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Appendix I. Fayette County CHNA HIP

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Appendix I. Fayette County CHNA HIP Powered By Docstoc
					             Iowa’s Strategic Prevention Framework
                      to Reduce Underage
                       and Binge Drinking

                 County Assessment Workbook




                      Needs
                    Assessment

                                                               Mobilize &
Evaluation                                                   Build Capacity
                       Cultural Competence &
                            Sustainability

              Policies,                       Strategic
              Practices,                        Plan
             & Programs




                           2011 Workbook

 (Adapted from the Wyoming Epidemiological Workgroup)




     Fayette County, Iowa County Assessment Workbook (CAW)
                              1
                                                                  Table of Contents




List of Tables ..................................................................................................................4
Contacts for Questions or Help ....................................................................................5
County Needs Assessment Workbook Contributors ..................................................6
Local Data Sources ......................................................................................................10
Introduction ..................................................................................................................15
Outcome-Based Prevention ........................................................................................16
Purpose.........................................................................................................................16
Workbook Organization...............................................................................................17
   Data From Existing Survey and Other Sources .......................................................................... 18
   Collection of Original Data................................................................................................................... 18
   Interviews With Key Partners and Stakeholders ........................................................................ 18
   County Focus Groups ........................................................................................................................... 18
EXPLORING DATA FOR YOUR COUNTY ...................................................................20
Description of Your County ........................................................................................20
       Canoeing on the Turkey and Volga Rivers are a popular pastime in Fayette County 22
Consequences .............................................................................................................24
   Alcohol-Related Crimes: ...................................................................................................................... 24
   Alcohol Related Conviction Rates:................................................................................................... 25
   Alcohol-Related Car Crashes: ........................................................................................................... 28
   Alcohol Dependence and Abuse: ..................................................................................................... 30
   Alcohol School Suspensions and Expulsions: ............................................................................. 34
       Other Data ............................................................................................................ 40
   Final Consequences Question .......................................................................................................... 41
Consumption ................................................................................................................42
   Underage Drinking: ................................................................................................................................ 42
   Adult Drinking: .......................................................................................................................................... 45
       Other Data ............................................................................................................ 46
   Final Consumption Question .............................................................................................................. 47
Potential Intervening Variables...................................................................................49
Intervening Variables ...................................................................................................50
Alcohol Availability (Retail) .........................................................................................50
   Per Capita Liquor Licenses and Gallon Sales: ............................................................................ 50
   Compliance Check Failure Rate ....................................................................................................... 51
   Percentage of Drive-Up Liquor Windows: ..................................................................................... 52
   Local Ordinances .................................................................................................................................... 52
   Other Data ................................................................................................................................................. 57
   Retail Availability Questions ............................................................................................................... 58
Key Law Enforcement Interviews ...............................................................................59
       Officers Assigned to Alcohol-Related Issues ................................................... 59
   Other Data ................................................................................................................................................. 60
In speaking with law enforcement, it was noted that any minor at a party that does not register
a BAC will be let off without charges, even if they are technically in possession of alcohol.
.......................................................................................................................................60
Social Availability ........................................................................................................60
                                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                                                2
  County Level Data:................................................................................................................................. 60
  County Meetings or Focus Groups .................................................................................................. 61
  Other Data ................................................................................................................................................. 61
In visiting with an Upper Iowa football player, it was noted that in his freshman year, the
football coach bought kegs to celebrate the end of the season. The coach was not concerned
about the age of the players and encouraged them to drink in celebration. ..........61
  Social Availability Questions............................................................................................................... 61
Promotion .....................................................................................................................62
  Sponsorships ............................................................................................................................................ 62
  Advertising .............................................................................................................................................. 64
     Step One ............................................................................................................... 64
     Step Two ............................................................................................................... 65
     Other Data ............................................................................................................ 68
  Promotion Questions ............................................................................................................................. 69
County Norms ..............................................................................................................69
  Temporary Alcohol Licenses for Community Events: (source ABD) .................................. 73
  County Meetings or Focus Groups .................................................................................................. 74
  Other Data ................................................................................................................................................. 74
  County Norms Questions..................................................................................................................... 74
Individual Factors ........................................................................................................76
  Surveys ....................................................................................................................................................... 76
  Graduation Rates .................................................................................................................................... 78
  Other Data ................................................................................................................................................. 79
  Individual Factor Questions ................................................................................................................ 79
Prioritizing ....................................................................................................................82
Resources.....................................................................................................................86
Final Question ..............................................................................................................88
Your Final Conclusions ...............................................................................................89
Appendix A. Law Enforcement Interviews .................................................................90
  Notes for Law Enforcement Interview About Alcohol Use ...................................................... 94
Appendix B. County Meeting or Focus Groups Protocol .........................................95
  Notes for Town Hall Meeting About Alcohol Use ....................................................................... 99
Appendix D. Underage Drinking Survey at Oelwein High School .........................103
Appendix E. Underage Drinking Survey of SODA students at Valley Community Schools 109
Appendix H. Fayette County Billboard Scan ...........................................................121
Appendix I. Fayette County CHNA HIP.....................................................................122
REFERENCES ............................................................................................................126




                                             Fayette County, Iowa County Assessment Workbook (CAW)
                                                                                  3
List of Tables
Table 1: Workbook Contributors ............................................................................................................................................... 6
Table 2: State Data Sources Used in the Assessment ............................................................................................................. 8
Table 3: Other Data Sources (see example)............................................................................................................................ 10
Table 4: Deadlines for Activities and Workbook Completion ............................................................................................ 19
Table 5: Proportion of Liquor License Holders That Failed a Compliance Check, source LEW ................................. 51
Table 6: Drive-Up Liquor Windows and Liquor Licenses in Your County, source ABD .............................................. 52
Table 7: Local Ordinances Targeting Alcohol in Your County, source CEW .................................................................. 52
Table 8: County Events and Their Alcohol-Related Sponsors Within Last Year, source LEW .................................... 63
Table 9: Local Alcohol Advertisements and Promotional Events, source LEW ............................................................. 66
Table 10: Current Resources and Strategies Focusing Upon the Underage and Binge Drinking by Intervening
variables........................................................................................................................................................................................ 86




                                                     Fayette County, Iowa County Assessment Workbook (CAW)
                                                                                                 4
Contacts for Questions or Help
Dr. Ousmane Diallo
Epidemiologist, Chair of the State Epidemiological Workgroup
IDPH, Division of Behavioral Health
ousmane.diallo@idph.iowa.gov
(515) 281-8261

Debbie Synhorst
SPF SIG Coordinator
IDPH, Division of Behavioral Health
deborah.synhorst@idph.iowa.gov
(515) 281-4404

Workbook is Available Online: www.iowaspfsig.org




                           Fayette County, Iowa County Assessment Workbook (CAW)
                                                    5
                         County Needs Assessment Workbook Contributors

List the names of people in your county, the organizations they represent, and the contributions they
made to completing this workbook in Table 1 below.

Table 1: Workbook Contributors
Name                        Organization                         Contribution

Dr Ousmane Diallo             Iowa Department of Public          Collection and analysis of
                              Health                             state and county indicators
Stacie Schroeder              Helping Services for               Fayette County
                              Northeast Iowa                     Coordinator, Collection &
                                                                 analysis of local data
Annette Butikofer             Valley SODA, Valley                LEW Chairperson,
                              Community Coalition                Collection and analysis of
                                                                 local data
Cindy Ira-Smith               Palmer Community Health            LEW Member, Collection
                                                                 and analysis of local data
Katie Bee                     Helping Services for               LEW Member, FCSAC
                              Northeast Iowa, Fayette            Coordinator - Collection of
                              County Substance Abuse             town hall meeting,
                              Coalition                          community readiness and
                                                                 focus group data.
Joann Boyer                   Palmer Community Health            Fayette County CHNA HIP,
                                                                 collection & analysis of
                                                                 local data
Kristi Miller                 Helping Services for               Fayette County Liaison,
                              Northeast Iowa                     collection & analysis of data
Cassie Peterson               Valley Community Coalition         FCSAC member, collection
                                                                 and analysis of data
Jim Davies                    Chief, West Union Police           Law enforcement interview
                              Department                         – insight to alcohol related
                                                                 issues in West Union
Cynthia Lamphier              QA/Pt Safety/Trauma                Alcohol associated data
                              Coordinator, Palmer                from Palmer Lutheran
                              Lutheran Health Center             Hospital
Brandon DeJong                Officer, Oelwein Iowa              Law enforcement interview
                              Police Department                  – insight to alcohol related
                                                                 issues in Oelwein
Jay Villont                   Assistant County Attorney          Insight to criminal justice
                              for northern half of Fayette       system and alcohol-related
                              County                             incidents
Kevin Kleve                   Mayor, City of Waucoma             Insight as to underage
                                                                 drinking in Waucoma
Lieutenant Eick & Sgt.        Iowa State Patrol, District        data on sobriety
Barker                        10 Post                            checkpoints and
                                                                 compliance checks in
                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     6
                                                                     Fayette County

Deputy Joe Miller                 Fayette County Sheriff’s   data and insight on
                                  Office                     underage drinking in
                                                             Fayette County
Dawn Milius and CCC Staff         Community Circle of Care,  insight and data on
                                  Child Health Specialty     underage drinking and
                                  Clinics                    effects on families
Vicki Rowland, Jeanine            Fayette County Supervisors insight on cultural norms
Tellin, Darrel Dolf, and Lori     and Fayette County Auditor and social availability
Moellers
Ben Loeb                          Juvenile Court Officer for         insight on JCO processes
                                  First Judicial District            and consequences of
                                                                     alcohol for youth.
Chief A.J. Sullivan               Clermont Police                    insight on law enforcement
                                  Department                         processes and data for
                                                                     Clermont
Kari Solheim                      Upper Iowa University,             alcohol advertising at UIU
                                  Office of Student
                                  Development
Brian Williams                    Valley Community Schools,          graduation rates and
                                  High School & Middle               expulsion information
                                  School Principal
Todd Wolverton                    North Fayette Community            graduation rates and
                                  Schools                            expulsion information
Carol Keune                       Fayette County Community           data on court ordered adult
                                  Services                           committals that involve
                                                                     alcohol dependence
Troy Schott                       Councilmember, West                participated in discussion
                                  Union City Council                 meeting
Lori Hover                        Juvenile Court Services            data on alcohol violations
                                                                     and referrals
Marcia Oltrogge                   Northeast Iowa Behavioral          data on services provided
                                  and Health                         in Fayette County
Judy Malget                       Mercy Medical Center




                                Fayette County, Iowa County Assessment Workbook (CAW)
                                                         7
State Data Sources:

Table 2: State Data Sources Used in the Assessment
Data Source                  Data Description                    Data Location
Iowa Youth Survey(state)      Statewide school survey of         www.iowayouthsurvey.org/counties
                              6th, 8th, and 11th graders
                              (2002, 2005, 2008).
Behavioral Risk Factor        The Behavioral Risk Factor         http://apps.nccd.cdc.gov/BRFSS/
Surveillance System           Surveillance System
(BRFSS)                       (BRFSS) is a state-based
                              system of health surveys
                              that collects information on
                              health risk behaviors,
                              preventive health practices,
                              and health care access
                              primarily related to chronic
                              disease and injury.
Justice Data Warehouse        The Justice Data                   http://www.humanrights.iowa.gov/cj
                              Warehouse (JDW) is a               jp/jdw/index.html
                              central repository of key
                              criminal and juvenile justice
                              information from the Iowa
                              Court Information System
                              (ICIS) and information from
                              the Iowa Correctional
                              Offender Network (ICON)
                              system
Project EASIER-               Project EASIER (Electronic         http://www.iowa.gov/educate/index.
Department of Education       Access System for Iowa             php?option=com_content&task=vie
                              Education Records) is the          w&id=44&Itemid=310
                              Iowa Department of
                              Education's initiative
                              involving the transfer of
                              individual student records.
Alcohol Beverage Division     The Iowa Alcoholic                 http://iowaabd.com/
                              Beverages Division is
                              responsible for the
                              regulation, control and
                              enforcement of state and
                              federal laws and
                              regulations regarding the
                              sale and use of alcohol and
                              tobacco products
Census Bureau                 Serves as the leading              http://www.census.gov/
                              source of quality data about
                              the nation's people and
                              economy, operating under
                              Title 13 and Title 26, of the
                              U.S. Code, provides
                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     8
Data Source                 Data Description                   Data Location
                            Population & Housing
                            Census (10 years),
                            Economic Census (5 years)
I-SMART/TEDS                A web-based computing              http://www.idph.state.ia.us/ismart/d
                            environment to enable              efault.asp
                            IDPH and providers to
                            share substance abuse
                            treatment data
Governor Traffic Safety     The Governor's Traffic             http://www.dps.state.ia.us/commis/
Bureau                      Safety Bureau, GTSB,               gtsb/
                            administers a number of
                            federally funded highway
                            safety initiatives, including
                            alcohol incentive grant, seat
                            belt incentive funds,
                            occupant protection funds,
                            highway safety data
                            improvement funds and
                            motorcycle safety funds




                          Fayette County, Iowa County Assessment Workbook (CAW)
                                                   9
Local Data Sources

In Table 3 below list all the local (county/community) data sources used in this workbook as well as a
description of the data, and where it came from.

Table 3: Other Data Sources (see example)
Data Source     Data Description Data Location

Iowa Youth        Statewide school      www.iowayouthsurvey.org/counties
Survey(state)     survey of 6th, 8th,
                  and 11th graders
                  (2002, 2005,
                  2008).
                  Consumption
                  variables
                  Information on        http://arlingtonia.com/
City of           Arlington city
Arlington         government and
website           community
                  events
City of           Information on        http://clermontia.org/
Clermont          Clermont city
website           government, PD
                  and community
                  events
City of Elgin     Information on        http://www.elginiowa.org/
website           Elgin city
                  government and
                  community
                  events
City of Fayette   Information on        http://www.fayetteia.com/
website           Fayette city
                  government,
                  police dept. and
                  community
                  events
City of           Information on        http://www.maynardiowa.org/
Maynard           Maynard city
website           government and
                  community
                  events
City of           Information on        http://www.cityofoelwein.org/main/
Oelwein           Oelwein city
website           government, PD
                  and community
                  events
                  Information on        http://www.wadenaiowa.com/
City of           Wadena city
Wadena            government and

                             Fayette County, Iowa County Assessment Workbook (CAW)
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Data Source      Data Description     Data Location

website          community
                 events
                 Information on       http://www.westunion.com/
City of West     Wadena city
Union website    government, PD
                 and community
                 events
                 County Health        http://www.countyhealthrankings.org/iowa/fayette
LaCrosse         Rankings
Medical Health
Science
Consortium
2010-2011      Community              received in paper format from Palmer Community
Iowa CHNA-     health                 Health
HIP report     improvement
               plan outlining
               health needs and
               priorities in
               Fayette County
Iowa State     Fayette County         http://www.recap.iastate.edu/local/housing/files/hou
University     Real Per Capita        sing_19065.pdf
Extension      Income

Iowa             graduation rates     http://www.iowaschoolprofiles.com/profilesdist.asp?
Department of    for county           new=1
Education        schools
North Fayette    District polices     http://www.n-
High School      on suspension        fayette.k12.ia.us/main/hs_handbook.html
                 and expulsion
Valley           District policies    http://www.valley.k12.ia.us/pages/uploaded_files/S
Community        on suspension        eries%20500%20-%20Students%20part%201.pdf
Schools          and expulsion
FCSAC            norms and            received from Fayette County Substance Abuse
Underage         perceptions of       Coalition in paper format.
Drinking         underage
Survey           drinking with
                 Valley SODA
                 students
FCSAC            norms and            received in paper format from Fayette County
Underage         perceptions with     Substance Abuse Coalition.
Drinking         Oelwein High
Survey           School Students
FCSAC            Upper Iowa           received in paper format from the Fayette County
Underage and     University           Substance Abuse Coalition.
Binge Drinking   students asked
Focus Group      about availability
                 and norms
                            Fayette County, Iowa County Assessment Workbook (CAW)
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Data Source      Data Description     Data Location

FCSAC            norms and            received in paper format from Fayette County
Underage         availability of      Substance Abuse Coalition.
Drinking Panel   underage
Presentation     drinking with
                 Upper Iowa
                 University
                 students
8th Grade        Starmont             received in paper format from Fayette County
Wellness         Schools students     Substance Abuse Coalition.
Survey           asked about
                 norms and
                 perceptions of
                 underage
                 drinking
West Central     alcohol expulsion    http://www.w-
Community        and good             central.k12.ia.us/Practice%20Page.html
Schools          conduct policy
U.S.             unemployment         http://www.bls.gov/web/laus/lauhsthl.htm
Department of    rates for county
Labor, Bureau    and state
of Labor
Statistics
Upper Iowa       crime statistics     http://www.uiu.edu/emergencypreparedness/fayett
University       data and policies    ecampus/Crime%20Report%20-%202010.pdf
                 for Fayette
                 Campus
US Places        Iowa county          http://www.us-places.com/Iowa/population-by-
                 ranking by           County.htm
                 population
Iowa             information on 3     http://educateiowa.gov/index.php?option=com_doc
Department of    year suspension      man&task=cat_view&gid=527&Itemid=1563
Education        and expulsions
                 related to alcohol




                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     12
Definitions

      Alcohol related Convictions: number of charges with a guilty finding in court for violations of
       Iowa Code chapter 123.
      Alcohol related offense Arrests: Number of Arrests made by local, county or state peace
       officers following a violation of Iowa Code chapter 123.
      Alcohol-Related Traffic Injuries: number of drivers that were injured in crash with BAC>0.01.
      Binge drinking prevalence: Proportion of Adults or Youth (males having five or more drinks on
       one occasion, females having four or more drinks on one occasion).
      Current alcohol use prevalence: Proportion of Adults or Youth who have had at least one drink
       of alcohol within the past 30 days.
      Drivers Involved in Fatal Crashes That Have Had a Drink (%): Proportion of drivers in Fatal
       crashes (limited to drivers only) that have BAC>0.01.
      Fatal Car Crash rates (per 10,000): Number of crashes resulting in fatalities divided by
       population times 10,000 (or total number of Vehicle Miles Traveled).
      Heavy Drinking: Proportion of (adult men having more than two drinks per day and adult
       women having more than one drink per day).
      Intervening variables: A hypothetical variable (events) postulated to account for the way in
       which a set of independent variables (risk factors) control a set of dependent variables i.
      Liquor Law Violations: Offenses dealing with sales or provision of alcohol.
      Operating While Intoxicated : Violation of Iowa Code chapter 321J (BAC>.08).
      Prevalence: Number or proportion (percent) of cases or events in a given population. Often
       further distinguished as point prevalence (single point in time) or period prevalence (over a
       period of time).
      Public intoxication: Violation of Iowa Code chapter 123.46.
      Rate: (Number of cases or events / total population)* 10,000. All rates in this county
       assessment workbook are per 10,000.
      Underage Possession: Violation of Code 123.47A which prohibit minors from purchasing or
       attempting to purchase, or possessing or having control of alcoholic beverages


List of Abbreviations

      ABD - Alcohol Beverage Division
      AC4C - Alliance of Coalitions for Change
      ATOD - Alcohol, Tobacco, and Other Drugs
      BAC - Blood Alcohol Content
      BRFSS - Behavioral Risk Factor Surveillance System
      CDC - Centers for Disease Control and Prevention
      CJJP - Criminal and Juvenile Justice Planning, Iowa Department of Human Rights
      DHS - Iowa Department of Human Services
      DOE - Iowa Department of Education
      DOT - Iowa Department of Transportation
      DPS - Iowa Department of Public Safety
      EUDL – Enforcing Underage Drinking Laws
      IDPH - Iowa Department of Public Health
      I-SMART - Iowa Service Management and Reporting Tool
      IYS - Iowa Youth Survey
                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     13
   JDW - Justice Data Warehouse
   LEW - Local Epidemiological Workgroup
   NSDUH - National Survey on Drug Use and Health
   OWI - Operating While Intoxicated
   SAMHSA - Substance Abuse and Mental Health Services Administration
   SEW - State Epidemiological Workgroup
   SPF SIG - Strategic Prevention Framework State Incentive Grant
   TEDS - Treatment Episode Data Set
   UCR - Uniform Crime Report




                       Fayette County, Iowa County Assessment Workbook (CAW)
                                                14
Introduction

Iowa received the Strategic Prevention Framework State Incentive Grant (SPF SIG) from the Federal
Substance Abuse and Mental Health Services Administration (SAMSHA) in July 2009.

The purpose of the project is to implement the five components of the SPF SIG planning model at
both state and county levels in Iowa. The following diagram details this process (Center for
Substance Abuse Prevention, 2005).


Figure 1: Five Steps of the Strategic Prevention Framework Process




At the state level, Iowa has completed the needs assessment and funding allocation plan.
Mobilization and capacity building take place throughout the project. The Iowa needs assessment
identified the targeted problem as underage drinking and binge drinking and related consequences,
and following a need based allocation strategy funded 23 counties. The first step for sub-
recipients/counties is to complete a comprehensive needs assessment for their communities.




