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Project Name: Implementing the PAUSE Pathway for Opioid Alternatives in the Emergency Department in a Western Ohio Hospital System Applicant: Kettering Medical Center Network, 3535 Southern Blvd, Kettering, OH 45429 Clinical Project Director: Nancy Pook, MD Web site: https://www.ketteringhealth.org Kettering Medical Center will implement a project that combines reviewing and implementing the PAUSE opioid alternative pathway, calling patients post-emergency room discharge with education or access to community resources, and providing educational programs for providers about pain management, alternatives to opioids, and addressing these issues in a culturally appropriate way. Nancy Pook, MD, Clinical Project Director, developed the innovative and timely PAUSE protocol, which provides safe prescribing alternatives to opioids through a compassionate understanding of disease pathology. PAUSE is a primary pathway for clinicians to manage chronic or benign pain by “Pausing and considering alternatives to opioids.” The PAUSE program offers free reference materials for clinicians that show alternatives to opioids for common types of pain. This project intends to combine PAUSE with post-ED visit communication with patients to close the loop between ED visits for pain and patient connection with community resources for addiction treatment. Rather than contributing to the cycle of opioid addiction through inappropriate prescribing, this approach enables ED clinicians to initiate a break in the cycle and provide patients with a strong pathway to addiction recovery. The population we propose to serve are age 18 or older, who come to one of Kettering Health’s 14 emergency departments in seven counties, have any of the three identified pain areas (sprain and strains, musculoskeletal pain/not low back, or headache/including migraine) and are not excluded by a co-occurring medical or surgical disease, trauma, or active cancer. The goals of this project are: (1) Revitalize and update the PAUSE “alternatives to opioids” order set, ensure internal systems support the PAUSE pathway, and educate staff about the updated pathway and systems; (2) Using a person-centered approach, refer those served to appropriate internal and external resources through collaboration with community organizations; and (3) Through training, technical assistance and collaboration, increase knowledge and develop the abilities of Kettering Health providers and staff to identify and meet the pain management needs of those who come to its emergency departments for care. All interactions with patients will be documented in Epic, Kettering Medical Center’s electronic medical record system. Using SMART Objectives focused on activities that produce tangible and measurable results, the PAUSE pathway will develop and implement new training processes to reduce physician opioid prescription writing. Through data collection, regular staff and stakeholder meetings, and routine program assessment, Kettering Health will work diligently to continually improve the PAUSE pathway. Upon approval of SAMHSA funding, and once integrated into Kettering Medical Center’s cadre of services, the PAUSE program is projected to enroll and serve 14,816 patients each year of the grant, for a total of 44,448 patients served in three years. With its extensive experience implementing and managing projects funded by federal grants, Kettering Medical Center and Kettering Health have a rich history of collaborating with organizations in under-resourced, underserved areas to offer services and programs where they are most needed. Through its current grant projects funded through HRSA, the Ohio Board of Nursing, the Ohio Department of Higher Education, and the Ohio Department of Development, Kettering Medical Center has the capacity and knowledge to implement and sustain project activities.

