Effectiveness of Community-Based Substance Abuse Prevention in Vermont: Findings From the SPF-SIG Statewide Evaluation

Abstract:

Introduction:Vermont’s Strategic Prevention Framework State Incentive Grant (SPF-SIG) was a federally funded initiative in which 24 community-based organizations received grants in November 2007 to build their substance abuse prevention capacity and address selected substance abuse problems.  All 24 community grantees focused on the prevention of underage drinking.  Twenty communities also chose to address “high risk drinking among persons under age 25” and the remaining four communities selected “marijuana use by persons under age 25” as their second priority.  The goal of the community grantees was to reduce population-level indicators of the targeted behaviors.

Methods:Communities implemented a variety of environmental prevention strategies, including policy change, enhanced enforcement, media campaigns, and other broadly disseminated public education efforts.  All grantees worked to increase their organizational capacity and participated in trainings focused on organizational development and sustainability, as well as more specific issues pertinent to planning, implementation, and evaluation.  Process data were collected to assess changes in organizational capacity and fidelity of implementation for each strategy.  Outcome data were obtained from biannual YRBS student surveys conducted in all school districts in the state, and two statewide web-based surveys of young adults.

Findings: Decreases in binge drinking among high schools students were significantly greater in the 24 intervention communities compared to unfunded  communities in the state (p<.01).  A similar pattern (p<.10) was observed for 30-day alcohol use.  The four communities that focused on marijuana use experienced greater relative decreases in 30-day marijuana use compared to unfunded communities (p<.01).   Slightly better outcomes for young adult binge drinking and marijuana use were observed in the SPF-SIG communities compared to unfunded communities, although those differences were not statistically significant.  Post hocanalyses showed that grantees that achieved larger decreases in binge drinking among high school students were those that: 1) improved the most in their organizational capacity, and 2) implemented their interventions with high fidelity.

Conclusions and implications: The findings regarding the implementation and effectiveness of the Vermont SPF-SIG support the utility of community-based prevention approaches focused on population-level change.   They also emphasize the importance of building the capacity of community-based organizations and implementing preventive interventions with fidelity.   Because nearly all Vermont communities are relatively small and rural, it is uncertain how well similar approaches would work in larger urban communities.  The long term sustainability of community-based prevention organizations and their ability to maintain positive trajectories in targeted outcomes also warrant further research.