THE NH STRATEGIC PREVENTION FRAMEWORK'S. A workbook for New Hampshire's Community Prevention Coalitions

Transcription

1 THE NH STRATEGIC PREVENTION FRAMEWORK'S Risk & Protective Factor A S S E S S M E N T T O O L B O X A workbook for New Hampshire's Community Prevention Coalitions Compiled March of 2008

2 TABLE OF CONTENTS

3 ACKNOWLEDGEMENTS This document would not have been possible without the hard work of the following people and organizations, all of which donated their time, resources and expertise to its creation. Pam DiNapoli Makin' It Happen Coalition for Resilient Youth and Greater Nashua Community Prevention Coalition Nicole LaPointe North Country Prevention Network Carol Oliver Northeast Center for Applied Prevention Technology Katy Shea Partners in Prevention and Capital Region Community Prevention Coalition Jonathan Stewart Community Health Institute Harry Wolhandler Community United for Substance Abuse Prevention INDIVIDUALS Rachel Kohn Community Health Institute Lisa Muré Community Health Institute Michelle Ricco NH Department of Health and Human Services Strategic Prevention Framework Program Chris Smith New Hampshire Minority Health Coalition George Tremblay Antioch University New England and Monadnock Voices for Prevention AGENCIES North Carolina Department of Health and Human Services North Carolina Strategic Prevention Framework New Hampshire Minority Health Coalition NH Strategic Prevention Framework Evaluation Contractor Community Health Institute

4 New Hampshire Risk and Protective Factor Toolbox S E C T I O N 1 : What are Risk/Protective Factors and Contributing Factors? Risk & Protective Factors are constructs that have been identified as being strongly related to, and influencing the occurrence and magnitude of, substance use. By exploring these constructs, your community/region will be able to address the issues with appropriate and targeted strategies. Based on what we know from the literature and data that has already been collected, we will look at seven risk and protective factors and their relationship to our consequence priorities Underage Drinking, Binge Drinking, and Binge Drinking amongst Young Adults. CONTRIBUTING FACTORS describe why something is a problem. 1. Retail Access/Availability 2. Social Access/Availability 3. Enforcement 4. Perception of Risk 5. Social Norms 6. Alcohol Pricing and Promotion 7. Screening Individuals for Alcohol Problems in Community Settings For example, consider social availability as the risk/protective factor of interest, and the more specified case of social availability is alcohol at in-home parties. The risk/protective factor of Social Availability is a construct, a category, for which there exist multiple specific instances or cases. In this example, what we hope to see changed or moved is the in-home parties. Doing it this way, a risk/protective factor category could, after a needs assessment, contain one or several specific variables. Therefore, each of the specific risk/protective factors would be explained by anywhere from one to many contributing factors. To make this classification more relevant to your specific community, we have reserved the designation contributing factor for the actual condition that a prevention strategy will directly try to affect. Note: Identifying contributing factors will guide the selection of your evidence-based strategies. The contributing factor describes why something is a problem not the problem itself. Example: kids serve alcohol at parties in their home with their parents permission. That is the problem (i.e., a specific case of social availability). To design a strategy, we have to know why parents think that is OK what factors contribute to that problem. Possible contributing factors for this example would be: parents don t know that it is illegal; the law is Section 1: Risk and Protective Factors 4

5 not enforced (which provokes another why question); parents believe it is safer for kids to drink at home; parents aren t aware of how much their kids are drinking. The Risk/Protective Factor Assessment Instrument will utilize several ways to assess the contributing factors. You will be able to use and organize the information gathered through your One-on-Ones, Readiness Survey, Focus Groups and Information Panels. This instrument will be a combined & revised survey instrument of the former Risk & Resiliency Survey and the Environmental Scan Survey. Once these assessments are completed the coalition will then prioritize the risk/protective factors and begin working on the completion of a comprehensive community prevention plan. RISK/PROTECTIVE FACTOR 1: RETAIL ACCESS/AVAILABILITY Access/availability of alcohol or illegal drugs led to increases in use. (Hawkins et al, 1995) Without access/availability, there can be no use and associated problems. Research has shown that when alcohol or other drugs are inexpensive, convenient, and easily accessible, people are more likely to use them. (Birckmayer et al, 2004). Retail availability refers to how available alcohol is in your community and how easy it is to obtain. To explore the status of retail availability in your community, we are going to look at four areas that affect the availability of alcohol: Liquor Permits per capita Retail access in the community Restaurant & Bar access Alcohol Law Enforcement The following table (1A) provides examples of possible contributing factors to retail availability. Please review these factors and determine the degree to which retail access/availability is or is not a problem in your community/region. Table 1A: Examples of Contributing Factors to Retail Access/Availability ID Issues Use of face Ids; failure of retailers to properly check Ids Compliance with laws/regulations Density Product Characteristics Employees Product Placement Mobility Sales to minors; sales to intoxicated persons High density package sales locations Forty-ounce containers; single sales; keg registration Clerks have underage friends and sell to them Ease of shoplifting; alcohol placement in store; segregated sales; alco-pops; energy drinks mixed with alcohol People commuting between towns for alcohol or alcohol-related parties Section 1: Risk and Protective Factors 5

