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Changing The Larger Environment: Critical Components

© 1999 Education Development Center, Inc.

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I. OVERVIEW: CHANGING THE LARGER ENVIRONMENT

Families, schools, other community organizations, and local practitioners have an important role to play in bringing about changes in the larger physical and psychosocial environment. The choice to use substances may occur at the individual level. But just as family, peer, and school factors influence these choices, so too do factors in the community and society as a whole. As Michael Klitzner, Ph.D., one of the founders of the Center for the Study of Environmental Approaches to Alcohol, points out, "The shared environment [norms, regulations, and availability] supports some behaviors and thwarts others." ^[1]

Individuals, professional and community groups, and state and national organizations can find opportunities to get involved in changing the environment in ways that contribute to prevention. Five environmental strategies can have a significant impact. ^[2]

A. Policy

B. Enforcement

C. Education

D. Communication

E. Collaboration

Note: These environmental strategies for preventing, reducing, or eliminating substance abuse also contribute to violence prevention.

II. STRATEGIES FOR CHANGING THE LARGER ENVIRONMENT

A. Policy

Perhaps the most potent strategies are the laws and regulations designed to control environments around schools and other community areas where young people gather. Policies are more likely to be effective if they:

1. Reduce the availability of substances (and firearms) to youth.

• Limiting the location and density of retail outlets may help contribute to reductions in alcohol consumption, traffic crashes, and certain other alcohol-related problems, including assaults.

• Restrictions on cigarette vending machines and self-service displays result in some reduction in youth sales rates.

2. Increase the price of alcohol and tobacco.

• Increasing the price of alcohol or tobacco through excise taxes is associated with effectively reducing consumption - number of times consumed and amount consumed. Increases in price can also reduce various alcohol-related problems, including motor vehicle fatalities, driving while intoxicated rapes, robberies, and suicide and cancer death rates.

3. Provide deterrents to using alcohol or firearms or incentives for not using these.

• Suspending the driver's license of a person under 21 years of age following a conviction for any alcohol or other drug violation is an effective way of increasing compliance with minimum-age purchase laws among the young.

• Setting the legal blood alcohol content (BAC) limit to 0.00 or 0.02 for young people under the age of 21 has been shown to significantly reduce traffic deaths among young people. Reduced BAC levels for minors are usually paired with a variety of driving restrictions that are gradually lifted as the driver gains experience.

• Revoking driver's license in the event of an illegal BAC or if the driver refuses to be tested has been shown to reduce the number of fatal crashes and repeat offenses among driving under the influence (DUI) offenders.

4. Restrict use and sale of alcohol and tobacco.

• Restricting use of tobacco in public places and private workplaces has been shown to be effective in reducing cigarette sales and tobacco use, because both lower average daily cigarette consumption among adults and youth.

• Restricting alcohol sales at youth- and community-oriented events (e.g., county fairs, sporting events, New Year's celebrations, political fund-raisers) may lead to reduced consumption.

5. Restrict alcohol and tobacco advertising that targets young people.

• Examples of strategies designed to counter the effects of alcohol and tobacco advertising include the following:

• Prohibiting the placement of alcohol and tobacco billboards and other forms of outdoor advertising near schools and other locations where children are likely to be present

• Terminating alcohol and tobacco industry sponsorship of sporting and other events

6. Promote community economic development.

Schools and community-based organizations (CBOs) can implement job training programs for youth and integrate community betterment projects into school curricula. They can participate with students in alternative activities that promote economic development, such as repairing dilapidated houses, cleaning play areas, and ridding towns and cities of abandoned properties where illegal activities take place.

B. Enforcement

Laws and regulations must be enforced in order to be effective.

Police officers, in particular, are important to enforcement and, as such, should be represented on community advisory boards, health task forces, or school and community coalitions. Police, however, are not the only ones who are key to enforcement in the community. Young people, their parents, and other community members play an important role in combination with police. This kind of enforcement is illustrated in the box below.