                           Fayette County, Iowa County Assessment Workbook (CAW)
                                                    15
Outcome-Based Prevention

The foundation of the SPF SIG project process is the outcome-based prevention model.
In this model, a county details its substance-related consumption and consequence data, researches
the intervening variables that may influence these problems, and chooses evidence-based policies,
practices, and programs to address the identified Intervening Variables (Figure 2 & 3).
Figure 2: SPF SIG project Needs Assessment Logic Model


     Consumption &                    Intervening                      Evidence- Based
     Consequences                                                         Strategies
                                       Variables




Purpose

The purpose of this workbook is to help SPF SIG project funded communities go through the
outcome-based prevention model. The first step is to complete a comprehensive needs assessment.
Sub-recipients must accurately assess their problems using epidemiological data, and they must do
research to understand what may influence these problems. To be effective, you should not complete
this workbook alone. Instead, a County EPI Workgroup (CEW) should be formed to complete this
task.
Keep in mind that at the state level the targeted need for this project is already identified underage
drinking and adult binge drinking and related consequences. However, the community may choose at
the end of the needs assessment other priorities that more specific. As an example, binge drinking
among college students may be more of an issue in a community that has college campuses. Thus
the community may direct its activities toward reducing binge drinking in that specific age group .

        “Underage drinking and adult binge drinking” means that:

        The primary target for the SPF SIG project is underage drinking, and adult binge
        drinking. Underage drinking refers to any use of alcohol by anyone under the age of
        21, while binge drinking refers to adults (>18) having five of more drinks on any one
        occasion (four for females).




                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     16
Workbook Organization

The tasks that follow are based on the outcome-based prevention model and recent research
detailing the intervening variables of substance-related problems. There are four major sections
(problems, causes, prioritization, and resource assessment). Within each there are data to collect and
questions to answer. Following from Iowa’s targeted need (underage and binge drinking) and the
known Intervening Variables, the previous model can be expanded to include evidence- based
strategies, as illustrated in Figure 3 (Birckmayer, Holder, Yacoubian, & Friend, 2004)ii.
Figure 3: Outcome-Based Prevention Model
Consequences        Consumption       Intervening Variables          Strategies
   Alcohol                                  Retail
   Related                                Availability
   Crimes


                                             Social
   Criminal                                                          Evidence
                                           Availability
   Justice                                                             Based
  Conviction                                                         Programs,
      s                Underage                                     Policies and
                      Drinking &                                     Practices
                      Adult Binge                                   Addressing
   Alcohol                                 Promotion
                       Drinking                                        Each
 Related Car
  Crashes                                                           Intervening
                                                                      Variable
                                          Community
   Alcohol                                  Norms
 Dependence
  and Abuse                                Individual
                                            Factors


Each sub-recipients must complete the tasks that follow to detail the problems and influences
surrounding underage drinking and binge drinking in their county. This will lead to focused
mobilization and capacity building, as well as aid in the prioritization of evidence-based strategies
within the county’s strategic plan.

The work that follows involves gathering data to illuminate both the problem(s) and the casual area(s)
that contribute to the problems in your county. This is achieved by answering a series of questions.
Most of the data you gather will exist in various data sources, but you also will have to do some
original research. Data gathering includes:
      Data from existing survey results.
      Original data collection.
      Interviews with key partners and stakeholders.
      Meetings with interested county members and leaders.



                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     17
Note: Most of the existing local level data used in this workbook are available at the county level.
Communities should complete this workbook as thoroughly as possible working with their County EPI
Workgroup.

Data From Existing Survey and Other Sources
Much of the data needed in this workbook may be publicly available or provided to you. In other
areas, where local level data is not available to IDPH, you will be responsible for finding the
information. Proportions or rates are used for simplicity, and it is acknowledged that they may vary
according to their margin of error. In addition, to the existing data sources that are specifically
outlined in this workbook, local surveys or other data sources are encouraged to be used as sources
of auxiliary information to aid in the decision making process. Your county may have already gathered
survey results from businesses or from local law enforcement that may help in the needs
assessment.

Collection of Original Data
In several areas of this workbook you will be asked to gather information. This data collection will
include counting the number of billboards that advertise alcohol or events sponsored by alcohol
companies or distributors. The purpose of this data collection is to gather information directly from
your county by observation or library research. In all cases, the data collection involves measures that
are easily gathered. Whenever possible, you may contact directly agencies that run the billboards to
collect the information.

Interviews With Key Partners and Stakeholders
You will also interview key partners and stakeholders in your county to provide a better picture of their
concerns regarding underage and binge drinking. One particular set of stakeholders that you will be
asked to interview are law enforcement officials. A sample protocol for these law enforcement
interviews is given in Appendix A. A brief description of the information sought in the law enforcement
interviews is provided. Interviews with other stakeholders will provide local information in other areas
of this workbook.

County Focus Groups
As part of the data collection, you will conduct county meetings or focus groups to gather county
views regarding what factors influence underage and binge drinking in your county. In particular, you
will need to find out how your county perceives social availability, county norms, and individual factors
influence underage and binge drinking in your county. In choosing the participants, SEW highly
recommends including a wide range of individuals and stakeholders that represent the diversity in the
county. A description on how to conduct the town hall meeting, and the information to gather from it,
is provided in Appendix B.




                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     18
Table 4: Deadlines for Activities and Workbook Completion
Due Date                       Product

July 26, 2011               Activities listed:
                            Interviews
                            Retail availability
                            Billboards
                            County Meetings or Focus Groups
August 19, 2011             County Needs Assessment Workbook completed and sent
                            to the IDPH, Division of Behavioral Health

A final copy of the County Needs Assessment Workbook should be submitted electronically to:

Dr. Ousmane Diallo
Epidemiologist
IDPH, Division of Behavioral Health
321 E. 12th Street
Des Moines, IA 50319
ousmane.diallo@idph.iowa.gov
(515) 281-8261




                           Fayette County, Iowa County Assessment Workbook (CAW)
                                                    19
                                       EXPLORING DATA FOR YOUR COUNTY




Description of Your County

Table: Demographics and Socioeconomic Indicators, source ACS 2000
  Demographics Description                  County             %                State             State
                                              (N)             Rate               (N)               (%)
AGE               <5                               1,127         5.6%               201,321                6.7%
                  05--17                           3,259        16.1%               511,292               17.1%
                  18-24                            1,873         9.3%               306,398               10.2%
                  25-44                            4,386        21.7%               750,505               25.1%
                  45-64                            5,551        27.4%               788,485               26.3%
                  >=65                             4,077        20.1%               444,554               14.8%
Gender
                  Female                          10,196        50.4%             1,519,683               50.8%

Race              White Non                      19,408        95.9%              2,699,203               90.2%
                  Hispanics
Education         Bachelor or Higher              2,793        13.8%               634,725                21.2%

Income            Median Household     $       40,706.0                   $        49,007.0
                  Income
Poverty           Poverty (130%) All              2,756        14.2%               331,057                11.4%
                  ages N(%)
                  Under 18                          737        17.0%                99,569                14.2%

Government         Food Assistance                1,398            6.9%            189,872                 6.3%
Assistance         (FA) Benefit
                   (Enrollment Month)
                   Total FA Benefits/  $    2,604,478.1   $    128.7      $   422,771,362.7   $           141.2
                   Per capita (Month )
                   Medicaid Enrollment            3,078        15.2%               376,830                12.6%
                   (Month)
                   Medicaid Benefits/  $   12,367,411.1   $    611.1      $ 1,799,575,816.5               601.1
                   Per capita (Month)
sources: Iowa Data Center- Census
American Community Survey.


Other Data

         2010 population: 20,880
         2000 population: 22,008
         Decrease from 2000 to 2010: 5.1%
         Fayette County has 0.69% of Iowa’s total population
         Fayette County ranks 31 out of 99 counties in population.
                                 Fayette County, Iowa County Assessment Workbook (CAW)
                                                              20
          The population density of Fayette County is 28.568 people per square mile.
          The population density for the state of Iowa is 52.4 people per square mile.

Figure 1.
Fayette County Iowa Population Trends
 35000


 30000


 25000


 20000


 15000


 10000


  5000


       0
             1850 1860 1870 1880 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010



Fayette County is the 7th largest county in the state in size.
    731.45 total square miles
    730.92 square miles of land
    0.52 square miles of water
    14.54 square miles of total land consists of towns and communities.
    The communities of Fayette County consist of only 1.987% of the total land.

Communities and municipalities in Fayette County (with 2010 population) include:

Arlington (429)                Clermont (632)                 Elgin (683)
Fayette (1,338)                Hawkeye (449)                  Maynard (518)
Oelwein (6,415)                Randalia (68)                  St. Lucas (143)
Wadena (262)                   Waucoma (257)                  West Union (2,486)
Westgate (211)

The remaining 6,989 people live in the rural areas of Fayette County.

The number of college graduates in Fayette County is less than the state rate. Additionally, the rate of
high school graduates, age 25+ from the years 2005-2009 was 88.5%. The state rate for high school
graduates was 89.6%. The Fayette County rates for college graduates and high school graduates are
smaller than the state rates.




                                Fayette County, Iowa County Assessment Workbook (CAW)
                                                         21
Figure 2.
Real Per Capita Income (in 2007 dollars), Bureau of Economic Analysis.




Incomes across Iowa, whether measured at the individual or household level, are not growing
uniformly across the state. Household income grew as little as 6 percent in one Iowa county and as
much as 40 percent in another.

Real capita income growth from the period 1992 – 2007:
    Fayette County has grown 34.4%
    The State of Iowa has grown 35.2%
    Fayette County is growing at a slower pace than the remainder of the State.

The unemployment rate for Fayette County as of June 2011 was 6.5%. The state average for the
same time frame was 6.0% indicating the county still struggles to get citizens back to work.

Canoeing on the Turkey and Volga Rivers are a popular pastime in Fayette County




                           Fayette County, Iowa County Assessment Workbook (CAW)
                                                    22
The Fayette County Court house is located in West Union,
the county seat.




                                                          Agriculture is a predominant industry in
                                                          Fayette County.




Question 1: Add any other information or unique historical, social and cultural particulars
that you feel important to specifically describe your county. Youth may participate by
creating a pictorial view of the county.

Fayette County has seen an overall decrease in population in recent decades as well as a
decrease in per capita income. The majority of the population is white, non-Hispanic and
female, consistent with State of Iowa averages. Many of the manufacturing facilities in
Fayette County have closed in recent years, supporting the data that the percentages of
Fayette County residents receiving government assistance is higher than the state
average. Furthermore, 14.2% of Fayette County residents fit within the poverty guidelines
which is higher than the State average of 11.4%.

The rate of unemployment in Fayette County is 6.5% where the state rate of
unemployment is 6.0%. This is for the time period ending June 2011. As many of the
manufacturing businesses closed, people are still struggling to find work and are dealing
with financial worries and stressors.

The large geographical area of Fayette County contributes to the challenges of law
enforcement, criminal justice and the school districts. There are over 731 square miles in
Fayette County to patrol and conduct business. To alleviate congestion at the County
Courthouse in West Union, a satellite magistrate court office has been placed in Oelwein,
Iowa. Services are offered in both West Union to serve the northern half of the county and
Oelwein to serve the southern half of the county.

It was noted by the discussion group that although Fayette County has a university, only
13.8% of citizens have a Bachelor’s degree or higher.




                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     23
Consequences

This section looks at alcohol-related consequence data and will help you identify which alcohol-
related consequences are of greatest concern in your county. Alcohol-related consequences are
defined as the social, economic, and health problems associated with the use of alcohol, such as
alcohol-related mortality, car crashes, crime and penalty. It is recognized that not all communities will
experience exactly the same problems, therefore this needs assessment in relation to alcohol use
and its consequences is to help identify individual county problems.

Alcohol-Related Crimes:

Table 5: Adult Alcohol Related Arrests (rate per 10,000), source JDW, CJJP
Alcohol-Related Crimes Adults Area                   2008          2009

                                   County                         8               43
                                             Rate               5.1             27.4
Alcohol Offenses
                                   State                    6,756            11,765
                                             Rate             29.6              51.3
                                   County                      135               135
                                             Rate             86.2              86.2
Operating While Intoxicated
                                   State                   13,934            13,930
                                             Rate             61.1              60.7

Table 6: Juvenile Alcohol Related Arrests (rate per 10,000), source JDW,
CJJP
Alcohol-Related Crimes           Area                2008           2009
Juveniles
                                   County                      15                 25
                                             Rate           43.9                75.6
Alcohol Offenses
                                   State                   2,021              1,693
                                             Rate           39.5                33.3
                                   County                       2                  2
                                             Rate      5.8530875                 6.1
Operating While Intoxicated
                                   State                     229                 188
                                             Rate             4.5                3.7




                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     24
Alcohol Related Conviction Rates:

Table 7: Adults Alcohol Related Offenses Convictions, source
JDW, CJJP
Alcohol-related Offense     AREA            2008        2009
Convictions - Number
and Rate per 10,000
Adults                      County N            129
                                                     145
                                  Rate         82.4         92.5
                            State N
                                          21,404     20,855
                                  Rate         93.8         90.9
Notes: Juveniles adjudications are not released by the CJJP

Table 7: Adults OWI Convictions, source JDW,
CJJP
OWI Convictions -         AREA            2008                2009
Number and Rate per
10,000
Adults                    County N           110
                                                          125
                                   Rate            70.3           79.8
                             State N
                                         15,144    14,681
                                    Rate      66.4       64.0

Other Data

Figure 3.
Alcohol-Related Statistics from Iowa State Patrol, District 10



                   Alcohol-Related Statistics, Iowa State Patrol, District 10
                               Conducted in Fayette County

                                                 Other                              Alcohol
                                        Open    Alcohol                  PBTs        Non-    Underage
           Year              OWI 0.02 Container Charges                  Used       Driving Possession
           2009              125** 5     121       50                     n/a         n/a      n/a
           2010               89   0      67       50                     210          29       21
 **includes OWI charges
         for drugs




                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     25
According to the Iowa State Patrol, alcohol-related incidents tend to be tied to local events and
recreational activities in Fayette County. Problem areas tend to be near the Turkey River and Volga
Lake. The Iowa State Patrol plans their sobriety checkpoints to coincide with local events and
festivities. The sobriety checkpoints are operated under the Iowa Special Traffic Enforcement
Program (sTEP) grant through the Governor’s Traffic Safety Bureau, CARE checks and the STOP
program. The alcohol-related incidents for the Iowa State Patrol are shown above in Figure 3.

According to the Clermont PD, there have been 31 charges of minor in possession in the past 5
years. They are unsure of the conviction rate because many charges are dropped after the
completion of alcohol class.

All of the police departments interviewed noted that the majority of their cases involve alcohol in some
way or another – either the violation is directly involving alcohol or the person being arrested is
intoxicated.

Figure 4.
Fayette County Sheriff’s Office Alcohol-Related Statistics, 2010




                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     26
Figure 5.
Oelwein PD Alcohol-Related Statistics

       Oelwein, Iowa Alcohol-Related Incident Statistics, 2009-2011
                                                                             Juveniles
                                                                    Number Cited, if
Year    Code                         Citation                        Issued Available
2009            OWI                                                       43
2009            .02 Violations                                             2         2
2009   123.28   open container - unlawful                                  7
2009   123.46   public intoxication                                       36         2
2009 123.47(1) supply alcohol to minors                                    1
2009 123.47(2) possession of alcohol under legal age                      44        44
2009 123.47(2)A possession of alcohol under legal age                      1         1
2009 123.47(4) supply alcohol to minors - serious                          1
2009   123.49   liquor laws: miscellaneous                                 2
2009 123.49(2)H Sale of alcohol to Minor                                   1
2009 123.91(1) public intoxication/second                                  4
2009 123.91(2) public intoxication/third                                   4

2010               OWI                                                    55
2010               .02 Violations                                          0
2010    123.46     public intoxication                                    22          1
2010   123.47(2)   possession of alcohol under legal age                  53         53
2010   123.91(1)   public intoxication/second                             10
2010   123.91(2)   public intoxication/third                              15

2011               OWI                                                    49
2011               .02 Violations                                          1          1
2011    123.46     public intoxication                                    16          1
2011   123.46(2)   public intoxication/open container                      3
2011   123.47(2)   possession of alcohol under legal age                  19         19
2011   123.47(2)   possession of alcohol under legal age-serious           1          1
2011   123.47(4)   supply alcohol to minor - serious                       1
2011   123.91(1)   public intoxication/second                              8
2011   123.91(2)   public intoxication/third                               3

Question 2:
Based on the preceding tables and your other local level data, how do alcohol
related offenses and convictions in your county compare to the state? Is your
problem bigger, smaller or about the same? Discuss the differences.

In comparing the data located in Table 4: Adult Alcohol Related Arrests, the
county arrest rate for 2008 and 2009 was considerably smaller than the State
Rate. However, the OWI arrests were 25% bigger in 2008 and 2009 than the
State rate. This may be due to the lack of public transportation in Fayette
                             Fayette County, Iowa County Assessment Workbook (CAW)
                                                           27
County and people willing to take the risks of drinking and driving.

In Table 5: Juvenile Alcohol Related Arrests, the incidents involving alcohol
offenses were considerably bigger than the State rates – 4.4% more in 2008
and 42.3% more in 2009. The juvenile OWI rates were also more than the
State rates – 1.35% in 2008 and 2.4% in 2009. This may be due to the fact that
youth feel they have nothing to do and drink to socialize and have fun. Youth
also seem to be willing to take the risks of drinking and hope they will not be
caught.

In comparing Table 7: Adults Alcohol-Related Offenses Convictions, the county
rate of convictions in 2008 was smaller than the State rate, but in 2009,
Fayette County exceeded in the state rate in convictions. Additionally, in Table
8: Adults OWI Convictions the county rate exceeds the state rate in both 2008
and 2009. While the arrests for OWI are more than the state rate, it appears
that the criminal justice system is also convicting drunk drivers more than the
state rate.

Figure 3 includes local data from the Iowa State Patrol. District 10 post has
changed their software and does not have consistent data for the preceding
years but does not that most OWI charges are tied to recreational areas and
community events in the area.

Figure 4 notes that in 2010, the Fayette County Sheriff’s Office responded to
25 underage drinking parties. This is new data, so there are few specifics
available.

Figure 5 shows the law enforcement data for the Oelwein PD, which is
separate from the Fayette County Sheriff’s Office. The number of OWI’s has
increased from 2009 to 2010 and is on target to again increase in 2011. In
2009, there were 8 citations issued for second and third offense public
intoxication. In 2010, this number increased to 25 and through July 2011, there
have been 11 citations issued. This indicates that law enforcement is doing
more to patrol troubled areas and that people are not deterred by their efforts.

Overall, the rate of arrests for alcohol related offenses in Fayette County are
smaller than the state rate. The rate of arrests for OWI is bigger than the state
rate. In 2009, the rate of arrests for juvenile alcohol related offenses was
bigger and in both years, the rate of juvenile OWI was bigger than the state
rate. Finally, the adult convictions for alcohol related offenses for 2009 were
bigger than the state rate and the OWI convictions were also bigger than the
state rate.

Alcohol-Related Car Crashes:

Another targeted consequence of underage drinking and binge drinking for Iowa’s SPF SIG project is
car crashes related to alcohol use.


                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     28
Table 8: Alcohol Related Fatal Crashes, Traffic Injuries and Drunk Drivers,
source GTSB
Indicators                      AREA               2006           2007                 2008

                                County N                  4               5                       2
Alcohol-Related Fatal
                                       Rate             1.9             2.5                     1.0
Crashes N (Rate per
                                State N                439             445                     413
10,000)
                                       Rate             1.5             1.5                     1.4
                                County               25.0%           20.0%                    0.0%
Drivers Involved in Fatal
                                (%)
Crashes That Have Had a
                                State                23.7%           24.9%                19.4%
Drink (%)
                                (%)
                                County N                98             120                    115
                                       Rate            47.3            58.8                   56.7
Traffic Injuries N (Rate per
                                State N
10,000)
                                                     23,497         26,478               22,204
                                         Rate          79.2           88.8                 74.0

Other Data

According to Palmer Lutheran Hospital in West Union, they had a total of 32 motor vehicle crashes of
which 5 were alcohol related. Of those 5 motor vehicle crashes, 4 of the drivers were under the age of
30.

The other hospital in Fayette County, Mercy Medical Center in Oelwein, does not keep statistics
involving alcohol related accidents or motor vehicle crashes.

Question 3
Based on preceding Tables and your community level data, how do alcohol-
related car crashes in your county compare to alcohol-related car crashes
across the state? Is your problem bigger, smaller or about the same? Discuss
the differences.

In Table 9: Alcohol Related Fatal Crashes, Traffic Injuries, and Drunk Drivers
the traffic injuries in Fayette County average 30% less than the state rate. In
2007 and 2008, the drivers involved in fatal crashes that have had a drink is
less than the state rate. Most notably, there were zero drivers involved in fatal
crashes that have had a drink in 2008. It was noted by the discussion panel
that because of the large geographical area in Fayette County, some drivers
may be involved in accidents on gravel roads and do not report them or seek
medical treatment.