6 Liquor Permits per Capita The most fundamental way to understand retail access/availability is the number of opportunities people have to buy alcohol. New Hampshire is somewhat unique because it is a control state. Controlled jurisdictions are involved in the sales of spirits and wines, the licensing of manufacturing, wholesale and retail businesses and the enforcement of laws related to these areas. Table 1B lists major liquor license types. Please use this table to record the number of liquor licenses for the region as a whole. To find all the active liquor licenses in a town, go to and do the following: 1) Under LICENSE LOOK-UP click on "Liquor Commission." You will be taken to the search page 2) Under PROFESSION select "Liquor Commission" from the drop-down menu 3) Under LICENSE STATUS select "Active" from the drop-down menu 4) In the CITY field, enter the name of the town you wish to search for active liquor licenses 5) Click SEARCH Screenshot of the Search Page for NH Online Licensing State Liquor Stores do not require a license, so they will not be listed on the NH Online Licensing site. A complete list of State Liquor Stores, including contact information, can be found at the NH Liquor Commission's website at A list of towns containing State Liquor Stores, and the number of State Liquor Stores they host, can be found in Table 1C. To calculate the rate of per capita licenses, please use the following formula: Total # of Licenses x 1,000 = Count Rate per 1,000 Town/Region Population (age 14 and above) The population of those 14 years and older is consistent with research done by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) regarding sales per gallon of ethanol. Section 1: Risk and Protective Factors 6

7 Table 1B: Major Liquor License Types License Type Region Town Rate OFF PREMISE Agency Store Combination Seasonal Combination State Liquor Store ON PREMISE Ballroom Bed and Breakfast Brew Pub Caterers On Site College Club Convention Center Race Track / Pari-Mutuel Hotel Military Club Performing Arts Facility Restaurant Seasonal Hotel Seasonal Restaurant Seasonal Sports/Rec Facility Social Club Sports Recreational Facility Sports/Entertainment Complex Vessel Veterans Club TOTAL You may want to calculate this per town to see if there is a part of the region with a higher concentration of retailers per capita. This statistic may inform where you want to concentrate your assessments of retail access, in particular cities or towns versus the region as a whole. The Liquor Investigator assigned to your region will be a great resource to collect this data. They could also inform the coalition as to whether any of the licenses within a given region are in non-compliance, license revocation or at risk for license revocation and the reasons why. Any Commission actions taken against a licensee can also be found at the NH Online Licensing website. Making a Connection Review your arrest data and determine if there is a relationship between alcohol-related arrests and location of alcohol outlets in your region. Section 1: Risk and Protective Factors 7

8 Table 1C: State Liquor Store Locations STATE LIQUOR STORE LOCATIONS STORES PER LOCATION STATE LIQUOR STORE LOCATIONS STORES PER LOCATION ASHLAND 1 LITTLETON 1 BEDFORD 1 LONDONDERRY 1 BELMONT 1 MANCHESTER 4 BERLIN 1 MEREDITH 1 BRISTOL 1 MERRIMACK 1 BROOKLINE 1 MILFORD 1 CAMPTON 1 N. HAMPTON 1 CENTER HARBOR 1 N.WOODSTOCK 1 CENTER OSSIPEE 1 NASHUA 4 CLAREMONT 1 NEW LONDON 1 COLEBROOK 1 NEWPORT 1 CONCORD 2 PELHAM 1 CONWAY 1 PETERBOROUGH 1 DERRY 1 PITTSFIELD 1 DOVER 1 PLAISTOW 1 FARMINGTON 1 PLYMOUTH 1 FITZWILLIAM 1 PORTSMOUTH 2 FRANKLIN 1 RAYMOND 1 GILFORD 1 RINDGE 1 GLEN 1 ROCHESTER 1 GOFFSTOWN 1 SALEM 1 GORHAM 1 SEABROOK 2 GROVETON 1 SOMERSWORTH 1 HAMPTON 2 STRATHAM 1 HILLSBORO 1 SWANZEY 1 HINSDALE 1 W. CHESTERFIELD 1 HOOKSETT 3 WALPOLE 1 HUDSON 1 WEST LEBANON 1 JAFFREY 1 WHITEFIELD 1 KEENE 1 WINCHESTER 1 LANCASTER 1 WOLFEBORO FALLS 1 LEBANON 1 WOODSVILLE 1 LEE 1 Retail Access to Alcohol in the Community The exercises in the previous section offer a better understanding of how the sale of alcohol is regulated within your region and its potential impact on liquor's availability and access. However, you will need to know how these regulations affect sales and access at the local level. Members of your coalition should use the Retail Access Assessment tool to collect information about selected retail liquor establishments in your region (see Appendix A). In consultation with your evaluator, your coalition will determine the most appropriate way to select which liquor outlets will be observed in your region. With assistance from the state evaluation team, your evaluator will develop a sampling design that will allow your coalition to describe the retail access to alcohol in cities, towns, and more rural areas in your region. Section 1: Risk and Protective Factors 8

