Community Assessment Report,, USA Prepared by: Fernando Almanza, Megan Heil, Andrej Birjulin, Mary Cotton, Karyn Anderson, Michelle Stecher, James Wilkins, Anabel Johnson, Britney Chavez, and Peter Brandes Date: June 29, 2017 Sponsoring Agency: Eagle River Youth Coalition
Community Assessment Report Outline I. Executive Summary II. III. IV. Introduction a. Communities That Care effort i. About the Communities That Care system ii. Key accomplishments in b. The risk- and protective-factor assessment i. Goals ii. How the assessment will be used iii. Data collection methods iv. Prioritization methods The Community Assessment Data a. Prioritized protective factors b. Prioritized risk factors c. Problem behaviors Conclusion a. Community strengths b. Community priorities c. Next steps V. Appendices a. Healthy Kids Survey data profile b. Social Determinants of Health data profile 2
Executive Summary This report describes the results of the risk- and protective-factor assessment completed as part of s Communities That Care effort. The Communities That Care system is a way for members of a community to work together to prevent youth problem behaviors, including substance use, delinquency, teen pregnancy, dropping out of school and violence. This system was developed by Dr. David Hawkins and Dr. Richard Catalano. It is based on their research, which has identified risk factors that predict youth problem behaviors and protective factors that buffer children from risk and help them succeed in life. A key goal of the Communities That Care effort is to identify which risk factors, protective factors and problem behaviors are prevalent in our community, and implement evidence-based programs that address our community s unique profile. To that end, the Risk- and Protective- Factor Assessment work group collected and analyzed data on. Then, with input from the community, they identified priority risk factors to address, as well as community strengths to build on. The assessment was completed using the Healthy Kids Survey (HKCS) and publicly available data. The HKCS was administered to students in grades 7-12 in all schools in Eagle County in November of 2015. To get the most complete picture of our community, the Risk and Protective-Factor Assessment work group also collected data from public records to measure risk factors and problem behaviors not covered by the survey. Based on the analysis of the data and input from the community, the following risk factors were identified as priorities for community attention: Perception of the Availability of Substances (Community Domain) Community Laws and Norms Favorable Towards Substance Use (Community Domain) Favorable Youth Attitudes Towards Substance Use (Peer and Individual Domain) These risk factors were selected as priorities for prevention action primarily because data indicated that they are significantly elevated throughout. The data also revealed s strengths. For example, the HKCS revealed that students are motivated to follow society s expectations and standards. They reported high levels of the protective factors High Involvement in Community Service and Extracurricular Activity and low levels of the risk factor Poor Academic Performance. This is an important area of strength on which to build to help promote well-being and protect our youth from the risk of health and behavior problems. This report recommends that the community give particular attention to the risk factors noted above when developing the community s action plan to prevent youth health & behavior problems and promote child and youth well-being. 3
Introduction The Communities That Care Effort In the fall of 2016, began the Communities That Care prevention planning process. Developed by Dr. David Hawkins and Dr. Richard Catalano of the Social Development Research Group in Seattle, Washington, the Communities That Care system is a way for members of a community to work together to efficiently and effectively promote positive youth development and prevent youth problem behaviors such as substance use, delinquency, teen pregnancy, dropping out of school and violence. implemented the Communities That Care (CTC) process to achieve the community s vision that all young people in grow up supported and nurtured by their families, schools and community, and become healthy adults who contribute positively to society. The CTC process has been launched with support of State marijuana tax revenues, with leadership from the Department of Public Health & Environment (CDPHE). Public Health is the grantee and has contracted the Eagle River Youth Coalition to coordinate the CTC Process. Key