Engaging Communities to Create Sustainable Change Across the Lifespan for Preventing Adolescent Substance Use or Abuse

Background:  This presentation describes an ethnographic community participatory research approach with 14 community leaders (CLs), 32 youth, and 7 parents in a southern rural tobacco producing county to understand social and environmental determinants and preventive and interventions strategies influencing adolescent lifestyles.

Methods: Pairs of Community Participatory Research Team (CPRT) members and investigators collected data from individual CLs; and, investigators conducted five youth group interviews (N=32) of 14 - 18 year olds and one parent group interview (N=7) using questions developed by the CPRT from a nominal group process. Domains of Core and History, Physical Environment, Idea Systems, Social Systems, and Behavioral Patterns formed the basis for 18 questions. Investigators analyzed the interviews using a constant comparative approach. Six themes emerged including Protective Factors and Substance Use Motivating Factors. Responses from CLs, youth, and parents were compared for similarities and differences.

Results:  Although the groups had agreement about a majority of the domains, some of their perceptions were different. For instance, most CLs and parents viewed their environment as peaceful, safe, and friendly with volunteers ready to assist youth achieving their goals. Some youth were quick to identify known drug dealers, where they could be found, and saw little reason to remain in their communities. Results from interviews and a community assessment were used to develop a substance use prevention program that can serve as a model for rural community engagement.

Conclusion: Information about ecological and contextual dimensions of the community, health attitudes, and behaviors informed and empowered the CPRT to select and customize a comprehensive and culturally relevant intervention that will influence the capacity of the community to promote substance-freeadolescent lifestyles.

Learning Objectives: 1) Identify the value of the ethnographic approach used in the development of the preventive intervention for youth in a southern rural tobacco producing community. 2) Compare and contrast the community leader responses, parent interview responses, and the youth interview responses for similarities and differences. 3) Describe the intervention model built to address the social and environmental determinants of health in a rural tobacco producing community.