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Recent traffic fatalities have focused attention on underage drinking in the Midlands of South Carolina.
The former Lexington/Richland Alcohol and Drug Abuse Council, now known as LRADAC, The Behavioral Health Center of the Midlands, and community coalitions, have been working on the problem and other community substance abuse issues by using a model known as Getting To Outcomes (GTO).
The coalitions and LRADAC developed the first statewide multi-jurisdictional Alcohol Enforcement Team, which used GTO. Their efforts were recognized with an award from the National Association of State Alcohol and Drug Abuse Directors and the U.S. Center for Substance Abuse Prevention.
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| Abe Wandersman |
"Getting To Outcomes is a systematic way to achieve results," said USC psychology professor Abe Wandersman, referring to the approach that can be used by organizations and agencies to achieve results dealing with almost any problem.
Wandersman co-authored the GTO Preventing Underage Drinking guide with LRADAC consultant Pamela Imm, Matthew Chinman of the RAND Corp., and colleagues from Boston University's Join Together, a resource center for communities working to reduce substance abuse.
The guide was developed for the U.S. Center for Substance Abuse Prevention to provide evidence-based environmental strategies leading to community-wide change that included sobriety checkpoints, beer keg registrations, and other counter measures to drastically reduce under-age drinking. It is available free on the Web at www.cas.sc.edu/psyc/
PDFDocs/WanderPreventUnderageDrink.pdf.
At the core of the guide are the answers to 10 questions developed by Wandersman, Imm, and Chinman that can also be used by other public or private entities to tackle any of a variety of societal issues, from teen pregnancy to diabetes prevention.
Development of what Wandersman refers to as "Taxpayer Questions" began in the 1990s when he and colleague Bob Goodman, formerly of USC's Arnold School of Public Health, served as local evaluators for community coalition efforts working on substance abuse prevention.
"Local coalitions became a mechanism for reaching into communities to handle public health problems, but the coalitions were only providing modest, if any, results," said Wandersman, who, with several graduate students, began to think about what it would take to make community coalition initiatives more effective.
The result was the 10-step Getting To Outcomes approach, developed with Imm and Chinman, which has been embraced by the accountability and results movement in initiatives ranging from education, to treatment and prevention.
"I put the 10 steps in the form of questions because I kept thinking, 'Why are people doing what they're doing, and do they know if what they're doing makes sense? The key to Getting To Outcomes is being able to answer each of the 10 questions which is like walking up stairs to reach results."
The GTO system can be used for programs like No Child Left Behind or Healthy People 2010, the federal government's national health promotion and disease prevention initiative. Both are accountability efforts that set ambitious goals, but don't provide clear avenues for achieving them, which in turn can lead to resistance and fear on the part of program administrators, Wandersman said.
The substance abuse work led to a participatory research grant from the Centers for Disease Control in which GTO was used in other community coalitions in the Midlands and in California. The results of the study showed that GTO helped build individual capacity to plan, implement, and evaluate, and to build the quality of program performance.
Wandersman also is collaborating with the USC Center for Public Health Preparedness in applying the 10 questions to emergency preparedness in situations like Hurricane Katrina. And he is a member of a group of researchers who are partnering in USC's application for a $40 million translational science grant from the National Institutes of Health. The project could help close the gap between what's known from medical research and how that knowledge is applied in medical practice.
"The idea is that you can take the 10 questions and work them into a book that tells people how to answer each one using state-of-the art information that helps bridge research and practice," said Wandersman. "You want to distill or synthesize state-of-the-art knowledge about how to do each of those 10 steps in a given content area so that practitioners and the public can use it.
"The USC Center for Public Health Preparedness is using GTO to train fire departments and other first responders in a collaborative approach to disaster responses in a way that has results-based accountability," said Wandersman, who can be reached at wandersman@sc.edu.
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