SPF Indiana

Purpose: Examine prioritized risk factors and gaps and select programs and systems change strategies to address them, develop evaluation objectives, and create a workplan
Audience: Community Board
Content: Description of the potential EBPs, primer and exercises on writing objectives, description of the sections of the workplan

A sample document that provides major sections of a work plan and budget with descriptions of content of each section.

Framework document to advance the mission of the Indiana Substance Abuse Prevention System.

“Evidence-based” strategies refers to those that have some evidence of influencing use rates and consequences in similar communities under similar circumstances.  According to CSAP, evidence-based strategies are those that are:

• Included on federal lists or registries of evidence-based interventions
• Find Youth Info www.findyouthinfo.gov,
• Blueprints http://www.colorado.edu/cspv/blueprints/,
• Comparison Matrix for Science-Based Prevention Programs CSAP Matrix. Science-based_Prevention_Programs.pdf
• National Registry of Evidence Based Programs, Policies, and Practices (NREPP) http://www.nrepp.samhsa.gov/
• Communities That Care Tested, Effective Programs http://www.sdrg.org/ctcresource/Prevention%20Strategies%20Guide/testedprograms.pdf
• American Foundation for Suicide Prevention http://www.sprc.org/bpr
• Collaborative for Academic, Social, and Emotional Learning http://casel.org/publications/safe-and-sound-an-educational-leaders-guide-to-evidence-based-sel-programs/
• Reported (with positive effects) in peer-reviewed journals (search http://scholar.google.com/ for scholarly articles); or
• Documented effectiveness supported by other sources of information and the consensus judgment of informed experts, as described in the following set of four guidelines (all must be met):
• Based in solid theory documented in a logic or conceptual model(such as the Social Development Model); and
• Similar in content and structure to interventions that appear in registries or peer-reviewed literature (address risk and protective factors, have similar contact hours, and teaching techniques, but address a different population); and
• The Intervention is supported by documentation that it has been effectively implemented in the past, and multiple times, in a manner attentive to scientific standards of evidence and with results that show a consistent pattern of credible and positive effects (there are unpublished evaluation results from several sites that show positive results); and
• The intervention is reviewed and deemed appropriate by a panel of informed prevention experts that includes: well-qualified prevention researchers who are experienced in evaluating prevention interventions similar to those under review; local prevention practitioners; and key community leaders as appropriate ,(e.g., the state-level Evidence-Based Practice Workgroup, Strategic Plan Review Team, and Indiana Prevention Resource Center TA/Evaluation Team).

A directory of unique and specific local ordinances, policies, and regulations that community anti-drug coalitions have worked to enact, and a description of the steps taken by coalitions to make these changes occur.

There has been no increase in Indiana alcohol tax rates since 19811—the state remains at $0.115, $2.68, and $0.47 per gallon for beer, liquor, and wine, respectively.2 Alcohol is now relatively more affordable for consumers than it was several decades ago.8 While there have been several attempts to raise this rate, none have been successful, and Indiana is ranked 42 out of the 50 states in terms of alcohol tax rate.3 Low alcohol taxation rates have long been the subject of research aimed at determining the relationship between the price of alcohol, alcohol consumption and related harms. There is currently strong evidence showing that increased alcohol price can reduce levels of consumption and negative health outcomes resulting from over-consumption, including alcohol-related morbidity and mortality, traffic fatalities, and other factors such as violence and sexually transmitted disease.6 Based on the weight of this and additional available evidence, the Task Force on Community Preventive Services concludes that the price of alcohol per unit should be raised in order to curb excess consumption and alcohol-related harms.

The state of Indiana’s most recent cigarette tax increase came ten years ago in 2007, when the tax was raised from 44 cents to 99.5 cents per pack.Indiana’s tobacco tax rate is currently the 13th lowest rate in the nation, and six of the twelve states with lower tobacco tax rates are tobacco-producing states. There is a large body of evidence suggesting that raising taxes on tobacco products is an effective way to curb smoking and tobacco use rates, particularly among high-risk subpopulations. Most major researchers and health organizations support the use of increased tobacco tax rates as a method to reduce tobacco consumption, some even going so far as to say that such policy changes are the single most effective way to curb consumption, including both continued use and initiation rates.