Grant Goals and Strategies: The HPW Coalition's target population for the STOP Act Grant includes Alachua County Public School students, University of Florida students and Santa Fe College students totaling over 78,000 youth as potential participants. Additional strategies will reach community members, and parents. The first goal is to alter community norms surrounding underage drinking among high school and college students. Strategies include reaching at least 300 students per year, 1,200 over the project period, with prevention education such as "Know the Law, " and hosting four or more Friday Night Done Right events in Alachua County to provide alcohol free alternative activities. The coalition will promote "Parents Who Host, Lose the Most" campaigns to teach parents about the risks of social hosting and how to talk to their children about drinking with SAMHSA's "Talk. They Hear You" program. The goal is that these efforts will reduce lifetime use of alcohol rates among students 6th— 12 grade from 48.3% (FYSAS 2022) to 46.3% by September 29, 2028. The second goal includes reducing current access to alcohol among underage drinkers by increasing the enforcement of the legal drinking age. By September 29, 2025, HPW staff, youth coalition members and law enforcement will conduct 120 compliance checks across stores in Alachua County with a 90% completion rate. By September 29, 2025, HPW staff will host two parent sessions to educate families on the risks of serving alcohol to minors, using the campaign Parents Who Host, Lose the Most, with 85% of families accepting HPW Coalition' s parent toolkit. The third goal is aimed towards lowering the rate of negative outcomes from alcohol use among underage drinkers by educating youth about consequences . By September 29, 2025, HPW staff and board members will host two Town Hall events on the consequences of early initiation and excessive alcohol use, including one held in a rural location, with evaluation surveys showing 85% of participants learned more about the negative consequences of drinking alcohol. By September 29, 2025, HPW staff and law enforcement will offer breathalyzer testing on drinking holidays and weekends to approximately 200 underage college students each year (800 over the project period) with 90% of participants agreeing they have a greater understanding of the connection between their impairment level and Blood Alcohol Content (BAC) Grant Required Reports : Disparity Impact Statement will be submitted no later than 60 days after the grant is awarded, and includes the number of people to be served in grant implementation along with a description of the population and rationale for selection. This also includes a quality improvement plan for how to monitor program outcomes by race, ethnicity and LGBT status along with strategies to reduce disparities. This plan should also include policies and procedures for adhering to Culturally and Linguistically Appropriate Services (CLAS) standards that respond to cultural beliefs and practices, preferred languages and health literacy. Grant recipients are required to gather quantitative and qualitative performance data and report to the awarding agency each quarter. Additionally, an annual Progress Report will be submitted through SPARS to beginning September 2025 and a Federal Financial Report (SF-425) must be submitted beginning December 2025.

Cabarrus Health Alliance (CHA) and the Healthy Cabarrus Substance Use Coalition will implement the STOP Act grant in Cabarrus County, North Carolina (geographic area). CHA, the coalition’s fiscal agent, serves as the public health authority and local health department for the county. Parts of Cabarrus County are considered socio-economically disadvantaged characterized by high general poverty (all ages), poverty of school-aged children, and profound social vulnerability. While only 9% of Cabarrus White (not Hispanic) residents live at less than 125% of the federal poverty level (FPL), 79% of American Indian/Alaskan Native, 64% of Native Hawaiian/Pacific Islander, 23% of Hispanic, 18% of Black, and 15% of multiracial residents live at less than 125% FPL. Additionally, the Cabarrus Youth Substance Use Survey indicates Hispanic middle and high school youth report the highest 30-day use of alcohol, collectively (6.2% & 13.4%). As the CHA DFC grant moves through years 6-10 with STOP Act funding, CHA and the coalition will build additional capacity to address service gaps specifically for the STOP Act grant population of focus, defined as Cabarrus youth ages 12-18 years old who are racial and ethnic minorities and those affected by persistent poverty and inequality. At least 50% of those served by grant funds will be from underserved communities as defined by Executive Order 13985. In alignment with STOP Act goals and in response to the required eight activities, CHA and the coalition will achieve the following outcomes by the end of the project period: ? By 12/31/2024, the coalition will have added at least two new Hispanic, two new Black, and six new youth members (10 total new members from the population of focus). ? By 12/31/2024, at least two members of the Youth Advisory Council and two coalition members will be attending each local Town Hall meeting to advocate for their concerns and for policy changes. ? By 12/31/2024, at least two coalition members will be attending school board meetings to advocate for more comprehensive strategies and interventions regarding substance use infractions ? By 8/1/2026, KCS will have adopted an alternative-to-suspension program similar to the CCS PASS program. ? By 05/31/2028, coalition members will facilitate four presentations regarding the relationship between youth alcohol use and retail alcohol density in close proximity to local middle and high schools. ? By 7/31/2028, the coalition will distribute 1,000 ""Talk They Hear You"" parent education brochures and resources at four events in the community. ? By 07/31/2028, CHA, the coalition, and a local alcohol law enforcement agency (ALE) will provide two BARS training to restaurant managers, bartenders, and servers (8 total). ? By 08/31/2028, CHA, the coalition, and a local alcohol law enforcement agency (ALE) will provide two BARS trainings to alcohol retailers per year in English and Spanish (8 total). ? By 08/31/2028, El Puente will have provided 8 series of Familia Adelante to at least 8 parents/caretakers and youth each session (64 parents/caretakers and youth total). ? By 08/31/2028, KCS and CCS will have incorporated learnings from evidence-based trainings during annual PASS programming to benefit at least 800 PASS students. ? By 08/31/2028, CHA and the coalition will implement culturally-relevant programs for at least 300 youth and their parents from the population of focus each year (1,200 total). ? By 08/31/2028, the number of KCS students suspended for alcohol-related infractions will decrease by 20% from project baseline. CHA requests a total of $60,000 in federal funds per year to implement the STOP Act grant program.