From M. Klitzner, Integrating Environmental Change Theory into Prevention Practice.

Local practitioners, school personnel, youth, and parents can work with key people to:

1. Enforce minimum-age purchase laws against selling alcohol and tobacco to minors using undercover buying operations (a.k.a sting or decoy operations).
   This kind of enforcement increases the likelihood that retailers will comply with such laws. Undercover community buying operations that provide positive and negative feedback to merchants are also effective in increasing retailer compliance with underage drinking laws.

2. Limit driving privileges for those who violate minimum-age purchase laws.
   Suspending the driver's license of a person under 21 years of age following a conviction for any alcohol or other drug violation is an effective way to increase compliance with minimum-age purchase laws among the young.

3. Enforce impaired driving laws.
   This kind of enforcement is important because it increases public perception of the risk of being caught and punished for driving under the influence of alcohol. Sobriety checkpoints are one example of this kind of public enforcement of underage drinking laws.

4. Pair enforcement of laws against service to intoxicated patrons and sales to minors with server training.
   Such pairing increases the effectiveness of training programs in producing changes in selling and serving practices.

5. Employ citizen surveillance and nuisance abatement programs.
   These strategies have been effective in dislocating drug dealers and reducing the number and density of retail drug markets.

C. Education

For environmental strategies such as policy changes, effective enforcement, and community collaborations to be successful, the public must know what measures are available to them and what policies they are expected to follow.

Public awareness campaigns are one tool for educating the public (see the section on Communications for others). A variety of more specific educational programs can contribute to successful environmental strategies. They include:

• Server training programs that work with bartenders and waitstaff to reduce service to minors and intoxicated customers

• Education of merchants on the laws and penalties for selling to underage customers

Educational programs are often conducted by knowledgeable professionals, but that does not exclude members of the community from becoming involved. They can:

• Point out to the owners of businesses they patronize (e.g., restaurant owners) that employees are not obeying laws (e.g., waiters serving drinks to minors)

• Suggest employee training to business owners

• In collaboration with other community members and business owners, encourage the municipal government to provide server or owner training, or set up such training independent of the government

D. Communication

Media and other communications efforts can be used to help change or reinforce community norms concerning tolerance of sales to and use by minors.

Policies must be in step with community beliefs about the harm of a particular substance or the "rightness" or "wrongness" of a particular action. For a community to accept, promote, and enforce a particular policy or regulation, there must some understanding of the problem and a readiness to change based on that understanding. The media efforts are effective tools for increasing awareness of the likelihood of apprehension and punishment and reducing retailer noncompliance with laws regarding liquor and tobacco sales to minors.

For this reason, prevention programs have employed the local media and public education strategies to influence community norms. Media can also increase public awareness about specific issues and problems related to substance use and violence, attract community support for other program efforts, reinforce school-based and CBO curricula for students and parents, and keep the public informed about program progress.

These communication campaigns are more effective when they:

1. Are combined with more intensive and interactive prevention approaches.
   When coupled with other, more intensive and interactive prevention approaches, the media can be a useful tool for reaching many people in the surrounding community, especially individuals who do not regularly interact with the school. The Midwestern Prevention Project, for example, included a mass-media component consisting of approximately 31 television, radio, and print broadcasts per year to help promote, reinforce, and maintain the project. These media efforts were offered in conjunction with parenting skills training, community action, skills-based instruction, and community policy change efforts targeted to students ages 10 to 15 years.

2. Present messages that appeal to young people's motives for using substances and their perceptions of substance abuse.
   Messages that appeal to or correct young people's perceptions of risk are more likely to be effective than messages that do not. For example, students may underestimate the risks associated with smoking marijuana. Messages might accurately portray these risks. Counter advertising campaigns that disseminate information about the hazards of a product or the industry that promotes it may help reduce cigarette sales and tobacco consumption. Students are also more likely to engage in a particular behavior if they believe that more of their peers are "doing it."  Messages might be used to correct misconceptions about prevalence of use: "Most of your friends don't smoke marijuana."

