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Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

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Page 1: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

Liz Lilliott, Ph.D.National Prevention Network Meeting

September 2009

Collecting Community Level Survey Data:

Lessons Learned from Trial & Error

Page 2: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

Introduction

• Brief background on the SPF SIG in NM

• Community Survey – years 1-4

• Lessons learned

Page 3: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

Substance-Related

ConsequencesSubstance Use Intervening

Variables

High rate of alcohol-related motor vehicle crashes and

fatalities

(Special emphasis on

underage youth)

Binge drinking

Drinking &Driving

Easy RETAIL Access to alcohol for

underage youth

Low enforcement of alcohol laws

Easy social access

to alcohol

Low perceived risk of alcohol use and

drinking and driving

Social norms

Underage Alcohol Use

Logic Model

Page 4: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

Intervening Variables vs.Contributing Factors

• We consider intervening variables (IVs) to be a broad category of predictors or correlates, in statistical terms similar to a factor that is made up of multiple associated measures.

• The IV is comprised of potentially multiple contributing factors (CFs) that explain why that IV is important to address.

• While each community may address retail access of alcohol to youth, the contributing factors as to why it is a problem in a community may differ, meaning their prevention strategy may also differ.

Page 5: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

For Example

Easy RETAIL Access to alcohol

for underage youth

Intervening Variable Contributing Factors Strategies

Alcohol retailers do not

consistently check ID’s

Underage youth ask strangers to buy them alcohol and they comply

There is no enforcement of laws prohibiting selling alcohol to

minors or providing

Responsible

Retailer training

Shoulder taps

Greater law enforcement

efforts to enforce laws

Greater pressure on judicial officers

to enforce consequences

Page 6: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

Other Examples of CFs being addressed:

• Sales of alcohol to intoxicated adults

• Minors obtaining alcohol from friends, family, etc.

• Underage parties

• Support of law enforcement efforts to reduce DWI and enforcement of aiding & abetting laws

• Norm that underage drinking is a “right of passage”

• Low perception of risk of being caught providing alcohol to minor or of being caught, arrested, etc. DWI

• Lack of judicial follow through on DWI arrests

Page 7: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

Sources of IV Data on CFs

• Archival data such as:

• Court records• Arrest data• Citation data• Data on sobriety checkpoints conducted• BRFSS• NSDUH• YRRS (YRBSS)

• Primary data collection:• Community Questionnaire

Page 8: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

Why do we need the community survey if we already have archival data?

• Of the BRFSS, the NSDUH, & the YRBSS, only the BRFSS is conducted every year

• The length of time to access the data is considerably long (typically 12 months or more)

• These data are not sufficient to measure change at the community level. In NM some communities are counties, but many are smaller than counties, such as tribal lands, towns, or even neighborhoods in a city

• Do not include measures of all contributing factors

Page 9: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

Goals of conducting a community survey

• To be able to definitively say something about change in CFs & consumption measures at the state level and at the community level and attribute the change to the prevention interventions implemented if at all possible.

• Therefore, our additional goals were to have large enough sample sizes at the community & state level to measure change & to have the samples be representative of the communities

Page 10: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

The Community Questionnaire

• Same survey used in all 15 SPF SIG communities & non-SPF SIG communities for comparison

• Includes measures of those contributing factors for which we do not have archival data at the community level

• Includes the National Outcome Measures (NOMs) required by CSAP including measures from the BRFSS & NSDUH & YRBSS

Page 11: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

SPF SIG Community Questionnaire

Sources of IV Data

• Social access for minors• Where did they get alcohol• Where did they drink alcohol• Attendance at keg parties

• Perception of risk• How likely police are to: Break up parties where teens are drinking Catch/arrest/convict you drinking and driving

• Norms• Support for law enforcement efforts• Exposure to media messages about efforts• How harmful is drinking too much

