David Collins

Pacific Institute for Research and Evaluation, Calverton, Maryland, United States

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Publications (15)17.05 Total impact

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    ABSTRACT: This article presents a sustainability strategy, its implementation protocols, and a pilot study of implementation and sustainability readiness. The strategy is guided by a conceptual framework that integrates (a) a strategy for sustaining prevention infrastructure and interventions and (b) a planning and evaluation process known as Getting To Outcomes. Data‐informed decision making is key to this strategy, which includes initial assessment of sustainability capacity and sustainable innovation characteristics, and progresses through planning, implementation, evaluation, and continuous quality improvement to sustain targeted innovations. A support system for implementing the strategy, including a toolkit, primer, electronic tools, and training and technical assistance, is described. Lessons learned from a pilot study for future testing and implementation of the strategy are also discussed. In sum, the article presents a conceptual‐based strategy to sustainability, an innovative support system, and lessons learned that have important implications for improving the evaluation and practice of sustainability.
    Journal of Community Psychology 01/2013; 41(3). · 0.99 Impact Factor
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    ABSTRACT: Children's misuse of harmful legal products (HLPs), including inhaling or ingesting everyday household products, prescription drugs, and over-the-counter drugs, constitutes a serious health problem for American society. This article presents a community prevention model (CPM) focusing on this problem among pre and early adolescents. The model, consisting of a community mobilization strategy and environmental strategies targeting homes, schools, and retail outlets, is designed to increase community readiness and reduce the availability of HLPs, which is hypothesized to reduce HLPs use among children. The CPM is being tested in Alaskan rural communities as part of an inprogress eight-year National Institute on Drug Abuse randomized-controlled trial. This paper presents the CPM conceptual framework, describes the model, and highlights community participation, challenges, and lessons learned from implementation of the model over a 21-month period.
    Evaluation and program planning 02/2012; 35(1):113-23. · 0.89 Impact Factor
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    ABSTRACT: Abuse of harmful legal products that can be inhaled or ingested is a serious and growing problem in many rural Alaskan communities, and particularly so among preteens. This study analyses data collected during baseline measurements of a 5-year NIH/NIDA-funded study entitled A Community Trial to Prevent Youth's Abuse of Harmful Legal Products in Alaska. Youth in 8 communities located throughout the state participated in a survey during the fall of 2009 to measure the prevalence and availability of harmful legal products (n=697). The goal of the analysis presented here is to compare the contextual factors of inhalant users and non-users in rural Alaskan communities. As reported in national surveys of substance use among youth, participants in this study indicated using alcohol more than any other substance. Inhalants were the second-most common substance abused, higher than either cigarettes or marijuana. Lifetime use varied among demographic factors such as age, gender and ethnicity as well as contextual factors including academic performance, parent employment, household living situation and income. When compared to non-users, significantly larger proportions of participants reporting lifetime inhalant use indicated easy availability of inhalants in their home, school and retail outlets. Users were also significantly more likely than non-users to have consumed alcohol. Results of this study may inform the development of effective interventions in other rural communities.
    International journal of circumpolar health. 01/2012; 71:1-4.
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    ABSTRACT: This article examines prevalence of non-medical use of prescription drugs (NMUPD) in a sample of elementary and high school students in an Appalachian Tennessee county. We found that lifetime prevalence of NMUPD (35%) was higher than prevalence of cigarette use (28%) and marijuana use (17%), but lower than lifetime prevalence of alcohol use (46%). We examined characteristics, as well as risk and protective factors in several domains, as predictors of NMUPD. For comparison, we also examined these characteristics and factors as predictors of alcohol, cigarette, and marijuana use. Using survey data from a sample of late elementary school and high school students (grades 5, 7, 9, and 11), logistic regression analyses showed that the risk factors of friends' non-medical use and perceived availability, and the protective factors of preceived risk, parents' disapproval, school commitment, and community norms against youth NMUPD were significant predictors of lifetime prevalence of NMUPD. Implications for prevention are discussed.
