David A. Collins

The Impact of Active Consent Procedures on Nonresponse and Nonresponse Error in Youth Survey Data: Evidence from a New Experiment.

This article reports results from a student survey fielded using an experimental design with 14 Kentucky school districts. Seven of the 14 districts were randomly assigned to implement the survey with active consent procedures; the other seven districts implemented the survey with passive consent procedures. We used our experimental design to investigate the impact of consent procedures on (a) participation rates, (b) demographic characteristic of the survey samples, and (c) estimates of alcohol, tobacco, and other drugs (ATOD) use. We found that the use of active consent procedures resulted in reduced response rates, underrepresentation of male students and older students, and lower lifetime and past 30-day prevalence rates for most drugs and for most antisocial behaviors. Methodological implications of these findings are discussed along with directions for further research.

Reducing Alcohol and Other Drug Use by Strengthening Community, Family, and Youth Resiliency An Evaluation of the Creating Lasting Connections Program

The Creating Lasting Connections 5-year demonstration project was designed to delay onset and reduce frequency of alcohol and other drug use among high-risk 12-through 14-year-old youth by positively impacting resiliency factors in three domains: church community, family, and individual (youth). Major program components included church community mobilization, parent/guardian training, youth training, early intervention services, and follow-up case management services. The program was implemented in multiple church communities in rural, suburban, and inner-city settings. The evaluation employed a true experimental design with three repeated measures over a I-yearperiod. Results showed that the program successfully engaged church communities in substance abuse prevention activities and produced positive direct effects on family and youth resiliency, as well as moderating effects on onset and frequency of alcohol and other drug use. Findings that are consistent with the program message and significant learnings are highlighted.

Changing community readiness to prevent the abuse of inhalants and other harmful legal products in Alaska.

This paper presents results from an application of the Community Readiness Model (CRM) as part of a multi-stage community mobilization strategy to engage community leaders, retailers, parents, and school personnel in preventing youth use of inhalants and other harmful legal products in rural Alaska. The CRM is designed to assess readiness to address a single social problem, based on a limited set of key informant interviews. In this study, researchers conducted 32 baseline and 34 post-intervention community readiness assessment interviews in four rural Alaskan communities. These interviews with key informants from the communities were coded and analyzed using CRM methods to yield readiness scores for each community. The aggregate results were analyzed using hierarchical linear modeling (HLM), and the individual community scores were analyzed in the context of the overall study. Significant positive changes in community readiness were found across six readiness dimensions as well as for the overall readiness score. Variation in the degree of changes in readiness across the four communities is attributed to differences in the intervention’s implementation. The implications of these results include the potential for CRM assessments to serve as an integral component of a community mobilization strategy and also to offer meaningful feedback to communities participating in prevention research.

A COMMUNITY PREVENTION INTERVENTION TO REDUCE YOUTH FROM INHALING AND INGESTING HARMFUL LEGAL PRODUCTS

Youth use of harmful legal products, including inhaling or ingesting everyday household products, prescription drugs, and over-the-counter drugs, constitutes a growing health problem for American society. As such, a single targeted approach to preventing such a drug problem in a community is unlikely to be sufficient to reduce use and abuse at the youth population level. Therefore, the primary focus of this article is on an innovative, comprehensive, community-based prevention intervention. The intervention described here is based upon prior research that has a potential of preventing youth use of alcohol and other legal products. It builds upon three evidence-based prevention interventions from the substance abuse field: community mobilization, environmental strategies, and school-based prevention education intervention. The results of a feasibility project are presented and the description of a planned efficacy trial is discussed.