Community Profile: Kamiah, ID is a small frontier community with a population of 1,273, characterized by its rural setting and historical significance as the winter home of the Nez Perce Tribe. The area faces challenges such as economic decline, high unemployment, and significant rates of poverty, especially among children and the elderly. Substance Abuse and Mental Health: The region reports high levels of adverse childhood experiences (ACEs) and substance use, particularly among youth. Contributing factors include the rural location, socio-economic conditions, and cultural norms. There is a lack of mental health services and substance abuse prevention programs. UYLC Initiatives: The Upriver Youth Leadership Council (UYLC) aims to address these issues through various initiatives, including reducing alcohol access, promoting pro-social involvement, and enhancing mental health services. They employ strategies like Responsible Beverage Server Training, compliance checks, and the SAFE HOMES program. Goals and Evaluation: UYLC has set clear goals to reduce alcohol use among students and increase pro-social opportunities. They plan to use a data-driven approach to evaluate the effectiveness of their initiatives and make necessary adjustments to achieve their objectives. The document outlines the staff roles, community partnerships, and detailed plans for implementation and evaluation.

STOP ACT Grant- Union County Drug Free Partnership Preventing Underage Alcohol Use in Union County Project Abstract The Union County Drug Free Partnership (UCDFP) of Union County, Ohio, requests $60,000 per year from 2024 through 2028 for the Preventing Underage Alcohol Use in Union County Project. These funds will be used to prevent and reduce youth and adult alcohol use. This goal will be achieved by implementing evidence-based prevention strategies, building county capacity for prevention initiatives, implementing environmental prevention efforts to reduce access and availability of alcohol to minors. The project will serve 5,000 individuals annually with 54% of individuals residing in two underserved census tracts in the northern portion of Union County. The project targets three specific populations: 1) families with middle school and high school-aged children, 2) youth and young adults aged 12-20, and 3) Local alcohol restaurants and retailers. A significant portion of project activities will focus on the North Union census tracts (population 8,681), which has higher rates of youth substance use compared to the rest of the county and ranks poorly regarding many social determinants of health. Of the 1,400 students in the region, 35% are economically disadvantaged. Project efforts to address alcohol misuse in this region will start with a community assessment reaching at least 75 residents, followed by convening a North Union Prevention Task Force to develop community prevention strategies. We will use funds to support the following project initiatives: 1) Improve coalition capacity to address underage alcohol use. The Coalition will grow to reach unique populations in the county that are underserved and more likely to misuse alcohol products. To that end we will for a task force to reach out to the northern portion of the county where the two underserved census tracts are located. We will also recruit coalition members from the new immigrant populations that are coming into our county. We will reach out to the Asian, and Asian Indian populations and well as other minority groups. 2) Provide evidence-based prevention initiatives targeting teens, and families with prevention information and promote community protective factors by supporting positive alternative activities for teens. Our Teen Prevention Leadership program will expand to have clubs operating from all three school districts. The teens in this program will spearhead prevention messaging among their peers and promote pro-social involvement. And 3) our Local law enforcement agencies will step up enforcement and community policing efforts. Namely they will conduct compliance checks on area businesses, work with local restaurants and retailers to better identify ways to reduce theft and identify when a patron is intoxicated. The Partnership looks forward to the opportunity to work more closely with our community partners to improve health and safety.