9 For example, if there are many outlets in a particular city, your evaluator may select a sample from the liquor permits listed on the Liquor Commission's website (described above). If on the other hand, one particular store has a history of non-compliance related to underage drinking, your evaluator may purposefully choose that store for observation. Your evaluator will specify the sample of retail outlets to be observed using the Retail Access Assessment tool prior to the start of data collection. Coalition members will then go to the selected liquor store outlets, convenience stores and grocery stores selling liquor in communities in your region to collect information regarding their operations, liquor pricing and promotion practices. By completing this assessment with a range of retailers, you will learn how alcohol is bought and sold in the communities in your region. Question What did you learn about the retail availability of alcohol in the communities in your region by completing the Retail Access Assessment Tool? Restaurant & Bar Access to Alcohol The number of bars and restaurants in a given community that sell alcohol will also affect how readily alcohol is available. By completing the Restaurant & Bar Access Assessment Tool (Appendix B), you will learn: How alcohol is bought and sold at restaurants and bars in your community/region How alcohol is priced at the restaurants and bars in your community (e.g. is it priced to encourage heavy drinking through happy hour specials, all-you-can-drink specials) How alcohol is promoted at the restaurants and bars in your community/region. Similar to the sampling of liquor retailers, your evaluator may select a sample of liquor permits for bars and restaurants, particularly from cities with the largest number of these types of establishments. None of these samples is meant to be a random probability sample. Each coalition will determine the best way to cluster establishments to draw the broadest sample within the categories most relevant to access in your region. Again, certain bars or restaurants may be selected for a particular purpose, for its popularity among college students, for example, or due to a history of non-compliance as reported to the liquor commission. However you decide to select the establishments to be observed, your evaluator will define the sample before you begin visiting these bars and restaurants in your region. Question What did you learn about how alcohol is bought and sold at bars in your community by completing the Restaurant & Bar Access Assessment Tool? Section 1: Risk and Protective Factors 9

10 Information about Alcohol Enforcement Activity in Your Community/Region The selling of alcohol to minors can contribute to the underage drinking and binge drinking problems in your community. One measure of this is the failure of compliance checks by retail outlets. Your coalition will need to gather your community/region compliance check data and compare the failure rate for the entire state. The coalition may also want to determine if specific communities have higher failure rates than others within your region. In collaboration with your Liquor Investigator and community police departments, your coalition can find out how often and where compliance checks are conducted in your region. Other Local Data Feel free to consider and analyze other data that will help you better understand how and to what extent retail availability may influence alcohol-related problems in your community/region. For example, you may have data on the density of retail outlets or anecdotal data on specific outlets that are known for selling to minors or intoxicated persons. You may also want to consider local laws surrounding retail availability. Identifying Contributing Factors Based on information from the Liquor Commission and your coalition's observations of retailers, bars and restaurants that sell alcohol, please list up to three contributing factors that have the greatest influence on Retail Availability in your region. Remember, these factors are the conditions that contribute to the problem and are specific enough to become a direct target of your coalition's interventions, should you choose to make retail access a high priority in your strategic plan. Please indicate up to three factors that contribute most to the problem of retail access in your region Section 1: Risk and Protective Factors 10

11 Next, please complete the following worksheet and priority matrix for each contributing factor. Extra copies of the worksheet are included in the back of this assessment tool. Strategic Prevention Framework (SPF) Assessment Contributing Factor Worksheet Consequence (circle one): Risk/Protective Factor: Underage Drinking Underage Binge Drinking Binge Drinking Young Adults RETAIL AVAILABILITY Contributing Factor: Who does this affect/occur with? Who allows this? When does this occur? Where does this occur? How does it occur? Under what other conditions is this allowed to happen? Then, to assist your coalition in viewing the larger picture, complete the matrix on the following page. This exercise will help you consider how important each contributing factor is in terms of its magnitude, severity, and consequences for your community. By comparing the factors you have identified that contribute to retail access along these dimensions, your coalition will form a more considered opinion as to how to rank retail access as a risk or protective factor in your region. Section 1: Risk and Protective Factors 11

12 Retail Access Contributing Factors: Matrix for Priority-Setting Factor Name: Magnitude 1. Frequency Does the factor occur frequently? 2. Duration Has the factor endured over time? 3. Scope Does the factor affect many people? Severity 1. Social importance Could the factor deprive people of legal rights 2. Risky behaviors Is the factor associated with risky or even dangerous behavior? 3. Injuries/Fatalities Does the factor raise the risk of alcohol poisoning, overdose or fatal crashes due to DWI? Consequences 1. Underage Drinking Does the factor contribute any alcohol use by youth? 2. Underage Binge Drinking Does the factor contribute excessive alcohol use by youth? 3. Binge Drinking Does the factor contribute to excessive alcohol use by young adults (age 18-34)? 4. Alcohol dependency Is the factor thought to contribute to the risk of developing alcohol dependency or alcoholism? Contributing Factor 1 Contributing Factor 2 Contributing Factor 3 Section 1: Risk and Protective Factors 12

