1. Environmental Strategies Becky Ireland- Higher Education Alcohol Prevention Project Mary Bourque - Partnership For A Tobacco-Free Maine

2. We can try to change conditions within each individual to influence their decisions But we also need to change conditions in the environment surrounding the individuals to encourage and support healthier/safer decisions

3. Definition of Environmental Strategies Those strategies that alter the legal, social, economic or physical environment in some way to make it more conductive for health and well-being

4. Policy and Environmental Interventions Policy interventions include laws, regulations and rules (formal and informal) Environmental interventions include changes to the economic, social, or physical environment. Policy & Environmental Change –Executive Summary ASTDHPPHE/CDC,2001

5. local / regional / national / global natural environment (physical) built; architectural environment (physical) political/policy environment (social) mass culture/media environment (social) technological environment (social) Maine Bureau of Health ENVIRONMENT

6. Individual vs. Environmental Strategies It is difficult to encourage young people to “just say no” when their environment in so many ways shouts “just say yes!” Research increasingly shows a need for both individual and environmental strategies

7. Why Environmental Strategies? Tobacco, alcohol, and other drugs are not just youth issues – adult attitudes and behavior must change as well if we hope to make progress Many people are “fence sitters” – will go either way if they are given a good enough reason and enough support to justify their decision It can be difficult to reach all of these fence sitters to convince them each to make healthy/safe decisions, but they are greatly influenced by their environment – rather than trying to convince them to go against the wind, we can sometimes increase our impact by changing the way the wind blows.

8. In order to better assess and address the environment, prevention uses a social ecological model. This model illustrates the multiple domains, or levels, which make up the overall environment.

9. Multiple levels within a social ecology framework Individuals Social Networks peers, families, cliques Organizations policies, practices Community norms, cultures, practices Policy & Environment public policies/regs (localstatefederal) environment = built or natural Community Health Program/Bureau of Health/DHS

10. Using the Framework To increase likelihood of effectiveness, prevention needs to use multiple strategies in multiple domains. By “attacking” the issue from multiple angles the likelihood of long-term, systemic change is improved.

11. Effective Prevention: Multiple Strategies in Multiple Domains Individual Knowledge Attitudes/Beliefs Social Skills Personal characteristics Aspirations Expectations about effects of substances Biological risk factors

12. Multiple Strategies in Multiple Domains Peers Family Friends’ attitudes/behavior Perceptions of norms Access to substances Peer pressure Family bonding/rewards Rules & enforcement Addiction Modeling behavior Access to substances Social Networks

13. School Academic success Policies & enforcement Opportunities/rewards for positive involvement Adult role models Youth Organizations Adult Organizations Policies & Enforcement Practices Role modeling Multiple Strategies in Multiple Domains

14. Community Norms, culture Practices Laws & enforcement Opportunities/rewards for positive involvement Access to substances Adult role models Multiple Strategies in Multiple Domains

15. Policy & Environment Local/State/federal laws Physical Environment Mass media Alcohol advertising Traditions/expectations Economic forces/ funding issues

16. Community Coalitions Fit the socio-ecological perspective because they work with multiple domains and promote community change.

17. Community Coalition Coalition - Organization of individuals representing diverse organizations combining to effect a specific change by working together. –Develop widespread public support –Maximize power through joint action –Minimize duplication –Help mobilize more talent, resources and approaches to issues

18. Changing the Environment: Where are the breakdowns in your community? NORMS AVAILABILITY REGULATIONS laws, policies, guidelines, rules -as designed -as communicated -as understood -as enforced -as perceived to be enforced -retail -social -what is acceptable? -actual norms (behavior) -as expressed/communicated - as perceived

19. Norms Occur at all levels of the social ecological model There is often a big variance between the “perceived norm” and the “actual norm” There is evidence that correcting people’s misperceptions can lead to behavior change

20. Tobacco Use Perception 60% of the high school students surveyed reported they think over 50% of high school students smoke cigarettes once a month or more.(2001 YTS) Adults surveyed reported that they think that out of 100 students 49% smoke cigarettes at least once a month. (2001 MATS) In reality 24.8% of high school youth smoke cigarettes at least once a month. (2001 YTS)

21. Social Norm Marketing Example PTM “92% Campaign” – (Teaser Campaign) Desired outcome -help middle school youth understand that most kids don’t smoke 92 % posters throughout participating middle schools – what is this about? Answer – 92% is the percent of kids that think smoking is not cool. (youth segmentation tobacco survey)

22. Researchers have found these misperceptions in every group they have studied, from middle school to college students

23. Strategies: Social Norms Theory –Correcting youth over perceptions of how much/often their peers are drinking –Highlighting the wide existence of desirable attitudes/beliefs/actions Media Campaigns –Correcting adult under perceptions of how much/often youth are using and other factors such as where they are getting it How you can get involved: Know the data – use it whenever you hear people verbalizing a misperception Present data from a positive perspective – what the majority is doing right Media advocacy Use existing materials locally; communicate needs for additional materials Changing Norms

24. Social Norms Theory: Considerations for Implementation In your experience, do students suffer from these exaggerated misperceptions? Is the real norm that the majority is making healthy choices? Does the exaggerated misperception influence people’s decisions? Can the misperception be corrected? How? Who are the “carriers” of the misperceptions? (people who spread them without even realizing they aren’t true) Would it make a difference if people knew the truth and understood the misperceptions? How?

25. Reducing Retail Availability Sample Strategies: Compliance Checks –collaborative effort –Nationally one of the most well-documented strategies for reducing underage retail access to tobacco/alcohol Vendor Education – “NO Buts” Point of Sale Initiatives Sticker Shock Campaign –May & December each year –Publicizes furnishing laws to deter adults from purchasing alcohol for youth How you can get involved: Be prepared to publicly support the strategy when opposition arises – letters to the editor, legislative contacts if necessary, etc. Many different options: –Youth/community group plans local initiative –Encourage stores to participate –Use materials in other ways

26. Regulations & Enforcement Includes laws, policies, guidelines, and rules Careful and continuous attention needs to be paid to how regulations are written, communicated to people, understood by people, as well as how they are enforced and how people THINK they are enforced

27. Examples of Tobacco Policy Initiatives Tobacco-Free School Policy (norms, avail., regs) Tobacco-Free Playing Field Policy (norms, avail., regs) Worksite No Smoking Policy (norms, avail., regs) Road map – Working Toward Sustainable Local Policy Change Steps and Examples (handout)

28. Examples of Alcohol Policy Initiatives Public possession/intoxication Minimum Drinking Age Providing to a minor Operating Under the Influence Alcohol Outlet Density Keg Registration Indirect policy initiatives- parties, noise

29. Finally… Don’t expect change overnight – make it a long-term commitment Celebrate small successes often Don’t underestimate your power to start an avalanche with a small strategic set of snowballs

30. Exercise Split into groups and read the scenario given to your group Answer the questions given to your group based on the scenario When all groups are done, we will as 1 or 2 people from the group to share the responses

31. Environmental Strategies Scenario Your community assessment indicates that the most common places youth are drinking alcohol is in a home or other private property with or without an adult’s permission. Within your coalition their has been discussion about how to address this. Please discuss how this issue can be addressed in terms of the environmental strategies that reach all of the domains in the social ecological model.