As the law stands, alcohol outlets in the state of Indiana are allowed to remain open between the hours of 7 a.m. and 3 a.m., Monday through Saturday. Unless alcohol is being sold at a bar, restaurant, or other properly licensed outlet, sales are not permitted between 3 a.m. on Sunday and 7 a.m. the following Monday. Prolonged hours of sale are one method through which alcohol is made more available for purchase. Given this increased availability, it is important to evaluate how modifying permissible hours of sale for alcohol outlets affects rates of negative events—such as assault or drunk driving—within communities. While still in its early stages related to this significant issue, research seems to support the hypothesis that there are links between total alcohol outlet hour availability, violent crime, and first-time DWI offenses.

Currently, Indiana state law prohibits the sale of packaged alcohol on Sundays—that is, no alcohol can be sold outside of licensed bars and restaurants (IC7.1-3) on Sunday. While there are few studies directly examining the link between restrictions on days of sale and variables such as crime, drunk driving, and traffic fatalities, there is evidence to suggest that the limitation of access to alcohol through a variety of means is an effective method of curbing excessive consumption and its detrimental effects. However, despite seemingly inconclusive evidence regarding the impact of these laws, The Task Force on Community Preventive Services, with the support of the U.S. Department of Health and Human Services, states that the maintenance of limits on days of alcohol sale is an effective method for curbing alcohol consumption and its related negative effects.

Drug overdose is the leading cause of accidental death in the United States, and opioid addiction is the leading factor of this epidemic. Naloxone (or Narcan^TM) is used as an opiate antagonist which can reverse an opiate overdose. Similar to the mechanism that occurs when an epinephrine injection is used to reverse an allergic reaction, Naloxone works by blocking the effects of opioids on the central nervous system and reversing the consequences of an overdose. Naloxone has no potential for abuse, meaning it will not produce a high if not used as indicated. It is only effective if opioids are present in the body. Previously, Indiana law only allowed emergency personnel (EMT, EMS, fire department, law enforcement, paramedic, etc.) to carry and administer Naloxone. “Aaron’s Law” (passed in 2015) allows Indiana residents to obtain a prescription for Naloxone if they believe a friend or family member is at risk for an overdose.

Alcohol-related unintentional injuries are one of the leading causes of death among youth in the United States. A Good Samaritan Policy is defined as exemption from law enforcement punishment for an underage youth who calls for medical assistance for a fellow intoxicated youth. Senate Bill 227 was passed in 2014 by the Indiana Senate and signed by Governor Mike Pence the same year. Indiana’s law allows individuals to not be taken into custody for an underage drinking offense, if the officer determines that the individual requested assistance for someone in need. It does not protect individuals from other charges (i.e., obstruction, assault, etc.), but allows for protection for those who look out for their peers.

Zero tolerance policies identify predefined consequences for infractions of specific school policies intended to promote safety and control behavior. However, research over the past 20 years has indicated these policies have little effect in promoting and improving school safety or student behaviors, and actually lead to disproportionate consequences for minority populations. Research suggests schools should develop disciplinary policies in accordance with evidence-based programs, and incorporate primary prevention.

The Transportation Equity Act for the 21st Century Restoration Act of 1998 requires states to implement open container laws to reduce the rate of drunk driving. The Act requires inclusion of six provisions to receive full federal monies for highway construction. Despite this, there are still 11 states that do not have all six provisions in place as of January 2015. While there is not extensive research showing effectiveness of these laws, there is effectiveness shown when implemented as a part of a larger enforcement effort.

School based student drug testing has been in effect for almost three decades. While some research has shown positive effects of randomized drug testing, there are also multiple studies that have shown no effect of the practice. Two separate US Supreme Court rulings have decided that drug testing student-athletes and those involved in extracurricular activities is constitutional, however, there are several federal guidelines schools should follow if they decide to implement drug testing with their students. Keeping these constraints in mind, schools may find it more worthwhile to implement universal prevention efforts school-wide to reach more students with evidenced-based strategies.

Alcohol advertising is found in online, physical, and print mediums. Despite advertising being regulated at the federal level, there are additional steps local and state governments can take to strengthen the protections of advertising aimed at youth. Current research has shown that advertising is linked to higher rates of alcohol use among youth, although reducing advertising has not been shown to reduce use when used alone. Studies have shown effectiveness when advertising restrictions are implemented as part of a comprehensive approach, including implementing other evidenced based approaches.

Strategy Guides
Include: Environmental Scan Strategies Guide for Alcohol, Environmental Scan Strategies Guide for Prescription Drugs

Alcohol outlet density is the concentration of establishments in which alcohol may be purchased within a defined geographic area. The regulation of alcohol outlet density is a public health concern, as research has shown that a higher concentration of alcohol outlets is known to contribute to negative health and social consequences. This research brief discusses existing data on alcohol outlet density research, the process retailers in Indiana must go through to obtain a license, and how your community can work to impact the density in your area.