3. Place messages where young people are likely to see and hear them.
   It is strategic to pay for television and radio "spots" in choice airtimes, when youth are more likely to view or listen. So is placing placards about underage drinking and smoking in liquor stores or stores that sell cigarettes, and putting posters in well-trafficked areas in and around schools.

4. Tailor messages to the audience.
   Ultimately, the messages conveyed should be tailored to the youth targeted. One way of determining their perceptions is to conduct an assessment of youth attitudes and beliefs about substance abuse and violence. For example, allow for the different viewing habits of younger and older adolescents, utilizing radio, television, and print media appropriately. The interests of youth also vary by gender, ethnicity, and geography. What appeals to young people living in the city might not appeal to youth living in rural America.

5. Avoid the use of authority figures and admonishments, as well as demonstration of harmful substances.
   Young people tune out when messages are overbearing or use scare tactics.

E. Collaboration

Collaborative efforts among different community sectors (e.g., public health, education, business, faith, medical, nursing, law enforcement) have been shown to be effective in raising awareness about the issues of substance abuse and violence and in coordinating prevention and treatment services.

Research indicates that effective community collaborations:

1. Are part of a comprehensive effort.
   This means that community collaboration should be offered in conjunction with or as a means for implementing other effective strategies, including skills-based instruction for students and families, policies designed to promote environments in which substance abuse is not accepted, policies that reduce the availability of and access to substances and weapons, enforcement of these policies and counseling and skills training for families and students at high risk for substance abuse and violence.

2. Use media and community education strategies.
   Such strategies increase public awareness, attract community support, reinforce the school-based curriculum for students and parents, and keep the public informed of the program's progress.

3. Coordinate with other community efforts.
   Don't duplicate efforts. Look at what the community is already doing to prevent substance abuse or violence and build on those efforts. Include program components that can be integrated or coordinated with other efforts to support your messages.

4. Reach different populations at risk.
   Collaborative efforts are more likely to be effective if they meet the needs of all the general population as well as those at risk. Further, community efforts, to be truly responsive, must include representatives from different segments of the population, including individuals from different religious, ethnic, and socioeconomic groups, as well as people of all ages.

5. Meet the needs of their members.
   Most people want to get something out of their collaborative experience. Appeal to different motivations for joining. Community leaders and professionals, for example, are more likely to seek outcomes or accomplishments related to their organizational or political interests, while community or citizen activists want to spend their time in a useful way that will make their communities better places to live.

6. Recruit and involve members whose positions, expertise, or skills match the purpose and plan of the coalition.
   For example, if direct community action is the focus of your work, then you should involve grassroots activists and community citizens.

7. Possess a shared vision of purpose and direction.
   Community collaboration is more likely to succeed if everyone shares the same vision of what he or she would like to achieve. Getting people "on the same page," so to speak, may require discussion about what kinds of strategies work, as well as the need for strategic planning.

8. Follow a structured organizational plan.
   Planning is critical to community collaboration. Community coalitions tend to be more effective when they begin with a clear understanding of the substance- or violence-related problems they want to change and then progress from that assessment through planning, implementation, and review to refinement, with feedback to and from the members of the community coalition at all stages.

9. Have specific, measurable objectives and activities.
   Such objectives and activities should be time-limited, feasible (given available resources), and integrated so that they work together across program components and can be used to evaluate program progress and outcomes.

FOOTNOTES

^[1]Klitzner, M. (1998). Integrating environmental change theory into prevention practice. Northeast CAPT Regional Summit: Environmental Strategies to Reduce Youth Substance Abuse. Providence, RI. Dec. 2 - 3, 1998.

^[2] Gardner, S. E., Brounstein, P. J., and Stone, D. B.  Guide to Science-Based Practices (2001). Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention, Division of Knowledge Development and Evaluation.