Abstract Studies indicate an increase in underage drinking by youths in Hamilton County, Ohio. A student Survey report by PreventionFirst (2022), conducted on 5,195,7th-12th grade students, attending schools in Hamilton County Ohio indicates that Past 30-Day use was 14.1%, the perception of harm was 72.6%, parental disapproval was 81.3% while friend disapproval was 61.2%. The report indicated that alcohol was the most abused by youths in Hamilton County in 2022 but had one of the least perceptions of harm which underscored the limited impact of existing interventions and their effectiveness on existing service models and interventions. This study and other related findings indicate a serious gap in the planning, funding, coordination, and implementation of service delivery for African Americans residing in this inner-city community. Exclusive Services (ES), the fiscal agent of the Cincinnati for HOPE (Healthy Outcomes through Prevention Efforts) Coalition intends to address the considerable unmet need for underage alcohol prevention at the community level by increasing access to information, enhancing skills, providing support, enhance access/reduce barriers change consequences, change the physical design and modify/change policies. This project will be achieved by addressing norms regarding alcohol use by youths, reducing opportunities for underage drinking, creating changes in underage drinking enforcement efforts, addressing penalties for underage use and reducing negative consequences associated with underage drinking, increasing community collaboration, hosting online and in-person events in schools and community, organizing workshops on underage alcohol prevention, implementing evidence-based underage alcohol prevention curriculum in schools, etc. This project aims to reduce alcohol use among youth and young adults ages 12-20 in nine (9) neighborhoods in the city of Cincinnati, Hamilton County, Ohio which include Avondale, Corryville, Evanston, Fairview-Clifton Heights, Mt. Auburn, Over-the-Rhine, Walnut Hills, West End, and Queensgate. Some of the objectives of this project are to strengthen its capacity to improve its delivery of alcohol abuse prevention programming as measured by a 50% increased capacity in preventing alcohol abuse use among youth in middle and high schools in the City of Cincinnati by September 29, 2027, to decrease 30-day alcohol use among African Americans aged 12 to 20 living in Ohio Health Improvement Zone in the City of Cincinnati, Hamilton County in the state of Ohio by September 29, 2027, etc. The strategies and activities designed during our proposed effort are expected to: (1) strengthen our infrastructure and mobilize resources at the community level so that we can effectively address the health crisis caused by underage drinking; (2) become prepared to offer evidence-based underage alcohol prevention and treatment services through planning and capacity building processes; (3) develop initiatives to address underage alcohol prevention and intervention services that are well structured and supported by scientific evidence; (4) to gain knowledge and expertise necessary to replicate this initiative in similar communities throughout Ohio Health Improvement zone, particularly in the city of Cincinnati.

The ALL Together coalition serving the Upper Valley of New Hampshire and Vermont is applying for the Sober Truth STOP Act Grant. The STOP funding will allow the regional coalition to expand current initiatives and begin new strategies to reduce underage drinking. This grant would support best practices in alcohol prevention for the coalition’s focus population of 1,719 high school age youth in four high schools, and over 1,433 middle school age youth in six middle schools in the Upper Valley. If funding is awarded, the goals of ALL Together is to decrease rates of 30-Day alcohol use among high school students in our region by: providing information, education and training; through policy change efforts affecting ease of access, and norms. We will do this by focusing on the following objectives: increasing the perception of parent disapproval of alcohol use; decreasing adult attitudes favorable toward youth alcohol use; increasing the perception that binge drinking is harmful; decreasing youth access. All of these objectives will be measured by the Vermont and New Hampshire Youth Risk Behavior Survey. All Together has identified the following strategies and interventions to accomplish this goal: provide information and education via multi-media social marketing campaigns, One Choice, “Talk. They Hear You,” and Don’t Serve Teens to parents, youth, and community across the region to strengthen protective parental social norms, challenge youth use norms, and spotlight social host liability. Strengthen school and community policies related to substance use violations and improve the quality of policy implementation; utilize Town Hall events to gain feedback from the communities on underage drinking issues and utilize this feedback to implement change; strengthen collaboration among communities and state and local governments to reduce alcohol use among youth and young adults. Estimated number of people to be served annually as a result of the award of this grant: 3,152.