The use of the same needle by multiple users has the potential to transmit blood-borne pathogens, which is a public health concern. The goal of Needle Exchange Programs (NEPs) is to provide sterile needles for used (and potentially contaminated) needles, with the intention of reducing the spread of diseases. The preponderance of evidence supports the notion that NEPs reduce infections, however, until recently in Indiana, these programs were not lawful. In April 2015, Governor Mike Pence declared a state of emergency, allowing counties to apply for state approval to allow NEPs to exist in their county. This research brief discusses the benefits of NEPs, the existing research, and Indiana’s specific relationship with them.

Link to the recorded webinar.

Alcohol remains the most abused drug by American adolescents despite all 50 states restricting alcohol possession to those under the age of 21. Research has shown that the majority of underage drinkers gain access to alcohol through a variety of social means including parents, friends and acquaintances. This is where social host liability can play a role in preventing underage drinking. Social host liability laws hold adults responsible for alcohol served to underage individuals on the adult’s property.

• CADCA Beyond_the_Basics_Working_with_the_Media.pdf
• CADCA Beyond_the-Basics-Environmental_Strategies-11-2010.pdf
• CADCA ES_FINAL-04-2008.pdf
• CADCA FAQ on Policy Change.pdf
• CADCA Media Relations.pdf
• CADCA Model Ordinance Regulating Alcohol Advertising.pdf
• CADCA Restricting Billboard Advertising.pdf
• CADCA_AlcoholDensityGuide.pdf
  This resource identifies available evidence-based community prevention strategies that have decreased the consequences associated with alcohol outlet density, the concentration of bars, restaurants serving alcohol, and liquor and package stores in a given geographic area. It also provides case studies and a section regarding how to influence policy regarding alcohol density.

• PIRE Party_Patrol_College.pdf
• PIRE Preventing Underage Parties.pdf
• PIRE Working with Law Enforcement on CampusUnderageDrinking.pdf

• OJJDP EnvStrat to Reduce Underage Alcohol.pdf
• OJJDP EnvStratCollege.pdf
• OJJDP Social Avail Strategies.pdf

• ENV_ST.Environmental Strategies Binder.pdf
• ENV_ST.Evidence-Based Environmental Strategies sheet with citations.docx
• ENV_ST.Selecting and Implementing Environmental Prevention Strategies.doc
• WHO Interventions for Alcohol Control
  This document explains the most effective and cost-effective interventions that are available for alcohol regulation. This document also goes into the suggestions for policy changes from the Health Evidence Network (HEN).

• Alcohol Restrictions Case Study PA.pdf
• Model Social Host Ordinance-CA.pdf
• Prohibit Alcohol Sponsorship_Ordinance.pdf
• FACE-AdvertisingRestrictions.pdf
• FACE-EnforceUnderageDrinkingLaws.pdf
• FACE-Policy Change Process.pdf
• FACE-SampleOrdinanceOutdoorAlcoholAdvertising.pdf

• Tool Kit to Pass a Local Ordinance.pdf
• Tool Kit-Excerpts from the Nebraska Strategy Approval Guide.pdf
• Tool Kit-ExternalCommunicationTool_kcsdv.pdf
• Prevention Messaging Made Easy Toolkit
  This resource is available through the Communities for Alcohol- and Drug-free Youth (CADY), and it was designed to assist with the substance abuse community’s need for accurate information. This toolkit provides coalition strategies, media ideas, and other resources that can help communities incorporate prevention messaging. The Prevention Messaging Made Easy Toolkit includes 12 months of customizable templates for a drug-free media campaign on a thumb drive.

Information from the National Institute on Drug Abuse outlining how communities can develop prevention plan, apply prevention principles to programs, and choose evidence-based strategies.

A guidance document created by the Nebraska SPF SIG grantee to provide communities with a set of tools to help them select and seek approval for the most appropriate prevention strategies to implement in their community.

This Child Trends fact sheet reviews evaluated programs that focus on adolescent substance use. Among other findings, this fact sheet explores whether both prevention and cessation programs work for adolescents, whether multi-component programs generally work, and whether programs that address all forms of drug use in combination generally work.

Pennsylvania Liquor Control Board, in its function of working with colleges and universities to reduce high risk drinking by college students has developed the following comparison of on line assessment tools. While the PLCB does not state this is a complete and exhaustive list of on line assessments, it will allow college and university staff the opportunity to review many of the more popular sites.

Developing a theory of change, logic models, and strategic and action plans

A useful guide from the Kellogg Foundation stepping communities through the development of a logic model.