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I work primarily with
rural communities. Can you help me identify some key resources that exist
for prevention practitioners working in rural communities?
The following is a selected list of resources that may be helpful for
prevention practitioners working in rural communities. This is not meant
to be an exhaustive list. If you would like to recommend an addition to
or modification of this list, please e-mail: sfuxman@edc.org. Some of these resources
will lead you to other sources of interest.
Data on Rural Substance Abuse
Cronk, C. E., Sarvela, P. D. (1996). Alcohol and other drug use among
rural and urban youth: A secondary analysis of the Monitoring the Future
data set. Center for Rural Health and Social Service Development, Center
Research Briefs, 2(1). Available at www.siu.edu/
The authors of this study used data from Monitoring the Future to
examine differences in substance abuse between urban and rural youth.
Some of the most important observations were that the use of "hard"
drugs used to be much higher in urban areas, but by the early 1990s
was similar for both urban and rural areas; in 1992 more rural students
than urban students reported using alcohol in the previous 30 days;
in the past 20 years excessive drinking (including binge drinking),
smoking more than a pack a day, and use of amphetamines has been more
common among rural youth than urban youth. According to the article,
these results complement similar studies, and are in contrast to the
popular notion that rural youth are protected from substance abuse.
Edwards, R. W. (1994). Alcohol, tobacco, and other drug use by youth
in rural communities. Perspectives on Violence and Substance Use in Rural
America. North Central Regional Educational Laboratory. Available at http://www.ncrel.org/sdrs/areas/issues/envrnmnt/drugfree/v1edward.htm
This article presents data comparing substance use and abuse in rural
and metropolitan areas, arguing that rural youth are as vulnerable to
substance use and abuse as their metropolitan peers. The author also
explains that unlike urban areas, the consequences of substance abuse
in rural areas are graver (i.e., youth driving under the influence at
high speeds on poorly lit roads). Based on the data, the author makes
two recommendations regarding substance abuse prevention in rural communities:
interventions should target students at an early age and communities
should assess local needs before planning interventions as substance
abuse issues differ greatly between rural communities.
The National Center on Addiction and Substance Abuse (CASA). (2002).
No Place to Hide: Substance Abuse in Mid-Size Cities and Rural America.
Commissioned by the United States Conference of Mayors, funded by the
Drug Enforcement Administration, with support from the National Institute
on Drug Abuse. Available at: http://www.casacolumbia.org/ProductSearch.aspx?CATID=121920079233524
This report analyzes the data from various data sources such as Monitoring
the Future, National Household Survey, and the Treatment Episode Data
Set in order to assess substance use and abuse in mid-size cities and
rural America. In addition to presenting the analysis, the authors also
look at several programs that have been effective in reducing substance
use such as Idaho's Enough is Enough public awareness program, Michigan's
Upper Peninsula Teen Leadership Program, and Kentucky's structured behavioral
outpatient rural therapy.
Crandall, L. A., Tobias, H., Metsch, L., and McCoy, C. (2002). Adolescent
alcohol, tobacco and other drug use along the rural-urban continuum. Annals
of Epidemiology, 12(7), 505.
The purpose of this article is to look at the impact of rurality on
substance use, controlling for risk and protective factors. The study
was conducted by applying the self-reported size of community of residence
to the 2000 Florida Youth Substance Abuse Survey Results show that rurality
strongly increase the risk of smokeless tobacco and smoke cigarettes,
but serves as protective factor for alcohol use, demonstrating that
the rural-urban continuum does not affect all substances equally.
Prevention Strategies
Biglan, A., Duncan, T., Irvine, A. B., Ary, D., Smolkowski, K., and James,
L. (1997). A drug abuse prevention strategy for rural America. National
Institute on Drug Abuse (NIDA) Research Monograph, 168, 364-397. Available
at http://www.nida.nih.gov/PDF/Monographs/Monograph168/Download168.html.
Given the lack of knowledge regarding factors that lead to substance
abuse in rural communities, the authors suggest developing and testing
prevention strategies based on what is known about causes of substance
abuse in non-rural areas. The article begins by discussing factors that
lead to substance abuse in rural communities such as the means of production
of each community (i.e., farming communities face different substance-related
challenges than mining communities). The authors then present different
factors and interventions that can be used to ameliorate these needs
such as family and peer influences, the role of schools and communities
in influencing or preventing drug abuse, and identifying and preventing
social and behavioral problems. Finally, suggestions for further research
to improve substance abuse prevention interventions in rural areas are
presented.