Project Name: Bay State Community Services (BSCS): Impact Quincy Project Summary: Impact Quincy (IQ) Coalition will reduce onset and progression of alcohol misuse and related problems for youth (12-20 years) in Quincy, MA who identify as BIPOC, immigrant, and/or LGBTQ+ by strengthening equitable youth-led, community prevention capacity and by developing/delivering/evaluating culturally and linguistically appropriate evidence-based strategies to address youth social norms, policy change, & caregiver knowledge. We will utilize the SPF to: Goal 1: Expand and strengthen equitable community-level and youth-led primary prevention infrastructure & capacity in Quincy.?1.A By October 2024, IQ will hire a part-time Project Coordinator to focus on prevention of youth alcohol misuse. 1.B In the first 180 days, IQ will begin monthly community-wide coalition meetings focusing on youth alcohol misuse with representation from focus population and SAMSHA's 12 sectors. 1.C By the end of year 1, IQ will establish a Youth Action Team of at least 5 youth to participate in coalition and alcohol prevention activities; at least 60% of youth will be from underserved populations. 1.D By the end of year 4, all staff and IQ members will be trained in the SPF. 1.E By the end of year 1, IQ will convene at least 2 Town Hall meetings (focusing on underserved communities) to obtain public feedback about issues related to underage drinking. At least 2 Town Halls will be hosted each year after. 1.F. Within the 1st year, IQ will establish a Health Equity Action Team of at least 3 members who will meet monthly to review strategies/activities to ensure they are equitable & aligned with the Disparities Impact Statement. 1.G Conduct a biennial YRBS in Fall 2024 with participation from at least 75% of Quincy high and middle school students to measure alcohol use rates and related data.?1.H Conduct biennial focus groups in Spring 2025 with at least 15 youth, 10 caregivers, & 6 youth service providers to enhance YRBS data. Goal 2: Reduce 30-day use rates of alcohol among high school students in Quincy by 2% by September 2028. 2.A By the end of year 4, IQ will enhance intergovernmental cooperation & coordination to adopt/strengthen model regulations for alcohol, including quarterly compliance checks. 2.B By the end of year 1, IQ will partner with the BUY Policy Action Team to create model recommendations for local and state-level alcohol prevention policies. 2.C Yearly, Quincy youth will educate their legislatures on alcohol policy, and its impacts through at least 1 statewide briefing or meetings with state legislators.?2.D Starting Fall of Year 2, IQ will increase caregiver knowledge of youth substance use prevention strategies by promoting the Talk They Hear You Campaign to reach 75% of caregivers of students grades 6-12. 2.E In year 3, IQ will partner with Quincy schools to implement youth social norms campaign to increase accuracy of perceptions around peer alcohol behaviors by 10% by end of year 4. Annually, this project will reach the majority of the 5,380 students in Quincy public middle and high schools. Over the lifetime of the project, we expect to reach all 101,727 residents in Quincy.