accomplishments to date: In September of 2016, Molly Hadley, MPH, was hired as the full-time Communities That Care Coordinator. In January through March, 15 community leaders attended a Key Leader Orientation and committed to the CTC effort. In March and April, a diverse group of 30 Community Board members came together for 10 hours of training. Five workgroups were formed with a volunteer Chair for each, including: o Risk and Protective Factor Assessment Workgroup o Resources Assessment Workgroup o Community Board Maintenance Workgroup o Community Outreach and Public Relations Workgroup o Youth Involvement Workgroups In April, CTC co-hosted a Postitive Youth Development (PYD) training with 45 local and regional participants. In June, the Risk- and Protective-Factor Assessment workgroup attended the Community Assessment Workshop and developed a plan for completing the community risk- and protective factor assessment. This Community Assessment Report is the result of that assessment. 4
In June, the Community Board Maintenance workgroup convened to develop guidelines and expectations for governance and CTC participant motivation. The Community Assessment Dr. Hawkins and Dr. Catalano have identified risk factors that predict problem behaviors in youth, and protective factors that help protect young people from those risks. By addressing risk and protective factors, communities can help prevent adolescent problem behaviors and promote positive youth development. A key goal of the Communities That Care system is for communities to develop a profile of the risk factors, protective factors and problem behaviors in their community, and to develop a plan for addressing the risk factors that are most elevated while enhancing protective factors. This report represents the first step in that process. The Risk- and Protective-Factor Assessment work group has collected data on risk factors, protective factors and problem behaviors in Eagle County. With input from the community, the work group has identified our community s strengths and the priority risk factors to address in the prevention plan. Data collection methods The local Healthy Kids Survey (HKCS) was most recently administered in November of 2015. All students in grades 7-12 enrolled in any local private or public school were asked to participate, and over 2,500 students completed the survey. The Healthy Kids Survey is a state survey that has been administered locally since 2007, offering a robust trend analysis of local youth behaviors, attitudes, perceptions and trends. The Healthy Kids data, along with state and local Social Determinants of Health data, helped steer the Risk- and Protective-Factor Assessment work group in analyzing needs and strengths. How the priorities were identified The Risk- and Protective-Factor Assessment work group analyzed the data to identify which risk factors are most elevated in. This initial short list of priorities will be presented to the Community Board, where other considerations, such as the community s ability to have an impact on certain risk factors at this time, may be discussed. By consensus, the Community Board then selected the final priorities for prevention action in. Those priorities were presented to Key Leaders for endorsement. Report Overview The next sections of the report provide detailed information and analysis of the protective factors, risk factors and problem behaviors in. The conclusion presents the final list of priorities and recommendations for future action. 5
Protective Factor: School Opportunities for Prosocial Involvement Finding meaningful opportunities for youth to become involved in their education and school community through extracurricular activities and positive student/teacher relationships, decreases the potential for substance use/abuse and the likelihood of completing high school. The 2015 Healthy Kids Survey revealed that a majority of students participate in extracurricular activities. More than 2/3 of the students surveyed stated that they felt that their teachers cared and provided encouragement. For these reasons, School Opportunities for Prosocial Involvement has been chosen as a significant strength in reducing the likelihood that youth in our community will engage in substance use or have mental health challenges. Recommended Priority ProtecCve Factor #1: School OpportuniCes for Prosocial Involvement Higher Value = Greater ProtecCon 0 10 20 30 40 50 60 70 80 90 100 Percent of students who feel safe at school 91.1 93.1 93.9 Teachers care and are encouraging 60.9 58.5 62.4 Schoolwork is meaningful and important 34.4 38.9 41.4 Percentage of students who parhcpate in extracurricular achvihes 65.9 69.3 68.0 Source: 2015 Healthy Kids Survey, 6
