drug policy. (editorial). International Journal of Drug Policy 17(2): 70-72, 2006. (5 refs.)

Peterson NA; Reid RJ. Paths to psychological empowerment in an urban community: Sense of community and citizen participation in substance abuse prevention activities. Journal of Community Psychology 31(1): 25-38, 2003. (57 refs.)

Empowerment represents a promising intervention target for substance abuse prevention activities. To date, however, there has been a paucity of research examining the role of empowerment processes engaged in by citizens within substance abuse prevention contexts. Addressing this concern, this study tested a path model that included perceptions of person, situation, and environment-related predictors of empowerment. The hypothesized model was found to fit data from a sample of randomly selected urban residents (n = 661) who participated in an evaluation of a Center for Substance Abuse Prevention (CSAP) Community Partnership. Findings elucidate the need for developing substance abuse prevention initiatives that promote empowerment by increasing participation in substance abuse prevention activities, with particular emphasis on incorporating strategies designed to improve sense of community. Limitations of the study and directions for future research are discussed.

Raitasalo K. Preventing adolescents' alcohol and drug use by activating parents: Evaluation of the 'Klaari Helsinki' project. Nordic Studies on Alcohol and Drugs 20(English Supplement): 116-119, 2003. (8 refs.)

This is one of 15 papers on particular projects. Klaari Helsinki is an alcohol and drug prevention project directed at youth (Klaari means clean or sover) and maintained by the Social Services Department of the city of Helsinki. It is designed to stimulate and co-ordinate mult0professional, cross-sectional and community-based activities in local settings. This article reviews the background and organization of the project, as well as a number of key assumptions underpinning the project. The single guiding principle is "joint responsibility for the young" and as a corollary that a good relationship between parents and children and a safe environment is crucial to preventing substance abuse by adolescents. This paper reports on one part of the project's evaluation: a process and formulative evaluation of the activities arranged for parents. Other part consisted of evaluation of the project's organization and financial structure, of region, multi-professional workgroups, and of activities directed by youth.

Rehnman C; Larsson J; Andreasson S. The beer campaign in Stockholm: Attempting to restrict the availability of alcohol to young people. Alcohol 37(2): 65-71, 2005. (16 refs.)

A number of Swedish studies have indicated that it is easy for underaged youths to purchase medium strength beer in grocery shops. The aim of this study was to follow the effects of a community action-based intervention involving information/training of parents, police, and shopkeepers, media advocacy, and monitoring of the sales of beer to underaged youths. Eighteen-year-old students, looking younger, attempted to purchase a six-pack of medium strength beer in grocery shops without showing ID. A questionnaire about perceived availability was distributed among ninth-grade students. Surveys of parental awareness and shopkeepers' attitudes were also conducted. A significant decrease in sales was observed in both the intervention area (from 73% of all purchase attempts to 44%) and in the comparison area (from 60% to 44%). No significant difference was found between the intervention and the comparison areas, in part due to a contamination effect in the comparison area, where similar activities were conducted by the local community. Perceived availability by teenagers did not change. Following the intervention, availability to medium strength beer for young people in the intervention area decreased, but remained high. It is possible that this moderate reduction was due to the intervention but the same is not certain, given the developments in the comparison area. The intervention was primarily based on information and training, whereas a policy of surveillance and sanctions in the comparison area appears to have achieved the same result, with lesser resources. The study also illustrates the feasibility of engaging parents in community action for prevention purposes.

Reinert B; Carver V; Range LM. Evaluating community tobacco use prevention coalitions. Evaluation and Program Planning 28(2): 201-208, 2005. (15 refs.)

The present project describes an objective evaluation system for tobacco use prevention coalitions in Mississippi. From in-person interviews with coalition leaders (N=29), telephone interviews with coalition members (N=183), information from monitors, and monthly reports, the evaluator rated each coalition from 5 (exceptional) to 1 (bad) on 24 criteria, then summed the scores to ascertain an actual overall letter grade for each coalition. Each coalition received the grade and specific suggestions for improvement. Coalitions graded D or D- were placed on probation, with 6 months to improve before funding was cut. The present scoring procedure allowed the tobacco prevention coalitions to have specific, detailed feedback about how to improve.

Rindskopf D. Heavy alcohol use in the "Fighting back" survey sample: Separating individual and community level influences using multilevel latent class analysis. Journal of Drug Issues 36(2): 441-462, 2006. (6 refs.)

