Institutionalizing community-based prevention through policy change

This article summarizes the types of community policies that have shown eff ects on decreasing youth drug use, the contribution of community organizati on to policy change, and finally, the role of policy change on maintaining- or institutionalizing-community-based prevention efforts. Two types of poli cy change are considered: those involving implementation and those related to applicable regulations. Implementation policies are those aimed at insti tutionalizing prevention programs, usually through raising funds, requiring standard implementation, and creating a formal non-profit organization to implement programs. Regulatory policies include all formal laws, regulation s, and ordinances aimed directly at decreasing drug use, for example, regul ations which enforce the monitoring of drug-free zones. Results of studies suggest that regulatory policies may show the most immediate effect on yout h tobacco and alcohol use. Programmatic policies have the most potential fo r long-term effects on use. Community organization appears to stimulate cha nge in both types of policy. As yet unresolved is whether policy change can subsequently contribute to long-term community prevention efforts. Recent research has identified several barriers to institutionalization of communi ty prevention, including a) a lack of perceived empowerment by community le aders to continue prevention work; b) insufficient preparation of community leaders for adoption of evidence-based programs; c) the notion of continui ng an ineffective approach because of the costs already "sunk; " and d) a g eneral perception that no proscribed evidence-based approach will work beca use each community has its own unique needs. Furthermore, by community lead ers and a supportive social norm for prevention. Depsite these barriers, se veral factors have emerged from case studies of community prevention which may expedite the movement of a evidence-based prevention from science into practice. Identification of a local "champion" for prevention, development of local resources to sustain prevention, feedback about prevention program effects and strategic use of supportive mass media are recommended to indu ce local policy change and institutionalize prevention in the community. (C ) 2000 John Wiley & Sons, Inc.