Evaluation of HIV/AIDS Prevention Resources in Liberia: Strategy and Implications

The purpose of this preliminary study was to assess the HIV/AIDS prevention needs, services, and resources in Liberia, including the readiness of local providers to conduct HIV/AIDS-related prevention programs based on a set of six key dimensions (prevention needs, knowledge, leadership, environment, risky behaviors, and resources). A valid self-administered qualitative-based health survey, based on a community readiness model, was utilized as the primary data collection source. A cross-sectional design that utilized a convenient sample of key informants such as health coordinators, program directors, and health administrator from both public and private HIV/AIDS-based organizations was used. Furthermore, an extensive review of the National Library of Medicine database of published articles from mid-1980 to 2002 was simultaneously conducted to gauge the extent of scientific publications on HIV/AIDS-related prevention services in Liberia. The findings from this study strongly suggest that Liberia is in a stage of vague awareness, as defined by the Tri-Ethnic Center community readiness framework, regarding HIV/AIDS-related activities, including a significant lack of HIV/AIDS-related resources and scientific publications. Accordingly, there is a critical need to acquire adequate resources and build capacity to implement effective HIV/AIDS-related prevention programming services in order to avert the negative public health consequences associated with HIV/AIDS, including the implementation of relevant evaluation and dissemination strategies. Most importantly, this model has the potential to be utilized in other resource-constraint settings, especially in the developing world, to assess prevention-related resources and programmatic readiness. This is the first published study to evaluate Liberias HIV/AIDS prevention resources and to systematically document the extent and magnitude of the HIV/AIDS crises in the country.

Influence of risk and protective factors on substance use outcomes across developmental periods: a comparison of youth and young adults.

Data were collected from samples of youth (ages 11–18; N = 38,268) and young 10 adults (ages 18–24; N = 602) across 30 Tennessee counties using surveys and telephone interviews conducted in 2006–2008. Data were analyzed using hierarchical nonlinear modeling to determine: (1) which risk and protective factors predicted alcohol and marijuana use, and (2) whether predictors differed as a function of developmental period. Findings provide preliminary evidence that prevention efforts need to take into consideration the changing environment and related influences as youth age, especially as they move from a more protected community environment to one where they live somewhat independently. Implications and limitations are discussed.

Mobilizing Church Communities to Prevent Alcohol and Other Drug Abuse

ABSTRACT This article presents a community mobilization strategy that focuses on the dynamics of organizing church communities to implement and evaluate alcohol and other drug (AOD) abuse prevention programs. Although the literature abounds with extensive discussions and case studies of community practice models, it clearly lacks documentation of successful strategies for empowering communities to engage in program implementation and evaluation. A model community mobilization strategy is described that highlights the involvement of church congregations in family recruitment, retention and replication of AOD prevention programs. The evaluation of the strategy provides evidence of the success in rural, suburban, and urban settings. Key lessons are presented to stimulate implementation of the model mobilization strategy in other church communities.

Reducing adolescent use of harmful legal products: intermediate effects of a community prevention intervention.

Purpose: Preliminary results are presented from a feasibility study of a comprehensive community prevention intervention to reduce the use of inhalants and other harmful legal products (HLPs) among adolescents in three Alaskan frontier communities conducted in 2004–2007. The legal products used to get high include over-the-counter drugs, prescription drugs, and common household products. Community mobilization, environmental and school-based strategies were implemented to reduce access, enhance knowledge of risks, and improve assertiveness and refusal skills. Methods: Pre- and post-intervention survey data were collected from 5–7th grade students from schools in three communities using standardized instruments to assess knowledge, assertiveness, refusal skills, perceived availability, and intent to use. The intervention consisted of community mobilization and environmental strategies to reduce access to HLPs in the home, at school, and through retail establishments. In addition, the ThinkSmart curriculum was implemented in classrooms among 5th grade students to increase the knowledge of harmful effects of HLPs and improve the refusal skills. Data were analyzed using hierarchical linear models that enable corrections for correlated measurement error. Results: Significant increases in knowledge of harms related to HLP use and decreases in perceived availability of HLP products were observed. The environmental strategies were particularly effective in reducing the perceived availability of HLPs among 6th and 7th graders. Discussion: Although limited by the absence of randomized control groups in this preliminary study design, the results of this study provide encouragement to pursue mixed strategies for the reduction of HLP use among young people in Alaskan frontier communities.

Individual and Contextual Predictors of Inhalant Use among 8th Graders: A Multilevel Analysis.