Protective Factor: Community Opportunities for Prosocial Involvement Finding meaningful opportunities for youth to become involved in their communities greatly impacts their desire to engage in harmful behavior like substance use/abuse. Providing youth with opportunities to give back to the communities that they reside in also allows them to take pride in those communities, engages their free time with healthy and productive behavior, and provides them with a sense of accomplishment allowing them to bond to their communities and decreasing the likelihood that they will participate in destructive decision-making. The 2015 Healthy Kids Survey revealed that nearly half of local students surveyed reported that they had participated in community service within the last 30 days. The survey also showed that 71% of local high school students have a trusted adult that can help them with serious problems. For these reasons, Community Opportunities for Prosocial Involvement has been chosen as a significant strength in reducing the likelihood that youth in our community will engage in substance use or have mental health challenges. Recommended Priority ProtecCve Factor #2: Community OpportuniCes for Prosocial Involvement 0 10 Higher 20 Value = 30 Greater 40 ProtecCon 50 60 70 80 90 100 % Students who performed Community Service in the last 30 days 42.7 41.4 45.9 % Students who have an adult to help with serious problems 71.3 71.3 71.1 Source: 2015 Healthy Kids Survey,. 7
Protective Factor: Family Opportunities for Prosocial Involvement Higher rates of drug problems occur when there is an absence of strong family structure. Increasing the family bond significantly increases the likelihood that youth will abstain from substance use. Intra-family communication is essential for strong, heathy relationships. The 2015 Healthy Kids Survey revealed the majority or youth reported that their families have clear family rules. Additionally 2/3 of those surveyed reported that their parents have spoken to them about substance use. For these reasons, Family Opportunities for Prosocial Involvement has been chosen as a significant strength in reducing the likelihood that youth in our community will engage in substance use or have mental health challenges. Recommended Priority ProtecCve Factor #3: Family OpportuniCes for Prosocial Involvement Higher Value = Greater ProtecCon 0 10 20 30 40 50 60 70 80 90 100 % Students who talk to parents about substance use dangers 54.1 58.1 63.8 % Students who could ask parents for help with personal problem 82.4 82.2 82.4 % Students who have clear family rules at home 90.6 91.7 94.1 Source: 2015 Healthy Kids Survey, 8
Risk Factor: Perception of the Availability of Substances The local results of the Healthy Kids Survey have shown over multiple years that there is a perception by local middle and high school age youth that there is easy access to substances, including both alcohol and other drugs such as cannabis and even hallucinogens. This perception has the possible negative consequence of supporting a misconception that drugs and alcohol are easily obtained and therefore more likely to be used in the community, even though information on actual use doesn t necessarily support this. Additionally, many studies have demonstrated that the availability of substances is associated with drug initiation and use. For these reasons, this risk factor has been identified as a priority for. Source: 2015 Healthy Kids Survey, 9
Risk Factor: Community Laws and Norms Favorable Towards Substance Use Based on community conversations that include anecdotal evidence, as well as information from the local Healthy Kids Survey, local laws, norms and attitudes favorable towards substance use were identified as a significant local risk factor. Given the area s decades-long status as a world class ski resort and more recent recognition as a year round vacation destination for wealthy travelers, there is a perception that substance use, including alcohol and cannabis, is an activity in which individuals whom are well off socially and economically are more likely to participate. This stems at least in part from the fact that the use of these substances is closely tied to the recreation industry s positive promotion of the party culture. This perception is furthered by local media s support of activities that are either sponsored by or directly promote purveyors of alcohol and cannabis. Based on Healthy Kids Survey data, around 70% of youth in believe that there is a lax enforcement of laws for both marijuana and alcohol. 