2010 Model Practice Application (Public)

Campus Community Initiative of the Combating Underage Drinking Coalition

Baltimore County Department of Health

The Campus Community Initiative (CCI) addresses underage and hazardous drinking both on and off college campuses and its negative consequences. In 2002, “A Call to Action: Changing the Culture of Drinking at U.S. Colleges," a report by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Task Force on College Drinking highlighted the extent of this problem. In 2007, according to The National Center on Addiction and Substance Abuse (CASA) at Columbia University Report, “Wasting the Best and the Brightest: Substance Abuse at America’s Colleges and Universities,” (2007) drinking among college-aged students remains “an alarming public health crisis on college campuses across the nation." The Initiative specifically focuses on areas in Baltimore County affected by the presence of four year and community colleges. The primary goal of CCI is to impact policies and practices associated with underage and high-risk drinking by college students in selected Baltimore County communities utilizing grass-root support. Three objectives have been identified by the Combating Underage Drinking (CUD) Coalition to achieve this goal: 1) Reduce youth access to alcohol, 2) Increase consistent enforcement of alcohol-related laws and policies, and 3) Educate the “impacted” public (community members, parents, college personnel) regarding underage and high-risk drinking among college youth. Research, stemming from NIAAA’s Rapid Response to College Drinking Problems Initiative, shows that community initiatives aimed at reducing alcohol-related problems among college-aged youth have been effective. The key factor in this effectiveness is a close collaboration between colleges and their neighboring communities. This includes environmental strategies such as vigorous enforcement of underage drinking laws and reduction in the availability of alcohol to individuals under age 21. Overall, the Campus Community Initiative seeks to reduce the availability and accessibility of alcohol to college students and, in so doing, reduce the commission of nuisance crimes (noise, public urination, illegal parking, disorderly conduct) and property crimes (primarily destruction of property) in the neighboring communities, and alcohol-related injuries, assaults and driving offenses. Now in its sixth year of implementation, the CCI has a lengthy list of accomplishments that attest to its success in meeting its three objectives. Each year a review of CCI’s activities and its results is conducted. As system change requires ongoing effort both in creating shifts in public attitudes and practices and in reinforcing those positive shifts, performance measures are adjusted accordingly year to year. The following are two examples of the Initiative’s initial outcomes: • Securing additional funding 1) to subsidize Responsible Server Trainings for Baltimore County alcohol servers, salespersons, managers and owners and 2) to add Reducing the Availability of Alcohol to Minors (RAAM) Details in each police precinct located in the vicinity of Baltimore County College residences. • In 2004, 285 Villa Julie College/Stevenson University students were screened on campus on National Alcohol Screening Day; in 2005, 386 students; and in 2009, 650 students.

