Organizer Survey f Organizer Survey for Initial and Follow-up

Attachment C: Organizer Survey

OMB No. 0930-0288

Expiration Date: xx/xx/20xx

Burden Statement: This information is being collected to assist the Substance Abuse and Mental Health Services Administration (SAMHSA) for the purpose of program monitoring of Communities Talk to Prevent Underage Drinking initiative. This voluntary information collected will be used at an aggregate level to determine experiences with program events and underage drinking prevention activities. Under the Privacy Act of 1974 any personally identifying information obtained will be kept private to the extent of the law. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid Office of Management and Budget (OMB) control number. The OMB control number for this project is 0930-0288. Public reporting burden for this collection of information is estimated to average 10 minutes per encounter, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 5600 Fishers Ln, Room 15 E57B, Rockville, MD 20857.

Communities Talk to Prevent Underage Drinking Survey

INFORMED CONSENT STATEMENT

On behalf of the Substance Abuse and Mental Health Services Administration (SAMHSA), one of its contractors called ICF Next invites prevention specialists working individually or as part of a coalition to fill out this survey. A coalition refers to any group of individuals or organizations working together. This survey asks about your possible experiences with Communities Talk to Prevent Underage Drinking and how your community might be carrying out evidence-based strategies to prevent underage drinking. Evidence-based strategies have been evaluated and found to have positive effects on the intended audience. The survey will last no more than 10 minutes. Your participation is completely voluntary. You can stop at any time. Refusal to participate will not affect your employment, funding for your work, or result in any other penalty or loss of benefit. The research team will collect everyone’s answers and then download them into a file that excludes everyone’s name and contact information. Your survey answers will be stored in a password-protected folder and will be summarized with the answers from everyone else in a report. The report will not identify you. Your thoughts are very important. They will help SAMHSA improve how it supports community-based prevention efforts. If you have any questions, please contact Genevieve Martinez-Garcia, Study Administrator, at [email protected].

By continuing, you are consenting to participate in this survey on behalf of your coalition or you.

Cancel

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NOTE: As you complete each page of the survey and click the right arrow, data entered will be automatically saved. This feature allows you to return to the survey to make changes or finish completing it. You will be allowed to return to the survey until the last question is answered.

Please answer each question by marking one of the answer choices. Some questions allow you to mark more than one answer. If you don’t find an answer that fits exactly, choose the one that comes closest.

Importance of Underage Drinking

Q1 In your opinion, how important is underage drinking, and its consequences, to the residents of your community?

• Very important

• Important

• Moderately important

• Slightly important

• Not important

Communities Talk

Q2 How many Communities Talk activities have ever taken place in your community? These events may have been primarily hosted by your organization or a different one.

# activities primarily hosted by your organization: __________

# activities primarily hosted by a different organization: __________

Q3 What was the total number of attendees at the most recent Communities Talk activity? (Estimates are okay.)

# of physical (in-person) attendees: _______________

# of virtual (not in-person) attendees: _______________

Evidence-Based Strategies

Q4 Evidence-based strategies have been evaluated and found to have positive effects on the intended audience. Certain advance preparation may or may not help professionals build their capacity to carry out any number of evidence-based strategies to prevent underage drinking in their community. Some of the preparation may be tied to Communities Talk, while some of the preparation may not be tied to Communities Talk. This question asks about any preparation for evidence-based strategies, other than hosting a Communities Talk activity. How much have you completed the following steps?

	Not Started	Started and Partly Completed	Started and Fully Completed
Got resources (e.g., time, funding, equipment)
Read materials on how to conduct evidence-based strategies (e.g., website, handbook, toolkit, checklist)
Made plans to use the materials on how to conduct evidence-based strategies
Got training
Talked to one or more of my managers
Talked to one or more of my peers
Got one-on-one advice

Q5 Have you used any material(s) from the Communities Talk website (www.stopalcoholabuse.gov/communitiestalk)?

• Yes

• No

Q5A <If Q5=Yes> What material(s) from the Communities Talk website (www.stopalcoholabuse.gov/communitiestalk) have you used?

• Quick Start Planning Guide

• Registration Tutorial Video

• Tips & Tools for Hosting a Virtual Activity (e.g., virtual activity starters and ideas)

• Using Social Media guides

• Social Media Images/Graphics

• Customizable Resources for Communities Talk Promotion and Implementation (e.g., PowerPoint template, flyer, logo, web badge)

• Other (please specify) _______________

Q6 Please rate your agreement with the following statement: I know how to use evidence-based approaches to carry out future underage drinking prevention activities.

• Strongly agree

• Agree

• Disagree

• Strongly disagree

Q7 Prevention professionals take several steps as part of their evidence-based work. How confident are you that you can carry out the following tasks?