In comparing the local data from the Palmer Lutheran Health Center, it was
important to note that 80% of the motor vehicle crashes involving alcohol were
drivers under the age of 30. This indicates that youth and young adults may be
more likely to engage in drinking and driving.

For Question #3, it is noted that Fayette County has a bigger problem with
alcohol related crashes than the rest of the state. Fayette County has a
smaller problem with drivers involved in fatal crashes that have had a drink
                               Fayette County, Iowa County Assessment Workbook (CAW)
                                                        29
and a smaller problem with alcohol related traffic injuries.




Alcohol Dependence and Abuse:

Table 10 below shows the rate by county of residence for treatment admissions due to alcohol as the
primary or secondary drug. The Iowa rate has been included in the table to provide a comparison.
The year-specific estimated census data were used for that purpose.

Table 9: Alcohol as a Primary Reason for Treatment Episodes
(Number and Rate per 10,000 Population) in Iowa by County of
Residence (TEDS/I-SMART)
Area                             2006         2007         2008

County                    N                170              192            189

Rate                                     105.8          120.6            119.0
State                       N           14,877         14,302          15,244
                                           65.9             63.0          66.6
Rate

Other Data

Northeast Iowa Behavioral Health works with clients in Fayette County that have both substance
abuse and mental health issues. In 2010, NEIBH had the following cases in Fayette County:
    40% of NEIBH’s total alcohol and related problem services (3,121 of 7,712).
    33% of BEIBH’s alcohol and related problems unduplicated services (305 of 934).
    Of the 305 unduplicated services, 45 of them were youth, or 13%.

OWI and legal offenses where the client is required to take a mandatory 12 hour class and evaluation
in order to get their license back. The client also has to follow through with any recommendations
made.

NEIBH suggested that parents be involved in an activity to show the differences in what kids today
drink and what they drank when they were younger. Oltrogge was insistent that youth today drink
much more than their parents did and while parents feel underage drinking is a rite of passage,
parents do not really understand the problem. This activity would help parents understand while
catching their attention and making them aware of the problem.

Fayette County Community Services in responsible for coordinating the court-ordered committals of
Fayette County residents. The annual budget of the County Community Services is $60,200 which is
paid for with county revenue. CCS covers:
     the commitment cost
     transportation by law enforcement to the facility
     hospitalizations up to the point of the hearing
     CCS does not pay for or fund any substance abuse treatment.
                              Fayette County, Iowa County Assessment Workbook (CAW)
                                                       30
 There were 18 adults and 3 children committed for alcohol treatment in FY 2010 by Fayette County
 Community Services.

 Figure 6.
 County Health Rankings: Fayette, Iowa, source LaCrosse Medical Health Science Consortium
 http://www.countyhealthrankings.org/print/iowa/fayette
                                                                                                                RANK
                                                             FAYETTE        ERROR         NATIONAL
                                                                                                       IOWA       (OF
                                                             COUNTY         MARGIN     BENCHMARK*
                                                                                                                   99)
HEALTH OUTCOMES                                                                                                      61
Mortality                                                                                                            81
 Premature death — Years of potential life lost before
                                                                   7,290 5,877-8,703           5,564    5,976
 age 75 per 100,000 population (age-adjusted)
Morbidity                                                                                                            17
 Poor or fair health — Percent of adults reporting fair or
                                                                    11%     8-16%               10%      12%
 poor health (age-adjusted)
 Poor physical health days — Average number of
 physically unhealthy days reported in past 30 days (age-             2.9   2.0-3.9              2.6      2.8
 adjusted)
 Poor mental health days — Average number of
 mentally unhealthy days reported in past 30 days (age-               2.4   1.5-3.3              2.3      2.7
 adjusted)
 Low birthweight — Percent of live births with low
                                                                    5.4% 4.2-6.5%              6.0%     6.8%
 birthweight (< 2500 grams)
HEALTH FACTORS                                                                                                       83
Health Behaviors                                                                                                     88
  Adult smoking — Percent of adults that report smoking
                                                                    24%     18-30%              15%      20%
  >= 100 cigarettes and currently smoking
  Adult obesity — Percent of adults that report a BMI >=
                                                                    29%     24-34%              25%      28%
  30
  Excessive drinking — Binge plus heavy drinking                    23%     17-30%               8%      20%
  Motor vehicle crash death rate — Motor vehicle crash
                                                                      26     18-35               12       15
  deaths per 100,000 population
  Sexually transmitted infections — Chlamydia rate per
                                                                     217                         83      314
  100,000 population
  Teen birth rate — Teen birth rate per 1,000 female
                                                                      29     24-34               22       32
  population, ages 15-19
Clinical Care                                                                                                        70
  Uninsured adults — Percent of population under age
                                                                    13%     10-15%              13%      13%
  65 without health insurance
  Primary care providers — Ratio of population to
                                                                  3,373:1                      631:1    984:1
  primary care providers
  Preventable hospital stays — Hospitalization rate for
  ambulatory-care sensitive conditions per 1,000 Medicare             75     69-81               52       68
  enrollees
  Diabetic screening — Percent of diabetic Medicare
                                                                    90% 73-100%                 89%      86%
  enrollees that receive HbA1c screening
  Mammography screening — Percent of female
  Medicare enrollees that receive mammography                       62%     46-77%              74%      67%
  screening

                                   Fayette County, Iowa County Assessment Workbook (CAW)
                                                             31
                                                                                                                 RANK
                                                            FAYETTE       ERROR        NATIONAL
                                                                                                      IOWA         (OF
                                                            COUNTY        MARGIN    BENCHMARK*
                                                                                                                    99)
Social & Economic Factors                                                                                             70
 High school graduation — Percent of ninth grade
                                                                 90%                        92%         87%
 cohort that graduates in 4 years
 Some college — Percent of adults aged 25-44 years
                                                                 57%                        68%         66%
 with some post-secondary education
 Unemployment — Percent of population age 16+
                                                                 8.0% 7.5-8.5%              5.3%       6.0%
 unemployed but seeking work
 Children in poverty — Percent of children under age 18
                                                                 17%      13-21%            11%         14%
 in poverty
 Inadequate social support — Percent of adults without
                                                                 18%      13-26%            14%         16%
 social/emotional support
 Single-parent households — Percent of children that
                                                                 23%                        20%         26%
 live in household headed by single parent
 Homicide rate — Deaths due to homicide per 100,000
                                                                                                  1          2
 population (age-adjusted)
Physical Environment                                                                                                  77
 Air pollution-particulate matter days — Annual
 number of unhealthy air quality days due to fine                     1                           0          1
 particulate matter
 Air pollution-ozone days — Annual number of
                                                                      0                           0          0
 unhealthy air quality days due to ozone
 Access to healthy foods — Healthy food outlets
 include grocery stores and produce stands/farmers’              25%                        92%         39%
 markets
 Access to recreational facilities — Rate of recreational
                                                                   10                         17         12
 facilities per 100,000 population

 Figure 7.
 Health Outcomes Map for Iowa, Source: LaCrosse Medical Health Science Consortium
 http://www.countyhealthrankings.org/print/iowa/fayette




 Figure 8.
 Health Factors Map for Iowa, source: LaCrosse Medical Health Science Consortium
                                  Fayette County, Iowa County Assessment Workbook (CAW)
                                                            32
http://www.countyhealthrankings.org/print/iowa/fayette




Question 4
Based on your county data, how does alcohol dependence and abuse in your
county compare to alcohol dependence and abuse across the state? Is your
problem bigger, smaller or about the same? Discuss the differences.

In Table 10: Alcohol as a Primary Reason for Treatment Episodes, the county
rate was approximately 40% more than the state rate.

Fayette County Community Services indicated that the reason more and more
committals were being processed through the court was the judges’ concerns
on denying cases and later being held liable for them. The CCS Administrator
noted that few cases are ever declined for court-ordered committals.

In Figure 6, Fayette County ranked 83 out of 99 for health outcomes which
included premature death, poor or fair health, poor physical health days, poor
mental health days and low birth weight. These outcomes are again noted in
Figure 7. This indicates that overall, Fayette County is not a healthy county.

In Figure 6 and again in Figure 8, the health factors of Fayette County are
presented. The county ranked 88 out of 99 in the health behaviors of adult
smoking, adult obesity, excessive drinking, motor vehicle crash death rate,
sexually transmitted infections, and teen birth rate. In viewing the excessive
drinking rates specifically:
     23% of Fayette County residents admit to excessive drinking
     Only 8% of Americans admit to excessive drinking
     20% of Iowans admit to excessive drinking
This indicates that excessive drinking is more prevalent in Fayette County than
in other general areas of the country. Overall, Fayette County ranked 61 out of
99 counties.

For question 4, it is noted that Fayette County has a bigger problem with
                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     33
alcohol dependence and abuse than across the state. The panel noted that
although many admitted to binge drinking and 30-Day use, they wondered how
many more were using alcohol and not admitting it.

The Fayette County Community Health Improvement Plan (CHNA HIP) is
shown in Appendix I. Surprisingly, the CHNA HIP does not include any alcohol-
related initiatives or concerns.

Alcohol School Suspensions and Expulsions:

The following table describes the rate of school alcohol-related suspensions and expulsions from the
Iowa Department of Education data center. Identify your district and the total number of suspensions
and expulsions because of alcohol for each year and calculate the rate using this formula: (total
number of suspension-expulsion/ total number of students in the district) X 10,000.

Table 10: Alcohol Related School Suspensions and Expulsions,
Project EASIER
Youth Alcohol Suspension      2006-2007 2007-2008 2008-2009                         2009-2010
and Expulsion Rate (per
1000)
North Fayette                               0               3               0               0

Oelwein                                     1               4               1               0
Starmont                                    0               0               0               0
Valley                                      0               0               0               0
West Central                                0               0               0               0
County                      N               1               7               1               0
                        Rate              2.6             18.6            2.6            0.00
State                       N            519              404            382              362

                        Rate             10.9              8.5            7.8             7.4


According to the Valley Community School District for the 2010-2011 school year, there were 8
students that violated the good conduct code pertaining to alcohol. Of those 8 students, there were 3
students that were charged with “possession” and 5 were charged with “mere presence”.

According to the North Fayette Community School District for the 2009 – 2010 school year, 14
students were suspended from extracurricular activities due to violations of the code of conduct for
alcohol use. During the 2010 – 2011 school year, there were 5 students that were suspended from
extracurricular activities for violations of the code of conduct alcohol policy.




                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     34
The Oelwein High School had 7 violations of the alcohol good conduct policy in the 2010 – 2011
school year. Oelwein Community Schools also has an alternative school, REC. In the 2010 – 2011
school year, there were 9 violations of the good conduct policy pertaining to alcohol.

There were no alcohol-related violations of the good conduct policies at Starmont and West Central
School Districts.

Question 5
Based on your county data, how does alcohol related school suspensions and
expulsions in your county compare to the state?
Is your problem bigger, smaller or about the same? Discuss the differences.

In Table 11: Alcohol Related School Suspensions and Expulsions, the alcohol
suspension and expulsions were bigger for Fayette County in the school year
2007 – 2008. The rates were smaller for Fayette County in the remaining
school years shown.

It was noted that North Fayette made a change to the good conduct policy after
the 2007-2008 school year that reduced the incidents of suspension related to
alcohol. The High School principal noted that now youth violate the good
conduct policy and are not receiving the expulsion and suspensions that they
once received. Today’s youth are being suspended from sports and activities
rather than school itself. The discussion panel noted that many schools do not
hold youth accountable for this rule because parents get involved and insist on
their children being allowed to play sports and participate in extracurricular
activities. For that reason, many school boards have backed off on the rules
and allow more kids to get away with alcohol use than in the past.
Additionally, if youth admit to the Athletic Director that they used alcohol or
were present at a party, their consequences are greatly reduced. While this is
teaching youth to be honest about their actions, they are not being held
accountable for their actions.

It was also noted that some of the smaller school districts like West Central,
Starmont, and Valley has mere presence policies, but the larger districts like
North Fayette and Oelwein do not. The schools with mere presence rules
consider a youth at a party an infraction, not only if they have been drinking.
With the mere presence policies, if a child admits they have been drinking
alcohol or at a party, they would still be in violation.

Could you list some of the districts policies regarding suspensions and
expulsions of students?
______________________________________________________________
North Fayette High School Alcohol Suspension and Expulsion Policy
Level VII Violations --
Drug and alcohol violations, possession, consumption, under the influence,
intent to deliver
Level VII Consequences --
Minimum of a 10-day out of school suspension. A conference will be held with
parent and legal authorities will be contacted. A determination will be made

                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     35
according to availability as to whether or not the student will be required to
participate in an alcohol or drug cessation program.
A second offense will result in notification of parents, suspension, and a
recommendation to the Board of Education for expulsion. Prior to being re-
enrolled at North Fayette High School, proof of participation in a drug/alcohol
treatment program must be provided.
Notice of Suspension
Notice of suspension of a student shall be sent in writing by the end of the next
school day to the President of the Board, the student's parents, and to the
superintendent. Suspension of students in special education shall follow the
state and federal guidelines.
Expulsion
Only the Board may expel any student from school for a violation of rules and
regulations approved by the Board, or when the presence of that student is
considered to be detrimental to other students within the educational process.
Suspended Students and Attendance at School Events
Students who are suspended from school cannot attend school events held on
North Fayette property until they are eligible to return to school.


Valley Community Schools Alcohol Suspension and Expulsion Policy

Code No. 502.9
SMOKING - DRINKING - DRUGS
The board prohibits the distribution, dispensing, manufacture, possession, use,
or
being under the influence of beer or alcohol, tobacco, other controlled
substances, or "look alike" substances that appear to be tobacco, beer or
alcohol
or controlled substances by students on school district premises or on property
within the jurisdiction of the school district or at any activities sponsored by
the school district, on or off school district property.
"School district location" means in a school building or on school premises; on
a school-owned vehicle or in another school-approved vehicle used to
transport students to and from school or school activities; off school property at
a school-sponsored or school-approved activity, event or function, such as a
field trip or athletic event, where students are under the jurisdiction of the
school district.

The board believes such illegal, unauthorized or contraband materials
generally cause material and substantial disruption to the school environment
or present a threat to the health and safety of students, employees, or visitors
on the school district premises.

Violation of this policy by students will result in disciplinary action including
possible suspension or expulsion. Use or purchase of cigarettes, tobacco or
tobacco products for those under the age of eighteen, may be reported to the
local law enforcement authorities. Possession, use or being under the
influence of beer or alcohol, for those under legal age, and/or of a controlled
                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     36
substance may be reported to the local law enforcement authorities.

Students who violate the terms of this policy may be required to satisfactorily
complete a substance abuse assistance or rehabilitation program approved by
the school board. If such student fails to satisfactorily complete such a
program, the student may be subject to discipline including possible
suspension or expulsion.

The board believes the substance abuse prevention program shall include:
Age-appropriate, developmentally-based drug and alcohol curriculum for
students in grades kindergarten through twelve, which address the legal,
social, and health consequences of drug and alcohol use and which provide
information about effective techniques for resisting peer pressure to use illicit
drugs or alcohol; A statement to students that the use of illicit drugs and the
unlawful possession and use of alcohol is wrong and harmful;

Standards of conduct for students that clearly prohibit, at a minimum, the
unlawful possession, use, or distribution of illicit drugs and alcohol by students
on school premises or as part of any of its activities; A clear statement that
disciplinary sanctions, up to and including expulsion and referral for
prosecution, will be imposed on students who violate the standards of conduct
and a description of those sanctions.

A disciplinary sanction may include the completion of an appropriate
rehabilitation program; Information about drug and alcohol counseling and
rehabilitation and reentry programs available to students; A requirement that
parents and students be given a copy of the standards of conduct and the
statement of disciplinary sanctions required; and Notification to parents and
students that compliance with the standards of
conduct is mandatory. It shall be the responsibility of the superintendent, in
conjunction with the principal, to develop administrative regulations regarding
this policy.

West Central Community Schools Alcohol and Suspension Policies

Illegal Items Found in School or in Students' Possession:
    Students are prohibited from distributing, dispensing, manufacturing,
possessing, using, and being under the influence of alcohol, drugs or look-a-
like substances and possessing or using tobacco, tobacco products or look-a-
like substances. Parents of students found in violation of this policy will be
contacted, and the students may be reported to law enforcement officials.

Detention and Suspension:
1. Offensive language or gestures, vulgarities or obscenities (spoken or
written), insubordinate behavior, disrespectful behavior or other unacceptable
conduct:
    1st offense - 2 detentions; up to an in-school suspension;
    2nd offense - 4 detentions; in-school suspension;
    3rd offense - in-school suspension for 1 or multiple days.
                             Fayette County, Iowa County Assessment Workbook (CAW)
                                                      37
2. Such behavior as in (1.) directed to any school employee will result in an:
      1st offense - 1 day suspension from school; or more depending on
offense
      2nd offense - suspension until a parent conference;
      3rd offense - suspension with referral to the board.
3. Possession of tobacco or smoking:
      1st offense - in-school suspension (1 day);
      2nd offense - in-school suspension (2 days);
      3rd offense - out-of-school suspension (3 days).

5. Use of or possession of alcoholic substances or drugs at school, school
sponsored activity or on buses: Parental conference followed by suspension or
expulsion.

6. Suspensions may also be served and are at the discretion of the principal.

Starmont Community Schools Good Conduct Policies
     The school board believes strongly in the message that minors should not
    use alcohol or other illegal drugs. Therefore, the board has included a
    requirement in the Good Conduct policy often referred to as the “mere
    presence” rule.
     Consequences for a violation of the Good Conduct Policy are as follows:
    o First Offense Within the Student's Junior High or High School Career
        - 30 school days of participation in all extra-curricular activities.
    o Second Offense Within the Student's Junior High or High School
        Career - 90 school days of participation in all extra-curricular activities.
    o Third or More Offense Within the Student's Junior High or High
        School Career - Twelve (12) calendar months of ineligibility.
     Penalties of the Good Conduct Policy begin on the first legal playing date
    of the athletic season as appointed by the Iowa High School Athletic
    Association and Iowa High School Girls Athletic Union or the beginning of
    any other extra-curricular activity.
    Some may question the fairness of a rule that imposes ineligibility on a
student for just being at a party or in a car and knowing this type of illegal
activity is going on. You may think the student should be rewarded for acting as
“designated driver” and refraining from illegal use of drugs or alcohol. But we
believe that the student who represents this school is looked up to and
emulated by other students, including younger children, and he or she should
not appear to condone illegal, unhealthy and dangerous activities or enable
other students to engage in them. Your support in this matter would be a
wonderful way to cooperate with the school and send the message to your
children that you are concerned about their health and moral character.

Oelwein Community Schools Alcohol Suspension and Expulsion Policy
Policy 502.3
SMOKING - DRINKING - DRUGS
The board prohibits the distribution, dispensing, manufacture, possession, use,
or being under the influence of beer, wine, alcohol, tobacco, other controlled
substances, or “look alike” substances that appear to be tobacco, beer, wine,
                             Fayette County, Iowa County Assessment Workbook (CAW)
                                                      38
alcohol or controlled substances by students while on school district property or
on property within the jurisdiction of the school district; while on school owned
and/or operated school or chartered vehicles; while attending or engaged in
school activities; and while away from school grounds if the misconduct will
directly affect the good order, efficient management and welfare of the school
district.
The board believes such illegal, unauthorized or contraband materials
generally cause material and substantial disruption to the school environment
or present a threat to the health and safety of students, employees, or visitors
on the school district premises.
Violation of this policy by students will result in disciplinary action including
possible suspension or expulsion. Use, purchase or being in possession of
cigarettes, tobacco or tobacco products for those under the age of eighteen,
may be reported to the local law enforcement authorities. Possession, use or
being under the influence of beer, wine, or alcohol, for those under legal age,
and/or if a controlled substance may be reported to the local law enforcement
authorities.
Students who violate the terms of this policy may be required to satisfactorily
complete a substance abuse assistance or rehabilitation program approved by
the school board. If such student fails to satisfactorily complete such a
program, the student may be subject to discipline including suspension or
expulsion.
The board believes the substance abuse prevention program will include:
• Age-appropriate, developmentally-based drug and alcohol curriculum for
students in grades kindergarten through twelve, which address the legal,
social, and health consequences of tobacco, drug and alcohol use and which
provide information about effective techniques for resisting peer pressure to
use tobacco, drugs or alcohol;
• A statement to students that the use of illicit drugs and the unlawful
possession and use of alcohol is wrong and harmful;
• Standards of conduct for students that clearly prohibit, at a minimum, the
unlawful possession, use, being under the influence of or distribution of illicit
drugs and alcohol by students on school premises or as part of any of its
activities;
• A clear statement that disciplinary sanctions, up to and including suspension
or expulsion and referral for prosecution, will be imposed on students who
violate the policy and a description of those sanctions;
• A statement that students may be required to successfully complete an
appropriate rehabilitation program;
• Information about drug and alcohol counseling and rehabilitation and re-entry
programs available to students;
• A requirement that parents and students be given a copy of the standards of
conduct and the statement of disciplinary sanctions required; and,
• Notification to parents and students that compliance with the standards of
conduct is mandatory.
It shall be the responsibility of the superintendent, in conjunction with the
principal, to develop administrative regulations regarding this policy.