The Campus Community Initiative broadly addresses community health and specifically the safety and health of young adults (ages 18-25). According to NIAAA as reported in their October 2002 Alcohol Alert #58, the extent of underage and high-risk drinking on college campuses “is more pervasive and destructive” than the public realizes. More recently, an article in the July supplement of the Journal of Studies on Alcohol and Drugs reported that alcohol-related deaths among U.S. college students had risen approximately 20% from 1998–2005 (from 1440 to 1825) along with an almost 6.5% increase of self-reported binge drinking (five or more alcoholic drinks on any occasion in the past 30 days).The need for underage drinking prevention in Baltimore County was highlighted in the Maryland Department of Education’s Adolescent Survey in 2002. Data showed that 47.2% of high school seniors in Baltimore County reported a pattern of regular alcohol use and 35.7% reported drinking five or more alcoholic beverages at one sitting (binge drinking). Students frequently arrive at college with patterns of heavy drinking already in place as well as preconceived perceptions that drinking alcohol is an accepted and anticipated part of college life. Also in 2002, the Baltimore County Local Management Board conducted a survey with Baltimore County residents. The survey results were reported in “Focus on Families: Creating a Foundation of Child Well-Being” (March, 2002). Among the top five concerns reported by County citizens was the need to address underage drinking and the negative consequences (nuisance and property crimes, assaults, injuries and DUIs) associated with it.The Baltimore County Department of Health responded to residents concerns and jurisdictional data by supporting the Bureau of Substance Abuse’s Combating Underage Drinking Coalition’s investigation of strategies and interventions that addressed problem drinking by college students particularly those under 21. The development of the CCI utilizing the CMCA approach activated Coalition members and provided needed impetus to implement changes in local policies and practices on both formal and informal levels. The use of an environmental approach reframed the issue as a community problem rather than simply the colleges' problem and brought together needed stakeholders to address the issue cooperatively. In 2004, the Combating Underage Drinking Coalition of the Department of Health, Bureau of Behavioral Health sought to develop a proven environmental strategy to address the problems of alcohol misuse by the County’s college students. In October of 2002, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Task Force on College Drinking had reviewed alcohol prevention strategies. The Task Force grouped those that were potentially useful into three tiers according to their effectiveness based on available research study results. The Coalition chose to implement Communities Mobilizing for Change on Alcohol, a Tier 2 strategy. These strategies were proven successful with general populations that could apply to college environments.In this instance, CMCA’s study population was young adults ages 18–25. At that time, two programs had focused on colleges working with their surrounding communities via grants provided through NIAAA’s Rapid Response Initiative: 2 universities in Washington State used Neighborhoods Engaging with Students (NEST) and the University of Rhode Island used Common Ground. Both demonstrated positive results. As CMCA was on SAMHSA’s National Registry of Evidence-based Programs and Practices, the Coalition decided to apply the approach specifically to the underage and hazardous drinking problem by students at the County’s colleges.Prior to the adoption of CMCA, Coalition prevention efforts were directed toward attitudinal and behavioral change on the part of individuals. The shift to a systems change via CMCA’s environmental approach presented the Coalition with a n

In the late 1990’s, the Baltimore County Department of Health, Bureau of Substance Abuse (now the Bureau of Behavioral Health) established the Combating Underage Drinking (CUD) Coalition that consisted of representatives from several government and private agencies to address the problem of underage drinking in the County. As information and materials on evidence-based programs and best practices in prevention were disseminated nationally, Bureau staff offered technical assistance and prepared member agencies and organizations to move toward a research-based prevention approach. Fiscal year 2005 offered a funding opportunity to develop, implement and evaluate an evidence-based prevention strategy. As a result of the foundation laid by Bureau staff regarding EBPs and best practices, the Coalition adopted Communities Mobilizing for Change on Alcohol (CMCA) adapting its environmental strategy to mobilize selected County communities impacted by the drinking behavior of students attending local colleges. Currently, members of the Coalition include representatives from the Baltimore County Liquor Board, Baltimore County Licensed Beverage Association, Baltimore County Public Schools, Baltimore County Police, Maryland State Police, Mothers Against Drunk Driving, Greater Towson Council of Neighborhood Associations, Department of Juvenile Services, University of Maryland Baltimore Campus, Stevenson University, Towson University, Goucher College, HELPS Coalition, Baltimore County Department of Corrections, Baltimore County State’s Attorney’s Office, Johns Hopkins University Health Education, Loyola University, Jewish Community Services, Hereford Zone Cares, concerned parents and County citizens, and Health Department staff from the Bureau of Behavioral Health in addition to the Coalition facilitator. All Coalition members are actively involved in the planning and implementation of the CCI as evidenced by the mutually beneficial collaborations and partnerships that have resulted from the wide representation of stakeholders. One result of these collaborations has been the establishment of the Cooperating Taverns and Alcohol Retailers' Agreement. This Agreement (a code of conduct) positively recognizes responsible alcohol retailers who are diligent in their compliance with underage drinking laws and demonstrate responsbility in pricing, promotion and policies and encourages other retailers to do the same. One hundred and twelve (112) licensees have signed the Agreement. The retailers receive a window cling advertising their participation and the Coalition members encourage the public to use those participating retailers.

