Using Statewide Youth Surveys to Evaluate Local Drug Use Policies and Interventions
Paschall, Mallie J., Flewellng, Robert L., Grube, Joel W., Contemporary Drug Problems
Systematic statewide youth surveys in the U.S. began in 1990 as part of the Youth Risk Behavior Surveillance System - now commonly referred to as the Youth Risk Behavior Survey (YRBS) - designed by the Centers for Disease Control and Prevention (CDC, 2006). The YRBS is conducted every 2 years, and is designed to obtain national and state estimates for the prevalence and incidence of health-related behaviors that could place adolescents at risk for acute or chronic health problems, including alcohol, tobacco, and other substance use. Some states also extend the sampling design of the YRBS in order to provide estimates for individual schools systems or communities. YRBS data thus provide a scientific basis for identifying and addressing public health problems in the adolescent population and monitoring progress towards achieving Healthy People 2010 objectives (U.S. Department of Health and Human Services, 2005). Some states have added their own items to the YRBS that solicit other healthrelated information from adolescents that is of special interest and relevance to the state and/or participating communities.
Statewide youth survey data provide health researchers with the opportunity to evaluate local policies and programs aimed at reducing adolescent substance abuse and related risk behaviors. This may be accomplished through a natural or planned experiment, wherein the type(s) and/or intensity of policy or program implementation varies across an adequate number of localities within a state. This article describes two studies that were designed to evaluate local policies and programs designed to reduce adolescent substance abuse in Vermont and Oregon. We provide an overview of these studies and discuss the utility of statewide youth surveys as well as their limitations for this type of research.
Vermont New Directions Evaluation
In 1997, Vermont was one of five initial states to receive a State Incentive Grant (SIG) from the U.S. Center for Substance Abuse Prevention. This grant supported 23 community coalitions across the state in identifying and implementing a range of youth substance use prevention strategies. Vermont's SIG, titled New Directions (ND), represented a major shift in the state's approach to substance abuse prevention through its funding of community coalitions rather than individual programs, its emphasis on the use of research-based prevention programs and strategies, and the high level of training, technical assistance, and financial support provided to the coalitions. The project was implemented by the Vermont Department of Health Division of Alcohol and Drug Abuse Programs, and evaluated by researchers from RTI International and the Pacific Institute for Research and Evaluation (PIRE).
ND coalitions implemented a variety of programs that include school-based prevention curricula, student assistance programs, mentoring, substance-free alternative activities, and family outreach programs. Coalition activities also included public awareness campaigns and other environmental strategies, and they served to enhance collaboration and networking among community organizations. Although the coalitions required an initial planning period, all were fully engaged by fall of 1999.
Outcome data were provided by Vermont's biannual Youth Risk Behavior Survey. This survey, which is completed by students in grades 8 through 12, is administered in the spring of every odd-numbered year in over 90% of the middle and high schools in Vermont. Because all students in each participating school and community are asked to complete the survey, it provides an assessment of how community-wide rates in substance use among eighth to twelfth grade students are changing. Although past experience shows that reducing overall prevalence rates at the population level is a formidable challenge, this is the ultimate goal of the federal initiative under which the SIG program was developed and is consistent with a public health approach to substance abuse prevention. …