                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                     39
Other Data

According to the Fayette County Juvenile Court Officer, the juveniles that are charged with 2 nd and
subsequent offenses of possession are placed on informal adjustment for 6 months. Loeb noted that
children often are able to abide by the rules and get off informal adjustment, but then are often back
in the future. Since alcohol only stays in the blood stream for a short time, kids can drink and get
away with it. So, Loeb uses GPS monitoring and the help of trackers to check on kids and make sure
they are following their informal adjustment.

In 2010, there were 55 referrals for alcohol to the Juvenile Court Services for Fayette County. The
breakdown of charges is as follows:
      4       consumption/intoxication
      1       possession/purchase of alcohol <21
      49      possession/purchase of alcohol <18
      1       OWI

Through July 27, 2011, there have been 24 referrals for alcohol to the Juvenile Court Services for
Fayette County. The breakdown of charges is as follows:

       2      consumption/intoxication
       18     possession/purchase of alcohol
       2      OWI

Figure 4: of Juvenile Alcohol Statistics from District 1 Juvenile Court Services
 70

 60

 50
                                                               Allamakee
 40                                                            Clayton
                                                               Fayette
 30
                                                               Howard
 20
                                                               Winneshiek
 10

  0
       2005    2006    2007      2008     2009     2010
                                                                          In comparing Figure 9,
Fayette County consistently has more juveniles referred for court services than Winneshiek, Howard,
and Allamakee counties. Fayette County received more referrals in 2006, 2008, and 2010 than any
other county.

       According to an Assistant Fayette County Attorney, he does not feel the punishments
       are effective in addressing the behaviors. People can get exceptions to their license and
       continue to drive after OWI offense. Kids with their first offense normally take an alcohol
       class and then are done. Others have informal adjustments but continue to drink. The
       Asst County Attorney feels that by the time people get to him it is too late to change the
                              Fayette County, Iowa County Assessment Workbook (CAW)
                                                       40
behaviors.

Final Consequences Question

Question 6
Based on your data and responses to previous consequence questions, what
are your county’s major concerns surrounding underage and binge drinking?
Please provide supporting evidence here and reference the section and page
where the information may be found.

Some of the concerns surrounding underage drinking and binge drinking in
Fayette County are:
    The reported number of Adult OWIs has increased, meaning the rate of
      incidence has also increased (Table 4, Page 24).
    School alcohol policies are inconsistent and possibly avoid dealing with
      underage alcohol use (Table 11, page 34).
    Parents are demanding leniency from law enforcement and schools in
      regards to their underage children drinking alcohol. The State law
      supports parents providing alcohol to minor children in their homes. As
      shown in Table 11 (page 34), the rate at which children are suspended
      for alcohol has dropped considerably in recent years.
    The juvenile rates for OWI and alcohol related offenses are higher in
      Fayette County when compared to the State rate (Table 5, page 24)
    Fayette County Sheriff’s Deputies responded to 25 underage drinking
      parties in 2010 (Figure 4, page 26).
    Oelwein has seen the rates of juvenile alcohol offenses steadily
      increase since 2009 (Figure 5, pages 26-27).




                    Fayette County, Iowa County Assessment Workbook (CAW)
                                             41
Consumption

This section looks at alcohol consumption data and will help you identify any
consumption concerns in your county. Consumption data includes information about the
percentage of underage people who drink alcohol, the percentage of youth and adult
who engage in binge drinking (males having five or more and females having four or
more drinks on one occasion), or the percentage or number of adults who engage in
heavy drinking (having more than two drinks per day (males) or one drink per day
(female).

Underage Drinking:

                                                 th
Table 12: Proportion of Students (All grades vs. 11 Grade) 30-Day Use and Binge Drinking, source IYS
Indicators                  Grade Grade                      2002                    2005              2008
                                                           N    (%)               N     (%)          N    (%)
Students Who Have Had a County      All Grades          182            22.1      175      21.2      160         22.1
Drink in the past 30 Days
(%)                                 11th                101            40.9      132      44.1      104         42.1

                          State     All Grades        21,124           22.1   18,906      19.5   17,764         18.5

                                    11th              13,017           43.2   12,573      40.0   10,925         35.6

Students Who Report        County   All Grades          140            17.0      131      15.8       99         13.7
Binge Drinking in the past
30 Days (%)                         11th                 85            34.4      113      37.8       79         31.9

                          State     All Grades        16,104           16.7   13,804      14.1   11,971         12.5

                                    11th              10,860           35.9   10,105      31.9    8,411         27.3

Other Data

In 2011, a wellness survey was conducted for 8th graders at Starmont Community
School District. Starmont schools are located in the southeast corner of Fayette County
and include the communities of Arlington, Strawberry Point, and Lamont. Students were
asked various questions about their use of alcohol, the availability of alcohol and
perceptions of drinking. There were 41 students that participated in the survey. A
complete copy of the survey is shown in Appendix C.

Some of the results were:
   15% of students stated they have been in a situation where peers are drinking
     sometimes.
   7% stated they are in the same situation often.
   49% of students polled said they have never drank alcohol with older people.
   78% of students think Starmont high schoolers drink sometimes or often.
   57% of students polled think that the legal age for drinking should be lower.
   56% of students polled would be afraid to tell their parents that they were at a
     party.


                          Fayette County, Iowa County Assessment Workbook (CAW)
                                                         42
On May 26, 2011, an underage drinking survey was conducted at Oelwein High School
in Oelwein, Iowa. The Oelwein Community School district is located in the south central
part of the county and includes primarily the community of Oelwein. The students were
asked about perceptions of underage drinking, substance abuse resources, and
parental consequences of alcohol. A complete copy of the survey is shown in Appendix
D.

Some of the results are:
   only 24% of students considered underage drinking a serious problem.
   57% considered underage drinking an acceptable behavior.
   73% of students felt their parents would be upset if they drank alcohol underage.
   52% of polled students responded that 75% or more of their classmates were
     drinking underage.

In May, 2011 an underage drinking survey was conducted with SODA (Students OK
without Drugs and Alcohol) students at Valley Community Schools. SODA students are
between 6th and12th grade and the school includes the communities of Wadena,
Clermont, and Elgin. A complete copy of the survey is shown in Appendix E.

Some of the results were:
   100% of students polled stated their parents would be upset if they drank alcohol
     underage.
   71% of students polled stated they think underage drinking is a problem.
   83% of students felt that underage drinking was an acceptable behavior in
     Fayette County.

Upper Iowa University is a college located in Fayette County, Iowa. Based on the crime
statistics for the campus, the majority of violations involved alcohol.

Some of the statistics are:
   Of the 57 crime statistics in 2006, 37 of them were violations of liquor laws. This
     is approximately 65% of violations.
   Of the 70 violations in 2007, 87% were liquor law violations.
   In 2008, 75 of the 92 violations involved the liquor law, equaling 82%.
   All violations cited are on-campus violations and do not distinguish between
     residential or non-residential facilities.


The complete stats for 2006-2008 are seen in Figure 10 below.




                     Fayette County, Iowa County Assessment Workbook (CAW)
                                              43
Figure 10.
Crime Statistics – Upper Iowa University, Fayette, 2008-2006
                           1/1-12/31        1/1-12/31       1/1-12/31
Category
                           2006             2007            2008
                             O    R    N    P O      R    N    P O       R    N   P
Homicide                    0    0    0    0    0    0   0    0    0    0     0   0
Manslaughter                0    0    0    0    0    0   0    0    0    0     0   0
Forcible Sex Offense        1    1    0    0    0    0   0    0    0    0     0   0
Non-Forcible Sex Offense 0       0    0    0    0    0   0    0    0    0     0   0
Robbery                     0    0    0    0    0    0   0    0    0    0     0   0
Larceny-Theft               0    0    0    0    0    0   0    0    0    0     0   0
Aggravated Assault          0    0    0    0    1    1   0    0    2    2     0   0
Simple Assault              0    0    0    0    0    0   0    0    0    0     0   0
Intimidation                0    0    0    0    0    0   0    0    0    0     0   0
Arson                       0    0    0    0    0    0   0    0    0    0     0   0
Destruction/Damage          0    0    0    0    0    0   0    0    0    0     0   0
Motor Vehicle Theft         0    0    0    0    0    0   0    0    0    0     0   0
Liquor Law                  37 37 0        0    61 61 0       0    75 75 0        0
Burglary                    15 15 0        0    0    0   0    0    9    9     0   0
Drug Related                2    2    0    0    7    7   0    0    5    5     0   0
Weapons Possession          2    2    0    0    1    1   0    0    1    1     0   0
Hate Crimes
 Race                       0    0    0    0    0    0   0    0    0    0     0   0
 Gender                     0    0    0    0    0    0   0    0    0    0     0   0
 Religion                   0    0    0    0    0    0   0    0    0    0     0   0
 Sexual Orientation         0    0    0    0    0    0   0    0    0    0     0   0
 Ethnicity                  0    0    0    0    0    0   0    0    0    0     0   0
 Disability                 0    0    0    0    0    0   0    0    0    0     0   0

O = On campus - includes incidents in/on residential facilities, buildings and property.
R = Residential Facilities - includes incidents in residential facilities only.
N = In or on non-campus building or property
P = On public property

In a survey conducted with Upper Iowa University College students, they had concerns
that there was nothing to do outside of alcohol. Some comments were:

       Coaches buying kegs for player party and not paying attention to ages.

                      Fayette County, Iowa County Assessment Workbook (CAW)
                                               44
     Student suggested a need for a dance club that doesn’t serve alcohol.
     Students indicated they would be receptive to presentations about alcohol and
      athletics and would encourage coaches to get involved.
The complete results of the focus group is located in Appendix J.

Question 7
Based on table 11, and your county’s own local data, how does student 30-day
use of alcohol and binge drinking in your county compare to student data
across the state? Discuss the differences and the trends in your county.

In Table 12: Proportion of Students Who Reported 30-Day and Binge Drinking,
the number of students in Fayette County (all grades) that have had a drink in
the last 30 days was bigger than the state rate. The number of Fayette County
students (all grades) that reported binge drinking in the last 30 days was also
bigger than the state rate.

Additionally, in analyzing the 8th Grade wellness survey from Starmont
Schools, the majority of youth have never been in a situation where their peers
were drinking or where their peers were driving drunk. The majority also noted
that they have never drank with older people, but felt that most high schoolers
have drank, indicating it is more accepted in high school than middle school.

At the high school level, the majority of kids see underage drinking as an
accepted behavior and most feel their peers are drinking. Youth felt that their
parents would be upset if they drank alcohol underage, but felt that underage
drinking is accepted in Fayette County.

At the college level, the majority of violations on campus were a result of
alcohol. It was noted by the Palmer Lutheran Health Center that many of the
alcohol-related admissions they have are a result of binge drinking at UIU. In a
survey of students, it was noted that a coach had purchased kegs for a sports
team as a end of season celebration. Students noted that alcohol on UIU
campus is available and many students drink for something to do.




Adult Drinking:

Consider the following table for adult binge drinking and heavy drinking rates taken from
the 2006-2008 Behavioral Risk Factor Surveillance Survey (BRFSS). The use of
combined BRFSS data allows to compare individual counties to Iowa as a whole.
However, describing trends at the county level may not be possible.




                     Fayette County, Iowa County Assessment Workbook (CAW)
                                              45
Table 13: Percentage of Adults (18 Years and Older) Who Report 30-
Day Use and Binge Drinking, source BRFSS 2006-2008
Indicators                County              State

30-Day Use                                   53.4                            57.1
Binge Drinking                               26.9                            20.3


Other Data

The alcohol-related issues noted by interviewed community members include:
    Alcohol charges including OWI
    Possession by a minor
    open container in motor vehicle and public property
    .02 violations
    Fights and altercations
    domestic violence
    public intoxication
    curfew violations
    liquor license violations
    Motor vehicle crashes involving alcohol
    committals for alcohol dependence
    parent-child interventions where alcohol is involved
    as a dual factor in mental health issues

Additional consequences noted in interviews:

      Kids that are out late tend to be involved in risky behaviors including drinking but
       also drug use, smoking, vandalism, theft, and sexual activity.
      Parents that drink and go out to bars may lose some communication and
       supervision of children – encouraging them to be out and about and participating
       in risky behaviors.

Those interviewed felt that the factors contributing to alcohol-related problems were:

      “Alcohol is seen as recreational” was the response of Emergency Room
       Personnel at Palmer Lutheran Health Center.
      Some parents condone drinking and even provide alcohol to minor children –
       often in bar settings.
      When children are cited for alcohol-related violations, some parents become irate
       and angry at law enforcement.
      Parents become embarrassed when police charge their children and will not
       allow them to accept the consequences.
      People tend to think that because they drank when they were younger, their
       children can drink “it is part of growing up”
                     Fayette County, Iowa County Assessment Workbook (CAW)
                                              46
      Youth tend to use the idea that there is nothing else to do and to be involved in a
       social setting, they have to drink. Parents do the same and tend to drink at
       events and festivals showing their children they have to drink alcohol to have fun.
      Any minor that receives their first charge involving possession is ordered to take
       an alcohol class and the charge is dropped. There may not be enough
       consequence in the criminal justice system.
      Single parent households and the current economic situations in Fayette County
       contribute to alcohol use. Parents are stressed with money and children and may
       use drinking as a coping method.
      Youth hang with older friends and adults that can buy alcohol where in the past,
       they hung with people their own age.
      Parents and children do not think bad things will ever happen to them when they
       drink.

 It was suggested that some people in Fayette County do not see themselves as equal
to others in the state and even Northeast Iowa. We are not as fortunate in rural
communities and do not have some of the facilities and services available that
encourage habits other than drinking. Some of those interviewed felt that citizens of the
county think drinking is what they are supposed to do and they never strive to be any
better than that. Citizens may not have confidence in themselves and consider others in
the state smarter than they are.


Question 8
Based on previous table, along with your county’s other data sources, how
does adult binge drinking, and adult heavy drinking in your county compare to
adult binge drinking, and adult heavy drinking across the state?

In Table 13: Percentage of Adults (18 Years and Older) Who Report 30-Day
Use and Binge Drinking, the rate of 30-Day use of Fayette County citizens is
smaller than the state rate. The binge drinking rate is bigger than the state
rate.

The discussion panel felt that binge drinking was so prevalent because people
tend to work during the week and then drink on weekends at parties, events,
bars, and during recreation. There were a wide range of alcohol related issues,
consequences, and contributing factors that were noted by those interviewed.
These bullet points can be seen on pages 45 – 46.

Final Consumption Question




                     Fayette County, Iowa County Assessment Workbook (CAW)
                                              47
Question 9
Based on the consumption data analyzed here and on your answers to the
previous Questions, what are your county’s major concerns surrounding the
problem of underage drinking, adult binge drinking, and adult heavy drinking?
Justify your decision.

The major concerns surrounding consumption, underage drinking and binge
drinking are:
     Youth find that underage drinking is widely accepted beginning in high
       school (School Surveys, pages 41-42 with summary on page 44).
     Alcohol is permitted at Upper Iowa University and accepted practice of
       some coaches.
     In Table 13 (page 44), it was noted that Fayette County has a higher
       rate of binge drinking than the state. This indicates that Fayette County
       has a problem and this is supported by the information from Figures 6
       and 8 on pages 30-32.

In Figure 6 and again in Figure 8, the health factors of Fayette County are
presented. The county ranked 88 out of 99 in the health behaviors of adult
smoking, adult obesity, excessive drinking, motor vehicle crash death rate,
sexually transmitted infections, and teen birth rate. In viewing the excessive
drinking rates specifically:
     23% of Fayette County residents admit to excessive drinking
     Only 8% of Americans admit to excessive drinking
     20% of Iowans admit to excessive drinking
This indicates that excessive drinking is more prevalent in Fayette County than
in other general areas of the country.




                     Fayette County, Iowa County Assessment Workbook (CAW)
                                              48
                 Potential Intervening Variables



        Contributing
          Factor

                                                           Contributing
                                                           Factor
                         Intervening
                            Variables

Contributing
  Factor
                                           Contributing
                                               Factor




         Fayette County, Iowa County Assessment Workbook (CAW)
                                  49
Intervening Variables

Alcohol Availability (Retail)

Per Capita Liquor Licenses and Gallon Sales:

The most fundamental way to understand availability around alcohol use is through the
number of opportunities people have to buy alcohol. Consider the following table, which
compares the number of liquor license issued in your county and the state. This table
includes all liquor license types.

Table 14: Alcohol Liquor Licenses and Gallon Sales, source ABD
Alcohol Sales Indicators (per      Area                      2007          2008         2009
population over 18 Years Old)
                                  County             N              128           128            128
Liquor Licenses                                    Rate         76.9           77.2             77.3
(rate per 10,000)                 State            N          12344           12345            12345
                                                   Rate         51.6            51.3          51.1
                                  County           N             103             103           103
Temporary Liquor Licenses                          Rate         61.9            62.1          62.2
(rate per 10,000)                 State            N         10,181          10,181        10,181
                                                   Rate         42.5            42.3          42.1
                                  County           N         17,022          18,624        18,107
                                                   Rate         1.09            1.19          1.16
Gallon Sales                      State            N      3,938,239       4,064,647     4,299,890
(per capita)
                                                   Rate         1.92           1.98             2.10



Question 10
Based on Table 14, how do the numbers of liquor licenses and gallons sold per
person in your county compare to the state? how does your county rate of
temporary licenses compare to the rest of the state? Is it higher, lower or about
the same? Discuss the differences. How would you explain these findings?

In comparing Table 14: Alcohol Liquor Licenses and Gallon Sales, the rate for
Fayette County liquor licenses was bigger than the state rate by at least 25%.
The rate of temporary liquor licenses for events was also bigger than the state
rate. However, the gallon sales per capita is smaller for Fayette County
residents than the state rate.

The panel discussed why we have so many liquor licenses in Fayette County
and felt it was the result of bars and alcohol providing a social setting and
gathering spot. The panel also discussed that restaurants do not always stay
open, but bars tend to stay around for a long time. It was also noted that
drinking may be secondary to the bars providing a gathering place.


                       Fayette County, Iowa County Assessment Workbook (CAW)
                                                50
Compliance Check Failure Rate

The selling of alcohol to minors can contribute to underage drinking and binge drinking
in your county. One measure of this is the failure of compliance checks by retail outlets.
Consider the following table for input. Since this information is not available at the state
level, you will need to generate it from your community law enforcement agencies. You
will have to list the communities in the county. The timeframe for the compliance
checks will be in the last two years.

Table 5: Proportion of Liquor License Holders That Failed a Compliance Check, source
LEW
County               Number of Number           Number       Percent      Percent
                     Licenses      visited      that failed visited       Failed
                                                the check
Other County         128           13           2            10%          15%
(2010)
County               128           14           0            11%          0%
Notes: ABD does not do compliance checks for alcohol; available with EUDL (CJJP &
DOT, Iowa State Patrol)

In 2010, the Fayette County Sheriff’s Office conducted 14 compliance checks which
was supported with EUDL funds. Of the 14 checks, all establishments passed and no
violations were issued – there was 100% success rate in the 2010 county compliance
checks.

The “other county” information provided is from the Iowa State Patrol and covers 2010.
Thus far in 2011, the Iowa State Patrol has conducted compliance checks at 11
establishments and 2 of them were cited for violations. Approximately 9 percent of
license holders have been visited in 2011 with 18% failing the compliance checks.


Question 11
Comment on the extent of alcohol retail compliance checks in your county. How
receptive are your law enforcement agencies or your police chief to doing alcohol
checks?

The panel felt that law enforcement was receptive to compliance checks. The
Councilmember that was in attendance noted that they ask law enforcement in
West Union to conduct compliance checks whenever a business requests a
renewal of their liquor license. That Councilmember felt that police were doing a
good job of checking up on businesses and determining if they were following the
rules of their licenses. Additionally, the rate of failure from the Iowa State Patrol is
15%. This indicates that some improvement has been made with the Beverage
Server Training offered with Helping Services for Northeast Iowa, the Valley

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                                               51
Community Coalition, and the Fayette County Sheriff’s Office.




Percentage of Drive-Up Liquor Windows:

The percentage of drive-up liquor windows in your county can contribute to alcohol-
related concerns because drive-up liquor windows make alcohol more easily obtainable
and may encourage drinking and driving. This section will help you determine both the
number of establishments with drive-up liquor windows and also what percentage of the
liquor license holders in your county have them. You may have to search the Iowa ABD
for establishments that hold liquor licenses in your county, see Table 5 for the link.

Table 6: Drive-Up Liquor Windows and Liquor Licenses in Your County, source ABD
County                                  Name of Establishment with Drive-up liquor
                                        window
None                                    None

Number of liquor licenses (from Table 15)= 0
County drive-up liquor window percentage = 0%

Question 12.
Comment on your county drive-up liquor percentage. How does it influence
drinking and driving, loitering, safety? Please refer to your county DUI charges
numbers and think whether there might be a relation.

Fayette County does not have any drive-up liquor windows. It was agreed that
having these windows would contribute to the availability of alcohol.




