Selecting evidencebased strategies
Our intervening variables
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Individual/Family factors: Individual and family factors affecting alcohol and
other drug use include biological factors, socioeconomic factors, parental
involvement, and individual attitudes, beliefs and perceptions around alcohol and
drug use.
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Community Norms: A community norm is a belief or behavior held or exhibited by
over half of the community. These community norms focus on the acceptability or
unacceptability of behaviors and attitudes related to Alcohol and other drug use as
well as the behavioral norms of substance use within the community.

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Focus is on individual attitudes and perceptions
Studies have indicated that individuals living in environments in which excessive drinking
is considered socially acceptable tend to consume more alcohol, Birckmayer et al., 2004.
Access/Availability: How available alcohol is in our community and how easy it is
to obtain. Can include information on retail availability, such as from stores, bars
or dispensaries, and social access, such as from friends, relatives, and social
events.

Studies have shown that the majority of alcohol consumed by youth is obtained through
social sources and that younger youth rely on social sources of alcohol more than older
youth, Birckmayer et al., 2004.
Seven strategies to affect community
change

Provide information

Enhance skills

Provide support

Enhance access/ reduce barriers- improving systems and processes to increase
the ease, ability and opportunity to utilize systems and services.

(reducing access/enhancing barriers- establish barriers to underage drinking or
other illegal drug use, it decreases its accessibility)

Change consequences (incentives/disincentives)- Increasing or decreasing the
probability of a specific behavior that reduces risk or enhances protection by
altering the consequences for performing that behavior.

Change physical design- changing the physical design or structure of the
environment to reduce risk or enhance protection.

Modify/change policies
Benefits of evidence-based practices

Implementing evidence-based strategies (as intended) can help us:
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Produce positive results and have a strong likelihood of success

Use scarce prevention resources strategically

Meet funder requirements
First step: determining a program’s fit

Evidence of effectiveness is only one of three important criteria to consider in
determining if a specific strategy is the best fit for our community.

It is also essential to consider interventions that represent the best fit for our
campus.

Evidence-based

Good conceptual fit

Good practical fit
Conceptual fit


Target the community’s specific:

Needs

Characteristics

Population

Local conditions
The conceptual fit of interventions is best defined by their relevance to the
identified community needs.
Practical Fit

For practical fit we should look for the following;

Human resources

Financial and physical resources

Political conditions

General readiness to change

Evidence-based practices: have been shown through research and evaluation
to be effective at preventing or delaying behaviors we want to prevent or
delay.

Promising practices: have some research or data showing positive outcomes,
but not have enough evidence to support generalizable conclusions.
SAMHSA definition of evidence-based

SAMHSA considers a program or practice evidence-based if:

1. It has been included in a federal registry of evidence-based interventions,
OR

2. Its effectiveness in achieving target outcomes has been reported in peer review
journals, OR

3. Its effectiveness has been formally documented using other types of supporting
information
Definition 1: Federal Registries

Different strategies use different ratings

Look for these terms…



Evidence-based

Strong evidence

Effective

High/moderate effectiveness
Avoid these terms…

Insufficient evidence

Too few studies

Ineffective

Not effective
Ensure the evidence pertains to a similar: setting, population of focus and
local conditions
Definition 1: Federal Registries

Examples of registries:

SAMHSA’s National Registry of Evidence-based Programs and Practices (NREPP)

NIAAA’s College Alcohol Intervention Matrix

Centers for Disease Control and Prevention’s Guide to Community Preventive
Services

The Agency for Health Research and Quality’s 2010-2011 Guide to Clinical
Preventive Services

Office of Justice Program’s Crime Solutions
SAMHSA definition of evidence-based

SAMHSA considers a program or practice evidence-based if:

1. It has been included in a federal registry of evidence-based interventions, OR

2. Its effectiveness in achieving target outcomes has been reported in peer
review journals, OR

3. Its effectiveness has been formally documented using other types of supporting
information
Definition 2: Peer-reviewed journal

Must be more than one article


Over half of articles must demonstrate positive outcomes
If we rely on peer-reviewed articles, we need to carefully consider:

How robust the published research is?

How relevant the published research is?
SAMHSA definition of evidence-based

SAMHSA considers a program or practice evidence-based if:

1. It has been included in a federal registry of evidence-based interventions, OR

2. Its effectiveness in achieving target outcomes has been reported in peer review
journals, OR

3. Its effectiveness has been formally documented using other types of
supporting information
Definition 3: Other supporting sources

To meet SAMHSA’s requirements, the strategy must meet all four of the
following guidelines:

Clearly documented theory or change in a logic model or conceptual model

Similar in content and structure to interventions in registries and peer-reviewed
journals

Repeatedly documented credible and positive effects

Reviewed and deemed appropriate by panel of informed prevention experts
Fidelity and adaptation


Fidelity: program is implemented as the developer intended

Do we have the capacity to implement the proposed strategy as planned?

Will we be implementing the strategy with a target population that is the same as,
or very similar to, the original target population?

Will we be working in a similar environmental context with similar local conditions?

Do we have the necessary resources and leadership to implement the strategy as
intended?
Adaptation: program is changed to meet local needs

Select programs with the best initial practical and conceptual fit

Change capacity before program

Retain core components

Adhere to evidence-based principles

Add rather than subtract
The big takeaways

Evidence-based practices give you the biggest bang for your buck.

Evidence base, conceptual fit, and practical fit are all important in
determining whether a strategy will be successful.

Selecting the best strategy takes time.
College AIM

CollegeAIM can help schools choose interventions wisely-boosting our chances
for success and helping them improve the health and safety of their students.

Developed with leading college alcohol researchers and staff, it is an easy-touse and comprehensive tool to identify effective alcohol interventions.

With the help of the college aim matrix, schools can review the individual and
environmental-level strategies to learn how our current or new strategies
compare to other alternatives.
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Find evidence-based options