The Coalition For Health Promotion Thrive Without Drinking (TWD) project will implement evidence-based prevention strategies in Youngstown, OH, to prevent and reduce underage drinking use among youth and young adults, ages 12-20, with a focus on underserved populations. The geographical area will be Youngstown, Ohio, (with a focus on the North, East, and West sides of town), which is located in the northeastern part of the State and is the largest urban area in Mahoning County. The primary population of focus will be youth and young adults, ages 12-20. Youngstown was a steel manufacturing giant which has lost 65% of its population since the 1960. With the demise of the local steel industry, the community risk factors of transitions and mobility, economic deprivation, low neighborhood attachment and community disorganization, and community laws and norms favorable to drug use, firearms, and crime became significantly more prevalent, as evidenced by the unemployment, poverty and crime rates, along with the prevalence of vacant housing after 1970. Consequently, the existence of multiple risk factors exist within our community has increased the probability of youth and young adults engaging in underage drinking. Limited protective factors also exist within this community. Regarding clinical characteristics, the percentage of unique treatment clients with a primary diagnosis of alcohol use disorder in SFY 2022 was 15.5% (Ohio MHAS Community Behavioral Health Claims Data, January 2024), and Behavioral Health Data Group/State Epidemiology Outcomes Workgroup (Ohio MHAS) data for Mahoning County indicates during the year 2021, that 42.9% of traffic fatalities involved alcohol-impaired drivers, and that 3.2% of crashes were caused by alcohol-impaired drivers. Program goals are to (1) identify, establish, and implement relevant evidenced based community approaches that will expand and increase the coalition's ability to address underage drinking in the community, including underserved communities, and (2) enhance intergovernmental cooperation and coordination at the city, county, and state level to reduce alcohol use among youth and young adults. Regarding measurable objectives and strategies/interventions, the Project will implement specific activities that comprise CADCA's Seven Strategies for Community Change, and the CSAP Prevention Strategies to reduce underage drinking (i.e. implementing the Talk, They Hear You campaign, providing information at community events, conducting town hall meetings on underage drinking, providing drug free alternative activities for youth, facilitating policy change initiatives with school systems regarding underage drinking school policy). Objectives will be measured to ascertain the level of correct change respective to: (1) Past 30-day use of alcohol, (2) Perception of risk or harm from alcohol use, (3) Perception of parental disapproval of alcohol use, and (4) Perception of peer disapproval of alcohol use. Additionally, measurable numerical totals for all Project objectives are specified in Section B of the Project Narrative The number of people to be served directly is 1,800 (annually), and 7,200 (for the entire project). The number served indirectly will be 27,500 (annually), and 110,000 (for the entire project).

STOP Act Proposal Abstract: SAFE in Northern Michigan The Health Department of Northwest Michigan, as the fiduciary of SAFE in Northern Michigan (SAFE), submits this Sober Truth on Preventing Underage Drinking Act (STOP Act) proposal aiming to reduce youth alcohol use across Antrim, Charlevoix and Emmet counties. This project proposal aligns with the mission statement of SAFE -- to prevent youth substance use, increase community awareness and create change through collaboration, education, prevention initiatives and environmental strategies of tobacco, alcohol and other substance use in Antrim, Charlevoix and Emmet counties. The target population of the proposal includes 5,299 middle and high school youth, from 12 school districts throughout Antrim, Charlevoix, and Emmet counties, which currently partner with SAFE, as well as the parents/guardians of those youth. This proposal builds upon the SAFE Drug-Free Communities Support Program action plan, enhancing existing strategies through community engagement, policy advocacy, and educational initiatives. The project's core goals include enhancing sector representation, expanding leadership development to empower youth and adult coalition members with leadership and advocacy skills, implementing an Alcohol Outlet Density Scan to inform policies, reducing youth access to alcohol through targeted campaigns, and decreasing negative outcomes associated with underage drinking by focusing on binge drinking and risk awareness. Activities are guided by CADCA's Seven Strategies for Community Change, using data and logic models to determine needs in the community. All components are in place for a successful project: identified need, carefully designed interventions, skilled staff to implement and evaluate them, and a high functioning organization.