13 Summary Question: Retail Availability How does retail availability impact underage drinking and/or binge drinking problems in your community/region? Is it a risk or protective factor? Justify your decision. Ranking Question: Retail Availability Based on the above considerations, to what degree does your coalition believe retail availability is affecting underage drinking and/or binge drinking in your community? Risk Factor Protective Factor high moderate low neutral low moderate high Section 1: Risk and Protective Factors 13

14 RISK/PROTECTIVE FACTOR 2: SOCIAL ACCESS/AVAILABILITY Surveys and focus groups of persons under the minimum legal drinking age have indicated that the majority of alcohol consumed by youth is obtained through social sources, such as parents and friends, at underage parties, and at home. (Birckmayer et al, 2004). Availability of alcohol or illegal drugs led to the increase in use (Hawkins et al, 1995). Social access/availability includes obtaining alcohol from friends, associates, and family members, but it also refers to the availability of alcohol gatherings such as parties and other social events where the alcohol is provided as part of the event. To explore the status of social access/availability in your community/region, we are going to look at eight areas that affect social access/availability of alcohol. Provision of alcohol to minors Lack of awareness about penalties for providing alcohol to minors Community celebrations Availability of unsupervised and other drinking locations Lack of parental monitoring of alcohol supply at home Belief that lack of chemical-free activities leads to alcohol use Workplace promotion Parental attitudes towards underage drinking Table 2A provides examples of contributing factors to social access/availability. Please review these factors as your coalition determines the degree to which social access/availability is or is not a problem in your community/region. Table 2A: Examples of Contributing Factors to Social Access/Availability Provision of alcohol to minors Parents provide alcohol to underage person; older siblings or other relatives provide alcohol to underage persons; young adults provide alcohol to underage persons; strangers provide alcohol when asked by underage persons; older friends supply alcohol; parents do not monitor the alcohol in the home and kids take it Adults unaware of penalties for providing alcohol to minors Community Celebrations Availability of unsupervised and other drinking locations Lack of parental monitoring of alcohol supply in the home Belief that lack of chemical-free activities leads to alcohol use Workplace promotion Parents providing a location/allowing underage person to drink alcohol Adults do not know that they can be arrested for providing alcohol to a minor; adults do not know that they can go to jail for a felony for providing alcohol to a minor Alcohol is obtained by underage person at community celebrations where there is little supervision; acceptant of binge drinking in many social settings Numerous party settings (e.g. sandpits, vacant lots, summer/winter camps and/or homes); cell phones make it easy to create parties at the last minute; off-campus college parties; friends with their own apartments Take/steal alcohol from parents home Belief that alcohol use is a substitute activity Workplaces promote drinking as part of the culture (e.g. construction industry) Parents think it is safer for youth to drink in their homes (so they are not driving around). Section 1: Risk and Protective Factors 14

15 To learn about the social access/availability of alcohol in your community/region, it is suggested to hold town hall meetings and/or a series of focus groups with the various sectors within your region. You may also utilize the individual dialogues and readiness interviews to get more in-depth information. Following are details on conducting town hall meetings and focus groups. Town Hall Meetings A town hall meeting occurs when members of the community get together to discuss their opinions on a given topic or problem. It can provide a first step toward understanding the community s needs and resources. Town hall meetings are good to use with large groups. You may wish to hold a town meeting for this needs assessment to discuss the social availability of alcohol in your community. In particular, you may wish to discuss how youths and adults in New Hampshire obtain and consume alcohol, and to what degree community members feel that social availability contributes to underage drinking, binge drinking and binge drinking by young adults in your community/region. Following are some suggestions for organizing a public meeting. If possible, hold meetings at more than one site and time to be sure that different people from the community can be involved. Schedule the meeting at an easy-to-find, public location that is accessible and comfortable; for example, a library, school, religious center, or place of worship. If possible, hold the meeting in the evening to avoid time conflicts with work and school. Publicize the meeting as widely as possible. Fliers, advertisements, public service announcements, and press releases can be used. Make sure the date, time, location, and purpose of the meeting are included. Personally recruit community leaders and diverse community members to attend the meetings. Ask them to recruit others as well. Serve light refreshments, if possible, to encourage mingling and set a friendly tone. You can also use a town hall format to bring together different sectors that normally don t meet (e.g., retailers and schools) To conduct a public meeting, consider the following: Assign a discussion leader the community knows and respects. This person should also know something about the topic, be a good listener, and be able to keep things moving on track. Agree upon an ending time, and stick to it. Provide information about your coalition, if appropriate. During the meeting, tape paper to the walls and record the discussion on each of the topics so participants can keep track of what has been discussed. To do this, you will need to identify a note-taker to record the meeting. Section 1: Risk and Protective Factors 15