    Journal of Drug Education 01/2011; 41(3):309-26. · 0.28 Impact Factor
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    ABSTRACT: This article reports results from a feasibility study of a community effort to reduce the availability of legal products that youth can use to get high. The study evaluated the potential of youth purchase attempts to detect actual changes in retail availability of harmful legal products. These results were triangulated with self-reports from retailers about their own policies and practices. Before the intervention, less than half of retailers reported using any of six possible strategies identified as ways to reduce youth access to harmful products, and less than 8% of baseline youth attempts to purchase potentially harmful legal products were refused or questioned. After the low-dosage intervention, retailers reported increased use of three strategies and a statistically significant increase in the percentage of purchase attempts that were either questioned or refused by retail clerks. These findings (a) demonstrate the potential feasibility of retailer-focused environmental strategies and (b) support continued use of youth purchase attempts as a measure of actual retailer behavior.
    Evaluation Review 10/2009; 33(5):497-515. · 1.20 Impact Factor
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    ABSTRACT: This article reports results from a student survey fielded using an experimental design with 14 Kentucky school districts. Seven of the 14 districts were randomly assigned to implement the survey with active consent procedures; the other seven districts implemented the survey with passive consent procedures. We used our experimental design to investigate the impact of consent procedures on (a) participation rates, (b) demographic characteristic of the survey samples, and (c) estimates of alcohol, tobacco, and other drugs (ATOD) use. We found that the use of active consent procedures resulted in reduced response rates, underrepresentation of male students and older students, and lower lifetime and past 30-day prevalence rates for most drugs and for most antisocial behaviors. Methodological implications of these findings are discussed along with directions for further research.
    Evaluation Review 07/2009; 33(4):370-95. · 1.20 Impact Factor
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    ABSTRACT: This study tests for the efficacy of a school-based drug prevention curriculum (Think Smart) that was designed to reduce use of Harmful Legal Products (HLPs, such as inhalants and over-the-counter drugs), alcohol, tobacco, and other drugs among fifth- and sixth-grade students in frontier Alaska. The curriculum consisted of 12 core sessions and 3 booster sessions administered 2 to 3 months later, and was an adaptation of the Schinke life skills training curriculum for Native Americans. Fourteen communities, which represented a mixture of Caucasian and Alaska Native populations in various regions of the state, were randomly assigned to intervention or control conditions. Single items measuring 30-day substance use and multi-item scales measuring the mediators under study were taken from prior studies. Scales for the mediators demonstrated satisfactory construct validity and internal reliability. A pre-intervention survey was administered in classrooms in each school in the fall semester of the fifth and sixth grades prior to implementing the Think Smart curriculum, and again in the spring semester immediately following the booster session. A follow-up survey was administered 6 months later in the fall semester of the sixth and seventh grades. A multi-level analysis found that the Think Smart curriculum produced a decrease (medium size effect) in the proportion of students who used HLPs over a 30-day period at the 6 month follow-up assessment. There were no effects on other drug use. Further, the direct effect of HLPs use was not mediated by the measured risk and protective factors that have been promoted in the prevention field. Alternative explanations and implications of these results are discussed.
    Prevention Science 06/2009; 10(4):298-312. · 2.63 Impact Factor
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    ABSTRACT: Preliminary results are presented from a feasibility study of a comprehensive community prevention intervention to reduce the use of inhalants and other harmful legal products (HLPs) among adolescents in three Alaskan frontier communities conducted in 2004-2007. The legal products used to get high include over-the-counter drugs, prescription drugs, and common household products. Community mobilization, environmental and school-based strategies were implemented to reduce access, enhance knowledge of risks, and improve assertiveness and refusal skills. Pre- and post-intervention survey data were collected from 5-7th grade students from schools in three communities using standardized instruments to assess knowledge, assertiveness, refusal skills, perceived availability, and intent to use. The intervention consisted of community mobilization and environmental strategies to reduce access to HLPs in the home, at school, and through retail establishments. In addition, the ThinkSmart curriculum was implemented in classrooms among 5th grade students to increase the knowledge of harmful effects of HLPs and improve the refusal skills. Data were analyzed using hierarchical linear models that enable corrections for correlated measurement error. Significant increases in knowledge of harms related to HLP use and decreases in perceived availability of HLP products were observed. The environmental strategies were particularly effective in reducing the perceived availability of HLPs among 6th and 7th graders. Although limited by the absence of randomized control groups in this preliminary study design, the results of this study provide encouragement to pursue mixed strategies for the reduction of HLP use among young people in Alaskan frontier communities.