Local Ordinances

Local policies can dissuade drinking and loitering, check whether your county is much
involved in preventing underage drinking. How many local ordinances specifically
related to alcohol consumption are there?

Table 7: Local Ordinances Targeting Alcohol in Your County, source CEW
County              Name of the local ordinances       Aim
Arlington           1.03 State Liquor Store Location   Bans liquor stores from being
                                                       located within 300 feet of a
                                                       school

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Arlington   1.04 Persons Under Legal Age              Bans any person under legal
                                                      age from purchasing,
                                                      attempting to purchase, or
                                                      possessing alcohol unless
                                                      provided under parental
                                                      supervision in private home.
Arlington   1.05 Public Consumption or                Bans possession or
            Intoxication                              consumption of alcohol on
                                                      school property and prohibits
                                                      consumption in any place that
                                                      does not have liquor license.
Arlington   1.06 Open Containers in Motor             Bans possession of unsealed
            Vehicles                                  bottle, can or jar in driver or
                                                      passenger area of vehicle.
Clermont    120.02 Persons Under Legal Age            Bans any person under legal
                                                      age from purchasing,
                                                      attempting to purchase, or
                                                      possessing alcohol unless
                                                      provided under parental
                                                      supervision in private home.
Clermont    120.03 Public Consumption or              Bans possession or
            Intoxication                              consumption of alcohol on
                                                      school property and prohibits
                                                      consumption in any place that
                                                      does not have liquor license.
Clermont    120.04 Open Containers in Motor           Bans possession of unsealed
            Vehicles                                  bottle, can or jar in driver or
                                                      passenger area of vehicle.
Clermont    120.05 License or Permit                  Bans the sale, possession or
            Required                                  transportation of alcohol
                                                      without liquor control license.
Elgin       45.01 Persons Under Legal Age             Bans any person under legal
                                                      age from purchasing,
                                                      attempting to purchase, or
                                                      possessing alcohol unless
                                                      provided under parental
                                                      supervision in private home.
Elgin       45.02 Public Consumption or               Bans possession or
            Intoxication                              consumption of alcohol on
                                                      school property and prohibits
                                                      consumption in any place that
                                                      does not have liquor license.
Elgin       45.03 Open Containers in Motor            Bans possession of unsealed
            Vehicles                                  bottle, can or jar in driver or
                                                      passenger area of vehicle.
Elgin       46.01 Curfew                              Curfew for minor under the

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                                     53
                                                    age of sixteen is 10 – 5 a.m.
                                                    Sun-Thurs and 11 – 5 a.m. on
                                                    Fri and Sat. Minors age 16
                                                    and 17 have curfew of 10 – 5
                                                    a.m. Sun-Thurs and 12
                                                    midnight – 5 a.m. on Fri. &
                                                    Sat.
Fayette   45.01 Persons Under Legal Age             Bans any person under legal
                                                    age from purchasing,
                                                    attempting to purchase, or
                                                    possessing alcohol unless
                                                    provided under parental
                                                    supervision in private home.
Fayette   45.02 Public Consumption or               Bans possession or
          Intoxication                              consumption of alcohol on
                                                    school property and prohibits
                                                    consumption in any place that
                                                    does not have liquor license.
Fayette   45.03 Open Container in Public            Bans possession in any open
          Places and 45.04 Open Container           container in public place,
          in Public Places                          street, or sidewalk unless
                                                    covered by liquor license.
Fayette   45.03 Public Consumption or               Bans possession or
          Intoxication                              consumption of alcohol on
                                                    school property and prohibits
                                                    consumption in any place that
                                                    does not have liquor license.
Fayette   46.01 Curfew                              Bans minors from being in
                                                    any establishment between
                                                    12:00 midnight and 6:00 a.m.
                                                    Curfew for all minors is 12
                                                    midnight to 6 a.m.
Hawkeye   120.02 Persons Under Legal Age            Bans any person under legal
                                                    age from purchasing,
                                                    attempting to purchase, or
                                                    possessing alcohol unless
                                                    provided under parental
                                                    supervision in private home.
Hawkeye   120.03 Public Consumption or              Bans possession or
          Intoxication                              consumption of alcohol on
                                                    school property and prohibits
                                                    consumption in any place that
                                                    does not have liquor license.
Hawkeye   120.04 Open Containers in Motor           Bans possession of unsealed
          Vehicles                                  bottle, can or jar in driver or
                                                    passenger area of vehicle.

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                                   54
Hawkeye   120.05 License or Permit                  Bans the sale, possession or
          Required                                  transportation of alcohol
                                                    without liquor control license.
Hawkeye   46.04 Minors in Taverns                   Bans minors from entering,
                                                    remaining, or frequenting a
                                                    business which has sales
                                                    volumes of less than 50%
                                                    food.
Hawkeye   46.05 Minors in Billiard Rooms            Bans minors from playing
                                                    billiards or pool or entering a
                                                    billiard or poll hall where
                                                    alcohol is sold.
Oelwein   11.1 Hours of Sale                        Bans the sale of liquor by
                                                    licensed establishments
                                                    between the hours of 2 and 6
                                                    a.m. on a weekday. If license
                                                    allows Sunday sales, they can
                                                    be made between 8 a.m.
                                                    Sunday and 2 a.m. Monday.
Oelwein   11-19 Miscellaneous Prohibitions          Bans the sale or dispensing
                                                    or alcohol to an intoxicated
                                                    person, or one simulating
                                                    intoxication.
Oelwein   11-19 Miscellaneous Prohibitions          Bans gambling, sale of
                                                    alcohol on credit, repackaging
                                                    of alcohol, employment of
                                                    person under age 18 to serve
                                                    alcohol, sale of alcohol to a
                                                    minor.
Oelwein   20.2 Possession by Persons                Bans any person under 18
          Under the Age of Eighteen                 from purchasing, attempting
                                                    to purchase, or possessing
                                                    alcohol unless provided under
                                                    parental supervision in private
                                                    home.
Oelwein   20.3 Persons Age Eighteen,                Bans any person age 18,19,
          Nineteen and Twenty                       or 20 from purchasing,
                                                    attempting to purchase, or
                                                    possessing alcohol unless
                                                    provided under parental
                                                    supervision in private home.
Oelwein   20.4 Furnishing Beer or Alcoholic         Bans providing alcohol to any
          Liquor to Persons Under the Age           person age 18,19, or 20
          of Eighteen, Nineteen or Twenty           unless provided under
                                                    parental supervision in private
                                                    home.

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                                   55
Oelwein   20.5 Misrepresentation of Age to          Bans any person from
          Purchase                                  misrepresenting their age to
                                                    purchase alcohol.
Oelwein   20.6 Consumption in Public                Bans possession or
          Places – Intoxication – Right to          consumption of alcohol on
          Chemical Test on Arrest                   school property and prohibits
                                                    consumption in any place that
                                                    does not have liquor license.
Oelwein   20.8 Open Container in Public             Bans possession in any open
          Place                                     container in public place,
                                                    street, or sidewalk unless
                                                    covered by liquor license.
Oelwein   20.9 Minors Prohibited from               Bans minors from entering,
          Certain Premises                          remaining, or frequenting a
                                                    business which has sales
                                                    volumes of less than 50%
                                                    food.
Waucoma   45.25 Amusement Devices                   Electronic or mechanical
                                                    amusement devices that
                                                    award prizes of merchandise
                                                    are allowed only in locations
                                                    that posses liquor license.
Waucoma   46.01 Curfew                              Curfew for minors is 11 – 6
                                                    a.m. Sun-Thurs and 1 – 6
                                                    a.m. on Fri and Sat.
Waucoma   120.01 Prohibition                        Bans the sale or dispensing
                                                    or alcohol to an intoxicated
                                                    person, or one simulating
                                                    intoxication.
Waucoma   120.02 Persons Under Legal Age            Bans any person under legal
                                                    age from purchasing,
                                                    attempting to purchase, or
                                                    possessing alcohol unless
                                                    provided under parental
                                                    supervision in private home.
Waucoma   120.03 Public Consumption or              Bans possession or
          Intoxication                              consumption of alcohol on
                                                    school property and prohibits
                                                    consumption in any place that
                                                    does not have liquor license.
Waucoma   120.04 Open Container                     Bans possession of unsealed
                                                    bottle, can or jar in driver or
                                                    passenger area of vehicle.
Waucoma   120.05 License or Permit                  Bans the sale, possession or
                                                    transportation of alcohol
                                                    without liquor control license.

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                                   56
West Union           45.01 Persons Under Legal Age             Bans any person under legal
                                                               age from purchasing,
                                                               attempting to purchase, or
                                                               possessing alcohol unless
                                                               provided under parental
                                                               supervision in private home.
West Union           45.02 Public Consumption or               Bans possession or
                     Intoxication                              consumption of alcohol on
                                                               school property and prohibits
                                                               consumption in any place that
                                                               does not have liquor license.
West Union           45.03 Open Containers in Motor            Bans possession of unsealed
                     Vehicles                                  bottle, can or jar in driver or
                                                               passenger area of vehicle.
West Union           46.03 Curfew                              Curfew for minors is 11 p.m.
                                                               to 5 a.m.
West Union           120.01 License or Permit                  Bans the sale, possession or
                     Required                                  transportation of alcohol
                                                               without liquor control license.
West Union           120.05 Prohibited Sales and Acts          Bans the sale or dispensing
                                                               or alcohol to an intoxicated
                                                               person, or one simulating
                                                               intoxication.
West Union           120.05 Prohibited Sales and Acts          Bans the sale of liquor by
                                                               licensed establishments
                                                               between the hours of 2 and 6
                                                               a.m. on a weekday. If license
                                                               allows Sunday sales, they can
                                                               be made between 8 a.m.
                                                               Sunday and 2 a.m. Monday.
West Union           120.05 Prohibited Sales and Acts          Bans gambling, sale of
                                                               alcohol on credit, repackaging
                                                               of alcohol, employment of
                                                               person under age 18 to serve
                                                               alcohol, sale of alcohol to a
                                                               minor.
West Union           120.06 Amusement Devices                  Electronic or mechanical
                                                               amusement devices that
                                                               award prizes of merchandise
                                                               are allowed only in locations
                                                               that posses liquor license.

Other Data

There are several bars in the Oelwein area that Officer DeJong noted sell to minors.
Chief Sullivan also noted that there is a bar in Clermont that tends to sell to minors.

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                                              57
It was also pointed out some bartenders and convenience store clerks do not always
calculate dates of birth correctly and this leads to minors purchasing alcohol. Chief
Sullivan went on to state he supports an ordinance that would prohibit anyone under the
age of 21 from being in a bar after 10 p.m. This change would not apply to bars that
serve a certain percentage of food, it would apply to any place that sells liquor.

On September 24, 2010, the Fayette County Sheriff’s Office conducted a vehicle safety
checkpoint for the Valley Community Coalition in West Union, Iowa. Fifteen law
enforcement officers worked for 5 hours and had the following citations issued:
    109 vehicles went through the checkpoint
    6 alcohol violations were issued
    5.5% of vehicles had alcohol violations

Retail Availability Questions

Question 13
Based on information gathered about liquor licenses per 10,000 population 15 years
and older, alcohol compliance check failure rates, drive-up liquor window
percentage, and other data sources, what are the concerns around retail availability
that might contribute to underage and binge drinking and its consequences in your
county? Justify your decision.

Retail availability is a large concern for the discussion panel, not only in the bars and
taverns, but more so in convenience stores and grocery stores. Now that liquor can
be sold in those places, it is much more available and prominent. It was also noted
that younger adults work in grocery stores and convenience stores, making it easier
to sell to their minor friends. In bars, you can see a minor go in, but in the grocery
store, you have no idea what they went in to buy.

It was also noted that purchasing liquor at a liquor store draws attention to people. If
someone sees a person parked at the liquor store, they know what they are there to
buy. That is not the case at the grocery or convenience store, the person can “hide”
their purchase in with other things. It is more discreet.

The panel discussed that liquor was to be sold at a different checkout lane than
other products and the panel was not sure that was happening. They also noted that
Beverage Server Training is not required for convenience and grocery stores.

Finally, one of the panel members discussed conducting the environmental scan
with a youth. The youth does not drink and is against drinking, however, she noted
all the “pretty” bottles in the liquor aisle and became curious to see what they were.
Although she does not like alcohol, she was drawn to the packaging.




                      Fayette County, Iowa County Assessment Workbook (CAW)
                                               58
Question 14
Based on the above considerations, to what degree does your coalition believe retail
availability is impacting underage and binge drinking and its consequences in your
county? Justify your decision.
(place an “x” next to a number from 0 to 10)

 No impact                                                               Major impact
 0     1         2       3       4        5        6        7       88        9       10


Key Law Enforcement Interviews

As part of this needs assessment you will conduct interviews of law enforcement
officers. You are encouraged to do at least one interview with a chief of police and one
with the County Sheriff, but consider what interviews would be the most appropriate and
informative for your county. You may also want to consider interviews with emergency
room staff, school officials, or treatment facility administrators about their interactions
with the justice system. A sample protocol for the law enforcement interviews and ideas
on how to gather and analyze qualitative data from these interviews can be found in
Appendix A.

Officers Assigned to Alcohol-Related Issues
During the interviews with key law enforcement personnel you need to find out how
many officers are assigned directly to alcohol-related issues and crimes. Questions
about this appear on the interview protocol in Appendix A.

Law Enforcement Officers Assigned to Alcohol-Related Issues and Crime (County) = 3

There are no officers or deputies in the County that are assigned specifically to alcohol,
but 3 that are responsible for alcohol education. The Oelwein PD has one officer that is
responsible for D.A.R.E. programs in Oelwein. The Fayette County Sheriff's Office has
one deputy that is responsible for D.A.R.E. programs at North Fayette, Valley, and West
Central Schools. The Iowa State Patrol has one officer that is responsible for safety
education in District 10.




                     Fayette County, Iowa County Assessment Workbook (CAW)
                                              59
Question 15
Based on your interviews with law enforcement officers and the number of officers
in your county assigned specifically to alcohol-related issues, when it comes to the
underage and binge drinking:

         What are the efforts your law enforcement agencies are pursuing?
         What are the efforts that they would like to pursue?

The efforts currently being pursued are:
    Liquor License Compliance Checks
    Sobriety Checkpoints
    Diligent patrolling, more so in areas that are known for issues.
    Education programs at schools, namely the D.A.R.E. program for 6th
       graders.
    Coordinating patrolling and efforts around holidays and local events.
The efforts law enforcement would like to pursue include:
    Additional education and presentations to high school students.
    Encouraging public involvement and policing.
    More substance abuse counseling.
    Enact ordinances that prohibit minors from being in bars at any time.

Other Data

In speaking with law enforcement, it was noted that any minor at a party that does not
register a BAC will be let off without charges, even if they are technically in possession
of alcohol.

Social Availability

Social availability includes the likelihood of obtaining of alcohol from friends, associates,
and family members, as well as the availability of alcohol at social gatherings such as
graduation parties, reception and other social events where alcohol is provided as part
of the event. This section assesses the proportion of students who perceived alcohol
easy or very easy to obtain in their neighborhood.


County Level Data:




                      Fayette County, Iowa County Assessment Workbook (CAW)
                                               60
Table 17: Proportion of Students Who Responded (easy and very easy) to Perception of Neighborhood Alcohol Availability Question, sou
(Ngacc)                            Area                Grade                  2002              2005       2008

In your neighborhood or community, County                ALL                   45.6               45.7      44.9
how difficult do you think it would be                   11th                  21.1               18.6      17.8
for a kid your age to get alcoholic    State             ALL                   44.6               47.7      45.4
beverages (beer, wine, liquor)?                             th                 18.0               20.3      20.7
                                                         11
Questions: 2002-G2; 2005-G2;
2008-G2

County Meetings or Focus Groups

In a town hall meeting conducted at Upper Iowa University in April 2011, students were
asked about underage and binge drinking. Sixty one percent of the students polled were
over the age of 21 and 39% were minors. The polled students noted the following
concerns about alcohol use:

       Underage Drinking (12%)
       Drinking and Driving (18%)
       Alcohol Availability (10%)
       Community Acceptance of Underage/Binge Drinking (13%)
       Consequences of Underage/Binge Drinking (8%)
       Lack of Alcohol Awareness and the Consequences (5%)
       Parents who drink in front of their children (1%)
       All of the above (33%)

In 2011, a panel presentation on underage drinking was conducted at Upper Iowa
University by the Fayette County Substance Abuse Coalition. The students were asked
about underage drinking.

       66% of students felt that underage drinking was acceptable on college
        campuses.
       42% of students felt that underage drinking was a little bit of a problem or no
        problem at all.
       61% of students felt that 75% or more of their peers consumed alcohol underage.
       44% of students felt their parents would be upset if they consumed alcohol
        underage - 56% were not concerned about their parent's opinions.
   
Other Data

In visiting with an Upper Iowa football player, it was noted that in his freshman year, the
football coach bought kegs to celebrate the end of the season. The coach was not
concerned about the age of the players and encouraged them to drink in celebration.

Social Availability Questions




                           Fayette County, Iowa County Assessment Workbook (CAW)
                                                       61
Question 16
Based on information gathered, what are the concerns around social availability that
might contribute to underage drinking and binge drinking and its consequences in your
county? Justify your decision.

Based on Table 17: Proportion of Students Who Responded (easy and very easy) to
Perception of Neighborhood Alcohol Availability, with the exception of all students in
2008, the students responded more often that it is easy to get alcohol in Fayette County
when compared to the state rate.

Concerns regarding social availability include:
    State law which allows parents to provide alcohol to their children in their home.
    Parents that take their minor children to the bar and allow them to drink.
    Parents and older adults that have celebrations and encourage youth to drink to
      have fun.
    Many of the students on UIU’s campus felt that drinking was an acceptable
      behavior and few saw problems with the rate of underage drinking.


Question 17
Based on these considerations, address the issue whether your coalition believes social
availability is having an effect on underage drinking and binge drinking and its
consequences in your county? Justify your decision.
(place an “x” next to a number from 0 to 10)

 No impact                                                                   Major impact
 0     1        2       3       4        5         6       7       8
                                                                   8         9      10


Promotion

Promotion refers to attempts by alcohol retailers and industry to increase demand
through the marketing of their products. Once again, this will require some original data
collection to acquire a sense of the depth of marketing surrounding alcohol in your
county.

Sponsorships

List all the major county events and festivals in your county under the heading county
events within the last year in Table 15. Indicate alcohol- sponsors in the designated
column. Calculate the percentage of events in your county that had alcohol-related
sponsorships. Try to assess the percent of sponsorship funding from the events, and
then calculate the total funding percent coming from all alcohol sponsors in your county.




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                                              62
Table 8: County Events and Their Alcohol-Related Sponsors Within Last Year, source
LEW
                                                   Alcohol-          Percent Alcohol
Community Events                   Dates
                                                   Sponsors          Sponsorship ($)
 Arlington      Arlington Days        July 2010
             Clermont Threshing
 Clermont                             July 2010
                     Days
 Clermont      Brick City Days      October 2010          0                  0
                   Clermont
 Clermont        Betterment            All year           2               $100
                   Activities
                Clermont Car
 Clermont                                                 0                  0
                     Cruise
             Clermont Ping Pong
 Clermont                                                 0                  0
                    Tourney
                 Clermont 5k
 Clermont                                                 0                  0
                  Walk/Run
                 Community
 Clermont                             July 2011
                  Fireworks
              Elgin Sweet Corn
   Elgin                              July 2010           1                $50
                     Days
   Elgin         Maize Maze        July – October         0                  0
               Shinbone Valley
   Elgin                              July 2010
                 Rendezvous
                  Gilbertson
   Elgin                              July 2010
                 Rendezvous
 Fairbank     Fireman’s Dance       January 2011
 Fairbank       Fairbank Days        June 2011
                    Fayette
  Fayette                           August 2010
              Watermelon Days
                 Upper Iowa
  Fayette         University        October 2010
                Homecoming
             DT’s Best Shot Golf
  Fayette                             July 2010           1             $480.00
                    Tourney
  Fayette
               Barn Quilt Tour         Ongoing            0                  0
  County
  Fayette      Fayette County
                                                          0                  0
  County         Tractorcade
 Hawkeye     Hawkeye Fun Days        June 2011
             Hawkeye Fireman’s
 Hawkeye                            August 2010
                     Dance
  Lima –
                                     September
   Rural       Lima Leaf Days
                                        2010
  Fayette
 Maynard        Maynard Days         June 2011
                    Fayette County, Iowa County Assessment Workbook (CAW)
                                             63
 Oelwein           Ride n’ Park           June 2011                 0              0
                    Community
 Oelwein         Celebration and          July 2011                 0              0
                     Fireworks
 Oelwein      Italian Heritage Day       August 2010                0              0
 Oelwein         Heritage Days           August 2010                0              0
                                          September
 Wadena          Wadena Days                                        0              0
                                            2010
              Wadena Fun Day in
 Wadena                                      July                0                 0
                    the Park
               Racing at Fayette
West Union                              All Summer               2
               County Speedway
               West Union Dairy
West Union                              June 2011                1
                      Days
West Union Fayette County Fair           July 2010               2
West Union         WU Stock            August 2010
                  Community
West Union                               July 2011               1
                   Fireworks
Note: In case of mix-events, try to identify the proportion of sponsorship linked to
alcohol. For example in a county fair: what is the total sponsorship dollars amount (from
all sources) and what is the proportion coming from Alcohol sponsors. If possible try to
get the % of sponsorship dollars that come from alcohol-related sponsors?