70.2% of High School youth believed that if a kid was drinking alcohol in their neighborhood police would not catch them. Similarly, with Marijuana, 69.3% of youth believed that if a kid was using marijuana in their neighborhood police would not catch them. This shows a youth perception that it is hard to get caught using drugs in their neighborhoods by law enforcement. Also, a little over half of youth report that both alcohol and marijuana are easy to access and readily available here in Eagle County. Health Indicators data showed that has a much higher rate of liquor stores per capita than the State of. has 5.2 liquor stores per 10,000 people, where as a whole has 2.4 liquor stores per 10,000 people. This shows a community norm of allowing many liquor stores per capita, and makes it easier for adults and youth to access alcohol. Finally, when looking at adult data from the Behavioral Risk Factor Surveillance System, adults in have a much higher rate of reporting binge drinking on a regular basis compared to data. The behavior of adults can have an impact on the behaviors of youth in the area. 10
Community Priority Risk Factor #2: Community Laws and Norms favorable towards Substance Use Higher Value = Greater Risk 0 10 20 30 40 50 60 70 80 90 100 Perceived Availability of Alcohol (HKCS) Perceived Availability of Marijuana (HKCS) 57.2 61.8 56.8 55.7 56.7 50.7 Lax Enforcement of Laws: Alcohol (HKCS) Lax Enforcement of Laws: Marijuana (HKCS) 75.1 76.0 70.2 70.3 70.5 69.3 Rate of liquor stores (per 10,000 pop.) 2012 2.4 5.0 5.2 % of adults who currently binge drink 2013-2014 18.1 26.9 Source: 2015 Healthy Kids Survey, ; Health Indicators 2012; Behavioral Risk Factor Surveillance System, 2013-2014 11
Risk Factor: Favorable Youth Attitudes Towards Substance Use The local data from the Healthy Kids Survey has also shown that local youth are more likely to have a favorable attitude towards substance use. This risk factor is closely tied to the previous risk factor mentioned, Community Laws and Norms Favorable to Substance Use. If local enforcement of laws designed to prevent substance use by minors are not consistently enforced, and at the same time there is positive promotion of substance use by local media and community attitudes, there is a greater likelihood youth will engage in substance use. Community Priority Risk Factor #3: Favorable Youth ARtudes towards Substance Use Higher Value = Greater Risk 0 10 20 30 40 50 60 70 80 90 100 Percephon of Harm from daily use of Alcohol 21.5 29.3 27.6 Favorable aktude toward monthly use of Alcohol 35.4 33.8 37.9 Percephon of Harm from regular Marijuana use 43.6 47.6 52.3 Favorable aktude toward Marijuana in general 29.3 34.5 39.4 Source: 2015 Healthy Kids Survey, 12
Community Challenges/Problem Behaviors The Risk and Protective Factor Planning Workgroup examined local data in comparison to regional, state and national data to identify community strengths, community challenges, and priority health and behavior problems. The primary source of data is the Department of Public Health and Environment s data profile for our region, which includes Eagle, Garfield, Grand, Pitkin and Summit counties. The report provides data for and comparative data at the various levels based on the 2015 Healthy Kids Survey (HKCS) administration. has a long history of administering the survey and in 2015 had a participation rate of over 85% in all the middle schools and while a sampling methodology was used in the high schools, over 80% of those identified for participation completed the survey. Therefore the local results are considered highly representative of the youth population in the county. An additional source of data is a locally developed report that includes select HKCS trend data in the county since 2007 and compares that to state and national trends. In depth examination of these data identified two priority health and problem behaviors, mental health and substance use, especially use of alcohol. While 2015 mental health measures (feeling sad or hopeless in past 12 months and suicide consideration in the past 12 months) at the high school level are below state and national averages, the local HKCS report shows that those that have been treated by a doctor or nurse for an attempted suicide is above the national figure. Additionally, middle school students that feel sad or hopeless have increased from 18.8% in 2011 to 24.6% in 2015. Even more concerning in that middle school students who say that they have seriously considered suicide has nearly doubled over the same period, from 8.7% in 2011 to 16.8% in 2015. Importantly, making a suicide plan and attempted suicide has both been trending upward since 2011 for both middle and high school students. While these increases were generally slow, but steady, middle school students making a suicide plan has risen dramatically from 4.8% in 2011 to 12.6% in 2015. The two charts below highlight these trends and underscore the importance of mental health as a priority area for Eagle County. 13
