Evaluating Community Readiness to Implement Environmental and Policy-Based Alcohol Abuse Prevention Strategies in Wisconsin.

Abstract

Background: Matching evidence-based alcohol prevention strategies with a community's readiness to support those strategies is the basis for the Tri-Ethnic Community Readiness Model (CRM). The purpose of this evaluation was to assess the association of a community's readiness to address alcohol abuse in their community with the implementation of environmental and policy-based strategies.

Methods: Twenty-one substance abuse prevention coalitions in Wisconsin participated in a pre-post intervention group-only evaluation using the CRM. As part of a Substance Abuse and Mental Health Services Administration (SAMHSA) grant, all grantees were obligated by the Wisconsin Department of Health Services to implement environmental and policy-based strategies focused on one of three priority areas: young adult binge drinking, underage drinking, and alcohol-related motor-vehicle injuries and fatalities.

Results: At baseline, all communities (n=21) scored at or below a Stage 4 (on a scale of 1-9) readiness level ("preparedness"). The mean change in community readiness over the three-year period (2009-2011) was significant, but was less than one complete CRM stage (0.77, p=<0.001; 95% CI: 0.49, 1.05).

Conclusion: These findings suggest that implementation of environmental and policy-based strategies may improve a community's progression in perceived readiness to address alcohol abuse regardless of the community's baseline level of readiness to address alcohol abuse.

Recommendation: An assessment specific for measuring community readiness for policy-related strategies should be developed. The assessment would include community-level factors (e.g. community climate) for implementing policy-related prevention strategies, and not assume a linear readiness model.