16 Focus Groups Conclude with a summary of what was achieved and inform participants how you plan to use this information. Announce the next meeting, if possible. Focus groups are similar to public meetings except they are smaller, typically with about six to eight people. They are usually easier to plan and less expensive to conduct. They are a good way for your coalition to get a sense of what members of the community/region know and feel about an issue. For this assessment, you may wish to hold a series of focus groups in your community to discuss how social availability affects drinking behavior. Focus groups also give you an opportunity to explore other risk/protective factors beyond social access, such as retail availability, social norms, and perceived risk. Other Local Data Feel free to consider and analyze other local data that will help you better understand how and to what extent social access/availability may influence underage drinking and binge drinking in your community/region. For example, you may have data from your college campus or local police department on parties where alcohol is freely available. Identifying Contributing Factors Based on information from any public gatherings you've held, and any other data your coalition has available that is relevant to this factor, please list up to three contributing factors that have the greatest influence on Social Access in your region. Remember, these factors are the conditions that contribute to the problem and are specific enough to become a direct target of your coalition's interventions, should you choose to make social access a high priority in your strategic plan. Please indicate up to three factors that contribute most to the problem of social access in your region Section 1: Risk and Protective Factors 16

17 Next, please complete the following worksheet and priority matrix for each contributing factor. Extra copies of the worksheet are included in the back of this assessment tool. Strategic Prevention Framework (SPF) Assessment Contributing Factor Worksheet Consequence (circle one): Risk/Protective Factor: Underage Drinking Underage Binge Drinking Binge Drinking Young Adults SOCIAL ACCESS/AVAILABILITY Contributing Factor: Who does this affect/occur with? Who allows this? When does this occur? Where does this occur? How does it occur? Under what other conditions is this allowed to happen? Then, to assist your coalition in viewing the larger picture, complete the matrix on the following page. This exercise will help you consider how important each of the three contributing factors are in terms of the factor's magnitude, severity, and consequences for your community. By comparing the factors you have identified that contribute to retail access along these dimensions, your coalition will form a more considered opinion as to how to rank social access as a risk or protective factor in your region. Section 1: Risk and Protective Factors 17

18 Social Access Contributing Factors: Matrix for Priority-Setting Factor Name: Magnitude 1. Frequency Does the factor occur frequently? 2. Duration Has the factor endured over time? 3. Scope Does the factor affect many people? Severity 1. Social importance Could the factor deprive people of legal rights 2. Risky behaviors Is the factor associated with risky or even dangerous behavior? 3. Injuries/Fatalities Does the factor raise the risk of alcohol poisoning, overdose or fatal crashes due to DWI? Consequences 1. Underage Drinking Does the factor contribute any alcohol use by youth? 2. Underage Binge Drinking Does the factor contribute excessive alcohol use by youth? 3. Binge Drinking Does the factor contribute to excessive alcohol use by young adults (age 18-34)? 4. Alcohol dependency Is the factor thought to contribute to the risk of developing alcohol dependency or alcoholism? Contributing Factor 1 Contributing Factor 2 Contributing Factor 3 Section 1: Risk and Protective Factors 18

19 Summary Question: Social Access/Availability How does social access/availability impact underage drinking and/or binge drinking problems in your community/region? Is it a risk or protective factor? Justify your decision. Ranking Question: Social Access/Availability Based on the above considerations, to what degree does your coalition believe social access/availability is affecting underage drinking and/or binge drinking in your community? Risk Factor Protective Factor high moderate low neutral low moderate high Section 1: Risk and Protective Factors 19

20 RISK/PROTECTIVE FACTOR 3: ENFORCEMENT As the actual and/or perceived likelihood of being detected and arrested or cited for law violations increases, so does compliance. Studies that look at efforts to enforce youth access and specific types of use policies have found that increased enforcement is related to changes in use and related problems. (Birckmayer et al, 2004). The next risk/protective factor has to do with enforcement. To understand how enforcement affects underage drinking and/or binge drinking in New Hampshire, your coalition could gather and review data on the following topics: Forensic tests for alcohol results (breathalyzer results) Number of underage drinking related arrests Number of impaired driving cases Conviction rates for alcohol-related offenses Views on underage drinking and binge drinking with young adults from a law enforcement perspective Table 3A provides examples of possible contributing factors to enforcement. Please review these factors as your coalition determines the degree to which enforcement is or is not a problem in your community/region. Table 3A: Examples of Contributing Factors Related to Enforcement Resources Shortage of law enforcement personnel; lack of training on alcohol issues; lack of community support for alcohol enforcement efforts; few or no retail compliance checks Law Enforcement Practices Judicial Practices Parental Enforcement Inconsistent application of underage drinking laws; inconsistent application of laws regarding selling to intoxicated persons; low number of arrest/citations for alcohol use by minors; don t hear about other kids getting caught; inconsistent application of social host laws; enforcement of alcohol laws is not a priority; campus security is inconsistent; alcohol is not a big issue relative to other drugs or other issues No prosecution by district attorney of referred cases; inconsistent application of legal consequences; few first offender consequences Parents have few rules, if any, around drinking; parents don t enforce underage drinking laws Key Enforcement Interviews and/or Focus Groups You are encouraged to interview local police chiefs/departments, county sheriff and state highway patrol officers assigned to communities in your region. You may also want to consider interviews with emergency room staff, school officials or treatment facility administrators about their interactions with the justice system. Included is a Law Enforcement Data Request form (Appendix C) that you could use to survey your law enforcement community. In addition, it would be helpful to know how many officers are assigned directly to alcoholrelated issues and crimes: Law Enforcement Officers Assigned to Alcohol-Related Issues and Crime (Town) = Section 1: Risk and Protective Factors 20