Feeling Sad or Hopeless and Seriously Considering Suicide by School Level and Year. 30 26.3 27.9 27.3 25 23.6 23.5 23.1 24.6 23.9 Percent 20 15 10 14.2 15.3 11.5 Felt Sad or Hopeless, Grades 9-12 18.8 12.6 8.7 15.6 11.8 16.8 15.1 5 Felt Sad or Hopeless, Grades 7 & 8 2007 2009 2011 2013 2015 Source: 2007-2015 Healthy Kids Survey, Making a Suicide Plan and Attempting Suicide by School Level and Year. Percent 20 15 10 5 0 12.3 14.3 10.9 5 Made a Suicide Plan, Grades 9-12 Made a Suicide Plan, Grades 7 & 8 Alempted Suicide, Grades 9-12 Alempted Suicide, Grades 7 & 8 Alempted Suicide Treated by Doctor/Nurse, Grades 9-12 6.7 9.6 10.6 4.1 11.3 11.7 8.9 6.4 6.9 5 6 4.8 2007 2009 2011 2013 2015 2.2 2.6 12.9 12.6 7.9 6.5 2.9 Source: 2007-2015 Healthy Kids Survey, 14
The second priority area, substance use (with a primary focus on alcohol) was identified because of the elevated percentage of students who currently drink alcohol and also binge drink in comparison to state and national average. Past 30 day alcohol use among high school students in is 1.1% higher than the national rate and 3.7% higher than the state rate. Of greater concern is that 1 in 5 high school students report binge drinking in the past 30 days and the local rate is 2.4% higher than the national rate and 3.7% higher than the state rate. In addition to alcohol use, marijuana use was also identified as a priority area. While local marijuana use rates are favorable in comparison to state and national rates, perceived risk of harm has been declining since 2011 and there is concern that this may translate into an increase of use in the near future. Finally, illegal use of prescription drugs is a third substance that was identified as a priority area. The local rate is slightly below the national rate, but 2.5% higher than the state rate. Additionally, while illegal use of prescription drugs had been trending downward since 2007, the trend reversed itself between 2013 and 2015 and came back up 1.5%. Past 30 Days Use: Alcohol (Grades 9-12) Percent 48 46 44 42 40 38 36 34 32 30 48 47 45 42 43 41 39 36 Nahonal 36 35 35 33 31 30 2007 2009 2011 2013 2015 Source: 2007-2015 Healthy Kids Survey, 15
Past 30 Days Use: Binge Drinking (Grades 9-12) Percent 34 32 30 28 26 24 22 20 18 16 33 31 28 26 25 24 22 22 21 21 Nahonal 20 18 17 17 2007 2009 2011 2013 2015 Source: 2007-2015 Healthy Kids Survey, Other Substance Use 2015 HKCS 16% 14% 12% 16% 14% 10% 8% 6% 8% 5% 6% 6% 4% 2% 3% 2% 2% 2% 0% Prescriphon drugs Cocaine Ecstasy Methamphetamine Heroin Source: 2015 Healthy Kids Survey, 16
s Strengths Conclusion and Recommendations The data revealed that young people in are motivated to follow society s expectations and standards. In particular, young people reported high levels of the protective factors High Involvement in Community Service and Extracurricular Activity. youth also showed low levels of the risk factor Poor Academic Performance. Our community should work to build on these strengths while enhancing other protective factors in its prevention efforts. Community Risk Factors to Prioritize Based on the analysis of the data and input from the community, the following priority risk factors were identified for the community to focus on over the next several years: Perception of the Availability of Substances (for all ages) Community Laws and Norms which are favorable towards Substance Abuse Favorable Youth attitudes towards Substance use These risk factors were selected as priorities because the data indicated that they are among the most elevated throughout the County. We recommend that our community give particular attention to implementing strategies and/or programs to address these three risk factors when developing a prevention plan. Next Steps The next step in the Communities That Care process is to find out what resources are already in place in that address the priorities outlined above. The Resources Assessment and Evaluation work group will attend the Assessing Community Resources Workshop beginning in July. Their assessment combined with this report, will make up the profile of that will be used to identify practices and strategies to promote child and youth well-being and prevent future health & behavior problems in our community. 17