Prescription Drugs Marijuana Underage Drinking DUI Crashes Key Intermediate Variables Involved in Underage Drinking UNDERAGE DRINKING Risk factor/underlying condition General description of risk factor/underlying condition Possible contributing local factors Possible strategies to employ Social norms accepting and/or encouraging use Social can send a conscious or unconscious message to community members that underage alcohol use will be accepted. Those attitudes affect youth’s decisions and affect the environment that adults create for youth. Social norms could, however, discourage youth use. Alcohol access at social events Lax enforcement of alcohol laws/policies Community sectors’ (family, school, etc.) lack of attention/concern regarding underage drinking Lack of local advocacy groups (e.g., or SADD youth groups) Community practices that may involve alcohol (hunting, boating, tailgating, etc.) Cultural practices or beliefs that may support alcohol use Social monitoring & enforcement High-visibility best practice enforcement operations Community media advocacy
Policies that do not include all events and (e.g., class trips, athletic areas) Lack of identification of early problem behaviors Early underage drinking behaviors can often be identified by educated parents, school staff, etc. When underage drinking behavior is identified and it is not addressed sufficiently, an opportunity is missed to prevent future underage drinking and the consequences that often come with it. Low capacity of adults to identify signs of underage drinking by youth Insufficient penalties, including too lax, without an educational opportunity, or lacking follow through, when underage drinking is identified Improved screening and referral systems Community media advocacy DUI CRASHES Risk factor/underlying condition General description of risk factor/underlying condition Possible contributing factors Possible strategies to employ Lack of identification of problem behaviors Many DUI offenders already have a DUI conviction. When an initial or subsequent charge does not lead to appropriate intervention, an opportunity is missed to prevent future drinking and driving and the consequences that often come with it. Insufficient screening processes in systems that could potentially identify those with drinking problems or inclinations to drive after drinking Insufficient penalties, including those too lax or without a proper screening, treatment, or educational opportunity, or penalties lacking follow through Improved screening and referral systems Community media advocacy Insufficient enforcement of laws Even when sufficient laws are in place, enforcement may not be adequately funded or equitably or properly enforced. Also, proper enforcement may Lack of use of appropriate best practice enforcement operations Insufficient levels of enforcement, overall or in a part of a county, due to lack of funding, training, or prioritization Adjudication systems enhancement
exist, but the judicial system may not address offenders in a manner that the community expects. Lack of public awareness of enforcement Inappropriate acceptance of plea bargaining Failure to impose or follow through on specified penalties/diversion programs Inadequate support for prosecution Insufficient communication b/w law enforcement and judicial officials on the required elements of a properly made case High-visibility best practice enforcement operations Community advocacy Social norms accepting and/or encouraging use Social send a conscious or unconscious message to community members that drinking and driving will be accepted. Those attitudes affect decisions and affect the environment in which those decisions are made. Social norms could, however, discourage drinking and driving. Alcohol access at social events Lax enforcement of alcohol laws/policies Perception of low penalties for offenders or low likelihood of conviction Community sectors’ (family, school, etc.) lack of attention/concern regarding drinking and driving Lack of local advocacy groups (e.g., MADD chapter, SADD club) Community practices that may involve alcohol (hunting, boating, tailgating, etc.) Cultural practices or beliefs that may support alcohol use High-visibility best practice enforcement operations Social event monitoring & enforcement Community media advocacy Over-service to intoxicated patrons State law forbids selling alcohol to an intoxicated patron, though it is rarely enforced, especially in establishments where some patrons will be driving home. Merchants may not adequately self-police, as well. Lax enforcement of sale to intoxicated patrons laws Insufficient education or emphasis by retail establishments High-visibility best practice enforcement operations Merchant education Community media advocacy Easy social access Impaired drivers may be leaving social events where there was inadequate attention Inadequate controls on alcohol provided at social events Sales at unlicensed establishments High-visibility best practice enforcement operations
given to guests driving home intoxicated Social event monitoring and enforcement Community media advocacy Low or discount pricing The consumption of alcohol is affected by its price. Discounted drink specials encourage higher consumption. Happy Hour or other promotions that encourage excessive alcohol use Low unit price of alcohol High-visibility best practice enforcement operations Restrictions on alcohol price/promotion Community media advocacy Insufficient laws and policies Enforcement or prosecution can be hindered by a lack of, or insufficient, laws, ordinances, regulations, or policies. Lack of effective laws/policies/ ordinances, such as restrictions on outlet density, DUI courts, or strong administrative license revocation provisions Regulations that do not produce adequate controls or accountability on alcohol availability Community mobilization for policy change Community media advocacy Limited transportation options When drinkers choose not to drive, their consumption does not raise the risk of crashes on the roadway. Availability of transportation options can help encourage drinkers not to drive. Poor accessibility to public transportation or paid transportation options (taxis, shuttles, etc.) Insufficient or ineffective designated driver practices Increase transportation options Community media advocacy
Appendix F: Data Collection Methods at a Glance Method Pros Cons Costs Time to Complete Response Rate Expertise Needed Interviews – face to face and open ended Gather in-depth, detailed info.; info. can be used to generate survey questions Takes much time and expertise to conduct and analyze; potential interview bias possible Inexpensive if done in house; can be expensive to hire interviewers and/or transcribers About 45 min. per interview; analysis can be lengthy depending on method People usually if it fits into their schedule Requires good interview/conversation skills; formal analysis methods are difficult to Open-ended questions on a written survey Can add more detailed info. to a structured survey People often do not answer them; may be difficult to interpret meaning of written statements Inexpensive Only adds a few more minutes to a written survey; quick analysis time Moderate to low Easy to content analyze groups Can quickly get info. needs, community attitudes and norms; info. can be used to generate survey questions Can be difficult to run (need a good facilitator) and analyze; may be hard to gather 6 to 8 people together Inexpensive if done in house; can be expensive to hire facilitator Groups themselves last about 1.5 hours People usually agree if it fits into their schedule Requires good interview/conversation skills; technical aspects can be learned easily
surveys (paper, Anonymous; inexpensive; easy to analyze; standardized, so easy to compare with other data Results are easily biased; misses info.; drop out is a problem for analysis Moderate Moderate, but depends on system (mail, distribute at school) Moderate, but depends on system (mail has the lowest) Little expertise needed to give out surveys; some expertise needed to analyze and interpret the data Face-to-face structured surveys Same as paper and pencil, but you can clarify responses Same as paper and pencil but requires more time and staff time More than telephone and surveys Moderate to high More than survey (same as telephone survey) Need some expertise to implement a survey and to analyze and interpret the data Archival trend data Quick; inexpensive; a lot of data available Comparisons can be difficult; may not show change over time Inexpensive Usually very good but depend on the study that collected them No expertise needed to gather archival data, some expertise needed to analyze and interpret the data Record review Objective; quick; does not require program staff or participants; preexisting Can be difficult to interpret, often is incomplete Inexpensive Time consuming Not an issue Little expertise needed; coding scheme may need to be developed