Form Organizer Survey Organizer Survey Organizer Survey

Assessment of the Underage Drinking Prevention Initiative

4. Attachment_C_Organizer_Survey_for_Initial_ Mod

Organizer Survey

OMB: 0930-0288

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Attachment C: Organizer Survey


OMB No. 0930-0288

Expiration Date: 12/31/2026


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 Alcohol and Other Drug Misuse initiative. This voluntary information collected will be used at an aggregate level to determine experiences with program events and alcohol and other drug misuse 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 Alcohol and Other Drug Misuse 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 Alcohol and Other Drug Misuse and how your community might be carrying out evidence-based strategies to prevent alcohol and other drug misuse. 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 or Sarah Caban, Study Administrators, at info@communities-talk.com.


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


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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 Alcohol and Other Drug Misuse

Q1 In your opinion, how important of an issue is alcohol and other drug misuse, and its consequences, to the residents of your community?


  • Very important

  • Important

  • Moderately important

  • Slightly important

  • Not important

  • I don’t know


Communities Talk


Q2 What is the total number of Communities Talk activities hosted in your community during this calendar year? 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 your most recent Communities Talk activity? (Estimates are okay.)


# of physical (in-person) attendees: _______________

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


Q4. What substances/topics, if any, will your Communities Talk activity cover? Choose all that apply.*

    • E-cigarettes/vaping

    • Prescription opioids

    • Fentanyl

    • Naloxone

    • Marijuana

    • Heroin

    • Cocaine

    • Methamphetamines

    • Mental health

    • Suicide

    • Alcohol

    • Other: [FILL IN]




Evidence-Based Strategies

Q5 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 your organization’s preparation for evidence-based strategies, other than hosting a Communities Talk activity. How much have you completed of 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


Q6 Have you used any material(s) from the Communities Talk website (https://www.samhsa.gov/substance-use/prevention/communities-talk)?

  • Yes

  • No


Q6A <If Q6=Yes> What material(s) from the Communities Talk website (https://www.samhsa.gov/substance-use/prevention/communities-talk) have you used?


  • Quick Start Planning Guide

  • 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)

  • Prevention Event Planner web app

  • Other (please specify) _______________


Q7 Please rate your agreement with the following statement: I know how to use evidence-based approaches to carry out future alcohol and other drug misuse prevention activities.


  • Strongly agree

  • Agree

  • Disagree

  • Strongly disagree


Q8 Prevention professionals take several steps as part of their evidence-based work. How confident are you that you can carry out the following tasks?


**If a task is outside your organization’s authority, please select “not applicable”.



Not confident

Somewhat confident

Very confident

Not applicable

Assess the needs and resources of the community

Define priority populations

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

Acquire/get 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

Collaborate with others to implement resources or programming

Work with my local legislators or policymakers to create laws and/ or policies



Q9 There are many ways to prevent alcohol and other drug misuse 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 on with others to prevent alcohol and other drug misuse in your community? (Mark all that apply.)


  • Hold meetings or discussion groups on alcohol and/or other drug misuse prevention

  • Create alcohol and/or other drug misuse prevention action groups (e.g., committees, task forces, and advisory boards)

  • Start a youth-led coalition on alcohol and/or other drug misuse prevention

  • Develop strategic plans to reduce and prevent alcohol and/or other drug misuse

  • Build coalitions with other agencies or programs to reduce and prevent alcohol and/or other drug misuse Enforce compliance checks to reduce youth access to alcohol and/or other drugs.

  • Encourage responsible beverage server training

  • Reduce or limit alcohol and/or other drugs outlet density

  • Increase taxes on alcohol sales

  • Increase sobriety and traffic safety checkpoints

  • Limit sales of alcohol at public events where youth are present

  • Prevent sales of other drugs 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 alcohol and/or other drug misuse 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): _______________


Q10 For the activities mentioned in Q9, what types of organizations do you typically collaborate with (check all that apply)?


  • Faith-based based organizations

  • Law enforcement

  • Youth-led organizations

  • Secondary schools

  • Elementary schools

  • Colleges or universities

  • Other community-based organizations

  • Local chapters of national organizations

  • Charitable organizations

  • Local businesses

  • State and local government agencies (e.g., public health departments)

  • Other


Q11 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 alcohol and other drug misuse in your community?



Very

Likely

Somewhat Likely

Not

Likely

Hold follow-up meetings or discussion groups on alcohol and/or other drug misuse prevention

Create alcohol and/or other drug misuse prevention action groups (e.g., committees, task forces, and advisory boards)

Start a youth-led coalition on alcohol and/or other drug misuse prevention

Develop strategic plans to reduce and alcohol and/or other drug misuse

Build coalitions with other agencies or programs to reduce and prevent alcohol and/or other drug misuse

Enforce compliance checks to reduce youth access to alcohol and/or other drugs

Encourage responsible beverage server training

Reduce or limit alcohol and/or other drugs outlet density

Increase taxes on alcohol sales

Increase sobriety and traffic safety checkpoints

Limit sales of alcohol at public events where youth are present

Prevent sales of other drugs 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 alcohol and/or other drug misuse 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

Q12 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 alcohol and other drug misuse in my community.

Communities Talk has increased my community’s capacity to prevent alcohol and other drug misuse

Communities Talk is advancing the prevention of alcohol and other drug misuse n my community.

My community needs Communities Talk to sustain its prevention of alcohol and other drug misuse


Q13 Do you have a report or something else (e.g., tables) that includes alcohol and other drug misuse data at the community level (e.g., incidences of use; activities or actions employed to prevent and combat alcohol and other drug misuse)?


  • Yes

  • No


Q13A <If Q12=Yes> Would you be willing to share the report with SAMHSA?

  • Yes

  • No


Q13B <If Q12A=Yes> Please send the report to the following address:


info@communities-talk.com


[or]


ICF

Attn.: Communities Talk—Genevieve Martinez-Garcia

530 Gaither Rd, Suite 500, Rockville, MD 20857


Demographics

Q14 How would you characterize the location where your Communities Talk activity was held?


  • Rural

  • Urban

  • Suburban

  • Reservation

  • Other (please specify): _______________


Q15 Which of the following best describes your organization?

  • Community-based organization

  • Institution of higher education

  • Other (please specify) __________


Q16 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

  • Prevention specialists and volunteers

  • Law enforcement officials

  • Legislators or policymakers

  • Doctors, nurses, or other health care professionals

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

  • Healthcare providers

  • 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

  • Other (please specify) __________

Exit screen>

Thank you again for sharing this important information about your experience with Communities Talk and alcohol and other drug misuse prevention activities in your community! Visit https://www.samhsa.gov/substance-use/prevention/communities-talk for the most current updates.


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