The potential impact of local policy change on preventing substance abuse is enormous. But not all policies are right for all communities—and not all communities are ready for policy. Multiple factors influence a community’s ability to plan and implement policy, including its attitudes toward the problem to be addressed, its readiness to act, and policies already in place. Below are some questions planners can ask to find out if changing or implementing local prevention policies is the appropriate course of action for their community.

1. What does the problem look like in the community?

The first step in surveying the landscape is to understand the nature, extent, and impact of the problem you hope to address. Consider the following questions:

• What does the problem look like?
• What are the associated issues?
• Are there particular places, times, or subpopulations that seem to be “driving the data” (i.e., consumption patterns)?
• Are there specific outcomes that seem to stand out?

Answering these and similar questions is important for several reasons. First, doing so helps define the problem for the particular community. Second, a close look at the data ensures that efforts address the right problem, not just the whim of a prominent alderperson. Third, defining the problem is necessary in order to select the appropriate strategy. Lastly, a review of relevant data may suggest ways to strengthen your policy initiative.

2. What makes the community unique? What are some of its norms?

Granted, every community is unique. But some community characteristics are more likely to influence policy decisions than others. Consider the demographic makeup of your town:

• Is the population disproportionately young—or old?
• Are there many transients (characteristic of a college town or vacation destination)?
• Does the town have a reputation—for better or worse—regarding substance use?

Also, consider community norms related to the substance abuse problem—widely held values or beliefs that a particular attitude or behavior is appropriate and acceptable. Norms can vary widely across communities. For example, one community may accept underage drinking as a “part of growing up.” Another may have strong norms against drinking and driving, but condone teen alcohol use in private homes.

Understanding community norms helps planners gauge the potential support for policy change. Public acceptance and support are necessary for getting the policy passed and, perhaps more importantly, for ensuring that the policy is enforced. Moreover, widespread support increases the extent to which individuals voluntarily comply.

3. Is the community ready to act?

Community readiness can be defined as the extent to which a community is adequately prepared to implement a prevention effort. It is a measure of a community’s willingness and ability to address a particular issue. Whereas norms reflect attitudes, readiness reflects potential for action. So even in a community where pervasive norms mitigate against policy change, there may be a committed group of individuals willing to move the initiative forward.

Many factors contribute to community readiness, including the extent to which people understand the issue and believe it is a problem, the types of prevention strategies already in place (and the degree to which they support policy efforts), competing priorities, and the extent to which community leaders are available and willing to do the necessary work. It is critical, however, that planners assess community readiness before initiating any policy efforts. If they don’t, it’s possible that the efforts may even make things worse.

4. Who are potential allies—and opponents?

Successful policy change hinges on the support of key allies—those individuals willing to help move forward the policy development process and, eventually, take ownership of it. At best, they are influential people, invested in seeing change happen and willing to demonstrate that support in highly visible ways. Every policy effort should involve a unique set of allies: the more specific, the better. Sometimes finding the right players can be difficult. It often takes time. But doors open when the right people are involved, so finding them and engaging their support is well worth the effort.

5. What policies already exist?

Knowing what policies are already on the books—and the degree to which they are supported and enforced—can help determine whether new policy development is warranted. A search of existing policies may yield some pleasant surprises; adequate policies may already be in place—and even properly enforced. By learning this early on, planners can redirect energies to developing other program components, such as educational programs for selected populations, to work alongside and reinforce these policies. In other cases, adequate policies may exist, but they don’t seem to be making a difference. In this case, planners should consider whether this is because the policy isn't clear, that it's not understood or enforced, or that it's perceived as inappropriate or unimportant. One, or a combination, of these reasons will erode the effectiveness of any policy—however well-written and clear. In these instances, efforts may be best directed building community awareness or strengthening enforcement, rather than on creating new policies.

References

• Alcohol Epidemiology Program (2000). Alcohol policies in the United States: Highlights from the 50 states. Minneapolis: University of Minnesota.

• Community Toolbox, University of Kansas (November, 2004). Surveying Communities to Establish Norms. Retrieved March 16, 2006, from http://ctb.ku.edu/en/toolsaction/SurveyingCommunities.aspx

• CSAP’s Western Center for the Application of Prevention Technologies. Community Readiness. Retrieved May 30, 2006 from http://captus.samhsa.gov/western/resources/prevmat/commread.pdf

• Imm, P., Chinman, M., and Wandersman, A. (2005). Preventing Underage Drinking: Using the SAMHSA Strategic Prevention Framework and Getting to Outcomes to Achieve Results. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention.

• Johnson, K. D. (2004). Underage Drinking. Problem-Oriented Guides for Police. Problem-Specific Guides Series. Guide Number 27. Office of Community Oriented Policing Services, U.S. Department of Justice.

• Komro, K. A. and Toomey, T. L. (2002). Strategies to Prevent Underage Drinking. Alcohol Research & Health, 26(1), 5–14. 

• Lenk, K. M., Toomey, T. L., Wagenaar, A. C., Bosma, L. M., and Vessey, J. (2002). Can neighborhood associations be allies in health policy efforts? Political activity among neighborhood associations. Journal of Community Psychology, 30(1):57–68.

• National Research Council and Institute of Medicine (2004). Reducing Underage Drinking: A Collective Responsibility. Committee on Developing a Strategy to Reduce and Prevent Underage Drinking, Richard J. Bonnie and Mary Ellen O’Connell, Eds. Board on Children, Youth, and Families, Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press.

• Oetting, E. R., Donnermeyer, J. J., Plested, B. A., Edwards, R. W., Kelly, K., and Beauvais, F. (1995). Assessing community readiness for prevention. International Journal of Addictions, 30(6):659–683.  

• Prevention Research Center (2004). Preventing Underage Alcohol Access: Essential Elements for Policy, Deterrence and Public Support. Available at http://resources.prev.org/resource_pub_pud.pdf

Developed under the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for the Application of Prevention Technologies contract. Reference #HHSS277200800004C. For training and/or technical assistance purposes only.