Denhan, A., Crouse Quinn, S., Gamble, D. (1998). Community organizing
for health promotion in the rural south: An exploration of community competence.
Family and Community Health, 21(1), 1-21.
This study explores how community organizing is being used in rural
North Carolina by interviewing 11 community initiatives. The study found
that some of the mechanisms used by these community initiatives that
increased community competence were strengthening contacts between people,
providing an organizational framework through which people can receive
trainings unifying communities behind a common mission, maintaining
community control, and creating opportunities for success.
D'Onofrio, C. N. The prevention of alcohol use by rural youth. (1997).
National Institute on Drug Abuse (NIDA) Research Monograph, 168, 364-397.
Available at http://www.nida.nih.gov/PDF/Monographs/Monograph168/Download168.html
The article reviews the literature on underage drinking in rural areas
and identifies what is known about prevalence, consequences, and causes
of rural underage drinking. The authors then discuss current prevention
efforts and the match between problem and solution. This analysis reveals
gaps between what is known about rural underage drinking and current
prevention practices. The article concludes with suggestions for policy
and research such as using multiple research methods, using alternative
approaches to evaluation of rural prevention programs, and collaboration
among researchers to obtain a more comprehensive picture of rural life.
Scaramella, L. V., Keyes, A. W. (2001). The social contextual approach
and rural adolescent substance use: Implications for prevention in rural
settings. Clinical Children and Family Psychology Review, 4(3), 231-251.
This article aims to define what is meant by rural, review empirical
research on causes of rural youth substance abuse from a social contextual
point of perspective, and to discuss the malleability of risk and protective
factor theory in rural settings. The authors also discuss challenges
of implementing prevention programs in rural communities.
Smith, G. L. and Keily, K. J. (2002). Utilizing technology: The challenges
and opportunities facing "substance abuse" professionals in
rural communities. Substance Use and Misuse, 37(5-7), 805-814.
The article discusses opportunities for substance abuse prevention
practitioners to use technology and telecommunication tools being set
up in rural communities. According to the authors, the growth in technology
is precipitating substance abuse in rural communities thus practitioners
should take advantage of the benefits that technology brings as well.
Treatment Improvement Exchange (TIE). (1997). Bringing Excellence To
Substance Abuse Services in Rural And Frontier America. Technical Assistance
Publication (TAP) Series 20. Available at: http://www.treatment.org/taps/tap20/tap20toc.html
This publication is a compilation of articles written on the topic
of substance abuse services in rural and frontier America, based on
the 1996 Award for Excellence papers of the third Call for Papers from
the Center for Substance Abuse Treatment (CSAT) and the National Rural
Institute on Alcohol and Drug Abuse (NRIADA). The articles discuss effective
programs implemented across the nation, as well as discussions on topics
such as issues of multiculturalism, challenges in providing services
to rural clients, and intergenerational substance abuse.
Resource Guides and Bibliographies
Alcohol and Drug Abuse Institute (ADAI). (1996). Rural Substance Abuse.
Available at: http://depts.washington.edu/adai/lib/bibs/sp_060.htm
This bibliography includes 148 references to research articles, conference
papers, and book chapters relating to substance abuse in rural America.
Topics vary from drinking patterns among Native American rural populations
to prevention strategies for rural high school students.
Center for Substance Abuse Prevention (CSAP). (1994). Alcohol, Tobacco,
and Other Drugs Resource Guide: Rural Communities. Available at: http://www.health.org/govpubs/ms416/
This CSAP resource guide focuses on the needs of substance abuse prevention
practitioners working in rural areas. It is divided into three sections:
prevention materials; studies, articles, and reports; and groups, organizations,
and programs.
National Rural Health Association. (2002). The Journal of Rural Health.
The Journal of Rural Health is a quarterly journal that publishes
cutting-edge research articles on health issues concerning rural communities.
Articles published in this journal cover topics such as statistical
differences between rural and urban communities, evaluations of projects
and intervention aimed at improving health, and use of health care in
rural communities.
Prevention Programs Implemented
in Rural Communities
Clark, J. J., Leukefeld, C., Godlaski, T., Brown, C., Garrity, J., and
Hays, L. (2002). Developing, implementing, and evaluating a treatment
protocol for rural substance abusers. Journal of Rural Health, 18(3),
396-406.
