Disparities in Community Substance Abuse Prevention Resources and Barriers: Results from the SPF SIG National Cross-Site Evaluation

Introduction: Racial/ethnic minority populations face heightened risk for experiencing consequences of substance abuse (NIDA, 2008). To implement effective prevention efforts with these populations, it is important to identify and address any unique intervention challenges.  Since 2004, Strategic Prevention Framework State Incentive Grant (SPF SIG) recipients (states, tribal organizations, jurisdictions) have funded diverse subrecipient communities to implement substance abuse prevention strategies. This presentation examines whether prevention resources and barriers varied across SPF SIG communities that did and did not target racial/ethnic minority populations, with an eye toward identifying capacities that may need to be built before health disparities can be addressed.

Method: The SPF SIG Community‑Level Instrument (CLI) collects data about subrecipient communities’ partnerships, process, and implementation. Analyses compared CLI responses for communities that did and did not target minority populations using t-tests (for continuous outcomes) and Fisher’s exact tests (for dichotomous outcomes). 

Results: Of the 429 communities included in analyses, 29% targeted one or more racial/ethnic minority populations for their prevention efforts. Those targeting minority populations reported significantly more implementation barriers than those not targeting minorities (M_m=13.5, M_nm =10.8,  = -6.4, p<.001). Law enforcement (LE) barriers were among the most common barriers reported by communities targeting minorities, including lack of trust in LE (p<.001), lack of LE staff to enforce laws (p<.001), and lack of clear jurisdictional boundaries among local LE agencies (p<.001). These communities also reported fewer resources, including fewer non-SPF SIG funds (p<.10) and less inclusion of LE agencies in their partnerships (p<.001)  and needs assessment and strategic planning processes (p<.05) . Further, these communities implemented a smaller percentage of population-based interventions such as environmental strategies (38.8% vs 53.3%, t = 3.3, p<.001), a finding associated with LE relationships (F(1, 365)= 6.9, p<.01).

Conclusions: Communities that targeted minority populations exhibited fewer prevention resources, including relationships with law enforcement, along with more barriers. These challenges may influence the kinds of interventions they implement. This is troubling given previous SPF SIG analyses showing smaller improvements in substance use outcomes for communities with challenges related to resources, law enforcement involvement, and implementation barriers (SAMHSA and DACCC, 2012). However, the findings of the study illuminate specific targets that may hold promise for bolstering prevention capacity and effectiveness in minority communities.