December 1, 2005
National Coalition Institute's Research into Action
Study: Multiple Strategies/Activities Improve Outcomes

Community coalitions that combine interventions focused on reducing alcohol availability and increasing substance abuse treatment have more success reducing alcohol-related fatal crashes, a study of coalitions that participated in the Fighting Back program shows. The Robert Wood Johnson Foundation financed initiatives to combat substance abuse and related problems in 12 communities.

The researchers identified five of the 12 Fighting Back sites that implemented at least eight activities to expand treatment and limit the availability of alcohol. Activities focused on decreasing alcohol availability included: limiting alcohol availability; engaging in sting operations; conducting responsible beverage training; enacting ordinances to prohibit public consumption or beverage sales; closing liquor stores/blocking new stores/monitoring problematic outlets; persuading liquor stores to sign voluntary agreements; limiting marketing/advertising; convening citywide taskforces. Activities focused on expanding treatment included: increasing publicly funded treatment; establishing referral and/or awareness campaigns about treatment services; creating or expanding treatment/aftercare programs; initiating hospital Emergency Department screens/referrals; establishing drug courts; opening new treatment/aftercare facilities; convening treatment provider consortia.

The communities were compared to: 1) multiple communities in the same state that were similar in size and demographic characteristics; and 2) Fighting Back communities that had less concentrated efforts in reducing alcohol availability and increasing substance abuse treatment. Researchers examined fatal crash data 10 years before and 10 years after the Fight Back program started in 1992.

The five Fighting Back communities had significant decreases in alcohol-related fatal crashes the 10 years following implementation of the Fighting Back program compared to the 10 years prior, even taking into consideration the decreasing trend in fatal crashes witnessed in recent years. The declines were greater in those communities that targeted an entire city. Additionally, the other Fighting Back communities with less focus on reducing access to alcohol and expanding treatment services did not experience these same declines.

Source: Hingson, R.W., Zakocs, R.C., Heeren, T., Winter, M.R., Rosenbloom, D., & DeJong, W. (2005). Effects on alcohol related fatal crashes of a community based initiative to increase substance abuse treatment and reduce alcohol availability. Injury Prevention, 11
What Coalitions Can Do www.coalitioninstitute.org
Choose strategies research shows specifically reduce alcohol-related problems
The presence of a coalition is not enough to guarantee change. Coalitions must find and use interventions with evidence of their effectiveness or a reasonable rationale for reducing alcohol-related problems.
Conduct activities to reduce alcohol availability AND expand access to treatment
Reducing alcohol-related problems requires a multi-strategy and multi-activity approach. Combining activities focused on expanding treatment access and decreasing the availability of alcohol results in a comprehensive solution. This study shows fewer, less diverse activities will not produce the same results.
Use a variety of data sources to keep a pulse on what's going on in your community
Social indicator data are available at the community-level to provide additional information to guide your coalition efforts. They should be used as part of your community assessment and evaluation, supplementing your student survey data.
Choose activities of efficient scale and scope what's going on in your community
You are unlikely to affect community-wide change by providing an alcohol prevention program to 40 youth in your middle schools. Coalition efforts should focus on changing the community system.
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Research into Action may be copied without permission. Please cite CADCA's National Coalition Institute as the source.
CADCA's National Coalition Institute is federally-funded through a grant from the Office of National Drug Control Policy that is administered by SAMHSA's Center for Substance Abuse Prevention. The Institute's mission is to increase the effectiveness of community anti-drug coalitions throughout the nation.