The article presents the Structured Behavioral Outpatient Rural Therapy
(SBORT), a substance abuse treatment developed specifically for rural
clients and delivered by rural clinicians. The authors discuss the development,
implementation and evaluation of this program. Overall, clients tended
to have positive feedback about the program, finding it to be helpful,
yet sometimes stressful.
Kosterman, R., Hawkins, J. D., Haggerty, K. P., Spoth, R., Redmond,
C. (2001). Preparing for the drug free years: Session-specific effects
of a universal parent-training intervention with rural families. Journal
of Drug Education, 31(1), 47-68.
This article presents evaluation results of Preparing for the Drug
Free Years, a parent-training intervention aimed at preventing adolescent
substance abuse implemented among rural families. Two hundred and nine
rural families were selected to either attend the program or to be part
of the control group. Analysis of the results showed that parents who
participated in the program did report an improvement in parenting behaviors
targeted in the program.
Rural Substance Abuse among Specific
Populations
Dawkins, M. P. and Williams, M. M. (1997). Substance Abuse in Rural
African-American Populations. National Institute on Drug Abuse, Research
Monograph, 168, 484-497. Available at: http://www.nida.nih.gov/PDF/Monographs/Monograph168/484-497_Dawkins.pdf
This article looks at the knowledge in the field relating to substance
abuse among African-Americans in rural areas. In addition, the authors
also discuss findings from national longitudinal surveys relating to
African-American substance abuse in rural areas. The article concludes
with suggestions for future directions, such as incorporating both qualitative
and quantitative methodologies in the research.
Rural Substance Abuse and Violence
North Central Regional Educational Laboratory. (1994). Perspective on
Violence and Substance Abuse in Rural America. Available at http://www.ncrel.org/sdrs/areas/issues/envrnmnt/drugfree/v1toc.htm
This monograph features six articles exploring violence and substance
abuse in rural America, the relationship between the two, the factors
leading to both, and the best interventions to reduce them. The authors
of the different articles set out to do away with the misconception
that violence and substance abuse are not as common in rural communities
as in urban areas, while identifying the unique strengths of rural communities
to overcome these challenges.
Office of Justice Programs/US Department of Justice. (1998). Ensuing
Public Safety and Justice in Rural America. Available at: http://www.ojp.usdoj.gov/
Noting the existence and consequences of crime in rural America and
the unique hurdles that exist to confront and prevent crime, the Office
of Justice Programs issued this report to provide rural communities
with information regarding OJP's funding, demonstration programs, research,
training, technical assistance, and other resources. The report covers
various types of crimes including substance use.
Organizations and Websites
Drug Use and Problems in Rural Communities (2001). Indiana Prevention
Resource Center at Indiana University.
This website provides links to various resources on substance abuse
issues in rural communities such as research articles, Internet resources,
and research centers. This page is part of the Indiana Prevention Resource
Center, which also provides resources on coalitions, drug information,
and statistics among other topics.
National Association for Rural Mental Health (NARMH) website. (2002).
Available at: http://www.narmh.org
NARMH is a national membership organization that aims to develop and
enhance rural mental health and substance abuse services and to support
mental health providers in rural areas. The website provides newsletters,
information on related events, and information on some of their projects,
among other useful resources. The website also provides membership information,
including a form to apply for membership.
National Institute on Drug Abuse. (1997). Rural Substance Abuse: State
of Knowledge and Issues. NIDA Research Monograph, Number 168. Available
at: http://www.nida.nih.gov/PDF/Monographs/Monograph168/Download168.html
This issue of NIDA Research series focuses on substance abuse issues
in rural America. Several chapters of this monograph discuss substance
abuse of particular populations in rural areas such as Mexican American,
African American, Indian, and migrant populations among others. Other
articles discuss topics such as multidisciplinary approaches, prevention
strategies, and social and economic consequences of substance abuse.
Rural Information Center Health Services (RICHS). (2002). Mental Health
and Substance Abuse in Rural Areas Information Resources. Available at:
http://ric.nal.usda.gov/nal_display/index.php?info_center=5&tax_level=1
This section of the Rural Information Center (RIC) features links
to publications, federal organizations, funding opportunities, and online
databases relating to rural mental health and substance abuse issues.
Other sections of the RICHS website provide information on conferences
and news articles relating to rural health issues, including substance
abuse. The website also provides the user with an opportunity to ask
the RIC questions relating to the research.
Please contact the Northeast CAPT at capt@edc.org for more information.
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