Several members of the Jicarilla Apache Tribe, along with other community members who worked on the reservation but were not tribal members, developed the Decade of Hope Coalition. Many of the residents struggled with alcohol abuse some time in their lives. Many of the tribal elders died from neglect and alcoholism, often dying of exposure during the long mountain winters. The coalition began in 1989, following a string of suicides among young tribal members. Mothers of these teens and young adults decided that something needed to be done about the problem beyond the limited efforts of the Tribal Council. The authors and collaborators began our involvement with this coalition near the end of 1991, when we were asked to help with evaluation of a successful grant proposal to the Community Partnership Program of the U. S. Center for Substance Abuse Prevention (CSAP).

A community action planning guide for substance abuse prevention provided a framework with which to create and adapt a vision for a healthy community and statement of what the community will do and why (vision and mission statement). The process also facilitates making that vision concrete through the development of a culturally-appropriate blueprint for action (objectives, strategies, and action plans). Unlike many other strategic planning processes, the Action Planning Guide provides a group with specific prompts for potential community changes (i.e., new or modified programs, policies and practices) that could be sought to reduce risk and enhance protection for substance abuse. Tribal members developed their own unique action plan to reflect local strengths, culture, needs and resources.

One result of the strategic planning process was the identification of sectors of the community targeted for change by the Decade of Hope Coalition. These sectors included tribal and non-tribal businesses, religious organizations, public schools and tribal education, tribal government, cultural organizations, tribal police and courts, youth organizations, media, as well as health and service organizations and native healing. During action planning, tribal members identified specific community changes to be sought (i.e., new or modified programs, policies and practices related to substance abuse) for each sector. For example, there were a number of changes identified for tribal and non-tribal businesses, such as a ban on people fighting in the local bars. A total of 85 objectives for community change were identified. It remained the task of coalition members to further specify who would do what by when to bring about the changes in the action plan. Coalition members and staff reviewed the objectives and related accomplishments during monthly coalition meetings and informally in the coalition office.

This coalition was instrumental in bringing about changes in the community relative to substance abuse prevention. The total of 69 documented changes included new programs, such as the establishment of a micro-grants program to create alternative activities for youth and address health-related problems in the community, the coordination of services among human service agencies, and policy changes such as requiring the local public radio station to air substance abuse prevention Public Service Announcements in Jicarilla as well as English.

The local evaluation coordinator (a tribal member) reviewed the records of the local Indian Health Service clinic to collect these data. Data were available from January 1985 through June 1993. There was a steady increase in the number of alcohol-related transports through January of 1992. The patterns were somewhat cyclical, with a series of peaks occurring in the summer months when tribal festivals are held. Although data for 1993 are not complete (because we only had data for 6 months), alcohol related transports decreased sharply when those months are compared to the same time period from the previous years. When viewed alongside data from the documentation system, the results show an association between decreased alcohol-related transports and changes facilitated by the coalition in 1992 and 1993. Although limited by data availability, this association is suggestive of coalition impact.

In July 1997, the Hawai’i District Health Office (HDHO) in partnership with the University of Hawai’i at Hilo Department of Baccalaureate Nursing, the Hawai’i County Office of Aging, the Hilo Community School for Adults and the Hawai’i Alliance for Community Health sponsored a workshop “Action Planning for Community-Based Initiatives.” A basic concept emerging from the meeting was the belief that it is important to change the environment in which individuals engage in “unhealthy” behaviors in order to maximize efforts to reduce the prevalence of those behaviors within the population. It encourages citizen participation and the development of a community’s capacity to address local health problems. In the workshop, participants identified barriers to creating and maintaining community partnerships/coalitions. Existing concerns of child abuse and neglect, promoting health for older adults, adolescent pregnancy, substance abuse, risk for chronic disease, and youth violence were topics used as examples for training purposes. These topics were consistent with priority health concerns for the 6 island communities as well as being reflected in Healthy Hawai’i 2000 objectives.
A community initiative focusing on building the capacity of community members on the Big Island of Hawai’i was created following the workshop. Four principal program objectives were identified in this project. They include:

  • Community partnership development in each of the 6 districts on the Big Island;
  • Providing initial staffing to coordinate and facilitate coalition development;
  • Providing training for the initial staff and for key community leaders in core competencies for doing the work (e.g., planning, facilitation, grant writing);
  • And documenting community change and the successes of the local community partnerships.

This Prezi presents the development of a grassroots movement to address the above issues, the capacity built as part of the initiative, findings from a participatory evaluation, and future directions.