In this article, multilevel latent class analysis is used to examine the structure of heavy alcohol use. A model with three latent classes (types) of people fits the data well: those who seldom suffer major consequences from heavy drinking, those who typically suffer only a small number of major consequences, and those who suffer serious consequences in a large number of areas of their lives. Individuals in the first class tend to be older, female, with domestic partners, more highly educated, employed, and either Catholic, Muslim, or Baptist.

Roffo AH. The carcinogenic effects of tobacco. (reprint). Bulletin of the World Health Organization 84(6): 500-502, 2006. (5 refs.)

This is a reprint of an article published in 1940 speaking to the relationship of smoking to lung cancer, published in Monatisschrift fur Krebsbekampfung, Vol 8, Issue 5, 1940. It summarizes numberous experiments carried out at the Cancer Institgd public aenos Aitions to reduce alcohol related harm, bred. The experimental work using fractiased on societal consensus. Background: Alcohol abuse is an avoidable behaviour that can threaten health. In Slovenia, only a few public campaigns against drinking alcohol are under way. It is important to establish which community measures are acceptable to society in Slovenia in order to reduce alcohol-related risks. Methods: A Delphi study with 45 professionals from different disciplines was conducted. Participants offered many suggestions to improve the current situation. After three rounds of questionnaires, 86 participant statements were accepted as a consensus. Results: Actions such as: state monopolies, alcohol taxation, legislative restrictions on availability and purchase of alcohol, age-related restriction on sales, drink-driving laws, school-based alcohol education and media information campaigns are most likely to be achieved by consensus. The main target populations for implementation of alcohol-related educational programs are children, young people and employees. Conclusions: As a result of the study, a number of community actions against drinking alcohol that could be acceptable for society can now be suggested. They vary across different target populations, change agents (individuals, organizations and institutions) and methods of implementation.

Public Domain

Roth N. The Lugna Gatan Project: An example of enterprise in crime prevention work. (editorial). Drugs: Education, Prevention and Policy 11(3): 193-198, 2004. (1 refs.)

This commentary addresses the emergence of voluntary organization active in crime prevention. One is described, "Lugna Gatan" established in Stockholm in 1994. The goal was to engage young adults were to patrol the underground and attend public festivities directed at young people, with the goal of mediating conflicts, intervening to prevent crime and initiate relationships with marginalized youth, undertaken by a community organization (Fryshuset) with a reputation for undertaking innovation community action initatives. The name Lugna Gatan was derived from a Charlie Chaplin silent movie, Easy Street. Beside the history of Lugna Gatan, there is also a description of its programs, as well as the political controversies and public policy questions that that have arisen, particularly as many of those employed by the program are drawn from the marginalized groups the organization is endeavoring to serve.

Russell TD. The Practice of Restorative Justice. Between town and gown: The rise and fall of restorative justice on Boulder's University Hill. Utah Law Review : 91-136, 2003. (107 refs.)

Seven weeks after I moved to Boulder, University of Colorado students rioted three-quarters of a block from my home. ... Watching this riot turned me into a neighborhood activist and set me on the path toward restorative justice. ... If neighbors are having a loud party that is disturbing your quiet enjoyment of your home, they are violating the Boulder municipal code noise ordinance. ... com site that addressed the basic issues concerning noise, garbage, overoccupancy, and alcohol, the Victim Impact Statement page offers basic instruction as to what the statements are and their utility to judges and prosecutors. ... The victim impact statement page also included a hyperlink that allowed neighbors to e-mail a statement directly to the Boulder municipal court's restorative justice coordinator. ... Another offender - a nonstudent convicted of a graffiti offense - worked closely with a neighbor, helping to log instances of graffiti in the neighborhood. ... Restorative justice fell on the Hill because restorative justice empowered members of the community to ask for more effective enforcement of Boulder's laws in order to repair harm to the neighborhood and prevent more harm from happening. ... Trash, noise, vehicles, beer cups: just what can be expected of tenants when nothing is expected of them by the landlord.

Ryan D. "Everything here is so political...." Separating the organizationally normal from the political in communities of organizations. Journal of Drug Issues 36(2): 331-349, 2006. (33 refs.)

The rhetoric of "community" is common in talk of social programs. With it comes imagery of common interests, overcoming turf battles, working together, and getting along. When programs fail to achieve goals or turn into outright flascos, personal, organizational, and community pathology, or simply "politics" are common explanations. Problems are assumed to be endemic and intractable or remediable only by gifted leadership or transcendence of business as usual. This article argues that such thinking is rooted in a false assumption. "Community" needs to be reconceptualized as a community of organizations, not people, and organizations as constrained actors not analogous to individuals. Organizations interact in peculiar, but analyzable ways, giving rise to unanticipated outcomes that could be labeled pathology or mere politics. Community alcohol and other drug AOD programs might be more successful if their logic models were based on realistic concepts of community that can distinguish the actually political from the organizationally normal.