In the late 1990’s, the Baltimore County Department of Health, Bureau of Substance Abuse (now the Bureau of Behavioral Health) established the Combating Underage Drinking (CUD) Coalition that consisted of representatives from several government and private agencies to address the problem of underage drinking in the County. In 2004, the CUD Coalition sought to develop a proven environmental strategy specifically to address the problems of alcohol misuse by the County’s college students. In fiscal year 2005, through funding by the Alcohol and Drug Abuse Administration, the Coalition began implementation of the Campus Community Initiative utilizing Communities Mobilizing for Change on Alcohol (CMCA), a community-organizing program on SAMHSA’s National Registry of Evidence-based Programs and Practices. The plan was to implement CMCA in target communities surrounding the County’s major four-year colleges: Towson University, Goucher College, University of Maryland, Baltimore County Campus and Villa Julie College (now Stevenson University). The Coalition envisioned a several stage implementation that started with the neighborhoods in the vicinity of Towson University and Goucher College (the Towson/Loch Raven corridor). This original grant money funded a Coalition facilitator (30 hours/week, $40,000 + mileage reimbursement at the designated federal level) and overview training for Coalition members and other stakeholders ($5,000). In-kind costs through the Health Department Bureau included operational expenses (phone, fax, computer, meeting facility, etc.). During its first year, most of CCI’s efforts were focused on educating parents, students and members of the target communities. Some of the accomplishments included the Sticker Shock Project (October 2004). College students and community Coalition members affixed approximately 3,500 stickers onto beer cases and distributed 400 window clings to alcohol licensees stating the law and penalties for adults purchasing alcohol for youth under 21. Also, a parenting brochure, educational door tags for off-campus students and a pamphlet for all students addressing underage drinking laws and resource information were distributed. The Coalition facilitator vigorously networked with community associations, college personnel and other community organizations/agencies. Both the CUD Coalition’s initial implementation funding and ongoing implementation of CCI is funded through the Alcohol and Drug Abuse Administration’s grant to the Bureau of Behavioral Health. This funds the salary of one (1) part-time Health Department staff person who serves as the Coalition facilitator providing administrative support and technical assistance. First year start-up required 30 hours/week with a salary of $40,000. The importance of this position cannot be underestimated as the facilitator serves to connect Coalition stakeholders, nurture their relationships and guide the members to a common purpose. Additional costs include funds to purchase ID scanners ($850/each) and to provide a continental breakfast to the members at their bi-monthly morning Coalition meetings ($50 total per meeting). Additionally, over the course of the Initiative, supplemental funding for specific projects (example: a specialized training or enforcement task) has been pursued by the Coalition.

The Campus Community Initiative is an environmental strategy implemented by the Combating Underage Drinking Coalition. The Coalition adapted its prevention efforts by utilizing the evidence-based program Communities Mobilizing for Change on Alcohol to mobilize selected communities. The communities targeted for this effort were those surrounding Baltimore County’s major four-year colleges (Towson University, Goucher College, University of Maryland, Baltimore County Campus, and Villa Julie College now Stevenson University). Focus has been on the expansion of its environmental strategies that include regulatory interventions acknowledged to be best practices (OJJDP. 2006. Regulatory Strategies for Preventing Youth Access to Alcohol: Best Practices) and that integrate principles of effective substance abuse prevention established by the Center for Substance Abuse Prevention (CSAP). Actions that were taken to create a functioning Coalition and an effective Initiative included: * Identify the community public health issue – underage drinking by college students * Obtain Health Department support through its Bureau of Behavioral Health for a staff person to serve as the dedicated Coalition facilitator, and approval to use in-kind resources (including food to have at Coalition meetings – “breaking bread” together makes a difference * Choice of facilitator – must be committed to the mission and have positive interpersonal skills * Select target areas for the Initiative – phase in implementation of strategies and interventions * Review evidence-based prevention strategies/programs * Based on the issue, the target population, Health Department resources and the hoped-for outcomes, select the strategy/program that fits best * Stick to “the plan” - keep focus on the identified objectives and continue to work toward achieving them * Appreciate and acknowledge the participation of Coalition members as partners The Campus Community Coalition has been in existence since 2004. The overall goal and three objectives have been ongoing and continue today. Each year activities and environmental strategies are planned and implemented for each of CCI's three objectives by the Coalition. These may be new events and interventions or ongoing strategies that are being maintained as a result of a shift in campus or community policy or practice.