**Note: Fayette County had a difficult time confirming alcohol sponsorship and
percentages of total budgets. We were able to get some information from local
newspapers, but most people were not willing to share budget information and
sponsorships for fear that it may be used against them. The numbers below reflect a
combination of what we found in the papers as well as what committee members
confirmed.

Total number of community events (ALL types) during that period in your county: 23
Total Number of events with alcohol-related sponsorship = 10
Total % of sponsorship from Alcohol Companies = n/a

Advertising

Advertising in America and Iowa has become ubiquitous. To gain a better sense of the
magnitude of alcohol advertising in your county you are going to gather data
(advertisement scan) on alcohol marketing on billboards, in a sample of local
newspapers, in schools, and local supermarket or groceries across your county.

Step One
The first measure of alcohol advertising in your county will be to count all the billboards
in your county. To do so, you will need to travel throughout your county to locate every



                      Fayette County, Iowa County Assessment Workbook (CAW)
                                               64
billboard within your county. Using a map1, mark the location of each billboard you
encounter. A billboard that advertises alcohol, alcohol sales, or alcohol establishments
should be marked with a red mark, whereas a billboard that does not advertise alcohol
should be marked with a green mark. Each billboard sign should only receive one mark
per advertisement presented on that billboard. If a billboard is visible from more than
one road, highway or interstate, then it should only be counted once. Youth on your
coalition or from another youth group may be helpful in doing this environmental scan.

After mapping all billboards in your county, record the total number of billboards located
and the number advertising alcohol and not advertising alcohol. To calculate the percent
of billboards which advertise alcohol.

Number of billboards advertising alcohol (A)= 3

The total number of billboards not advertising alcohol (B) =15

Percentage of billboards advertising alcohol [A/(A+B)*100] = 14.3%

A map of the Fayette County Billboards is show in Appendix H.

Step Two
In this next step, there will be two concurrent parts. The first part will involve counting
the number of alcohol advertisements in your local newspaper(s), in stores in your
county or within schools. The second part will involve counting the number of alcohol
advertisements that specifically market promotional events that encourage the use of
alcohol. The basic methodology you follow is the same for both parts.

To measure the number of alcohol advertisements you will need to look at copies of the
major local newspapers (including the door-step deliveries), visit the major schools (high
schools, colleges) or the main stores (supermarkets, grocery stores) in your county at
four specific time points during the assessment period (example once every six weeks).
The data collection will capture information about two holiday periods and two non-
holiday periods. Note, you will need to examine all issues of the newspaper during the
identified time periods. For instance, if your major newspaper only appears once per
week you would only count that one single day. If the newspaper is biweekly, then you
will examine the two issues in the week. If the newspaper is daily, then you will examine
all seven issues in the week. If your newspaper only appears once per month, count the
ads that appear in that single monthly issue regardless of which week it appears. The
reason for this data collection is to better understand exposure to alcohol marketing. As
a result, a newspaper that appears only once a week provides less exposure than one
that appears every day. Again, youth may be helpful for this data collection.

When visiting the schools or grocery stores, look for posters or examining the


1See whether companies in Iowa can provide a listing of their billboards in Iowa; so that you
may get the information directly from them.
                       Fayette County, Iowa County Assessment Workbook (CAW)
                                                65
newspapers, count all advertisements for alcohol brands, alcohol distributors, liquor
stores, and bars. You will also need to count restaurant advertisements that mention
alcohol or bar service. You should look at the regular print advertisements, the
classifieds and the added flyers and coupons in your search.

As you count alcohol advertisements, also note the number of advertisements that
market promotional events encouraging the increased use of alcohol. Examples include,
but are not limited to: ladies' night, happy hour, double bubble, all you can drink, and
free or reduced priced drinks with a coupon.

If you have trouble counting the number of advertisements and special promotions in all
your local news papers and need help, contact Dr. Ousmane Diallo at
(ousmane.diallo@idph.iowa.gov) for technical assistance.


Table 9: Local Alcohol Advertisements and Promotional Events, source LEW
                                                                        Total Number
                                                       Total Number
Advertisement                  Time Period                             of Promotional
                  Name                                  of Alcohol
Scan                           (Enter Date)                                 Event
                                                      Advertisements
                                                                       Advertisements
                               First scan (6/29/11)           1               0
                  Frequency: Second scan (7/6/11)             1               1
Elgin Echo
                  Weekly       Third scan (7/13/11)           3               0
                               Fourth scan (7/20/11)          1               0
West Union                     First Scan (6/29/11)           8               2
Area Shoppers                  Second Scan (7/6/11)          10               1
Guide                          Third Scan (7/13/11)           9               0
                  Weekly
(including
Moore’s                        Fourth Scan (7/20/11)          8               0
Grocery flyer
                               First Scan (6/29/11)           6               2
The Fayette                    Second Scan (7/6/11)           4               2
                  Weekly
County Union                   Third Scan (7/13/11)           8               0
                               Fourth Scan (7/20/11)         13               3
Clayton                        First Scan (6/29/11)           3               1
County Market                  Second Scan
Basket                                                        1               1
                  Weekly       (7/6/2011)
(including                     Third Scan (7/13/11)           1               0
Wilke’s
Grocery flyer)                 Fourth Scan (7/20/11)          1               0
                               First Scan (6/29/11)          12               3
Wisconsin-                     Second Scan (7/5/11)          10               4
Iowa Shopping Weekly           Third Scan (7/13/11)          10               3
News
                               Fourth Scan (7/26/11)         11               4


                     Fayette County, Iowa County Assessment Workbook (CAW)
                                              66
The Fayette                   First Scan (07/5/11)                 8        1
County                        Second Scan
Shopper’s                                                          7        1
                              (7/13/11)
Reminder        Weekly        Third Scan (7/20/11)                 7        1
(including
Fareway                       Fourth Scan (7/26/11)                8        2
Grocery Flyer
                              First Scan (7/5/11)                  5        2
                              Second Scan
Oelwein Daily   Daily with                                         3        0
                              (7/11/11)
Register        no Sunday
                              Third Scan (7/18/11)                 4        0
                              Fourth Scan (7/25/11)                3        0
                              First Scan (6/29/11)                 0        0
The Fayette                   Second Scan (7/6/11)                 1        1
                Weekly
Leader                        Third Scan (7/13/11)                 0        0
                              Fourth Scan (7/20/11)                1        0
                              First scan (7/5/11)                  0        0
                              Second scan (7/11/11)                0        0
Upper Iowa
                School        Third scan (7/18/11)                 0        0
University
                              Fourth scan (7/25/11)                0        0

                              First scan
                                                                   4        0
Moore’s Inc.,                 (7/05/2011)
Elgin, Iowa     Store         Second scan (7/11/11)                4        0
                              Third scan (7/18/11)                 4        0
                              Fourth scan (7/25/11)                4        0
                              First Scan (7/05/2011)              16        5
Moore’s                       Second Scan
                                                                  18        11
Foods, West     Store         (7/12/11)
Union, Iowa                   Third Scan (7/20/11)                18        11
                              Fourth Scan (7/25/11)               18        11
                              First Scan (7/11/2011)              19         6
                              Second Scan
Fareway,                                                          19        6
                Store         (7/12/11)
Oelwein, Iowa
                              Third Scan (7/22/11)                19        6
                              Fourth Scan (7/25/11)               21        4
                              First Scan (7/11/2011)               7        2
                              Second Scan
Gavins IGA                                                         7        2
                Store         (7/20/11)
Fayette, Iowa
                              Third Scan (7/22/11)                 7        2
                              Fourth Scan (7/25/11)                6        2

Average of alcohol advertisements and promotional events in Newspapers = 5.25
                   Fayette County, Iowa County Assessment Workbook (CAW)
                                            67
Average of alcohol advertisements and promotional events in Schools = 0
County average of alcohol advertisements and promotional events in Stores = 11.94


Question 18
Based upon the data you collected above, comment on your results. What
impact do you expect that the advertisements have on underage and binge
drinking?

During the week of July 4th, the number of alcohol advertisements and
promotions in local newspapers were higher than at any other time of the scan.
Even higher numbers were noticed in the papers closest to the Mississippi
River, a large recreational area of boating, fishing, camping, and canoeing. The
number of ads would have increased overall due to the fact that grocery stores
are now selling alcohol and their advertisements now include those sales as
well as food items.

Additionally, many county fairs are being held at this time of year and we could
see in the newspaper scans that advertisements including the beer tents were
more prevalent. Most of the county fair ads in the local newspapers made
mention of the beer tent and alcoholic beverages available.

Upper Iowa University does not allow alcohol advertising on premises, and if it
is ever found, it is destroyed.

The environmental scan found a great deal of alcohol advertising in grocery
stores. There were a couple of stores that had entire aisles of alcohol with
hanging banners, rebate offers, raffle prizes. Appendix G shows photos of
alcohol advertising and placement in the grocery stores of Fayette County.

Other Data
Local youth completed an environmental scan of external-facing liquor advertisements
in convenience stores. Pictures of the results can be seen in Appendix F.

Figure11.
Results of External Facing Scans in Fayette County
                       Number
                          of         Number of
                        Stores External-Facing
     Community        Scanned Advertisements
 Arlington                 1             2
 Clermont                  1             4
 Elgin                     1             1
 Fayette                   3            13
 Maynard                   1             1

                     Fayette County, Iowa County Assessment Workbook (CAW)
                                              68
Oelwein                     3                 9
West Union                  3                10

County Average of External Facing Alcohol Advertisements in Convenience Stores:
3.08


Promotion Questions

Question 19
Based on information gathered from alcohol sponsorship of events, billboards,
newspaper advertisements, and other data sources, what are the concerns
around promotion that might contribute to underage and binge drinking and its
consequences in your county?

The rate of alcohol billboards is more common in West Union because an
Anheuser-Busch Distributor is located in West Union. The newspapers
advertisements tie into the fact that people drink for social gatherings and events
to have fun. Many of the events and activities in Fayette County are associated
with drinking and the ads support that.

The number of external facing ads in convenience stores does contribute to
minors seeing the ads and being aware of the brands. It may raise curiosity as it
did for the youth that noticed the pretty bottles of alcohol. The results of the
external facing advertisements in Fayette County are shown in Figure 11.

Furthermore, promotions of any type in regards to alcohol promote binge drinking
and often result in black outs, vomiting, and risky behaviors. Overall, the
discussion panel did not feel that promotion was as big of a problem as retail and
social availability.

Question 20
Based on these considerations, to what degree does your coalition believe
promotion is influencing underage drinking and binge drinking and its
consequences in your county? Justify your decision.
(place an “x” next to a number from 0 to 10)

 No impact                                                              Major impact
 0     1        2       3       4        5        66      7        8      9       10



County Norms



                     Fayette County, Iowa County Assessment Workbook (CAW)
                                              69
Once again, data from the IYS are of use in this needs assessment. County norms refer
to the acceptability or unacceptability of certain behaviors in a county, and it is the one
Intervening variable that most often overlaps with other factors. In this section you will
mostly gather data around county events. However, be aware that issues like social
availability and law enforcement also reflect county norms.

Table 20: Proportion of Students Who Responded (agree and strongly agree) to Perception of Social Norms Questions, source IYS
Indicators                         Area                Grade                 2002               2005      2008

How much do you agree or disagree that each of the following statements is true?

It is against my values to use      County                ALL                  74.6            77.4       74.4
alcohol and drugs as a teenager.                               th
                                                          11                   53.8            49.5       48.6
(ValDrk)
Questions: 2002-C11; 2005-C11;      State                 ALL                  75.3            78.0       78.1
2008-C11.                                                      th
                                                          11                   51.4            55.3       56.2
Students caught drinking, smoking, County                 ALL                  93.8            93.4       94.3
or using an illegal drug are not                          11
                                                               th              89.5            88.6       93.1
allowed to participate in any
                                   State                  ALL                  90.8            91.6       91.2
extracurricular activity for some                              th
                                                          11                   86.4            87.3       88.5
time period. (Stdcaught)
Questions: 2002-E4; 2005-E4;
2008-E4




                          Fayette County, Iowa County Assessment Workbook (CAW)
                                                       70
Table 21: Proportion of Students Who Responded (wrong and very wrong) on the Perception of Peer's Norms questions, source IYS
Indicators                         Area                Grade                2002               2005      2008
Thinking of your best friends, how wrong would most of them feel it would be for you to (Very wrong/wrong):

To drink beer, wine or hard liquor County                   ALL                   63.3                  63      67
(for example vodka, whiskey, gin)?                          11   th               34.4                 25.7    33.7
(FrDrWrg)                          State                    ALL                   64.6                 66.1    68.1
Questions: 2002-D1; 2005-D1;
2008-D1.
                                                            11th                  33.4                 34.0    38.6

Go to a party where kids under 21      County               ALL                   62.6                 63.6    66.2
were using alcohol? (FrAPWrg)
                                                                 th               33.7                 27.4    32.9
Questions: 2002-D7; 2005-D7;                                11
2008-D7
                                       State                ALL                    64.5                 66.4   68.5
                                                              th                   31.8                 33.7   38.0
                                                           11
How wrong would most of the students in your school (not just your best friends) feel it would be for you:


Drink beer, wine or hard liquor (for   County               ALL                   57.7                 58.4    61.5
example vodka, whiskey, gin)?                               11th                  22.3                 15.8    22.5
(MstDrWrg) Questions: 2002-E7;         State                ALL                   59.3                 60.4    63.0
2005-E7; 2008-E7.                                                th               20.2                 20.7    25.8
                                                            11

Go to a party where kids under 21      County               ALL                   58.3                 60.0    62.4
were using alcohol? (MstAPWrg)                              11   th               24.4                 20.5    25.3
Questions: 2002-E13; 2005-E13;         State                ALL                   58.5                 60.1    63.8
2008-E13.
                                                                 th               21.0                 22.4    28.5
                                                            11




                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                          71
Table 22: Proportion of Student Who Responded (wrong and very wrong) to Perception of Parental and Adult Neighbors Norms, source
Indicators                         Area                Grade                2002                2005       2008

How wrong would your parents/guardians feel it would be for you to: (wrong / very wrong)

Drink beer, wine or hard liquor (for   County             ALL                   89.9             88.2    87.8
example vodka, whiskey, gin)?                             11
                                                               th               77.7             73.6    72.2
(ParDrWrg)                             State              ALL                   89.4             89.7    89.6
                                                               th               79.4             79.2    80.2
                                                          11
Go to a party where kids under 21      County             ALL                   91.6             90.8    90.7
were using alcohol? (ParAPWg)                             11
                                                               th               82.5             79.7    79.0

                                       State              ALL                   90.2             91.5    91.7
                                                               th               80.8             82.7    84.7
                                                        11
How wrong would most adults in your neighborhood and/or community feel it would be for you to:
Drink beer, wine or hard liquor (for   County             ALL                   83.6             86.9    83.9
example vodka, whiskey, gin)                              11
                                                               th               70.9             78.5    68.0
without their permission?              State              ALL                   84.0             84.0    84.8
(NgDrWrg)                                                      th               73.4             73.0    74.5
                                                          11
Go to a party where kids under 21      County             ALL                   86.5             87.9    86.8
were using alcohol? (NgAPWrg)                             11   th               78.0             79.7    74.9
                                       State              ALL                   84.1             84.9    86.6

                                                          11th                  73.8             75.2    78.1
*Note: in the label of the questions (under 21 was dropped) in 2005.


Question 21
Based on IYS data, how does your county compare to the rest of the state when it
comes to students perception of how adult and peers feel about underage drinking?
Discuss the differences.

In comparing Table 20: Proportion of Students Who Responded (agree and strongly
agree) to Perception of Social Norms, when asked if it was against the youth’s
values to use alcohol and drugs as a teenager, the number of students who agreed
was slightly less, but similar to the state rate. Furthermore, in comparing only 11th
graders with the same question, the number of responses were smaller than the
state rate. This indicates that as youth become older, they find it more acceptable to
drink.

Again in Table 20, when asked if students were caught drinking, smoking, or using
an illegal drug are not allowed to participate in any extracurricular activity for some
time period, all Fayette County students responded at a bigger rate than the state
rate that they agree or strongly agree. This indicates there are some consequences
at the schools and kids are aware of them.

In comparing Table 21: Proportion of Students Who Responded (wrong or very
wrong) on the perception of Peer’s Norms, students were asked their friends

                            Fayette County, Iowa County Assessment Workbook (CAW)
                                                        72
responses to the youth drinking alcohol or attending a underage drinking party.
Fayette County students responded “wrong or very wrong” at a smaller rate to these
questions than the state rate. Students were also asked how students in the school,
not just best friends would respond to their drinking, and again, Fayette County
students had a smaller rate than the state rate. This indicates that youth think it is
acceptable among their friends and peers to drink alcohol and attend parties.

In comparing Table 22: Proportion of Students Who Responded (wrong or very
wrong) to Perception of Parental and Adult Neighbors, all students felt that parents
would find underage drinking wrong or very wrong at a rate bigger than the state
rate, but 11th graders specifically responded at a rate smaller than the state rate.
When asked parents perceptions of attending underage parties, students responded
at a rate bigger than the state rate, but again, 11th graders responded at a smaller
rate. This again indicates that as youth become older, they are less concerned about
parental consequences and more accepting of alcohol use.

When asked about neighborhood adults perceptions for attending underage parties
or underage drinking, Fayette County students responded wrong and very wrong at a
bigger rate when asked about drinking alcohol without permission, but 11 th graders
responded at a rate smaller than the state rate.

When asked about attending underage drinking parties, students responded it was
wrong or very wrong at a rate bigger than the state rate. In this question, both
Fayette County students and all 11th graders had bigger rates than the state rate.
This may indicate that students are concerned about the perceptions of other adults
more so than their parents.

The discussion panel felt that youth in Fayette County do not perceive alcohol use
and underage drinking is not as wrong as youth in the rest of the state.

Temporary Alcohol Licenses for Community Events: (source ABD)

Another way to understand community norms around alcohol use of through the number
of alcohol permits distributed for community events. Table 24 shows the combined
number of temporary (per event) licenses per 10,000 population 15 and older. These
types of licenses cover most sales of alcohol at fairs, festivals and other special events.

Table 23: Number of Temporary Liquor Licenses per 10,000 Population Aged 18 and
Older in 2009, source ABD
Area                       Number of Licenses           Rate per 10,000 population
                                                        (18 years and older)

County
State
***Data not available at this time***

                      Fayette County, Iowa County Assessment Workbook (CAW)
                                               73
Question 22
Based on table 23, how does your county rate of temporary license compare to
the rest of the state? Is it higher, lower or about the same? Discuss the
differences.

The rate of temporary liquor licenses for Fayette County is significantly higher
than the state rate, with a rate difference of 20% bigger. The discussion panel
felt that groups and agencies felt that the only way to draw people to their
events was with alcohol and therefore every event applied for and received
temporary liquor licenses.

County Meetings or Focus Groups

As part of this needs assessment you will need to conduct a town hall meeting to find
out about the general attitudes in your county around alcohol and a description of the
alcohol culture. Information gathered from this town hall meeting will be used to answer
Question 23 below.

A sample protocol for the town hall meeting and ideas on how to gather and analyze
qualitative data from this meeting can be found in Appendix B.

A focus group was conducted in July 2011 which asked respondents about their alcohol
use, availability, community norms and individual factors. Some of the results are:

      95% of respondents said alcohol is easy to get.
      80% of respondents have used alcohol in the last 30 days.
      55% of respondents excessive and binge drinking.
      90% of respondents drink with their peers.
      90% of respondents do not feel that alcohol ads influence them.
      90% of respondents do not feel pressured to drink.
      65% would still buy alcohol even if they had to drive more than 5 miles to get it.
      60% of respondents do not feel that alcohol is an accepted behavior.

Other Data



County Norms Questions




                     Fayette County, Iowa County Assessment Workbook (CAW)
                                              74
Question 23
Based on information gathered from the local assessment and other data sources,
what are the concerns around community norms that might contribute to underage
drinking and binge drinking and its consequences in your county? Justify your
decision.

The discussion panel felt that as youth became closer to the age of 18, they became
more and more accepting of underage drinking. Parents may feel that they can’t do
anything with their children and do not follow through with consequences later on.
The children are more independent and see their parents drinking, so they emulate
the behaviors even though the parents may be telling them they cannot drink.

The panel wondered if conversations between parents and their children stopped after
a certain age and contributed to kids’ change in perceptions.

In a final discussion, parents and adults were seen as still acting youthful and wanted
to party and hang out with their children and the young crowd. Adults want to be
friends with younger people and this contributes to underage drinking and the
perceptions that it is OK because it may actually be encouraged.