Schinke SS; ColeK. Prevention program implementation. IN: Sloboda Z; Bukoski WJ, eds. Handbook of Drug Abuse Prevention: Theory, Science, and Practice. New York: Kluwer Academic/Plenum Publishers, 2003. pp. 575-586. (31 refs.)

This chapter deals with the implementation of prevention programs. A case study is used to illustrate major issues. These include ensuring community ownership and consideration of significant elements such as advisory councils and volunteers. Also discussed is efforts to determine the integrity of implementation.

Shillis JA; Hall BA; Sneden GG; Gottlieb NH. Keeping the focus on public health: The struggles of a tobacco prevention task force. Health Education & Behavior 30(6): 771-788, 2003. (47 refs.)

This case study examines a nonlegislative task force as it struggled to reach internal consensus despite external political constraints. The study highlights the convergence of politics and science, revealing complex issues likely to be confronted by advocates and public health officials. Three themes capture participants' experiences: context, sizing up the opportunities and constraints; task force process, tacit strategy to operate outside the political context and play the science card; and aftermath, a glass half full. The task force took advantage of ambiguous parameters, crafting a comprehensive statewide plan to reduce tobacco use and breaking out of the common public health paradigm of allowing budget considerations to drive program design. These internal victories could not sustain a policy success in the legislature. However, the group's product sets science-based standards for future program development, and the task force's process provides valuable insights into other states developing tobacco prevention and control policies.

Small D; Palepu A; Tyndall MW. The establishment of North America's first state sanctioned supervised injection facility: A case study in culture change. International Journal of Drug Policy 17(2): 73-82, 2006. (33 refs.)

The serious adverse health consequences associated with illicit drug use in Vancouver has brought international attention to the city. It is now widely recognized that innovative and bold strategies are required to confront epidemics of drug overdose, HIV and Hepatitis C infections, and injection-related bacterial infections. The establishment of North America's first supervised injection facility (SIF) required a major cultural shift in the way drug addiction is viewed. The story behind the SIF in Vancouver is a complex and interconnected series of events brought about by the activities of advocates, peers, community agencies, politicians, journalists, academics and other key players to bring about social change. The aim of this narrative is to highlight the ideas, processes and historical events that contributed to a cultural transformation that was critical to opening the SIF in Vancouver. By doing this, we hope to encourage other communities to take the bold steps necessary to reduce the devastating health and social consequences of injection drug Use.

Smith EA; Malone RE. Thinking the "unthinkable": Why Philip Morris considered quitting. Tobacco Control 12(2): 208-213, 2003. (71 refs.)

Objective: To investigate the genesis and development of tobacco company Philip Morris's recent image enhancement strategies and analyse their significance. Data sources: Internal Philip Morris documents, made available by the terms of the Master Settlement Agreement between the tobacco companies and the attorneys general of 46 states, and secondary newspaper sources. Study selection: Searches of the Philip Morris documents website (www.pmdocs.com) beginning with terms such as "image management" and "identity" and expanding as relevant new terms (consultant names, project names, and dates), were identified, using a "snowball" sampling strategy. Findings and conclusions: In the early 1990s, Philip Morris, faced with increasing pressures generated both externally, from the non-smokers' rights and public health communities, and internally, from the conflicts among its varied operating companies, seriously considered leaving the tobacco business. Discussions of this option, which occurred at the highest levels of management, focused on the changing social climate regarding tobacco and smoking that the tobacco control movement had effected. However, this option was rejected in favour of the image enhancement strategy that culminated with the recent "Altria" name change. This analysis suggests that advocacy efforts have the potential to significantly denormalise tobacco as a corporate enterprise.

Smith KC; Wakefield M. Newspaper coverage of youth and tobacco: Implications for public health. Health Communication 19(1): 19-28, 2006. (29 refs.)

The presentation of smoking as a "youth" issue is a powerful component of current tobacco-control efforts. Agenda setting theory demonstrates that the media serve as a potent forum in which the consideration and presentation of perspectives of social problems take place. This analysis of 643 U.S. youth-focused newspaper articles examines the messages being conveyed to the public and policymakers through coverage of tobacco issues focused on youth. Data illustrate that the issue of youth tobacco use is newsworthy but also suggest that youth-focused issues garner little commentary coverage. Rather, straightforward reports of "feel good" stories dominate the coverage, and youth-focused articles tend to conceptualize the problem of tobacco as being one of a need for greater individual-level education rather than structural or policy changes.

