1. Community Prevention III Evaluation & Institutionalization
Harold D. Holder, Ph.D.
Prevention Research Center
Berkeley, California USA
Associação Brasileira de Estudos de Álcool e Outras Drogas,
Sao Paulo
September 6, 2003

2. Evaluation = Determine if prevention worked
Why?
--determine effects
--Improve/learn
--avoid mistakes
--support prevention (it works)

3. Steps in Evaluation         
1. Define outcome—What do you want to change? 
2. Design prevention based upon science 
3. Collect baseline data 
4. Implement prevention 
5. Document implementation 
6. Collect follow up data 
7. Determine change (if any) in outcome 
8. Rule out other explanations 
9. Report results

4. Alcohol-involved Trauma at the Community Level: Conceptual Model`````````
MOBILIZATION
DRINKING AND DRIVING
Local News about Alcohol Problems & Enforcement
Perceived
Risk of Arrest
Local Law
Enforcement
RESPONSIBLE BEVERAGE
SERVICE
Social Access
to Alcohol
Driving after
Drinking
Alcohol
Serving and
Sales Practices
UNDERAGE DRINKING
Local Regulation
of Alcohol
(Density, Hours
of Sale)
Retail Alcohol Availability
(On and Off-premise)
Alcohol-involved
Injury
Alcohol Intoxication
or Impairment
ALCOHOL ACCESS
Non-Traffic Risk Activities

5. Steps in Evaluation    2. Design prevention based upon science
1. Define outcome—What do you want to change? 
2. Design prevention based upon science 
3. Collect baseline data

6. Measure Outcomes Sources of Data
1. Archival—collected regularly over time
2. Observations—Documentation and experiences
3. Surveys—self reports (school surveys, community surveys, key leader interviews)

7. Holder, et al., J. American Medical Association, 2000
Underage Alcohol Purchase Survey -Experimental and Comparison Communities- 60
PRETEST
POSTTEST 53 50 47 45 40
Percent Selling 30 20 10
Comparison
Experimental No Training
Experimental Training
Holder, et al., J. American Medical Association, 2000

8. DRINKING AND DRIVING COMPONENT
ACTION MODEL
Enforcement
News
Perceived Risk
Of DUI Arrest
Drinking & Driving
Driver BAC
Crashes

9. Steps in Evaluation      
1. Define outcome—What do you want to change? 
2. Design prevention based upon science 
3. Collect baseline data 
4. Implement prevention 
5. Document implementation 
6. Collect follow up data

10. Underage Alcohol Prevention Activities

11. Holder, et al., J. American Medical Association, 2000
Underage Alcohol Purchase Survey -Experimental and Comparison Communities- 60
PRETEST
POSTTEST 53 50 47 45 40 35
Percent Selling 30 20 19 16 10
Comparison
Experimental No Training
Experimental Training
Holder, et al., J. American Medical Association, 2000

12. Unfortunately, there are some problems associated with alcohol outlets
- Pedestrian Injury Collisions
- Arrests for Drunken Driving
- Assaults

14. Purchase/Service Rates for Waves 1 and 2
Underage Survey
Pseudo-Intoxicated Patron Survey
Pre
Post
Post – Pre
South
.49
.32
-.17
.68
.86
+.18
North
.20
.61
+.41
.80
.87
+.07
At-Large
.38
.47
+.09
.63
.92
+.29

15. Steps in Evaluation         
1. Define outcome—What do you want to change? 
2. Design prevention based upon science 
3. Collect baseline data 
4. Implement prevention 
5. Document implementation 
6. Collect follow up data 
7. Determine change (if any) in outcome 
8. Rule out other explanations 
9. Report results

20. Essential to Institutionalization of Community Prevention
Community Leadership 
Connection to Existing Patterns 
Media Advocacy 
Seek Local Alliances

21. Essential to Institutionalization of Community Prevention (continued)
Accommodate Staff Changes in Key Organizations 
Seek Local as Well as Regional and National Resources 
Work with Local Politics 
Incorporate and Recognize Local Cultural Values

22. Elements in Effective Local Prevention: The top 10
10. Cultural Values& best science Local Cultural &Best Science  
9. Community as a System 
8. Media Advocacy (local news) 
7. Enforcement in local action 
6. Partnership of local & nation/state 
5. Community Leadership and Responsibility 
4. Central government supporting local action 
3. Local information (evaluation) 
2. Evidence based strategies 
1. Courage & Passion

23. You have been wonderful students
Obrigado