One of the most the most significant process outcomes of the CCI is the degree of stakeholder commitment. As previously noted, there continues to be an expanding membership of actively involved agencies and organizations on the CUD Coalition. In addition, a focus group with key Coalition members held in November 2008 yielded feedback that confirmed the effectiveness of the CUD Coalition’s Campus Community Initiative. In summary, the key informants indicated that the CCI gives legitimacy to the problem of underage drinking, the Coalition’s CCI activities are “impressive” and that there is growing interagency cooperation and collaboration that would never have occurred naturally. Finally, there is acknowledgment of the benefits of their participation as members – the satisfaction of witnessing progress on issues and the sharing of insights and resources. This embedded motivation sustains the ongoing mission of the Coalition and CCI’s work. Funding may come and go due to any number of economic and political variables. However, commitment is an intangible force that is capable of sustaining a mission despite adverse conditions. The good will and collaboration that has developed among Coalition members has continued into fiscal year 2010 and actually has led to an expansion of the environmental approach to a jurisdictioanl neighbor. Loyola University, a long time Coalition member, has begun a Baltimore City Campus Community Coalition through a Department of Education grant. The CUD Coalition has lent its support from the onset and is continuing to offer technical assistance. This fledgling partnership creates the opportunity to share resources and collaborate across jurisdictions.

The overall practice goal was and is to impact policies and practices associated with the underage and high-risk drinking of students attending colleges in Baltimore County utilizing grass root support. The objectives of the Coalition’s Campus Community Initiative have remained constant since its inception with performance measures tailored yearly to match current issues. Reduce youth access to alcohol. This objective addresses two areas of alcohol availability to youth: commercail availability (alcohol retail establishments) and non-commercial availability (parents, siblings, friends, other adults of legal age).Commercial availability 1) Increase the number of ID scanners installed and used (OJJDP Best Practice 6) 2) Increase the number of compliance checks carried out (OJJDP Best Practice9, CSAP S/E-19) 3) Increase student attendance to testify at Liquor Board Hearings of alcohol licensees non-compliant with underage drinking laws (CSAP C-8) Non-commercial availability 4) Development of one (1) peer-led intervention (CSAP P-6 & S-3) An ongoing record for activities is compiled and maintained by the Coalition facilitator. Collected jurisdictional data is provided by the State’s Attorney’s Office, College/University Police, Baltimore County Police –Traffic Safety Division and specific Precincts, the Baltimore County Liquor Board and the Maryland State Highway Administration.The record of CCI activities is maintained as they occur. The jurisdictional data is collected monthly. Activities and data are reported on a fiscal year basis (July 1 -June 30).The Coalition facilitator, Bureau supervisor and manager and the prevention program evaluator receive the data results. An initial lesson learned was the tendency of Coalition members to want to spin off in too many directions resulting in CCI's focus becoming diluted at times. This tendency required the Coalition facilitator is to assist members to remain on track and set obtainable outcomes each year. The outcomes listed are for fiscal year 2009. * An additional nine (9) alcohol licensees purchased ID scanners * A training in the use of ID scanners was offered by BBH staff and 2009 Checking Guides were distributed to alcohol retailers and the Baltimore County Police * Towson University continued its use of scanning equipment at Tiger FEst, tailgating and other social events on campus * 23 additional alcohol establishments wew checked for compliance than in 2008 by the Baltimore County Police * There was nearly 100% student attendance at Liquor Board Hearings * Towson University has created the Student Community Ambassadors Program in which students who live off-campus serve as positive liaisons between students, their community neighbors and the UniversityIncrease consistent enforcement of alcohol-related laws and policies as they apply to underage and high-risk drinking 1) Employ more frequent enforcement operations (CSAP S/E-19) 2) Implement and enforce zero toerance laws (OJJDP Best Practice 20) 3) Include representatives from every organization that play a role in the fulfillmentof the Initiative (CSAP C-8)An ongoing record for activities is compiled and maintained by the Coalition facilitator. Collected jurisdictional data is provided by the State’s Attorney’s Office,college/University Police, Baltimore County Police –Traffic Safety Division and specific Precincts, the Baltimore County Liquor Board and the Maryland State Highway Administration. The record of CCI activities is maintained as they occur. The jurisdictional data is collected monthly. Activities and data are reported on a fiscal year basis (July 1 -June 30).The Coalition facilitator, Bureau supervisor and manager and the prevention program evaluator receive the data results. A lesson that is continually being reinforced is the need for key stakeholders to be participating members of the Coalition if Initiative efforts are to be successful.