Authored by Kathleen Staples, Manager Alcohol & Drug Prevention Services

Table of Contents

Introduction and Overview
Mission Statement
Prevention Mission Statement
Goals and Objectives
Evaluation
References
Attachment 1

I. Introduction and Overview

Recent years have brought increasing challenges to our prevention work at Ventura County Department of Alcohol and Drug Programs, as we have striven to have more cost-effective programs, that reach a larger number of people, are research based, and have measurable alcohol and other drug related outcomes.

In an effort to guide our prevention planning, we brought together informed community members, reviewed current prevention literature, consulted experts in the field and reviewed successes and failures within our programs. The diverse responses that we received from a brainstorming session with community members indicated the great need for continued prevention work in our county. However, the sheer number and variety of requests for prevention services greatly exceed the current prevention resources in the Department, and generally consisted of information-giving to small groups of individuals at a time.

It became clear through research, our contact with other experts in the field and our own work that no matter how good programs are in the smaller context, their message and impact are undermined unless community norms and policies also help to create an environment with a low level of alcohol and other drug problems.

Further, our investigation of prevention research revealed that experts generally agree that the most effective approach is a public health system model that acknowledges the complexity of interactions contributing to the development of problems. Our past alcohol and other drug prevention efforts have focused almost entirely on individual behavior change. According to prevention expert Bonnie Benard, this has been due to viewing problems apart from their environmental context, and on the emphasis on the disease model of addiction, which centers on individual vulnerability and disregards the social, economic, and cultural environmental contexts of alcohol and other drug problems. But a large body of both national and international research confirms a relationship between availability and consumption, and between consumption and levels of problems (Edwards, et al. 1994). For example, research evidence confirms alcohol outlet density is positively correlated with incidence of violent crime (Scribner, 1994).

On the other hand, a Community Prevention Model addresses environmental factors, that is, the physical and social context in which drinking and other drug using occurs (including factors such as availability and youth access). This environmental approach also addresses public policy, that is, "those laws, regulations, formal, and informal rules and understandings that are adopted on a collective basis to guide individual and collective behavior." (Mosher and Jernigan)

Rather than trying to change individual behavior, the goal of an environmental/public policy approach to the prevention of alcohol and other drug problems is to contribute to the creation of an environment that is conducive to the lowest level of alcohol and other drug related problems (Wallack). According to Mosher and Jernigan, public policies toward alcohol need to do the following:

1. Promote an environment conducive to low risk drinking and abstention;
2. Reduce factors in the social and cultural environment that encourage heavy drinking in the general public and any drinking in high-risk groups;
3. Promote changes in the physical environment when high risk drinking does take place.

There are obvious advantages to relying on policy-based environmental approaches to solving alcohol and other drug related problems. First, these approaches affect large numbers of people. For example, the national movement to raise the minimum drinking age to 21 has resulted in the saving of more than 14,000 lives just in alcohol-related traffic crashes since the laws were changed (National Highway Safety Administration, 1994). These gains from a single policy are in addition to significant reductions in other alcohol-related problems among young people (e.g., O'Malley and Wagenaar, 1991). Second, once implemented, many policy changes are relatively maintenance free, do not require ongoing expenditures, and free up prevention resources to assist communities in addressing other aspects of the problem.

Other community health and safety problems which have been addressed by public policy approaches have met with great success. Some examples of safety problems that have been reduced by policy strategies are: raising the drinking age to 21 in all 50 states; mandatory seat belt and child restraint regulations; fire-retardant children's sleepwear. Additionally, community health risks have been reduced by the proliferation of mandatory smoke-free public places. Policy change doesn't necessarily mean a change in laws. Community members may work with local merchants to establish voluntary policies with regard to alcohol advertising, or placement and price of alcohol products.

Focusing on the problem that alcohol and other drugs cause in communities rather than on individual behavior produces results that are more immediate and directly related to community health and safety. Because of this we can more easily develop and utilize strategies with measurable outcomes.

Many communities use a variety of legal and policy strategies to eliminate illicit drug marketplaces, including using zoning and building codes to raze or board up crack houses (CSAP 1994; Uchida, Forst, and Annan 1992; CSAP 1995), or changing street traffic patterns to make drug sales to people in cars more difficult (Stewart 1992).

Based on all of this collected information, a work plan was developed that reflects the goals and strategies of an environmental public policy approach.

The purpose of this work plan is to focus prevention efforts in the direction of environmental/public policy change, that is both comprehensive and strategic. We recognize that communities need more than information alone to change -- they need to take action.

In providing technical assistance, we can assist community leaders to gain the skills they need to direct their action in a way that effects change in public policy around the specific alcohol and drug related problems they identify in their own communities. This innovative approach actually consists of three interwoven prongs:

• public policy
• community organizing
• media advocacy

To be successful, media advocacy work should broaden the discussion about alcohol and other drug problems as public health and safety issues, as well as to present policy-based solutions to these complex community problems. Working with the media is especially important in policy work because it is a natural public forum, community organizing tool, and the means by which most people receive information about what is happening in their communities.

In this model, the community defines both the problems and the policy-based solutions. The role of Ventura County Department of Alcohol and Drug Programs is to assist the community's process of clearly defining specific alcohol and other drug problems, and developing policy goals that directly address those problems by providing technical assistance and consultation. Assistance will be available to community-based organizations, community coalitions, and other groups in their efforts to take action to address alcohol and other drug problems with an environmental/public policy approach.

The benefits of this approach are many. For example, we can affect large numbers of people since we will work on a community-wide problem, rather than focusing on a few select individuals, whose behavior we hope to impact. Secondly, rather than just talking about the problems, communities can carve out specific goals for change that may greatly improve the health and safety of their neighborhoods. Also, since the community takes the lead and local environmental/public policy experts emerge, we can be more sure that prevention efforts can continue without ongoing use of county resources.

The Department has identified the following four "issue tracks" which will be used to guide communities in the implementation of this plan. These "issue track" areas are:

• Driving Under the Influence
• Alcohol/Drug Access to Youth
• Availability of Alcohol and Other Drugs
• Alcohol and Other Drug- Related Violence

It is our intent to assist community members in organizing their efforts to address these specific areas.

To maximize efforts to assist communities, Ventura County has developed a formal relationship with the Institute for Health Advocacy and its Media and Policy Advisory Board of nationally recognized experts, the California Council on Alcohol Policy, the Marin Institute, and the Prevention Research Center and its federal trials projects. Additionally, Ventura County is collaborating, and in some cases developing joint public policy projects with the following: Santa Barbara, San Luis Obispo and San Diego counties.

Ventura County Department of Alcohol and Drug Programs has chosen environmental/public policy as its prevention focus. At the same time, we support the broad variety of other prevention strategies that are so important in addressing the full spectrum of alcohol and other drug related problems in our communities. We expect this strategic plan to evolve and change over time. An integral part of this plan is its ability to grow, and reflect the specific needs of the communities. Since these needs are as complex as the problems themselves, we recognize the value of programs that address individual behavior change as well as the environmental change we are addressing.