Question 24
Based on these considerations, to what degree do you believe community norms are
impacting underage drinking and binge drinking and its consequences in your county?
Justify your decision.
(place an “x” next to a number from 0 to 10)

 No impact                                                              Major impact
 0      1        2       3        4        5        6
                                                    6        7        8       9      10




                     Fayette County, Iowa County Assessment Workbook (CAW)
                                               75
Individual Factors

Individual factors that can influence underage drinking and binge drinking include
biological factors, socioeconomic factors, and individual attitudes, beliefs and
perceptions around alcohol use and drug use. Since little can be done to change
biological predisposition or socioeconomic status (in this grant), the primary focus of this
last contributing factor will focus on individual attitudes, along with unique
characteristics in your county that may influence underage and binge drinking.

Surveys

Often evidence-based prevention efforts target specific individual factors (for example
specific beliefs that people have in general) that influence alcohol-related problems. In
Iowa, these can be measured using the IYS.

Table 24: Risk and Protective Factors that Best Predict 30-Day Alcohol Use and
Percentage of Students at Risk or Protected by Grade levels[i], source IYS, 2008
Grade                              Factors that best     Percent of students at
                                   predict 30-day        high risk or at low
                                   alcohol use           protection on predictive
                                                         factors
11th Grade                            Factors label            County        State

Construct                             Alcohol construct
                                      (current alcohol         42.6          36.2
                                      use)
C16                                   Sensation Seeking:
                                      (Even if it is           67.6          68.4
                                      dangerous, I like to
                                      do exciting things)
C18                                   Perceived risk for
                                      Alcohol Binge            75.1          74.6
G2 (hard and very hard)               Perceived
                                      availability of          17.8          20.7
                                      Alcohol
G3-G6 (hard and very hard) on 1       Perceived
item                                  Availability of          66.5          66.3
                                      Drugs
F13, F19                              Parent attitudes to
(wrong and very wrong)                Alcohol                  98.4          96.9
ALL Grades                            Alcohol construct
Construct                             Alcohol construct
                                      (current alcohol         22.5          19.0
                                      use)

                     Fayette County, Iowa County Assessment Workbook (CAW)
                                              76
C16
                                      Sensation Seeking        56.9          59.1
C18                                   Perceived risk for
                                      Alcohol Binge            77.3          75.6
G2                                    Perceived
                                      availability of          44.9          45.4
                                      Alcohol
G3-G6                                 Perceived
                                      Availability of          74.8          74.9
                                      Drugs
F13, F19                              Parent attitudes to
                                      Alcohol                  98.8          97.6

Notes: Student answers are (Strongly agree and agree, Very wrong and wrong, Very
hard and hard)

Question 25
How does your level of risk based on the combination of risk and protective factors
compare to the risk levels for the State of Iowa? Is your percentage of students at high
risk of alcohol use bigger, smaller, or about the same as the state? Discuss the
differences.

In comparing the 11th graders from Table 24: Risk and Protective Factors that Best
Predict 30 Day Alcohol Use, the number of students that admitted to current alcohol use
was bigger than the state rate as was the perceived risk for alcohol binge. When
comparing sensation seeking and perceived availability among 11th graders in Fayette
County, the proportion was smaller than the state. Additionally, 11th graders that felt
their parents perceptions of underage alcohol use was wrong or very wrong was bigger
than the state rate. This is the first indication we have seen of 11 th graders understanding
their parents concerns in relation to alcohol.

In comparing all grades of Fayette County student from Table 24, the number of students
that admitted to current alcohol use and were at risk for alcohol binge was bigger than
the state rate. Students perceptions on the availability of alcohol and sensation seeking
was smaller than the state rate. The number students who reported that parents would
see alcohol as a negative was bigger than the state rate.




                     Fayette County, Iowa County Assessment Workbook (CAW)
                                              77
Question 26
Based upon discussions with the 2008 IYS, which of the risk factors listed there have the
highest prevalence rates for your county?

      Current alcohol use
      Perceived Risk for Binge Alcohol
      Perceived Availability of Alcohol




Graduation Rates

Consider the following table which lists the graduation rate for each school in your
county. To compare your county to Iowa as a whole, SEW will provide the overall
county and state numbers and rates. You will need though to find your specific school
district graduation rates and compare to the county and state. This will help you
pinpoint districts that have real problems.

 Table 27. Graduation Rates, source Project EASIER
 Communities                             2007-2008          2008-2009 2009-2010
  North Fayette Community
                                            94.79             95.60         92.77
 School District
  Oelwein Community School
                                            91.60             91.16         88.57
 District
 Starmont Community School
                                            92.16             91.38         90.77
 District
 Valley Community School District           90.38             91.84         95.24
 West Central Community School
                                             100              97.14         95.65
 District
 County                                     93.19             92.89         91.22
 State                                      90.49             88.71         87.21
Note: The NGA rate is calculated by dividing the number of on time graduates (including
transferred in graduates) by the number of first time 9th graders four years previous




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                                              78
Question 27
Based on data in Table 27, how do your graduation rates compare to the Iowa
graduation rates? Is there a specific district that has a problem with graduating
students?
Is your percentage bigger, smaller, or about the same as the state? Discuss the
differences.

In comparing the county and state graduation rates from Table 27: Graduation
Rates, Fayette County’s rate was smaller than the state rate in 2007-2008, but in
the years 2008-2010, the number is bigger than the state rate.

In comparing individual school districts (200-2010) from Table 27, Oelwein and
Starmont school districts rates were smaller than the state rate. Furthermore,
Oelwein has had graduation rates lower than the County and state rates for all
years 2007-2010. This indicates a problem with school attendance and supports the
socioeconomic data of the Oelwein area.

Other Data

Figure 12.
Fayette County Schools Drop Out Rate
        Fayette County Schools Drop Out Rate, 2009-2010
                     Number of          Total
School District      Drop Outs          Enrollment           Rate
North Fayette                       1                  432    0.23%
Oelwein                            21                  653    3.22%
Starmont                            1                  316    0.32%
West Central                        0                  147    0.00%
Valley                              5                  254    1.97%

Individual Factor Questions

Question 28
Based on information gathered from the IYS, graduation rates, town hall meetings,
and other data sources, what are the concerns around individual factors that might
contribute to underage and binge drinking and its consequences in your county?
Justify your decision.

Based on the results of Figure 12 and comparing the rates of drop out, Valley and
Oelwein Schools have the greatest percentage of drop outs.

The individual factors that contribute to underage drinking and binge drinking are:
    Socioeconomic status
    Family dynamics

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                                              79
      Availability of Alcohol
      Community Perceptions
      Fact that many people think there is nothing to do but drink alcohol.




Question 29
Based on these considerations, to what degree does your coalition believe individual
factors are impacting underage and binge drinking and its consequences in your
county? Justify your decision.
(place an “x” next to a number from 0 to 10)

 No impact                                                              Major impact
 0     1        2       3        4        5        66      7        8       9      10




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                                              80
                                 Set Priorities




                         Task Three:
Rank the Five Intervening Variables from the Greatest Contributor to
Your Community’s Problems to the Smallest Contributor




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                                       81
Prioritizing

The next stage involves prioritizing the intervening variables. The first step is achieved
by placing the appropriate scores from previous questions next to its related Intervening
variables. Based on the impact scores, rank each Intervening variables with 1 being the
highest priority (the area with the highest score) and 6 the lowest. In the case of a tie,
decide which area is of higher priority for your county in relation to underage and binge
drinking. After having completed the ranking, justify your prioritization. Then work to
decide what combination of intervening variables would be best to focus on in reducing
underage and binge drinking in your county. You may want to consider other mitigating
factors like special communities characteristics that influence underage drinking or
binge drinking. Feel free to point out or comment on any other circumstances.

     Score                    Rank            Intervening variables




       9                        1             Retail Availability (Question 14)




       8                        2             Social Availability (Question 17)




       6                        4             Promotion (Question 20)




       6                        3             Community Norms (Question 24)




       6                        5             Individual Factors (Question 29)




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Question 30
Justify your prioritization of the intervening variables.

1. Retail Availability – Liquor is now available in grocery stores and
convenience stores in addition to bars, restaurants, and liquor stores making it
more available and present in citizens lives. Beverage Server training is not
required for grocery and convenience stores and should be mandated to
ensure laws are being met.

As shown in Table 14, the number of liquor licenses and temporary event liquor
licenses far exceed the state rates. It is an assumption in Fayette County that
you have to drink to have fun.

Compliance checks are being done, but results are not being tracked.
Additionally, it was noted that sometimes failures are not reported to ABD.

There are no ordinances to keep minors from entering bars and curfews are
varied, making it difficult for the Sheriff’s Office to enforce them.

2. Social Availability - As shown in Table 17, the majority of youth stated it was
easy or very easy to get alcohol. While youth in 8th grade noted their parents
would be upset if they drank underage, that number continued to decline as the
youth attended high school and college. This indicates that youth feel it is
acceptable to drink underage and binge drink the older they get.

The state law allows parents to provide their own child alcohol in their home,
however, parents take this farther and allow their children to drink in bars with
them or provide alcohol for many children. Also, it was noted that parents often
want to be their child’s friend and hang out with them. As shown in Table 22,
youth knew their parents would be upset if they drank underage, but they were
similarly sure other adults in their lives would be concerned.

On the Upper Iowa University, it appears that underage drinking and binge
drinking are widely accepted and this is supported with the focus group survey
shown in Appendix J. The addition of two new bars in Fayette supports the fact
that college kids are expected to drink.

3. Community Norms – As youth become closer to the age of 18, it becomes
more acceptable for them to drink. Adults often say that kids drink because that
is what they did. Youth also see parents drinking as a way to have fun and
emulate their behaviors.

Parents also try to get their children out of trouble to protect themselves from
embarrassment, but also because they do not see it as a problem. The criminal
court system is lax with first time offenders and allows them to get off with little
or no consequences. This was discussed in various interviews shown on pages

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                                               83
39 – 40.


4. Promotion – Promotion is of concern, but because we were unable to get
specifics on alcohol advertising, it was difficult to assess. The number of
newspaper advertisements went up around the July 4th holiday and there are
many signs and banners in grocery and convenience stores. The panel felt that
promotion was directly affected by retail availability, social availability, and
community norms, so it was not chosen to be a focus at this time. People want
the alcohol, the businesses are there to make money, so the stores offer it was
the general consensus.

5. Individual Factors – Fayette County has some issues with poverty, lack of
education, and other family dynamics that contribute to the graduation and
drop out rates of students. In Table 24, youth are more likely than the state rate
to admit to drinking and ¾ of students surveyed were considered to be at
perceived risk for alcohol binge. Students also felt it was easy to get alcohol in
Fayette County. The panel again decided to focus on Retail and Social
Availability and Community Norms to address the issues of individual factors.




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                                              84
                  Resource Assessment




                 Task Four:
Evaluate the Current Resources Going toward
        Each of the Five Intervening variables




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                              85
Resources

Most communities already do some sort of substance abuse prevention, ranging from
implementing school based programs to pursuing policy changes. Therefore, it is
important to consider the resources already being used in any of the five intervening
variables. Complete the table below by listing current strategies and resources being
expended within each Intervening variables. Note that these must include some focus
upon the prevention of underage drinking and adult binge drinking. You may want to
consider certain school or local policies/ordinances related to alcohol.
Resources most often refer to funding but could also refer to other efforts like individual
time spent pursuing policy change, dedicated staff, etc.

Table 10: Current Resources and Strategies Focusing Upon the Underage and Binge
Drinking by Intervening variables
Intervening Strategies                Resources
variables
Retail             Reduce            Alcohol Compliance Checks (EUDL)
Availability          excess          Alcohol Info/Packets for License Holders
                      drinking and    Seller/Server Training
                      sale to minors. Special Event Monitoring
                   Reduce OWI        Vehicle Check Points
                      and alcohol     City Government
                      violations.     State Government Agencies (ABD, DOT)
                   Reduce            State Legislature and Elected Officials
                      personal        Juvenile Courts and Drug Court
                      injuries and    Fayette County Substance Abuse Coalition (FCSAC)
                      unintended
                      deaths.
Social             Increase          SODA
Availability          parental        Substance Free Celebrations
                      awareness.      Talking Matters Campaign
                   Improve           Think Before you Sink
                      substance       What Do Water, Carrots and Beer Have in Common?
                      abuse           5 Ways to Have the Best Night Ever Social Media
                      education.      Alcohol & Athletes Program
                                      Parent Networks
                                      DARE and local School Districts
                                      FCSAC
                                      Valley Community Coalition (VCC)
                                      Northeast Iowa Behavioral Health
                                      Abbe Center
Promotion          Provide           Upper Iowa University, Office of Student Services
                      alcohol free    Substance Free Celebrations (VCC)
                      alternatives    Media – Newspaper, Radio and TV
                                      FCSAC


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County          Reduce             Social Host Ordinance (VCC)
Norms            excess             Mentoring Programs – Helping Services for NE Iowa
                 drinking, binge    Parenting Classes – VCC
                 drinking, and      Parenting Classes – Parent Share and Support
                 underage           Town Hall Meetings - FCSAC
                 drinking.          Food and Fitness Initiatives – Public Health and ISU
                Increase           Extension
                 parental           Community Park and Rec Departments
                 awareness.         Civic Groups
                Reduce risky       SODA
                 behaviors          Faith-based organizations
                 associated
                 with binge and
                 underage
                 drinking.
Individual      Reduce binge       Post Prom Activities
Factors          and underage       Youth Center
                 drinking.          Evidence-based Refusal Skill Programs
                Provide            JEL
                 alternatives for   Good Conduct Policies
                 healthy            Boy Scouts
                 behaviors.         Girl Scouts
                Increase           Abbe Center
                 awareness on       Northeast Iowa Behavioral Health
                 consequences       Faith-based organizations
                 of drinking.       Juvenile Courts and Drug Court
                                    Alcoholics Anonymous
                                    FFA, 4H, and ISU Extension




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                            Final Question




                    Task Five:
Determine What Combination of Intervening variables Your SPF
                Project Will Target




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Your Final Conclusions

Now that you have considered the data pertaining to your county alcohol problems and
their Intervening variables, you need to decide what to do. This decision will ultimately
be part of your county SPF SIG Strategic Plan and lead to very specific evidence-based
strategies that you will implement.

For now, think about your data and especially your final rankings as well as your
resource assessment. Also, think about the possible connections among the Intervening
Variables. Would it be possible to target social availability without also targeting county
norms? Will changes in retail availability necessarily require changes in the enforcement
of policy? Now answer the following question.

Final Needs Assessment Question

Question 31
It is very unlikely that your county can or needs to address every possible cause or
implement every possible evidence-based strategy to change alcohol-related
problems. What combination of Intervening Variables is your county going to target
with the SPF SIG and why?

The intervening variables that will be targeted by SPF SIG are:
   1. Retail Availability
   2. Social Availability
   3. Community Norms

The panel felt that the increased access to alcohol is consistent with the norms and
perceptions of underage drinking and binge drinking. The panel also felt that while
they may have drank when they were younger, today’s youth are drinking much
more at a time and more often. By focusing on norms and availability, the group felt
that we were more likely to have success in changing the behaviors from a culture
that supports and encourages drinking to a culture that is more aware of the effects
of alcohol.

In Fayette County, we recognize that we have a problem with alcoholism and the
panel felt that it was important to change the norms and perceptions about drinking
to reduce the incident of long-term drinking and the effects on the people of the
county. Consistency in laws and regulations as well as education about substance
abuse will be the best ways to address this problem.




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                                        Appendices

Appendix A. Law Enforcement Interviews

One method for obtaining data is the face-to-face interview. With this method, you talk
to each participant directly. This can be done in the participant’s workplace, in your
office, or any other suitable place. We recommend that you use a semi-structured
interview format. This means that you will ask a set of questions prepared in advance.
Clarification to follow-up questions may still be used. By asking general questions and
having your participants provide answers in their own words, you may gain more
complete information. The interview should be structured, but not so structured that it
does not allow participants to discuss underage and binge drinking in the county freely.

Although face-to-face interviews are a valuable way to collect data, they are not without
drawbacks. The appearance and demeanor of the interviewer may affect the responses
of the participants. Subtle changes in the way an interviewer asks a question may elicit
different answers. Also, be aware that the interviewer may not respond similarly to all
participants. For example, an interviewer may respond differently to a participant they
know versus a participant they have never met before.

The Interviewer

Fundamental to the interview is an interviewer who leads the discussion. This person
should feel at ease speaking in a one-on-one conversation. The interviewer’s goal is to
make the participant feel comfortable in expressing themselves openly while remaining
unbiased and keeping the discussion on track. It is recommended that you use
someone who has conducted face-to-face interviews before. The interviewer should be
able to ask the questions the same way for each participant and be able to read the
questions in a neutral manner. The interviewer should also be practiced in active
listening techniques that encourage participants to honestly and openly respond to the
interview questions.

Choosing the Participants

As part of this needs assessment, you will need to conduct interviews of key law
enforcement officers, such as the Chief of Police and the County Sheriff. You should
consider what other interviews would be most appropriate and informative for your
county. In addition to the law enforcement interviews, you may want to interview
emergency room staff, alcohol treatment providers, or county leaders. One thing to
consider when choosing your participants may include the length of time they have held
their current position. Be careful not to choose someone who is too new to be able to
accurately answer your questions. The interviewer should keep in mind the questions
they are trying to answer, and they should feel creative in how they choose participants.

Conducting the Interview



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The interview should last about 30 minutes and follow a semi-structured format. Only
the interviewer and the participant should be present during the interview, and the
interviewer should make sure the interview is being conducted in a private location
where others cannot hear the conversation. The interviewer should ask the questions
and let the participant respond without interrupting. The interviewer should allow the
participant to talk freely but not ramble about unrelated issues. The interviewer should
make every attempt to find a balance between keeping the conversation on track and
allowing it to flow naturally. To accomplish this, a “funnel” structure is often used. This
approach is best outlined as a series of questions that move from general to specific.

Introductory Questions

These are questions that introduce the topic for discussion. They should make the
participant feel at ease with the interviewer. Usually they are not critical to the research;
rather, they are intended to foster conversation and get the participant to start thinking
about the topic.

Key Questions

These are questions that drive the research. Their answers provide the best data for
later analysis. They should be focused on the topic of interest and open-ended. The
interviewer’s goal with these questions is to illicit open responses from the participant.
You should avoid both questions that allow for short answers and questions that can be
answered with a “yes” or “no.”

Ending Questions

These questions bring closure to the discussion and enable the participant to look back
upon previous comments. The participant should be asked to summarize their thoughts
in some way.

Sample Questions You May Choose to Use for Your Interviews

Introductory Questions:

What alcohol-related problems do you see in our county?

What factors do you believe are causing these problems?

Key Questions:

What percent of arrests are a result of alcohol-related offenses in our county?

What percent of convictions are a result of alcohol-related offenses in our county?

How many alcohol-related offenses do you think go undetected in our county?

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Are any officers assigned specifically to alcohol-related issues or offenses in our
county?

How many officers are assigned?

What does their work consist of?

What special training do officers have in order to deal with alcohol-related offenses?

Do you hold sobriety check points?

How many sobriety check points were held in 2009?

How many drivers were tested?

How many positive BAC levels were obtained?

Where were the sobriety check points held?

Have you conducted any compliance checks for retail sales?

How many compliance checks for sales to intoxicated patrons were conducted in 2009?

What else are law enforcement officers doing around the underage and binge drinking
in our county?

What aren’t law enforcement officers doing around the underage and binge drinking in
our county?

What locations are known for alcohol-related incidents?

Are there particular people that are known for repeated alcohol-related incidents? If yes,
what do you do to keep track or work with those people?

How do you think law enforcement could better address the alcohol-related problems in
our county?

Ending Questions:

How do you think the criminal justice system is helping reduce the alcohol problems in
our county?

How do you think concerns in the criminal justice system are contributing to the alcohol
problems in our county?



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Our goal is to find out what the driving factor is that is causing the underage and binge
drinking in our county. Is there anything you would like to add or do you have any final
comments?

Thank you for your time and input.

Recording and Using the Information

In addition to taking notes, every effort should be made to record the law enforcement
interview, but first seek permission from your participant. The use of recording
equipment is important because it will allow to revisit the conversation and pull direct
quotes made by the participant. This discussion can also be transcribed or at least
listened to for quotes and general ideas. We suggest using a data matrix like the one
found on the next page to keep track of major themes and quotes from the discussion.

The information gathered from these interviews should be used to complement other
quantitative work by the use of participant quotes and the grouping of ideas. The
grouping of ideas refers to categorizing the participant attitudes, feelings, or beliefs
toward the topic. This may simply involve discussions revolving around a single
question. In other cases this may involve outlining the major topics brought up during
the interview.




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      Notes for Law Enforcement Interview About Alcohol Use

Date:__________ Location:___________________              Participant’s Title:_____________________
Interviewer:________________

Section                         Major Ideas of Themes                                 Quotes
Question 1




Question 2




Question 3




Other thoughts, ideas, comments, or themes that arose during the interview:




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Fayette County, Iowa County Assessment Workbook


Appendix B. County Meeting or Focus Groups Protocol

Holding a town hall meeting is an efficient way to gather qualitative data through the use
of a focus group methods. The reward for this work is dynamic information not just
about what people feel, but about why people feel the way they do about a particular
subject or idea. Group discussions have the potential to provide data with both accuracy
and depth. The town hall meeting is intended as a complement to the rest of the needs
assessment.