	Not confident	Somewhat confident	Very confident
Assess the needs and resources of the community
Define priority populations and create goals and objectives
Choose evidence-based strategies
Tailor the evidence-based strategies to the community
Assess organizational capacities to implement the evidence-based strategies
Plan to implement the evidence-based strategies
Find materials for priority populations
Manage coalition members
Monitor implementation of the evidence-based strategies
Evaluate the evidence-based strategies
Continually improve the evidence-based strategies
Sustain the evidence-based strategies

Q8 There are many ways to prevent underage drinking in a community. Different communities need different evidence-based strategies. SAMHSA wants to learn what works best for your community. Currently, which of the following activities are you or your organization collaborating with others on to prevent underage drinking in your community? (Mark all that apply.)

• Hold follow-up meetings or discussion groups on underage drinking prevention

• Create underage drinking prevention action groups (e.g., committees, task forces, and advisory boards)

• Start a youth-led coalition on underage drinking prevention

• Develop strategic plans to reduce and prevent underage drinking

• Build coalitions with other agencies or programs to reduce and prevent underage drinking

• Enforce compliance checks to reduce youth access to alcohol

• Encourage responsible beverage server training

• Reduce or limit alcohol outlet density

• Increase taxes on alcohol sales

• Increase sobriety and traffic safety checkpoints

• Limit alcohol sales at public events where youth are present

• Reduce the number of hours for possible happy hours

• Implement social host ordinances

• Draft policy changes for my community that focus on underage drinking prevention

• Work with my local legislators or policymakers to educate about the importance of changes to, or recommend enforcement of, existing laws and policies

• Other (please specify): _______________

Q9 A community’s needs and its resources may change over time. In the future, how likely is it that you or your organization will plan or collaborate with others on the following activities to prevent underage drinking in your community?

	Very Likely	Somewhat Likely	Not Likely
Hold follow-up meetings or discussion groups on underage drinking prevention
Create underage drinking prevention action groups (e.g., committees, task forces, and advisory boards)
Start a youth-led coalition on underage drinking prevention
Develop strategic plans to reduce and prevent underage drinking
Build coalitions with other agencies or programs to reduce and prevent underage drinking
Enforce compliance checks to reduce youth access to alcohol
Encourage responsible beverage server training
Reduce or limit alcohol outlet density
Increase taxes on alcohol sales
Increase sobriety and traffic safety checkpoints
Limit alcohol sales at public events where youth are present
Reduce the number of hours for possible happy hours
Implement social host ordinances
Draft policy changes for my community that focus on underage drinking prevention
Work with my local legislators or policymakers to educate about the importance of changes to, or recommend enforcement of, existing laws and policies

Usefulness of Communities Talk

Q10 Think about all of the Communities Talk activities that might have taken place in your community. How much do you agree with the following statements?

	Strongly Agree	Agree	Disagree	Strongly Disagree
Communities Talk has increased my knowledge of how my community can prevent underage drinking in my community.
Communities Talk has increased my community’s capacity to prevent underage drinking in my community.
Communities Talk is advancing the prevention of underage drinking in my community.
My community needs Communities Talk to sustain its prevention of underage drinking.

Q11 Do you have a report or something else (e.g., tables) that includes underage drinking data at the community level (e.g., incidences of use; activities or actions employed to prevent and combat underage drinking)?

• Yes

• No

Q11A <If Q11=Yes> Would you be willing to share the report with SAMHSA?

• Yes

• No

Q11B <If Q11A=Yes> Please send the report to the following address:

[email protected]

[or]

ICF

Attn.: Communities Talk—Genevieve Martinez-Garcia

530 Gaither Rd, Suite 500, Rockville, MD 20857

Demographics

Q12 How would you characterize the location where the Communities Talk activity was held?

• Rural

• Urban

• Suburban

• Reservation

• Other (please specify): _______________

Q13 Which of the following best describes your organization?

• Community-based organization

• Institution of higher education

• Other (please specify) __________

Q14. Which of the following best describes the primary audience(s) served by your organization? (Mark all that apply.)

• Youth

• Parents

• Teachers or other education staff

• Law enforcement officials

• Legislators or policymakers

• Doctors or other health care professionals

• Youth leaders (e.g., coaches, parks and recreation personnel, and scouting leaders)

• Clergy

• The media

• American Indian or Alaska Native community members

• Asian community members

• Black or African American community members

• Hispanic community members

• Native Hawaiian or Other Pacific Islander community members

• Lesbian, gay, bisexual, or transgender (LGBTQ) community members

• Other (please specify) __________
  
  

1-Year Recontact

<ALL ENDING> SAMHSA would like to contact you in about 1 year to get an update on prevention activities taking place in your community. Are you willing to be contacted in about 1 year to complete an online follow-up survey?

• Yes

• No

<Exit screen 1 (Yes to recontact)> Thank you again for sharing this important information about your experience with Communities Talk and underage drinking prevention activities in your community! We will contact your organization in about 1 year to follow up on any actions that were taken as a result of the Communities Talk activity that was held in your community. Visit https://www.stopalcoholabuse.gov/communitiestalk/ for the most current updates.

<Exit screen 2 (No to recontact)> Thank you again for sharing this important information about your experience with Communities Talk and underage drinking prevention activities in your community! Visit https://www.stopalcoholabuse.gov/communitiestalk/ for the most current updates.

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