Young adults between the ages of 18 and 25 use substances at higher rates than the general population. According to results from SAMHSA’s National Survey on Drug Use and Health (NSDUH), young adults in 2012 experienced the highest rates of binge drinking (39.5%), illicit drug use (21.3%), and tobacco use (38.1%) when compared to other age groups. Because of these troubling trends, many communities are prioritizing the substance misuse prevention needs of this group.
Yet young adults can be a difficult group to size up. They are mobile and in transition—beginning college, starting out in the workforce, and exploring new places to travel and live. Practitioners looking for local data on this population often struggle: either the data is absent entirely or it provides only part of the picture. For example, a variety of sources include data on youth enrolled in college, but few capture information on young adults who are not in school.
With more and more states prioritizing the substance-related needs of young adults between the ages of 18 and 25, the need for relevant data has become more acute. To fill this data gap, states are exploring a variety of strategies to learn more about this population. Two of these strategies, implemented by Nebraska and Ohio, respectively, are worth considering. The following examples demonstrate the importance of careful preparation and planning—as well as the value of keeping an open mind to a range of partners and possibilities.
Nebraska: Success by Mail
In 2006, Nebraska was awarded a Strategic Prevention Framework State Incentive Grant (SPF SIG) to prevent substance misuse problems in communities across the state. Sixteen local prevention coalitions were asked to address up to three state-specified alcohol prevention priorities; half of the coalitions focused on reducing binge drinking among young adults between the ages of 18 and 25.
But when they looked for local data on this population, the coalitions came up empty.
“Nebraska routinely collects data through our Nebraska Behavioral Risk Factor Surveillance System (BRFSS),” said Renee Faber, prevention system coordinator from the Nebraska Department of Health and Human Services (DHHS), “but around the time we received our SPF SIG, the response rate for 18- to 25-year-olds was 2.3%—an all-time low. And NSDUH, which contains a lot of good information on this age group, doesn’t really have a lot on alcohol-related attitudes and perceptions.”
So the state turned to its newly formed epidemiology outcomes workgroup—a collaborative effort of state agencies, organizations, and individuals focused on using data to inform and enhance prevention practice—for help. The workgroup established a binge drinking sub-committee which, over the course of a year, developed Nebraska’s Young Adult Alcohol Opinion survey—a new instrument designed specifically to measure the alcohol-related behaviors, attitudes, and perceptions of this population.
With their new survey in hand, the group was ready to start collecting data. The question was how. What would be the best approach for accessing this hard-to-reach population? The Nebraska Office of Highway Safety (NOHS) ended up holding the key.
“Through our NOHS, we were able to access the Department of Motor Vehicles database, which contains contact information for all of the state’s registered drivers,” said Faber. “The majority of our young adults have driver’s licenses. So we were able to use the DMV’s database to create our survey sample.”
Using the database, Nebraska’s DHHS created a sample of 10,000 19- to 25-year-olds across the state. (Eighteen year-olds were excluded since they are considered minors in Nebraska.) The sample was stratified by the sixteen SPF SIG coalition areas so it could produce regional-level data.
To maximize their response rate, Nebraska’s DHHS administered the survey during the winter holiday and spring/early summer, when young people were more likely to be at their home address. Young adults were mailed the survey, accompanied by a $1 cash incentive. Ten days after the initial mailing, DHHS sent non-responders a postcard reminder, followed by another copy of the survey 20 days later. Respondents had the option of completing the survey online, but very few used this option: almost all of the respondents returned the survey by mail.
Nebraska’s careful preparation and planning proved worthwhile. The survey boasted a 30–40% response rate over each of the three years it was administered. “We were thrilled with the response rate and the wealth of data we collected,” says Faber. “It was a great improvement over other methods that we’ve used in the past. The survey helped us better understand local norms and attitudes toward alcohol use, and allowed us to refine and target programs and policies to address the needs of the young adults in our state.”
Ohio: Success In-Person
When Ohio’s Department of Mental Health & Addiction Services received its SPF SIG in 2009, they too were confronted by the state’s high rates of substance use among its 18- to 25- year-olds. And, like Nebraska, they also lacked the data they needed to describe what the problem looked like at the local level.
“We knew we didn’t have a lot of experience with this young adult population,” said Dawn Thomas, SPF SIG Project Director, from the Ohio Department of Mental Health and Addiction Services, “yet we recognized this was an area that really needed to be addressed. Unfortunately, Ohio doesn’t have a statewide youth survey that could collect all the data we needed,” explained Thomas.
So the state began building local capacity to do so. It required each of its 13 SPF SIG-funded communities to assemble a data committee that would be responsible for developing its own survey instrument. “We wanted to make sure that the instruments were a good match for the region—that the language ‘rang true’ with the local culture of each of our county board areas said Thomas. The committees were supported by Ohio’s SPF SIG Evaluation Team and training subcontractor, as well as a state-level project team that provided additional training, technical assistance, and access to state resources, as-needed.
The communities were also charged with developing individualized plans for collecting data. While these plans varied considerably, most met with considerable success. One urban community, for example, posted its survey online, then used incentives such as coupons to local restaurants to drive young adults to the site. Another community reached out to young adults as they waited for appointments at the local Job and Families Services Office.
The state was surprised and delighted when one unexpected venue—local festivals—emerged as a veritable data goldmine. Regional fairs and festivals are a mainstay of Ohio social life, frequented by young adults both in and out of college. Moreover, attendees tended to be happy and relaxed, with time on their hands to complete a brief, in-person survey (accompanied, of course, by a small incentive).
“The festival/fair participants were very receptive, and the SPF SIG communities far exceeded their [data-collection] expectations,” stated Thomas. “Eventually, other SPF SIG communities began targeting festivals and fairgoers, as well.”
By connecting with young adults in multiple ways, the state was able to meet its data collection goals and begin to understand the various factors driving substance use across the state. Moreover, by employing a variety of innovative strategies, the communities were able to bring new partners to the prevention table, leading to increased capacity for the SPF project, overall.
To learn more about Nebraska’s Young Adult Alcohol Opinion Survey, read the 2013 survey summary report (PDF | 1.8 MB). To learn more about Ohio’s survey success, contact Erin Ficker, associate coordinator of CAPT’s Central Regional Resource Team, at email@example.com.
CAPT works with a number of agencies representing states, tribes, and jurisdictions as well as other key local contacts. These contacts can answer questions regarding localized prevention efforts and resources. Find prevention contacts near you.