What follows is a discussion of the general system for running a town hall meeting
successfully.

The Moderator

Fundamental to the town hall meeting is a moderator who facilitates the discussion. This
person should feel at ease speaking in front of the group, but he or she is not a teacher.
The moderator’s goal is to make the participants feel comfortable in expressing
themselves openly while keeping the discussion on track.

Becoming a talented moderator takes practice. For most novices the best strategy is to
play the role of a seeker of wisdom. This role assumes that the participants have the
wisdom you need and will share it if asked the right questions.

Most importantly, moderators must learn to listen and not talk.

Choosing the Participants

You can do one town hall meeting or a series of meetings. These meetings should
consist of at least 10 people who either volunteered to come or who were chosen
specifically. Most meetings are made up of a homogeneous group of strangers, but
don’t be afraid to invite specific individuals to attend the meeting. Key participants may
include county members, police officers, parents, adolescents, someone from your
advisory council, bar owner, and any other individuals who may have insight on the
topic. The State Epidemiological Workgroup strongly recommends the inclusion of
individuals that represent the diversity of the county or the minority groups. It is helpful
to keep contact information for the participants as they may be involved in other parts of
the project.

Setting the Rules

Prior to starting the discussion, the moderator should lay down a few ground rules.
Generally, these include, only one person talking at a time; no side discussions among
participants; no members should be put down because of their opinions; all thoughts
and ideas are valued; and there are no wrong or right answers. Like with selection of
group members, care and creativity should be used when setting rules.
Conducting the Discussion

The discussion itself should last between 1 and 2 hours and follow a structured format.
The moderator should make every attempt to find a balance between keeping the group
discussion on track and allowing it to flow naturally. In order to accomplish this, a
“funnel” structure is often used. This approach is best outlined as a series of questions
that move from general to specific.


Opening Question

This is a “round robin” question that everyone answers at the beginning of the meeting.
It is designed to be answered quickly and to identify those characteristics that
participants have in common. It should make everyone in the group feel more at ease.

Introductory Questions

These are questions that introduce the topic for discussion. Usually they are not critical
to the research; rather, they are intended to foster conversation and interaction among
the participants.

Key Questions

These are questions that drive the research. Their answers provide the best data for
later analysis. They should be focused on the topic of interest and open-ended. The
moderator’s goal with these questions is to illicit discussion among the participants. You
should avoid both questions that allow for short answers and questions that can be
answered with a “yes” or “no.”

Ending Questions

These questions bring closure to the discussion and enable participants to look back
upon previous comments. Once again a “round robin” approach is best, and participants
should be asked to summarize their thoughts in some way.

Sample Protocol You May Use for Your County Meeting(s) or Focus groups

Opening Question:

Tell us your name and what brought you here today. (Round Robin)

Introductory Questions:

What are the alcohol-related problems in our community?

What factors are causing these problems?

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A number of alcohol-related concerns and possible causes for those concerns have
been mentioned. Let’s think about three possible causes of alcohol use in particular.
For the remainder of this discussion, let’s think about social availability, community
norms and individual factors.

Key Questions

Let’s start with social availability. Social availability refers to the procurement of alcohol
through social sources such as friends and family.

Where are the youth in our county getting alcohol? Give examples.

       Where are high school aged youth and younger getting alcohol?

       Where are minors out of high school getting alcohol?

Where do adults in the county obtain alcohol?

Where is the alcohol consumed? For youth and adults?

What are your experiences with underage drinking at parties, or with adults providing
alcohol to minors?

There’s been a lot of talk about underage and binge drinking as a problem in our
county, but to what extent do you think social availability really contributes to the
problem? (Round Robin).

Next, let’s talk about community norms. Community norms reflect general attitudes
about alcohol use and societal expectations regarding the level and type of use that is
considered appropriate.

What are the norms of our county?

What are the general attitudes about drinking in our county?

What is the alcohol culture like?

In our county, is it okay to serve alcohol to a minor and if so, under what
circumstances?

In our county, at what age is it acceptable to use alcohol?

What is our county’s attitude toward drinking and driving?

What kind of groups or organizations promote the use of alcohol in our county?



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Now that we’ve had this discussion, to what extent do you think community norms
contribute to the underage and binge drinking in our county? (Round Robin)

Lastly, let’s think about individual factors. Individual factors could be biological, socio-
economic, or individual attitudes.

What makes the people in our county different and unique?

What individual characteristics contribute to the underage and binge drinking in our
county?

Based on the things we’ve just talked about, to what degree do you think the individual
characteristics of the people in our county are a cause of the underage and binge
drinking? (Round Robin)

Ending Question:

Considering the three causes that we’ve talked about today, social availability,
community norms, and individual factors, which one is the leading cause of the
underage and binge drinking in our county? (Round Robin)

Our goal is to find out what is contributing to the underage and binge drinking in our
county. Have you missed anything? Do you have any final comments?

Thank the participants for coming.

Recording and Using the Information

Every effort should be made to record the town hall meeting by having a colleague take
notes and through the use of a tape or video recorder. The use of recording equipment
allows the meeting to be revisited when needed. Consider soliciting the audience and
parental consent (if youth are involved) before starting video-taping the event. This
discussion can also be transcribed or at least listened to for quotes and general ideas.
We suggest using a data matrix like the one found on the next page to keep track of
major themes and quotes from the discussion. Feel free to expand the table as needed.

The information gathered from this meeting should be used to compliment other
quantitative work by the use of participant quotes and the grouping of ideas. The
grouping of ideas refers to the categorizing of attitudes, feelings, or beliefs of the group
toward the topic. This may simply involve discussions revolving around a single
question. In other cases this may involve outlining the major topics brought up by the
group.




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                     Notes for Town Hall Meeting About Alcohol Use

Date:__________     Location:__________________________________________

Number of People in Attendance:______                 Note Taker:_________________

Section              Major Ideas of           Quotes                  Consensus or
                     Themes                                           Disagreement?
Question 1




Question 2




Question 3




Other thoughts, ideas, comments, or themes that arose during the town hall meeting:




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Appendix C. 8th Grade Wellness Survey at Starmont Schools


How often have you been in a situation where your peers were drinking?
                                                  Never             22                      54%
                                                          Rarely                  10        24%
                                                          Sometimes               6         15%
                                                          Often                   3         7%



How often have you been in a vehicle where the driver was using alcohol?
                                                   Never            21                      51%
                                                           Rarely                 9         22%
                                                           Sometimes              6         15%
                                                           Often                  5         12%



How often have you drank alcohol with your age group?
                                                                    Never              21    51%
                                                                    Rarely             12    29%
                                                                    Sometimes          4     10%
                                                                    Often              4     10%



If you have done #3, what type of alcohol did you drink?
                                                    Beer                     16        73%
                                                          Wine               12        55%
                                                          Liquor             12        55%
                                                  People may select more than one
                                                  checkbox, so percentages may
                                                  add up to more than 100%.
How often have you done things while drinking that you wouldn't do sober?




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                                                               Never                    30        73%
                                                               Rarely                   4         10%
                                                               Sometimes                3         7%
                                                               Often                    3         7%



How often have you drank with older people?
                                                             Never                  20           49%
                                                             Rarely                 11           27%
                                                             Sometimes              6            15%
                                                             Often                  3            7%



How often do most Starmont high schoolers drink?
                                                             Never                      2             5%
                                                             Rarely                     7             17%
                                                             Sometimes                  12            29%
                                                             Often                      20            49%



How often have you been physically ill after drinking?
                                                                     Never                   34        83%
                                                                     Rarely                  3         7%
                                                                     Sometimes               3         7%
                                                                     Often                   1         2%



Drinking beer is okay, but drinking hard liquor is not.
                                                                     Strongly agree               8        20%
                                                                     Mildly agree                 7        17%
                                                                     Mildly disagree              9        22%
                                                                     Strongly disagree            17       41%



The legal age for drinking should be lower.


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                                            101
                                                         Strongly agree       15   37%
                                                         Mildly agree         8    20%
                                                         Mildly disagree      3    7%
                                                         Strongly disagree    15   37%



I will drink alcohol if and when my friends do.
                                                          Strongly agree      8    20%
                                                          Mildly agree        8    20%
                                                          Mildly disagree     12   29%
                                                          Strongly disagree   13   32%



If I drank at a party I would be afraid to tell my parents.
                                                      Strongly agree          20   49%
                                                         Mildly agree         3    7%
                                                         Mildly disagree      6    15%
                                                         Strongly disagree    11   27%




                    Fayette County, Iowa County Assessment Workbook (CAW)
                                            102
Fayette County, Iowa County Assessment Workbook


Appendix D.
Underage Drinking Survey at Oelwein High School

                        I think underage drinking is?



                                   Not a problem
                                        16%
                                                   A serious problem
                                                          24%

                              A little bit of a
                                  problem              Somewhat
                                    28%                concerning
                                                          26%

                Depends on what
                 type of alcohol
                       6%



                Do you believe underage drinking is an
                accepted behavior in Fayette County?



                                    No
                                   43%


                                                           Yes
                                                           57%
Would your parents be upset if you drank
          alcohol underage?


                  No
                 27%




                                    Yes
                                    73%




 Are you aware of available resources to
address alcohol use and abuse in Fayette
                County?



                 No
                44%

                                    Yes
                                    56%




      Fayette County, Iowa County Assessment Workbook (CAW)
                              104
  Are you interested in joining the Fayette
    County Substance Abuse Coalition?
                              Yes
                              1%




                           No
                          99%




What percent of high school students do you
  think are drinking alcohol underage?
                          Less than 25%
                                6%




              More than 75%           About 50%
                  52%                   42%




       Fayette County, Iowa County Assessment Workbook (CAW)
                                105
        Which of the following topics are you
         interested in learning more about?
                 Campus policy        Other
                     13%               4%



                                              Use of illegal
            Treatment                            drugs
            availability                          22%
                9%

                                                                Misuse/abuse of
                                  Legal                        prescription drugs
                              consequences                            18%
                                  34%




     Where did you see the "Talking Matters"
                  campaign?
                        Press Newspaper Ad
Helping Services       Release    7%
    website              1%
               Yard Sign
      2%                                Basketball
                  6%
                                          games
                                           18%

                           Flyer               Word of mouth
                           19%                     21%

            VCC Website
                                   Facebook
                0%
                                     15%
             Key chain                                Water bottles
                2%                                        9%




                Fayette County, Iowa County Assessment Workbook (CAW)
                                               106
Do you feel the "Talking Matters" campaign
 made students think twice about alcohol?



                                        Yes
                                        42%


                  No
                 58%




Do you feel this campaign stopped students
          from drinking alcohol?

                                  Yes
                                  18%




                        No
                       82%




       Fayette County, Iowa County Assessment Workbook (CAW)
                               107
         Do you feel this campaign changed student's
             behavior when it comes to alcohol?


                                                   Yes
                                                   26%




                                  No
                                 74%




           Do you feel there was peer involvement in
                 the campaign at your school?


                                                    Yes
                                                    34%




                                 No
                                66%




Comments:
   Good luck!
   Please continue this campaign. Pound it into teenagers brains! I think underage
    drinking is a very terrible thing that needs to stop. Getting drunk is so stupid!!!




                     Fayette County, Iowa County Assessment Workbook (CAW)
                                             108
Appendix E. Underage Drinking Survey of SODA students at Valley Community Schools




                   Fayette County, Iowa County Assessment Workbook (CAW)
                                           109
Fayette County, Iowa County Assessment Workbook (CAW)
                        110
Appendix F. Youth Environmental Scan – Convenience Stores in Fayette County




                                         Phillips 66




West Union, IA




                                      The youth was particularly interested in this
advertising she thought was obviously geared toward young people. She also made
note of the bad advertising campaign to make alcoholic cans patterned after energy
drink cans.




                    Fayette County, Iowa County Assessment Workbook (CAW)
                                            111
                                            The Pumper
Fayette, IA




              Fayette County, Iowa County Assessment Workbook (CAW)
                                      112
    Shell Express Station, West Union, IA




            Triple J Mart, Fayette IA




Fayette County, Iowa County Assessment Workbook (CAW)
                        113
                                  Charlie’s Quick Stop Arlington, IA




Fayette County, Iowa County Assessment Workbook (CAW)
                        114
Another Cenex station in Oelwein. Full of people and the youth was too scared of the
atmosphere to go in.




                    Fayette County, Iowa County Assessment Workbook (CAW)
                                            115
           Kwik Star Station, Oelwein




Fayette County, Iowa County Assessment Workbook (CAW)
                        116
                Casey’s General Store Maynard, IA
     The last picture was not of advertising but just something
that was eye catching – shot glasses and ashtrays in with the toys.




         Fayette County, Iowa County Assessment Workbook (CAW)
                                 117
Appendix G
Youth Environmental Scan – Fayette County Grocery Stores




                              Gavin’s Foods, Fayette, IA
                                 Note-no hard liquor




                   Fayette County, Iowa County Assessment Workbook (CAW)
                                           118
        Moore’s Foods, West Union, IA




                        Fareway Oelwein, IA




Fayette County, Iowa County Assessment Workbook (CAW)
                        119
                                          Fareway Oelwein, IA




Note: the youth who did this scan was overwhelmed by the sheer amount of liquor
carried and how it was everywhere! Liquor was the first thing you saw when you walked
in and tobacco was the last thing you saw when you left.




                    Fayette County, Iowa County Assessment Workbook (CAW)
                                            120
Appendix H.
Fayette County Billboard Scan




                   Fayette County, Iowa County Assessment Workbook (CAW)
                                           121
Fayette County, Iowa County Assessment Workbook


Appendix I. Fayette County CHNA HIP

Fayette County
Community Health Improvement Plan
 addresses community-wide health needs and priorities as identified during the community health needs assessment process.

GOAL                                                                     Strategies                                                Who is responsible?          When? (Timeline)
Decrease the percentage of obese adults in Fayette County from           Develop I WALK Committee at North Fayette High School     Community Health and      Ongoing, I-WALK in place by
22.8% to less than 20% and decrease the percent of children over         and complete spring and fall teacher tallies to measure   School Wellness Committee Fall of 2011
the age of 2 that are overweight and obese children by 3% by 2015.       the number of students walking or biking to and from
                                                                         school
                                                                         Offering a Healthier You yearly to community members      West Union Park and Rec,     Start in January 2011
                                                                         which includes motivational seminars and screenings       PLHC

                                                                         Monthly Community Wide Screenings for Diabetes            Diabetic Educators at PLHC   Jan-11
                                                                         Host Heart Risk Assessment in February                    Cardiac Rehab                Feb-11
                                                                         Offer Youth Wellness a six week course to third graders   PLHC HR, Community           Start Spring of 2011
                                                                         in Fayette County                                         Health, Cardiac Rehab
                                                                         Develop a school garden with emphasis on nutrition and    Community Health, PLHC,      Spring on 2012
                                                                         exercise                                                  North Fayette HS, Dietary,
                                                                                                                                   Master Gardeners
                                                                         Diabetes Risk Assessment to monitor blood sugars and      Diabetic Educators at PLHC   Nov-11
                                                                         educational seminars
                                                                         Offer employee health benefits to community               Employee Health            Start 2012
                                                                         employers                                                 Committee
                                                                         Conduct a Safe Routes to School parent meeting            Food and Fitness, Heidi    Mar-11
                                                                                                                                   Skildum, PCH and North
                                                                                                                                   Fayette School Wellness
                                                                                                                                   Committee
                                                                         Have worksite goal of having PLHC particpation at the     PCH, Jamie Hoey Marketing, Jun-11
                                                                         annual American Cancer Walk                               Human Resources at PLHC

                                                                         Offer Matter of Balance Classes to residents of Fayette   Community Health and      Begin offering classes in
                                                                         County                                                    Northland Agency on Aging 2011-2012




GOAL                                                                     Strategies                                                Who is responsible?          When? (Timeline)
Establish a website to list services availabe for residents of Fayette   Working with Palmer Lutheran Hospital in adding a link Community Health, Fayette Start Progress 2011 in and
County by 2013 (Currently we do not have a website).                     for Communtiy Health and listing community resources. County Board of Health, IT be completed by the end of
                                                                         Work with PLHC Marketing                               staff and Marketing       2013

                                                                         Working with the Fayette County BOS and IT staff to       Community Health, Fayette Start Progress in 2011 and
GOAL                                                               Strategies                                              Who is responsible?         When? (Timeline)
Educate the community on Public Health Emergencies and              Offering community classes during the Preparedness     Community Health, EMA         In place by September 2011
Preparedness by decreasing the number of respondents from 29% Month of September                                           and Disaster Relief Coalition and ongoing
to 20% who report preparedness is available but fails to meet needs
adequately by 2015.
                                                                    Monthly newsletter with the EMA discussing             Randy Frank, EMA, PLCH   Start 1/1/12 and continue
                                                                    Risk communication with the public to relay messages   Community Health and EMA Start March 2011
                                                                    during the time of a emergency




                                                  Fayette County, Iowa County Assessment Workbook (CAW)
                                                                                123
       Fayette County, Iowa County Assessment Workbook


                                 Appendix J. UIU Focus Group – Adults 18-24
                                                 Over 18 Alcohol Survey
                                                       Age_______
                                                        7/2011
                                                     Survey results
I have used alcohol in the last 30 days                                       Never   4
       20%
                                                                              Hardly 1
       5%
                                                                              Sometimes    8    40%
                                                                              Often 7           35%

When I drink alcohol I drink more than 4 drinks (girls) or 5 drinks (guys)    Never   7
     35%
                                                                              Hardly 2
       10%
                                                                              Sometimes    8    40%
                                                                              Often 3           15%

I am physically ill after drinking                                            Never   12
      60%
                                                                              Hardly 4
       20%
                                                                              Sometimes    2    10%
                                                                              Often 2           10%

I have blacked out or had memory loss after drinking                          Never   13
       65%
                                                                              Hardly 5
       25%
                                                                              Sometimes    2    10%
                                                                              Often 0

I have injured myself or someone else when I have been drinking               Never   18
       90%
                                                                              Hardly 2
       10%
                                                                              Sometimes    0
                                                                              Often 0

When I drink I drink beer                                                     Never   5
     25%
                                                                              Hardly 2
       10%
                                                                              Sometimes    7    35%
                                                                              Often 6           30%

When I drink I drink wine or liquor                                           Never   2
     10%
                                                                              Hardly 3
       15%
                                                                              Sometimes    10   50%
                                                                              Often 5           25%
I drink with my peers                                                                         Never    2
       10%
                                                                                              Hardly 0
                                                                                              Sometimes         7        35%
                                                                                              Often 11                   55%




Have you seen any advertisements for alcohol today?                                           Yes      8                 40%
                                                                                              No       12                60%

Do you feel alcohol ads influence you?                                                        Yes      2                 10%
                                                                                              No       18                90%

Do you feel pressured to drink?                                                               Yes      2                 10%
                                                                                              No       18                90%

Is alcohol easy to get?                                                                       Yes      19                95%
                                                                                              No       1                 5%

Would you still buy alcohol if you had to go more than 5 miles to get it?                     Yes      13                65%
                                                                                              No       7                 35%

Do many people your age drink alcohol more than once a week?                                  Yes      17                85%
                                                                                              No       3                 15%

Is it common for people your age to drink and drive?                                          Yes      10                50%
                                                                                              No       10                50%

Do you think it is more common for adults to abuse alcohol in Fayette
County than in other places?                                                                  Yes      8                 40%
                                                                                              No       12                60%

Are you aware of available resources to address alcohol use and abuse in
Fayette County?                                                                               Yes      9                 45%
                                                                                              No       11                65%

Do you feel binge drinking is accepted behavior?                                              Yes      8                 40%
                                                                                              No       12                60%




Comments__
- College student told me about coaches buying kegs for player party and not paying attention to ages
- Community youth complained there was nothing to do in Fayette County
- College student suggested a need for a dance club that doesn’t serve alcohol
- College student indicated they would be receptive for a presentation (especially to coaches) about alcohol and athletics
- Community youth said, “I’d rather drink than go out, going out is pointless”

This information comes from surveys and informal personal interviews. The target range covered was 18 - 25 year old
participants from a broad range of people (mainly in the town of Fayette) from young adult lifelong community members and
UIU college students.

                                  Fayette County, Iowa County Assessment Workbook (CAW)
                                                               125
REFERENCES

i
   intervening variable. (n.d.). Collins English Dictionary - Complete & Unabridged 10th Edition.
Retrieved February 16, 2011, from Dictionary.com website:
http://dictionary.reference.com/browse/intervening variable
ii
    Birckmayer, J.D., Holder, H.D., Yacoubian, GS, & Friend, K.B., (2004). A general causal model
to guide alcohol, tobacco, and illicit drug prevention: Assessing the research evidence. Journal
of Drug Education, 34, 121-153.




                       Fayette County, Iowa County Assessment Workbook (CAW)
                                               126

				
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