21 Question Based on your interviews/focus groups with law enforcement officers and the number of officers in the communities assigned specifically to alcohol-related issues, what efforts are the law enforcement agencies pursuing or not pursuing when it comes to underage drinking and binge drinking? Where do they think problems arise? Do they have a designated officer in their unit who handles alcohol-related offenses? If so, what does their work consist of? What special training do officers receive in order to handle alcohol-related offenses? Where do they usually conduct surveillance for underage drinking, drunk driving etc? Do they conduct sobriety check points? When and where? Do they conduct compliance checks for sales to underage or intoxicated patrons? How often? Are any locations known for alcohol-related incidents? (e.g., campgrounds, park areas, eateries, etc) What do they do to monitor or work with these locations to reduce the number of incidents? How do they feel the courts support their alcohol-related arrests? What would help them to better address alcohol-related issues in their community? Liquor Commission Actions Punitive actions taken by the Liquor Commission against a non-compliant licensee can be found at the NH Online Licensing site ( Details about how to search this site can be found above, in the " RISK/PROTECTIVE FACTOR 1: RETAIL ACCESS/AVAILABILITY " section of this manual. You may also wish to get in touch with the Liquor Investigator assigned to your region. The Liquor Commission can only address non-compliant activities that are reported to them following correct protocol. There may be additional action that has been taken by local law enforcement that does not fall under the aegis of the Liquor Commission. You should be in contact with your local law enforcement agencies to get the lay of the land from their point of view, too. Other Local Data Feel free to consider and analyze other local data that will help you better understand how ant to what extent criminal justice issues in your community/region contribute to underage drinking and binge drinking problems. For example, you may have information on unique Section 1: Risk and Protective Factors 21

22 policies or strong enforcement of underage drinking laws in a community, or specific laws relating to a community. Identifying Contributing Factors Based on information from the Liquor Commission, key interviews, and any other data your coalition has available that is relevant to this factor, please list up to three contributing factors that have the greatest influence on Enforcement in your region. Remember, these factors are the conditions that contribute to the problem and are specific enough to become a direct target of your coalition's interventions, should you choose to make social access a high priority in your strategic plan. Please indicate up to three factors that contribute most to the problem of enforcement in your region Section 1: Risk and Protective Factors 22

23 Next, please complete the following worksheet and priority matrix for each contributing factor. Extra copies of the worksheet are included in the back of this assessment tool. Strategic Prevention Framework (SPF) Assessment Contributing Factor Worksheet Consequence (circle one): Risk/Protective Factor: Underage Drinking Underage Binge Drinking Binge Drinking Young Adults ENFORCEMENT Contributing Factor: Who does this affect/occur with? Who allows this? When does this occur? Where does this occur? How does it occur? Under what other conditions is this allowed to happen? Then, to assist your coalition in viewing the larger picture, complete the matrix on the following page. This exercise will help you consider how important each of the three contributing factors are in terms of the factor's magnitude, severity, and consequences for your community. By comparing the factors you have identified that contribute to retail access along these dimensions, your coalition will form a more considered opinion as to how to rank enforcement as a risk or protective factor in your region. Section 1: Risk and Protective Factors 23

24 Enforcement Contributing Factors: Matrix for Priority-Setting Factor Name: Magnitude 1. Frequency Does the factor occur frequently? 2. Duration Has the factor endured over time? 3. Scope Does the factor affect many people? Severity 1. Social importance Could the factor deprive people of legal rights 2. Risky behaviors Is the factor associated with risky or even dangerous behavior? 3. Injuries/Fatalities Does the factor raise the risk of alcohol poisoning, overdose or fatal crashes due to DWI? Consequences 1. Underage Drinking Does the factor contribute any alcohol use by youth? 2. Underage Binge Drinking Does the factor contribute excessive alcohol use by youth? 3. Binge Drinking Does the factor contribute to excessive alcohol use by young adults (age 18-34)? 4. Alcohol dependency Is the factor thought to contribute to the risk of developing alcohol dependency or alcoholism? Contributing Factor 1 Contributing Factor 2 Contributing Factor 3 Section 1: Risk and Protective Factors 24

25 Summary Question: Enforcement How does enforcement impact underage drinking and/or binge drinking problems in your community/region? Is it a risk or protective factor? Justify your decision. Ranking Question: Enforcement Based on the above considerations, to what degree does your coalition believe enforcement is affecting underage drinking and/or binge drinking in your community? Risk Factor Protective Factor high moderate low neutral low moderate high Section 1: Risk and Protective Factors 25

