An Introduction to Environmental Strategies as Part of a Comprehensive Plan

University of Wisconsin – Madison

Center for Health Enhancement Systems Studies (CHESS)

Chuck Klevgaard, CSPS, Prevention Manager

Objectives

• Define environmental strategies

• Explain the role and benefits of environmental strategies in a comprehensive prevention approach

• Identifying risk factors that can be addressed using environmental strategies and link risk factors and community conditions using a logic model

Environmental Strategies Definition

Prevention efforts that aim to change or influence community standards,

institutions, structures, attitudes that shape individuals’ behavior

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Honeycutt, S., Leeman, J., McCarthy, W. J., Bastani, R., Carter-Edwards, L., Clark, H., ... & Kegler, M.

(2015). Evaluating Policy, Systems, and Environmental Change Interventions: Lessons Learned From

CDC's Prevention Research Centers. Preventing chronic disease, 12, E174-E174.

Evidence-Based Environmental Strategies

1. Designed to reduce alcohol-related problems in the community.

2. Part of comprehensive substance use and misuse prevention plan

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Types of Strategies Defined

• Individual-focused strategies are designed to help individuals develop the intentions and skills to act in a healthy manner.

• Environmental strategies focus on creating an environment that supports healthy behavior.

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O’Connell, M. E., Boat, T., & Warner, K. E. (2009). Preventing mental, emotional, and behavioral

disorders among young people: Progress and possibilities (Vol. 7). Washington, DC: National

Academies Press.

GOAL

Individual and Environmental: Core Differences

Personal control of

alcohol/other drugs

Community control of

alcohol/other drugs

Individual Environmental

TOOLSEducation, support, small

group activitiesMedia and policy

advocacy, social pressure

WHOEducator & student;

professional & client

Coalitions, stakeholders,

community organizers

Focus Individual Behavior Policy, Laws, Norms

Holder, H. D. (in press). Prevention aimed at the environment. In B. S. McCrady, & E. E. Epstein (Eds.),Addictions: A comprehensive guidebook for practitioners. Oxford: Oxford University Press.

Continuum of Care

Universal IndirectInterventions target the general

public and/or the whole population

that has not been identified on the

basis of individual risk, by changing

the social context that influences

knowledge, attitudes and behavior.

Universal DirectInterventions target the general

public and/or the whole population

that has not been identified on the

basis of individual risk. Interventions

are directed to everyone in that

group.

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Elements of Community Climate

Availability

Norms

Regulations and

Enforcement

Klitzner M. (1999). Integrating environmental change theory into prevention

practice. In: Environmental Prevention Strategies: Putting Theory Into

Practice, Training and Resource Guide.

Three Advantages of Including Environmental Strategies

1. Broad and efficient reach

2. Establishes conditions favorable to non-use

3. Enduring effects

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Fisher D. A., (1999) Environmental Prevention Strategies: An Introduction

and Overview, Environmental Prevention Strategies: Putting Theory Into

Practice, Training and Resource Guide. Deborah A. Fisher

Communication and Education

▪ Public Education▪ PSA, Billboard, Brochure

▪ Social Marketing▪ Messaging to persuade

people to adopt new behavior

▪ Media Advocacy▪ Using media to build support

for policy

▪ Media Literacy▪ Critical thinking skills

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Communication

and Education

Policy Adoption

Policy can be broadly defined as “standards for behavior that are formalized to some degree (that is, written) and embodied in rules, regulations, and procedures.”

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Policy Adoption

Types of Policies

Economic policies▪Tax

Restrictions on access and availability ▪Limits on days, hours,

happy hour restrictions, restricting sales at public events, home delivery sales)

Restrictions on location and density

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Policy Adoption

Types of Policies

▪ Deterrence

✓ Social host liability, lower blood alcohol for young drivers, graduated driver’s license

▪ Restricting Use

✓ Keg registration, open container laws, minimum age of sellers.

▪ Limiting the marketing of alcohol products

✓ Advertising or sponsorship restrictions

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Policy Adoption

Enforcement

▪Surveillance▪Prohibiting sales to minors,

compliance checks

▪Penalties, fines, and detention▪Over service law enforcement,

ignition locks

▪Community policing▪Party patrols, party-buster

hotlines, controlled dispersal and noisy assembly

▪ Incentives

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The Relationship Between Enforcement & Policy

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▪ Policy alone does not imply enforcement.

▪ Enforcement alone won’t work if the policy isn’t appropriate or isn’t accepted by the general population.

▪ Policy and enforcement are designed and implemented by two different systems.

Policy

Adoption

Enforcement

Education, Marketing, and Law

Information and Education (SHOW ME)

Social Marketing

(HELP ME)

Policy and Regulation

(MAKE ME)

Adapted from Jay Kassier, Tools of Change and Dave Ward, Puget Sound Partnership

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Source of Last Alcohol Used Among Past-Month Alcohol Users Ages 18 to 20: 2008-2009 (SAMHSA, CBHSQ, NSDUH, special data analysis, 2010)

What’s Driving the ProblemLocal Conditions

Behavior, Social Pressure and Control

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Over 21 Purchasing

Underlying Condition

Not Checking ID

Underlying Condition

Clerks Are Young

Underlying Condition

Control

Communication

Social Pressure

Retail

Availability

Access

Social Marketing

RBST

Hiring Policy

Behavior

Policy

Adoption

Control, Visibility and Deterrence

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Lack of Consistent

Compliance Checks

Underlying Condition

Follow up Checks Not

Conducted for Failures

Underlying Condition

Administrative Citations

Not Issued Consistently

Underlying Condition

Deterrence

Policy Adoption

Enforcement

Visibility

Retail

Availability

Access

100 % Twice a Year

Within 90 Days

Graduated Penalties

Control

Apply Penalties

Compliance Checks

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Drinking Locations by Age Group, 18-20: 2008-2009 (SAMHSA, CBHSQ, NSDUH, special data analysis, 2010)

What’s Driving the ProblemLocal Conditions

Using the Handout, Answer the Following Questions

1. What conditions would you seek to change?

2. What strategies would you select to implement?

3. How could you create synergy ?

4. What additional information would you like to have?

Group Activity

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Drinking Locations by Age Group, 18-20: 2008-2009 (SAMHSA, CBHSQ, NSDUH, special data analysis, 2010)

What’s Driving the ProblemLocal Conditions

Behavior and Conditions

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Easy Access to

Alcohol at Home

Underlying Condition

Parents Don’t

Communicate

Disapproval

Underlying Condition

Alcohol at Parties

Underlying Condition

CommunicationSocial

Marketing

Social

Middle

School

Access

Marketing

Behavior Conditions

Policy Adoption

Behavior, Penalty/Pressure and Deterrence

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Easy Access to

Alcohol at Home

Underlying Condition

Parents Don’t

Communicate

Disapproval

Underlying Condition

Alcohol at Parties

Underlying Condition

Deterrence

Communication Enforcement

Behavior

Social

Middle

School

Access

Social Host Liability Marketing

Penalty and

Pressure

Party Patrol

Worth the InvestmentIf you have the time

DATA

Criteria for Determining Readiness

Do I know what’s driving the problem

locally?

Capacity Does my coalition or organization have the

capacity, including an understanding of

how environmental strategies work?

Resources & Reach

Does my coalition or organization have the

resources and the reach?

Commitment Are we in it for the long haul?

Where is Your Agency, Community, or Coalition?

https://www.stopalcoholabuse.gov/resources/reporttocongress/RTC2018.aspx

https://www.wyomingpreventiondepot.org/strategies/target-areas/alcohol/