Study to Prevent Alcohol-Related Consequences Using a Community Organizing Approach to Implement Environmental Strategies in and around the College Campus – An Intervention Manual 2 SPARC2 Study to Prevent Alcohol-Related Consequences Using a Community Organizing Approach to Implement Environmental Strategies in and around the College Campus – An Intervention Manual Barbara Alvarez Martin, MPH1 Alicia Sparks, MPH2 Michael Sparks, MA1 Scott D. Rhodes, PhD, MPH2 Kimberly G. Wagoner, DrPH, MPH1 Mary Claire O’Brien, MD2 Erin L. Sutfin, PhD2 Doug Easterling, PhD2 Kathleen L. Egan, MS2 Mark Wolfson, PhD2, 3 1 Lead Author; 2Consulting Author; 3Principal Investigator Department of Social Sciences and Health Policy Division of Public Health Sciences Wake Forest School of Medicine Winston-Salem, N.C. Preparation of this publication was supported by the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health (Grant No. RO1AA14007). Martin, Barbara A.; Sparks, Michael; Wagoner, Kimberly G.; Sutfin, Erin L.; Egan, Kathleen L.; Sparks, Alicia; Rhodes, Scott D.; O’Brien, Mary Claire; Easterling, Doug; Wolfson, Mark. (2012). Study to Prevent Alcohol-Related Consequences: Using a Community Organizing Approach to Implement Environmental Strategies in and around the College Campus-An Intervention Manual. Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine. Winston-Salem, NC. SPARC 3 Contents Preface ....................................................................................................................................................... 4 Chapter 1: Introduction ................................................................................................. 6 Chapter 2: SPARC Step 1 Conduct Assessment ............................................................. 24 Chapter 3: SPARC Step 2 Build the Coalition and its Capacity ......................................... 35 Chapter 4: SPARC Step 3 Develop a Strategic Plan .............................................................. 45 Chapter 5: SPARC Step 4 Implement and Action Plan.........................................................55 Chapter 6: SPARC Step 5 Sustaining Efforts ......................................................................... 62 Chapter 7: Summarizing the SPARC Intervention Steps through the Lens of the Reassessment Pathway...................................................... 69 Appendix 1: Assessment and Scanning Resources ........................................ 72 Appendix 2: Resources for Action Phase ......................................................... 73 Appendix 3: Resources for Environmental Strategies .................................. 74 Appendix 4: Policy Steps ..................................................................................... 78 Appendix 5: Sample Action Plans ..................................................................... 88 References ................................................................................................................................................. 93 4 Preface SPARC The SPARC Intervention Manual The SPARC Intervention Manual provides step-by-step guidance on how to implement the interventions of the Study to Prevent Alcohol-Related Consequences (SPARC), a randomized community trial to address high-risk drinking by students involving ten universities in a southeastern state that was funded by the National Institute on Alcohol Abuse and Alcoholism. SPARC interventions for addressing problems related to includes a range of evidence-based interventions student drinking both on campus and in surrounding that have been proven effective at reducing risk communities have demonstrated effectiveness and and decreasing alcohol-related problems. SPARC produced the following meaningful results: interventions are grounded in that evidence. • Decreases in severe consequences due to students’ SPARC is inexpensive. While implementing SPARC own drinking interventions takes time and resources, it is not costly. • Decreases in alcohol-related injuries caused High-risk drinking is deeply ingrained in the campus to others culture at many colleges and universities. Existing Reductions in interpersonal campus and community alcohol policies may, in fact, consequences due to others’ contribute to an environment that reinforces the very drinking behaviors that result in expensive problems for students and community residents alike. While altering that These results translate into saved lives and reduced environment does take time and resources, SPARC harms to students. Because alcohol use and high-risk campuses found that could be accomplished by drinking is pervasive in the campus culture, colleges and redirecting resources away from ineffective efforts and universities need to assure that they are investing scarce dedicating a part-time staff person to focus on coalition resources in prevention strategies that work. building and assist in the implementation of evidence- based environmental strategies. SPARC is unique. These interventions are based on evidence-based community organizing and SPARC is flexible. Although the most powerful features environmental strategies that alter the structures and of SPARC interventions are clarity of focus and design, systems that influence student drinking, resulting each campus and surrounding community has its own in reduced high-risk drinking on campus and in the set of alcohol-related problems and factors underlying surrounding community. The SPARC environmental those problems. The SPARC model is designed to strategies focus on four domains: alcohol availability, identify and support the implementation of strategies alcohol prices and marketing, norms concerning high- that respond to the social, political and economic factors risk drinking, and harm minimization. Each category specific to each campus community. SPARC Preface 5 For example, some campuses have problems associated nature and extent of the alcohol problem are assessed, with loud and unruly parties in off-campus housing. other group members are recruited, strategies are Others are surrounded by bars that promote low cost, selected, and required resources are identified. high potency drinks to students. SPARC is designed to This manual has two key audiences: college decision take those unique set of conditions into consideration makers and the practitioners responsible for carrying out when community coalitions select and implement the day-to-day work on campus and in the community. strategies. It provides a clear rationale for implementing SPARC SPARC is comprehensive. No single program or interventions and a detailed description of how intervention is sufficient to effectively reduce high-risk to do so. The manual presents the theoretical and drinking by students at a particular campus. Problems empirical foundation for SPARC, including an in-depth related to alcohol use take many forms and can occur description of the program design, an explanation of in many settings, both on and off campus. SPARC environmental strategies and community organizing, assessment and action step planning components and a discussion of the types of coalition structures facilitate a thorough analysis of contributing factors required to implement the intervention. wich pose risks for students both on campus and in the For practitioners who are charged with reducing high- surrounding community. Specific strategies selected to risk drinking by students and related problems both on respond to these conditions will vary and unfold over campus and in the surrounding community, this manual time. provides comprehensive instructions for carrying out the Initiating SPARC does not have to be complicated. The intervention with specific focus on assessment, coalition first step is simply acknowledging that there are alcohol building, strategic planning, action and sustainability. It problems on campus and in the community. The next contains all the information needed to do the work based step is bringing together a core group of people who are on the lessons learned from the SPARC research project. willing to look at alcohol problems through new eyes. These two steps effectively launch the process and can For information about SPARC, please contact the SPARC lead directly into the assessment and planning phases of study team at [email protected]. the initiative. But things do get more complicated as the 6 Chapter One SPARC Introduction High-risk drinking by college students is associated with an array of adverse consequences and presents problems for those who drink, their peers, and society at-large. Alcohol use is the greatest single contributor to injury and death among college students (Hingson, Zha, & Weitzman, 2009). For the drinker, high-risk alcohol use is associated with a organizing approach for planning and implementing greater likelihood of traffic-related injuries and fatalities, environmental strategies focused on modifying social mortality and morbidity from unintentional injuries, norms, policies and enforcement practices (Wagoner, assault, sexual harassment, unplanned and unsafe sex, Rhodes, Lentz, & Wolfson,2010; Wolfson et al., 2012). health problems, impaired sleep and study time, and Those environmental strategies have been shown to lead interpersonal problems (Hingson et al., 2009; Nelson, to reductions in high risk-drinking and alcohol-related Zuan, Weitzman, & Wechsler, 2009; Perkins, 2002; consequences. Rhodes et