26 RISK/PROTECTIVE FACTOR 4: PERCEPTION OF RISK Research has established that low perception of harm towards alcohol and other drug use is a risk factor for use (Henry et al. 2005). Initiation into substance use is preceded by values favorable to its use (Hawkins, et al 1992). The next risk/protective factor has to do with perception of risk. To understand perception of risk affects underage drinking and/or binge drinking in New Hampshire, your coalition could gather and review data on the following topics: Perceived risk of arrest and/or other penalties relating to alcohol use Perceived health and safety risks of alcohol use Table 4A provides examples of possible contributing factors to perception of risk. Please review these factors as your coalition determines the degree to which risk perception is or is not a problem in your community/region. Table 4A: Examples of Contributing Factors Related to Perception of Risk Low perceived risk of arrest/penalties Belief that there is a low risk of getting caught drinking; police are not summoned by schools for alcohol law violations; belief that penalties for underage drinking are not serious; belief that there are too few law enforcement officers to catch underage drinkers; perception that there is a risk for drinking and driving but nothing else related to alcohol use; lack of knowledge of penalties around providing alcohol to minors Low perceived risk of alcohol use Alcohol is not as dangerous as other drugs; belief that alcohol is safe as long as you are not driving; belief that hard liquor is dangerous but beer is not Focus Groups For this assessment, you may wish to hold a series of focus groups in your community to discuss how perception of risk affects drinking behavior. Focus groups also give you an opportunity to explore other risk/protective factors beyond perceived risk, such as retail availability, social norms, and enforcement activities. Other Local Data Feel free to consider and analyze other local data that will help you better understand how and to what extent risk perception in your community/region contributes to underage drinking and binge drinking problems. For example, you may have school-based survey data available, such as the Youth Risk Behavior Survey (YRBS) or Teen Assessment Project (TAP) survey. Section 1: Risk and Protective Factors 26

27 Identifying Contributing Factors Based on information from any public gatherings you've held, and any other data your coalition has available that is relevant to this factor, please list up to three contributing factors that have the greatest influence on Perception of Risk in your region. Remember, these factors are the conditions that contribute to the problem and are specific enough to become a direct target of your coalition's interventions, should you choose to make social access a high priority in your strategic plan. Please indicate up to three factors that contribute most to the problem of perception of risk in your region Section 1: Risk and Protective Factors 27

28 Next, please complete the following worksheet and priority matrix for each contributing factor. Extra copies of the worksheet are included in the back of this assessment tool. Strategic Prevention Framework (SPF) Assessment Contributing Factor Worksheet Consequence (circle one): Risk/Protective Factor: Underage Drinking Underage Binge Drinking Binge Drinking Young Adults PERCEPTION OF RISK Contributing Factor: Who does this affect/occur with? Who allows this? When does this occur? Where does this occur? How does it occur? Under what other conditions is this allowed to happen? Then, to assist your coalition in viewing the larger picture, complete the matrix on the following page. This exercise will help you consider how important each of the three contributing factors are in terms of the factor's magnitude, severity, and consequences for your community. By comparing the factors you have identified that contribute to retail access along these dimensions, your coalition will form a more considered opinion as to how to rank perception of risk as a risk or protective factor in your region. Section 1: Risk and Protective Factors 28

29 Perception of Risk Contributing Factors: Matrix for Priority-Setting Factor Name: Magnitude 1. Frequency Does the factor occur frequently? 2. Duration Has the factor endured over time? 3. Scope Does the factor affect many people? Severity 1. Social importance Could the factor deprive people of legal rights 2. Risky behaviors Is the factor associated with risky or even dangerous behavior? 3. Injuries/Fatalities Does the factor raise the risk of alcohol poisoning, overdose or fatal crashes due to DWI? Consequences 1. Underage Drinking Does the factor contribute any alcohol use by youth? 2. Underage Binge Drinking Does the factor contribute excessive alcohol use by youth? 3. Binge Drinking Does the factor contribute to excessive alcohol use by young adults (age 18-34)? 4. Alcohol dependency Is the factor thought to contribute to the risk of developing alcohol dependency or alcoholism? Contributing Factor 1 Contributing Factor 2 Contributing Factor 3 Section 1: Risk and Protective Factors 29

30 Summary Question: Perception of Risk How does perception of risk impact underage drinking and/or binge drinking problems in your community/region? Is it a risk or protective factor? Justify your decision. Ranking Question: Perception of Risk Based on the above considerations, to what degree does your coalition believe perception of risk is affecting underage drinking and/or binge drinking in your community? Risk Factor Protective Factor high moderate low neutral low moderate high Section 1: Risk and Protective Factors 30

31 RISK/PROTECTIVE FACTOR 5: SOCIAL NORMS Social norms and influences were classified into wider social norms, peer influence, and respect and image. Wider social norms referred to the perceived acceptance and normality of binge drinking. Binge drinking was seen as a common pastime for most young people of equivalent age, and it was widely believed that all teenagers drink as part of the natural transition to adulthood. The influence of the peer group was commonly reported as a leading motivation behind young people s binge drinking, but responses were notably mixed (Coleman and Cater, 2005). The next risk/protective factor has to do with social norms. To understand how social norms affect underage drinking and/or binge drinking in New Hampshire, your coalition could gather and review data on the following topics: Acceptance of alcohol use by parents, workplaces and other points of authority Alcohol as a "Rite of Passage" Multigenerational alcohol use Youth perception of the acceptability of alcohol Cultural acceptability Availability in homes Table 5A provides examples of possible contributing factors to social norms. Please review these factors as your coalition determines the degree to which social norms are or are not a problem in your community/region. Table 5A: Examples of Contributing Factors Related to Social Norms Acceptance Parents permit underage drinking (or think it s OK); parents don t care if teenagers drink; many adults think it s OK for youths to drink; he/she is 18 and can do what he/she wants; the more other drugs are an issue, the more alcohol is acceptable (i.e., lesser of two evils); some workplaces promote drinking as part of the culture Rite of passage Multigenerational use Youths perceptions Culturally acceptable Available in homes Using alcohol and binge drinking are what kids do Drinking is a normal pattern of parents and other relatives Drinking is a bonding activity; binge drinking is normal and not harmful; drunkenness/excessive consumption of alcohol is OK, even cool; it s not a party without alcohol Drinking is part of the everyday life of the community Alcohol is available in the home Town Hall Meeting As part of this needs assessment, you may need to conduct a town hall meeting to find out about the general attitudes in your community/region toward alcohol and to formulate a description of the alcohol culture in your community/region. Community Perception Survey Surveying members of your community is another way to learn about social norms related to underage drinking and/or binge drinking. Conducting a survey will allow you to gather data Section 1: Risk and Protective Factors 31