Few studies of inhalant use have examined a large number of predictors at the individual level, including risk and protective factors and delinquent behavior, while also taking into account contextual variables (such as school size and poverty rates). This exploratory study uses 8th grade data from a large-scale survey of students in Kentucky to examine individual and contextual predictors of prevalence of inhalant use, and compares the predictors of inhalant use with factors predicting the use of marijuana and other drug use. Hierarchical Generalized Linear Modeling results using a logit link function suggest that the relationships between inhalant use and some of these factors are different than the relationships between the factors and both marijuana and other drug use. Implications for prevention of inhalant use are discussed.

Demographic and contextual factors associated with inhalant use among youth in rural Alaska.

BACKGROUND Abuse of harmful legal products that can be inhaled or ingested is a serious and growing problem in many rural Alaskan communities, and particularly so among preteens. METHODS This study analyses data collected during baseline measurements of a 5-year NIH/NIDA-funded study entitled A Community Trial to Prevent Youths Abuse of Harmful Legal Products in Alaska. Youth in 8 communities located throughout the state participated in a survey during the fall of 2009 to measure the prevalence and availability of harmful legal products (n=697). The goal of the analysis presented here is to compare the contextual factors of inhalant users and non-users in rural Alaskan communities. RESULTS As reported in national surveys of substance use among youth, participants in this study indicated using alcohol more than any other substance. Inhalants were the second-most common substance abused, higher than either cigarettes or marijuana. Lifetime use varied among demographic factors such as age, gender and ethnicity as well as contextual factors including academic performance, parent employment, household living situation and income. When compared to non-users, significantly larger proportions of participants reporting lifetime inhalant use indicated easy availability of inhalants in their home, school and retail outlets. Users were also significantly more likely than non-users to have consumed alcohol. CONCLUSION Results of this study may inform the development of effective interventions in other rural communities.BACKGROUND Abuse of harmful legal products that can be inhaled or ingested is a serious and growing problem in many rural Alaskan communities, and particularly so among preteens. METHODS This study analyses data collected during baseline measurements of a 5-year NIH/NIDA-funded study entitled A Community Trial to Prevent Youths Abuse of Harmful Legal Products in Alaska. Youth in 8 communities located throughout the state participated in a survey during the fall of 2009 to measure the prevalence and availability of harmful legal products (n=697). The goal of the analysis presented here is to compare the contextual factors of inhalant users and non-users in rural Alaskan communities. RESULTS As reported in national surveys of substance use among youth, participants in this study indicated using alcohol more than any other substance. Inhalants were the second-most common substance abused, higher than either cigarettes or marijuana. Lifetime use varied among demographic factors such as age, gender and ethnicity as well as contextual factors including academic performance, parent employment, household living situation and income. When compared to non-users, significantly larger proportions of participants reporting lifetime inhalant use indicated easy availability of inhalants in their home, school and retail outlets. Users were also significantly more likely than non-users to have consumed alcohol. CONCLUSION Results of this study may inform the development of effective interventions in other rural communities.Background: Abuse of harmful legal products that can be inhaled or ingested is a serious and growing problem in many rural Alaskan communities, and particularly so among preteens. Methods : This study analyses data collected during baseline measurements of a 5-year NIH/NIDA-funded study entitled A Community Trial to Prevent Youths Abuse of Harmful Legal Products in Alaska. Youth in 8 communities located throughout the state participated in a survey during the fall of 2009 to measure the prevalence and availability of harmful legal products (n=697). The goal of the analysis presented here is to compare the contextual factors of inhalant users and non-users in rural Alaskan communities. Results : As reported in national surveys of substance use among youth, participants in this study indicated using alcohol more than any other substance. Inhalants were the second-most common substance abused, higher than either cigarettes or marijuana. Lifetime use varied among demographic factors such as age, gender and ethnicity as well as contextual factors including academic performance, parent employment, household living situation and income. When compared to non-users, significantly larger proportions of participants reporting lifetime inhalant use indicated easy availability of inhalants in their home, school and retail outlets. Users were also significantly more likely than non-users to have consumed alcohol. Conclusion : Results of this study may inform the development of effective interventions in other rural communities.