    Substance Use &amp Misuse 01/2009; 44(14):2080-98. · 1.11 Impact Factor
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    ABSTRACT: Few studies of inhalant use have examined a large number of predictors at the individual level, including risk and protective factors and delinquent behavior, while also taking into account contextual variables (such as school size and poverty rates). This exploratory study uses 8th grade data from a large-scale survey of students in Kentucky to examine individual and contextual predictors of prevalence of inhalant use, and compares the predictors of inhalant use with factors predicting the use of marijuana and other drug use. Hierarchical Generalized Linear Modeling results using a logit link function suggest that the relationships between inhalant use and some of these factors are different than the relationships between the factors and both marijuana and other drug use. Implications for prevention of inhalant use are discussed.
    Journal of Drug Education 02/2008; 38(3):193-210. · 0.28 Impact Factor
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    ABSTRACT: This study examined pre-adolescent use of harmful but legally obtainable products (HLPs) "in order to get high" in 4 communities in northwest and southeast Alaska. These products include inhalants, over-the-counter medications, prescription medications taken without a doctor's prescription and common household products. Cross-sectional survey. A student survey was administered to the 447 students whose parents consented and who agreed to participate. A descriptive analysis with frequencies, percentages, bivariate associations and appropriate statistical tests produced the study results. The lifetime overall use of HLPs among fifth, sixth and seventh grade students in 4 Alaskan communities was 17.4%. The lifetime use of inhalants (6.8%) and prescription medications taken without a doctor's prescription (8.0%) appear to be comparable to use rates from other studies. The use of over-the-counter medications (5.7%) appears to be slightly higher than in other U.S. surveys. The use of common household products was 6.1%. No significant differences in the lifetime or 30-day use were found correlated to region, gender, ethnicity or student grade. There was a strong association between 30-day or lifetime use of some HLPs and the (30-day or lifetime) use of alcohol, cigarettes and smokeless tobacco. The use of harmful everyday legal products by fifth, sixth and seventh graders in Alaska appears to be similar to data collected in other parts of the country. The possibility that there may be a link between the use of available legal substances and alcohol, tobacco and marijuana deserves additional attention.
    International journal of circumpolar health 01/2008; 66(5):425-36. · 1.30 Impact Factor
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    ABSTRACT: Communities across the nation have become increasingly concerned about inhalant use and use of harmful legal products among youth because of increasing prevalence rates and deleterious health consequences from abusing these products. The increasing concern of communities about inhaling and ingesting legal products has been coupled with increasing awareness and concern about ability of youth to access and abuse a variety of other legal retail products. There are few examples of scientifically designed community prevention projects that seek to reduce youth abuse of such legal products. This article describes a community prevention trial that is designed to reduce sales of inhalants and other harmful legal products to youth and demonstrates how the retailer component of the trial can be rigorously evaluated. It also shows how data from youth purchase attempts can complement survey data from retailers.
    Evaluation Review 09/2007; 31(4):343-63. · 1.20 Impact Factor
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    ABSTRACT: Youth use of harmful legal products, including inhaling or ingesting everyday household products, prescription drugs, and over-the-counter drugs, constitutes a growing health problem for American society. As such, a single targeted approach to preventing such a drug problem in a community is unlikely to be sufficient to reduce use and abuse at the youth population level. Therefore, the primary focus of this article is on an innovative, comprehensive, community-based prevention intervention. The intervention described here is based upon prior research that has a potential of preventing youth use of alcohol and other legal products. It builds upon three evidence-based prevention interventions from the substance abuse field: community mobilization, environmental strategies, and school-based prevention education intervention. The results of a feasibility project are presented and the description of a planned efficacy trial is discussed.