Page 12: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

Some ideals (assumptions) we had for the survey process going in:

the sample would be large enough at the community level to be used by communities for needs assessment & evaluation purposes as well as at the state level

the sample would be random & representative of the communities

the comparison communities would be matched to the SPF SIG communities for a stronger design

we’d get good baseline data we’d use the same survey method every time

because…we’d be successful the first time

Page 13: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

What actually happened

The first attempt:• 2006-2007 (Interventions began in 2006-2007) • This was to be our baseline data collection• Survey targeting 18 to 25 year olds in SPF SIG & non-

SPF SIG communities (not matched)• Phone interview- using random digit dialing (RDD)• 398 questionnaires were completed • Cost: $60K • Average age: 20.9

Page 14: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

The first attempt:

The pluses:• No burden of cost or time on communities• No burden on the evaluators

The drawbacks: • Not a representative sample• Not a large enough sample to be useful to

communities or to the state• Cost: $151 per completed survey• Method not appropriate for target age group nor

cultural characteristics

Page 15: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

What actually happened

The second attempt:• 2007-2008• No money to conduct a phone survey • Had to get communities involved• With State Epi Workgroup we redesigned the survey,

changing some questions and made it fit a written format

• Survey targeting 18 to 65 year olds in SPF SIG & non-SPF SIG communities (not matched)

• Tried to get a more random/representative sample by recruiting at MVD offices in communities for an on-line survey or a phone survey

• Had one open ended question• Average age for SPF SIG 36.2 years; n= 2954

Page 16: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

The Recruitment Process

• Received permission & support from the Director of MVD to recruit at state run MVD offices

• Letter sent to MVD office supervisors asking them to cooperate with local prevention folks to recruit

• Trained preventionists on how to train the MVD staff on how to recruit

• Requested clients to complete a card indicating that they wished to be contacted by email or phone to complete survey. Provided 1st name, email or phone #. These were sent to PIRE on a weekly basis.

• Invitation emails were sent, phone calls were made• Reminders were sent • Incentives for MVD staff, incentives at the MVD,

incentives for completing the survey

Page 17: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

The second attempt:

The pluses:• We increased our overall sample size considerably• Improved our representativeness in those communities where it

actually worked. • Local communities partnering with MVDs created prevention

allies • Gave communities an appreciation (understanding) of data

gathering and what’s involved• Responses to the open ended questions were powerful

The drawbacks: • Not a representative sample in most communities• Not a large enough sample in most communities to be useful• Method not appropriate for some communities without MVD

offices; MVD offices are not all participatory• Very labor & time intensive; complicated. If one link was broken

it all broke down.

Page 18: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

What actually happened

The third attempt:• 2008-2009• Had to get communities involved but had to make it

simpler if we were to survive• Survey targeting 18 & over in SPF SIG & non-SPF

SIG communities (not matched)• Placed greater emphasis on face-to-face surveying• Recommended recruitment strategies to increase

representativeness and decrease bias of the sample but knew this was unlikely

• Eliminated phone survey completely• Internet survey recruitment card provided a direct link

to the survey• Average age for SPF SIG: 39.2; n = 7011

Page 19: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

The Recruitment Process

• We asked the programs to identify themselves into 1 of 5 groups relative to how successful they were the year before

• Recommended locations for them to recruit• As part of the planning process, programs created

community specific data collection protocols for completing paper &/or internet surveys

• Provided a target # of completed surveys for each community

• Provided detailed training & documentation for communities of data collection protocols, roles, responsibilities, etc.

Page 20: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

The third attempt:

The pluses:• We increased our overall sample size considerably• Improved our within community sample sizes• Local communities partnering with local businesses &

stakeholders strengthened prevention allies • Communities were successful & empowered- more

sustainable for future data collection• Good cooperation between entities (state, evaluators,

prevention providers)• More culturally appropriate

The drawbacks: • Still time consuming & labor intensive for communities &

evaluators, but better results• Can be expensive for program esp. in staff hours & travel• Sacrificed representativeness for larger sample sizes

Page 21: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

The fourth attempt:

