Using Data to Guide and Sustain Community Interventions

Using Data to Guide and Using Data to Guide and Sustain Community Sustain Community

InterventionsInterventionsJoel W. Grube, Ph.DJoel W. Grube, Ph.D..Prevention Research CenterPrevention Research Center

Pacific Institute for Research and EvaluationPacific Institute for Research and Evaluation

OJJDP UDETC National Leadership ConferenceOJJDP UDETC National Leadership ConferenceTucson, AZTucson, AZ

August 18-20, 2005August 18-20, 2005

Preparation of this presentation was supported byNIAAA grants AA006282 and AA014958

What is Sustainability?What is Sustainability?Sustainability addresses three issues:Sustainability addresses three issues:

Maintaining the benefits of a programMaintaining the benefits of a program

Continuing a programContinuing a program

Building the capacity to continue a programBuilding the capacity to continue a program

Broadly speaking sustainability refers to:Broadly speaking sustainability refers to:

““The process of ensuring an adaptive preventive The process of ensuring an adaptive preventive system … can be integrated into ongoing system … can be integrated into ongoing operations to benefit diverse stakeholders.”operations to benefit diverse stakeholders.”

((Johnson, Hayes, Center, & Daley, 2004, p. 137))

Key Issues in SustainabilityKey Issues in SustainabilitySustainability is an Sustainability is an ongoingongoing dynamic process dynamic process

Sustainability is an Sustainability is an adaptiveadaptive process process

Sustainable innovation is Sustainable innovation is integratedintegrated into normal into normal operations and requires operations and requires adequate infrastructureadequate infrastructure capacity capacity

Sustainable innovation should have proven Sustainable innovation should have proven benefitbenefit to to diverse stakeholders diverse stakeholders

Sustainability requires Sustainability requires commitmentcommitment and support: and support:ChampionsChampionsDecision-makersDecision-makersStakeholdersStakeholdersWorkersWorkers

Source: Johnson, Hayes, Center, & Daley, 2004

Model of SustainabilityModel of Sustainability

Sustainable Sustainable Innovation Innovation

ContinuationContinuation

Sustainable Sustainable Innovation Innovation

ContinuationContinuation

Innovation Innovation Integration into Integration into

SystemSystem

Innovation Innovation Integration into Integration into

SystemSystem

Source: Johnson, Hayes, Center, & Daley, 2004

AssessAssessPlanPlan

ImplementImplementEvaluateEvaluate

Reassess/ModifyReassess/Modify

AssessAssessPlanPlan

ImplementImplementEvaluateEvaluate

Reassess/ModifyReassess/Modify

DataDataDataData

CapacityCapacityBuildingBuilding

CapacityCapacityBuildingBuilding

Stakeholder Stakeholder BenefitsBenefits

Stakeholder Stakeholder BenefitsBenefits

Some Examples Using Data:Some Examples Using Data:

Oregon Youth Alcohol Access ProjectOregon Youth Alcohol Access ProjectCommunity Trials Project to Reduce Alcohol TraumaCommunity Trials Project to Reduce Alcohol Trauma

Diadema ProjectDiadema Project

Assess:Assess:Is there a problem?Is there a problem?

What is the problem?What is the problem?

30-Day Drinking30-Day DrinkingOregon 11Oregon 11thth Graders Graders

0

10

20

30

40

50

60

70

80

90

100

Oregon

US (YRBS)

Source: Oregon Healthy Teens Survey 2005Source: Oregon Healthy Teens Survey 2005http://oregon.gov/DHS/ph/chs/youthsurvey/yrbsdata.shtmlhttp://oregon.gov/DHS/ph/chs/youthsurvey/yrbsdata.shtml

Half of Oregon 11Half of Oregon 11thth graders graders report drinking in the past 30 report drinking in the past 30 days….days….

30-Day 5+ Drinks30-Day 5+ DrinksOregon 11Oregon 11thth Graders Graders


0

10

20

30

40

50

60

70

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

Year

Per

cen

t

Oregon

US (YRBS)

Of those Oregon 11Of those Oregon 11thth graders who graders who report drinking in the past 30 days, report drinking in the past 30 days, 60% report having 5+ drinks….60% report having 5+ drinks….

30-Day Drug Use Among 30-Day Drug Use Among Oregon 11Oregon 11thth Graders Graders

0 10 20 30 40 50 60

Alcohol

5+ Drinks

Marijuana

Inhalants

Any Other Illict Drug Alcohol is by far the most Alcohol is by far the most commonly used and abused drug commonly used and abused drug among Oregon 11among Oregon 11thth graders…. graders….


Annual Costs of Underage Annual Costs of Underage Drinking in Oregon 2001Drinking in Oregon 2001

(Millions of Dollars)(Millions of Dollars)

$428

$139

$130

Pain & Suffering

Work Lost andOther Costs

Medical Costs

Source: Enforcing Underage Drinking Laws Website: http://www.udetc.org/UnderageDrinkingCosts.asp

Total Costs: $697 million annually $387 per capita per year

Annual Costs of Underage Annual Costs of Underage Drinking in Oregon (2001)Drinking in Oregon (2001)

ProblemProblem Total Costs (Millions)Total Costs (Millions)

Youth ViolenceYouth Violence $351.5$351.5

Youth Traffic CrashesYouth Traffic Crashes $86.1$86.1

High Risk SexHigh Risk Sex $59.6$59.6

Youth Property CrimeYouth Property Crime $49.1$49.1

Youth InjuryYouth Injury $36.7$36.7

Poisonings & PsychosesPoisonings & Psychoses $11.8$11.8

FAS Mothers Age 15-20FAS Mothers Age 15-20 $11.7$11.7

Youth Alcohol TreatmentYouth Alcohol Treatment $90.5$90.5

TotalTotal $697.2$697.2

Source: Enforcing Underage Drinking Laws Website: http://www.udetc.org/UnderageDrinkingCosts.asp

Planning:Planning:Where do we intervene?Where do we intervene?