    Journal of Drug Education 02/2007; 37(3):227-47. · 0.28 Impact Factor
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    ABSTRACT: This article reports results of a meta-analysis of the effects of a set of community coalitions that implemented science-based substance use prevention interventions as part of a State Incentive Grant (SIG) in Kentucky. The analysis included assessment of direct effects on prevalence of substance use among adolescents as well as assessment of what "risk" and "protective" factors mediated the coalition effects. In addition, we tested whether multiple science-based prevention interventions enhanced the effects of coalitions on youth substance use. Short-term results (using 8th-grade data) showed no significant decreases in six prevalence of substance use outcomes -- and, in fact, a significant though small increase in prevalence of use of one substance (inhalants). Sustained results (using 10th-grade data), however, showed significant, though small decreases in three of six substance use outcomes -- past month prevalence of cigarette use, alcohol use, and binge drinking. We found evidence that the sustained effects on these three prevalence outcomes were mediated by two posited risk factors: friends' drug use and perceived availability of drugs. Finally, we found that the number of science-based prevention interventions implemented in schools within the coalitions did not moderate the effects of the coalitions on the prevalence of drug use. Study limitations are noted.
    Substance Use &amp Misuse 02/2007; 42(6):985-1007. · 1.11 Impact Factor
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    ABSTRACT: Liberia's prolonged post-conflict transition has negatively impacted its health infrastructure, including the functioning of its health care delivery system. Considering the current national health crises, a study was conducted to identify research gaps and the need to propose changes for improving the health care delivery system in the country. The study results clearly demonstrated a lack of HIV/AIDS research infrastructure including organizational structure, linkages, leadership, champions, expertise, resources, and policies and procedures. Alignment of research needs and practice, and research use to support HIV/AIDS service delivery programmes in the country was also limited. An international research capacity-building partnership is proposed as an effective planned change strategy to strengthen HIV/AIDS-related research infrastructure and to inform management and practice within the Liberian HIV/AIDS service delivery system. A proposed capacity-building planning model can also strengthen research infrastructure and the production and use of research to positively impact the HIV/AIDS epidemic in Liberia and other developing countries.
    Journal of Evaluation in Clinical Practice 07/2005; 11(3):257-73. · 1.51 Impact Factor
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    ABSTRACT: The purpose of this preliminary study was to assess the HIV/AIDS prevention needs, services, and resources in Liberia, including the readiness of local providers to conduct HIV/AIDS-related prevention programs based on a set of six key dimensions (prevention needs, knowledge, leadership, environment, risky behaviors, and resources). A valid self-administered qualitative-based health survey, based on a community readiness model, was utilized as the primary data collection source. A cross-sectional design that utilized a convenient sample of key informants such as health coordinators, program directors, and health administrator from both public and private HIV/AIDS-based organizations was used. Furthermore, an extensive review of the National Library of Medicine database of published articles from mid-1980 to 2002 was simultaneously conducted to gauge the extent of scientific publications on HIV/AIDS-related prevention services in Liberia. The findings from this study strongly suggest that Liberia is in a stage of vague awareness, as defined by the Tri-Ethnic Center community readiness framework, regarding HIV/AIDS-related activities, including a significant lack of HIV/AIDS-related resources and scientific publications. Accordingly, there is a critical need to acquire adequate resources and build capacity to implement effective HIV/AIDS-related prevention programming services in order to avert the negative public health consequences associated with HIV/AIDS, including the implementation of relevant evaluation and dissemination strategies. Most importantly, this model has the potential to be utilized in other resource-constraint settings, especially in the developing world, to assess prevention-related resources and programmatic readiness. This is the first published study to evaluate Liberia's HIV/AIDS prevention resources and to systematically document the extent and magnitude of the HIV/AIDS crises in the country.
    AIDS PATIENT CARE and STDs 04/2004; 18(3):169-80. · 3.09 Impact Factor