Saxe 2006.
Methods |
Study design: controlled cross‐sectional before‐after study Sampling frame: adults age 16 to 44 years and living in experimental and control communities Sampling method: random‐digit dial population survey Collection method: telephone interview Description of the community coalition: Robert Wood Johnson Foundation’s Fighting Back program to prevent and control drug and alcohol abuse. Community coalitions were established at each site and involved local political, business, and grassroots leaders. Community leaders chose, developed, and implemented strategies with autonomy, thus sites differed in their approaches |
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Participants |
Communities: 41 communities in sections of the following US cities: Washington, DC, Santa Barbara, Vallejo, Little Rock, New Haven, San Antonio, Kansas City, Milwaukee, Columbia, Charlotte, Newark, and Worcester. On average, sites were more urban, more African American, and poorer than the USA at large Country: USA Ages included in assessment: 16 to 44 years old (n = 2804) Reasons provided for selection of intervention community: Targeted neighborhoods were economically disadvantaged with higher rates of drug and alcohol problems Intervention community (population size): Area represented by each coalition ranged from 100,000 to 250,000 residents, typically portions of cities Comparison community (population size): communities similar in size and demographics within the same city as the intervention community |
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Interventions |
Name of intervention: Fighting Back Theory: not reported Aim: to develop a comprehensive system of prevention, treatment, and aftercare for substance abuse Description of costs and resources: Communities received, on average, US $3 million over a 5‐year implementation period to bring coalition groups together, hire staff, and develop a plan for interventions Components of the intervention: broad‐based community initiatives, including public awareness, prevention targeted at youth, early identification of substance abuse problems, and treatment and relapse prevention Start date: 1995 Duration: 4 years |
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Outcomes |
Outcomes and measures: use of any illicit drug, heroin use within 12 months, daily marijuana use Time points: baseline (1995) and follow‐up (4 years later) |
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Notes | Funding source: government | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | High risk | Intervention was not randomly assigned |
Allocation concealment (selection bias) | High risk | No allocation concealment |
Baseline outcome measurement similar | Low risk | Baseline measures were similar in control and intervention groups |
Baseline characteristics similar | Low risk | Reported baseline characteristics were similar in control and intervention groups |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Population‐based telephone survey |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Random‐digit dial population survey with large sample size |
Blinding of participants and personnel (performance bias) All outcomes | High risk | No blinding |
Protection against contamination | Unclear risk | No statement regarding possibility for contamination |
Selective reporting (reporting bias) | Low risk | Relevant outcomes reported |