32 from a greater number of people than you can from holding a town hall meeting alone. You may want to conduct the survey and analyze the results before a town hall meeting so that you can use the results to guide the development of the Discussion Guide. It will also give the leader of the town hall meeting a feel for your community s norms on alcohol use and underage drinking and/or binge drinking. Surveys are included in Appendices E and F. Other Local Data Feel free to consider and analyze other local data that will help you better understand how and to what extent community norms may influence underage drinking and/or binge drinking problems in your community. For example, you may have completed earlier focus groups or surveys of youths, parents, school personnel, or community members. Another source of information may be from those colleges and universities in your region who participate in the New Hampshire Higher Education Alcohol, Tobacco, and Other Drug (NHHEATOD) survey. The statewide data from the 2007 survey has been shared by the New Hampshire Higher Education Alcohol and Other Drug Committee to the New Hampshire Bureau of Prevention Services in order to inform the SPF. Pending approval by the survey designers on this Committee, the survey questionnaire will be made available to community prevention coalitions so you may conduct your own surveys of young adults in your region. The survey includes questions on social norms which may be adapted for use with young adults in the community. For example, question 14 (displayed in Table 5B) could be rephrased to refer to attitudes among other people your age in the community to gauge perceived social norms among young adults not in college. Table 5B: Sample Questions Related to Social Norms from NHHEATOD Survey Section 1: Risk and Protective Factors 32

33 Identifying Contributing Factors Based on information from any public gatherings you've held, and any other data your coalition has available that is relevant to this factor, please list up to three contributing factors that have the greatest influence on Social Norms in your region. Remember, these factors are the conditions that contribute to the problem and are specific enough to become a direct target of your coalition's interventions, should you choose to make social access a high priority in your strategic plan. Please indicate up to three factors that contribute most to the problem of social norms in your region Section 1: Risk and Protective Factors 33

34 Next, please complete the following worksheet and priority matrix for each contributing factor. Extra copies of the worksheet are included in the back of this assessment tool. Strategic Prevention Framework (SPF) Assessment Contributing Factor Worksheet Consequence (circle one): Risk/Protective Factor: Underage Drinking Underage Binge Drinking Binge Drinking Young Adults SOCIAL NORMS Contributing Factor: Who does this affect/occur with? Who allows this? When does this occur? Where does this occur? How does it occur? Under what other conditions is this allowed to happen? Then, to assist your coalition in viewing the larger picture, complete the matrix on the following page. This exercise will help you consider how important each of the three contributing factors are in terms of the factor's magnitude, severity, and consequences for your community. By comparing the factors you have identified that contribute to retail access along these dimensions, your coalition will form a more considered opinion as to how to rank social norms as a risk or protective factor in your region. Section 1: Risk and Protective Factors 34

35 Social Norms Contributing Factors: Matrix for Priority-Setting Factor Name: Magnitude 1. Frequency Does the factor occur frequently? 2. Duration Has the factor endured over time? 3. Scope Does the factor affect many people? Severity 1. Social importance Could the factor deprive people of legal rights 2. Risky behaviors Is the factor associated with risky or even dangerous behavior? 3. Injuries/Fatalities Does the factor raise the risk of alcohol poisoning, overdose or fatal crashes due to DWI? Consequences 1. Underage Drinking Does the factor contribute any alcohol use by youth? 2. Underage Binge Drinking Does the factor contribute excessive alcohol use by youth? 3. Binge Drinking Does the factor contribute to excessive alcohol use by young adults (age 18-34)? 4. Alcohol dependency Is the factor thought to contribute to the risk of developing alcohol dependency or alcoholism? Contributing Factor 1 Contributing Factor 2 Contributing Factor 3 Section 1: Risk and Protective Factors 35

36 Summary Question: Social Norms How do social norms impact underage drinking and/or binge drinking problems in your community/region? Is it a risk or protective factor? Justify your decision. Ranking Question: Social Norms Based on the above considerations, to what degree does your coalition believe social norms are affecting underage drinking and/or binge drinking in your community? Risk Factor Protective Factor high moderate low neutral low moderate high Section 1: Risk and Protective Factors 36