• Will take place February – March, 2010• Keep everything the same as last year• This fall we will revisit local level data collection protocols

and communities will revise as needed• We will re-train everyone again on recruitment protocols• We will spend more time working with comparison

communities in particular and monitoring their progress• Try to get MVD & electric company to recruit through their

correspondence

Page 22: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

The many lessons learned

Planning: • Easily ¾ of your effort will be in planning training, &

monitoring the data collection process• It is critical have a global plan (state level) as well as local

plans (community level) for how data collection will take place

• Acts of God will happen but you can try to plan for some problems; consider the weather issues, the school schedules, the holidays, etc. that may affect your data and/or data collection

• Keep the plans as simple as possible & eliminate bureaucracy when you can

• Get permissions & approvals early!

Page 23: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

The many lessons learned

Planning: • Use/build connections & collaborate whenever possible• Find volunteers to help, just make sure they are well

trained• Community level buy in is critical; do whatever it takes to

get it (e.g., Native American communities)• It can be difficult for local staff to understand the

importance of data collection; create that big picture for them

• Find your extroverts to help with recruiting (responsible ones)

• Be as culturally sensitive as you can be without completely compromising the process

• At the local level, try not to have staff dual task. Staff responsible for data collection need to focus on just that.

Page 24: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

The many lessons learned

Planning: • Provide a community specific target or goal for completed

surveys• Create an incentive or reward system to keep staff

motivated. This can be as simple as a chart that indicates progress towards reaching goal

• Establish roles & responsibilities for those at the state level & local level at the very beginning

• Define resources used to finance data collection

Page 25: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

The many lessons learned

Data Collection:• Monitor progress toward reaching community target goals

& state target goals• Don’t delay in beginning data collection, it will always take

longer than you think it will• Follow the plan, but if it’s not working, revise it so it does

and keep that revision for next time• Don’t use people who haven’t been directly trained or

underage youth unless there is someone overseeing them directly; the need to be knowledgeable about the process & the survey itself

• Always have a consent form/explanation document to provide to participants

Page 26: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

The many lessons learned

Data Collection:• It’s hard to overcome our biases when approaching people

to participate, but we absolutely must; provide strategies to recruiters on how to recruit participants to be more representative.

• Incentives should be culturally appropriate and not coercive

• Often local establishments will donate small incentives if asked.

• Protect anonymity of respondents

Page 27: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

The many lessons learned

Data processing & distribution• Data entry folks should be trained ahead of time; but there

are still likely to be data entry errors so cleaning the data is very important.

• The main incentive for a community to participate in data collection is to get data that will be useful in planning community level interventions. Therefore, getting the data to communities is very important.

• You can do this several ways. One is to provide the data to them. This is fine, if there is someone who can analyze data and present it.

• Alternatively, you can create presentations, or provide slides, graphs & interpretation for them to use in presentations to their stakeholders or for use when writing grants, reports, etc.; Make it user friendly.

Page 28: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

The BIG lessons learned• Our success has grown as we’ve become more culturally

competent and worked with communities; therefore, keep a good balance between flexibility and direction.

• You can’t please everyone, but you try to be accommodating when you can.

• Which goals are most important if you have to sacrifice something?

• In the spirit of community based participatory research, community involvement in the planning process from the beginning is important. It may take longer, but it means there’s ownership of the process and a desire for it to be successful.

Page 29: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

The BIG lessons learned

• Transparency of how decisions are made is important. Ideally decisions are not top down.

• Do not underestimate the importance of piloting the survey & the data collection process.

• Help communities to understand how to use the data for needs assessment, planning and implementation and not just evaluation.

• Use data in media or social marketing campaigns• To encourage law enforcement to increase

enforcement• To create buy-in for prevention efforts from local

authorities• For use in Local Epi Workgroups

Page 30: Liz Lilliott, Ph.D. National Prevention Network Meeting September 2009 Collecting Community Level Survey Data: Lessons Learned from Trial & Error

• www.nmprevention.com• Under New Mexico SPF SIG - Project Documents

• Contact Information: Liz Lilliott, [email protected]

Martha Waller, [email protected]