Snell-Johns J; Imm P; Wandersman A; Claypoole J. Roles assumed by a community coalition when creating environmental and policy-level changes. (editorial). Journal of Community Psychology 31(6): 661-670, 2003. (22 refs.)

A significant amount of federal, state, and local resources are spent organizing large-scale community coalitions designed to address the issues of alcohol, tobacco, and other drug (ATOD) use in communities. Thus far, results regarding the effectiveness of community coalitions in reducing ATOD rates are mixed. This article discusses the importance of strategies designed to impact environmental-level changes (e.g., policies, laws), which, in turn, can impact individual use. The development of prevention structures that consistently and continuously promote Prevention efforts must be established before significant change in use rates can occur and be sustained. In order to identify the roles assumed by a coalition in order to affect policy-level changes, this article examines the specific efforts of the Lexington/Richland Drug and Alcohol Abuse Coalition in Columbia, South Carolina. Review of meeting minutes and interviews with staff and coalition members suggest that the coalition assumed three central roles: developer, facilitator, and arbitrator. The coalition's success in influencing community policies and sanctions is attributed to its responsiveness and ability to assume diverse roles, depending on the specific needs of the community. Changes in policies/laws and sanctions are presented as evidence of the coalitions success in impacting and reinforcing community-wide prevention structures thought to reduce the abuse of alcohol and other drugs.

Stafstrom M; Ostergren PO; Larsson S; Lindgren B; Lundborg P. A community action programme for reducing harmful drinking behaviour among adolescents: the Trelleborg Project. Addiction 101(6): 813-823, 2006. (34 refs.)

Aims" To evaluate a 3-year community intervention programme by measuring changes in drinking patterns in a 15-16-year-old population. Design, setting, participants and measurement: The action programme included five demand-reducing and one supply-reducing interventions. Cross-sectional, non-repeated data were collected from a questionnaire distributed in classrooms from 1999 to 2001 and 2003 (n = 1376, 724 boys and 652 girls; response rate = 92.3%). Stepwise logistic regression analyses were used to determine the relationship between different risk factors and excessive drinking, heavy episodic drinking, purchaser of alcohol and alcohol provided by parents. The results from the intervention community were also compared with similar Swedish cross-sectional data sets. Findings The results of our analyses indicated a decrease in harmful drinking behaviour in Trelleborg when comparing baseline with postintervention measurements. The comparison with other studies showed that the changes in these indicators were more rapid and consistent in Trelleborg. Finally, the multivariable logistic regression analyses showed that the outcomes were not likely to be attributed to changes in environmental factors. Conclusions: We concluded that a community action programme based on the systems approach reduced hazardous alcohol consumption effectively among adolescents in Trelleborg.

Stigler MH; Perry CL; Komro KA; Cudeck R; Williams CL. Teasing apart a multiple component approach to adolescent alcohol prevention: What worked in Project Northland? Prevention Science 7(3): 269-280, 2006. (44 refs.)

This paper presents the results of a post hoc component analysis designed to tease apart the effects of different intervention strategies used in Project Northland, a group-randomized, community-wide, multi-level intervention trial originally conducted in the 1990's to prevent and reduce alcohol use among a cohort of mainly White students in rural Minnesota. This study focuses on Phase I, when students were in 6th-8th grade. The intervention during this phase included five components: classroom curricula, peer leadership, youth-driven/led extra-curricular activities, parent involvement programs, and community activism. Student exposure to/participation in these components was followed over time using reliable process measures. These measures were used as time-varying covariates in growth curve analyses to estimate the effects of the intervention components over time. Multi-item scales from annually-administered student surveys were used to measure relevant outcome variables, like alcohol use. The impact of the components appears to have been differential. The strongest effects were documented for the planners of extra-curricular activities and parent program components. The classroom curricula proved moderately effective, but no effects were associated with differential levels of community activism. The interactions tested here did not provide support for synergistic effects between selected intervention components. Care must be taken when selecting and combining intervention strategies meant to reduce adolescent alcohol use.

Susic TP; Svab I; Kolsek M. Community actions against alcohol drinking in Slovenia - a Delphi study. Drug and Alcohol Dependence 83(3): 255-261, 2006. (45 refs.)

Aim: To define the national stratey ancute in Buenos Aitions to reduce alcohol related harm, bred. The experimental work using fractiased on societal consensus. Background: Alcohol abuse is an avoidable behaviour that can threaten health. In Slovenia, only a few public campaigns against drinking alcohol are under way. It is important to establish which community measures are acceptable to society in Slovenia in order to reduce alcohol-related risks. Methods: A Delphi study with 45 professionals from d