How?How?

Ease of Obtaining AlcoholEase of Obtaining Alcoholby Oregon 11by Oregon 11thth Graders Graders

11.1%

28.4%

53.0%

7.5%

Very Easy

Sort of Easy

Sort of Hard

Very Hard


…Over 81% of Oregon 11th graders say it would be very easy or sort of easy to get alcohol if they wanted…

Sources of Alcohol Sources of Alcohol Past 30 Days by Oregon 11 Past 30 Days by Oregon 11thth

GradersGraders

16 16

410

30

5546

21 20

73

0

10

20

30

40

50

60

70

80

90

100

Perc

en

t

Commercial Social

Source: Dent, Grube, & Biglan, 2005

Oregon teens use multiple sources to obtain alcohol…

Indicated Points of InterventionIndicated Points of Intervention

Commercial AvailabilityCommercial AvailabilityReward and ReminderReward and ReminderCompliance ChecksCompliance Checks

Social AvailabilitySocial AvailabilityShoulder TapsShoulder TapsParty DispersalParty DispersalMIPMIP

Targeted MediaTargeted Media

Monitor Implementation Monitor Implementation

What is being done?What is being done?

What dosage?What dosage?

0

20

40

60

80

100

120

140

160

Q2 Q3 Q4 Q1 Q2

COMPLIANCECHECKS

CITATIONSISSUED

OUTLETSTRAINED(RBS)

Pre-intervention Intervention Period

Underage Access ActivitiesUnderage Access ActivitiesCommunity Trials ProjectCommunity Trials Project

Source: Grube, 1997

Evaluate/Assess Evaluate/Assess

What effects?What effects?

What benefits?What benefits?

Effects of Reward and Effects of Reward and Reminder on Tobacco SalesReminder on Tobacco Sales

0

10

20

30

40

50

60

70

80

90

100

T1 T2 T3 T4 T5 T6 T7 T8 T9 T10 T11 T12 T13 T14

Baseline Post Intervention

Biglan, Ary, Smolkowski, Duncan, & Black, 2000

Effects of Reward and ReminderEffects of Reward and Reminderon Weekly Alcohol Useon Weekly Alcohol Use

0

5

10

15

20

T1 T2 T3 T4 T5

Per

cen

t R & R + School-Based

School-Based Only

Biglan, Ary, Smolkowski, Duncan, & Black, 2000

Homicides per 1,000 Residents:Homicides per 1,000 Residents:Diadema, BrazilDiadema, Brazil

0.00

0.02

0.04

0.06

0.08

0.10

0.12

0.14

Rat

e

Before Sales Hours RestrictionAfter

Restriction

Duailibi, Laranjeira, Ponicki, Grube, & Lacey, 2005

There were an average of 301.3 homicides per year before the sales restrictions and 169.6 per year afterward

Estimated Effects of ReducingEstimated Effects of ReducingHours of SalesHours of Sales

Number of Lives SavedNumber of Lives Saved 273273

95% CI95% CI 208-338208-338

% Reduction in Homicides% Reduction in Homicides 46.1%46.1%

Number of Assaults PreventedNumber of Assaults Prevented 224224

95% CI95% CI -66 – 514-66 – 514

% Reduction in Assaults% Reduction in Assaults 25.8%25.8%

Duailibi, Laranjeira, Ponicki, Grube, & Lacey, 2005

Reassess/Modify Reassess/Modify

What is What is notnot working? working?

What should be changed?What should be changed?

Where are more resources needed?Where are more resources needed?

Effects of Compliance Checks and Effects of Compliance Checks and RBS on Underage SalesRBS on Underage Sales

4753

45

35

1916

0

10

20

30

40

50

60

Per

cen

t o

f O

utl

ets

Sel

lin

g

Pretest Posttest

Comparison (NoTreatment)

ComplianceChecks

ComplianceChecks + RBS

Source: Grube, 1997

ConclusionConclusionData can guide and sustain programs:Data can guide and sustain programs:

Define the problem and the solutionDefine the problem and the solution

Plan and target interventionsPlan and target interventions

Monitor implementationMonitor implementation

Evaluate outcomesEvaluate outcomes

Reassess and modify interventionsReassess and modify interventions

Marshall support for increased allocation of Marshall support for increased allocation of resources and infrastructure capacityresources and infrastructure capacity

Key reference:Key reference:

Johnson, K., Hays, C., Center, H., & Daley, Johnson, K., Hays, C., Center, H., & Daley, C. (2004). Building capacity and C. (2004). Building capacity and sustainable prevention innovations: A sustainable prevention innovations: A sustainability planning model. sustainability planning model. Evaluation Evaluation and Program Planning, 27and Program Planning, 27, 135-149., 135-149.

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Using Data to Guide and Sustain Community Interventions