Marin Healthy Youth Partnerships Equity Approach to Underage Alcohol Use Prevention in Marin County Marin Healthy Youth Partnerships (MHYP) proposes to reduce underage drinking in Marin County among Latino/a/x youth by tailoring current initiatives for cultural and linguistic responsiveness, empowering Latino youth with the skills to influence peers and policy, and by developing an Equity Strategy that will guide the organization’s prevention approach. In its 7th year of DFC funding, MHYP is a community-based coalition that reshapes community norms that drive youth substance use. Marin ranks high in both the state and nation for youth alcohol use. 25% of Marin County 11th graders reported binge drinking in the past 30 days compared to 8% of 11th graders in California as a whole (CHKS, 2019). Health disparities and social injustice are prevalent issues, with Marin ranking in the bottom 10% of California counties for income inequality and second in the state for racial disparities. 25% of the County’s child population is Latino with approximately 3,500 Spanish-speaking families of middle and high school students. MHYP expects to reach approximately 10,000 youth and families in our populations of focus. Goals and Objectives: 1) Reduce the rates of underage drinking among Latino youth by 10% a) Engage 150 Spanish-speaking caretakers annually in tailored Let’s Talk Community Discussions b) By the end of year 4, Be the Influence program materials and campaigns will be tailored and translated for Spanish-speaking parents and caretakers, and distributed to families of middle and high school students in the service area c) MHYP will partner with Youth Transforming Justice to offer 10 or more Spanish-speaking youth and families Substance Use Prevention and Harm Reduction Training. 2) Build the capacity of Latino youth to drive prevention and intervention efforts that reduce underage drinking a) Partner with Alcohol Justice (AJ) to collaborate on two trainings annually for Latino youth that enhance skills in policy, advocacy, and media literacy to impact environmental and policy factors that influence underage alcohol use b) In partnership with AJ, support opportunities for youth to engage in policy work around best practices for retail stores selling alcohol by engaging and providing a stipend to 10 Latino youth annually. 3) Enhance the capacity of the coalition to address health disparities in underage drinking a) By the end of year 1, MHYP will assess current coalition capacity using the Meyer DEI Spectrum Tool and determine and address priority areas to strengthening the organization’s ability to address disparities in underage drinking b) By the end of year 2, MHYP will seek to broaden representation and inclusion by recruiting at least one bicultural and bilingual member of the Board of Directors c) By the end of year 3, MHYP will ensure that 80% of coalition staff, leadership and active volunteers are trained on employing an equity approach to substance use prevention activities and adopt a policy for equity training for new hires and volunteers.

The problem of underage drinking is a serious threat to the youth, families and communities in Berkeley County, West Virginia. For this project, The Martinsburg Initiative (TMI) has identified the risk and protective factors for underage drinking which we will use to support environmental prevention and reduction strategies. Our focus is on policy change/awareness, enforcement, and youth-led social norms campaign along with prevention education to accomplish our goals. The Martinsburg Initiative is an innovative and holistic police-school- community-health-education coalition. TMI was awarded the Drug-Free Communities Grant in September 2022. The program focuses on youth substance use prevention and addressing Adverse Childhood Experiences (ACEs) to create a trauma-informed community working to build resilience in children, so they are less likely to succumb to scientific research prediction. TMI, Berkeley County Schools, Shepherd University, and the local police departments in Berkeley County have a shared vision of promoting a safe, healthy, drug-free community and seek to promote resilience in downtown Martinsburg, the city hub of Berkeley County, West Virginia. From our selected goals and objectives, we hope to expand our capacity and capabilities of working effective environmental strategies to address underage drinking prevention. At a minimum, 6,000-8,000 people (yearly) will be part of our efforts or be affected by our initiatives. We intend to serve all sectors of our community throughout the lifespan of this grant.

Project Name: Preventing Underage Drinking in Pottawatomie County, OK Population to be Served: Youth aged 12-20 in Shawnee, Tecumseh, McLoud, and Bethel Acres, Oklahoma Demographics and Clinical Characteristics: Number of youth in target area: Approximate 6,200; Median Household Income: $50,582; Child Poverty: 23%; % of 6th, 8th, 10th, and 12th graders in Pottawatomie County who self-reported using alcohol in the previous thirty days: 2018 - 20.3%, 2020: 19.5%, 2022: 12.0% Strategies Interventions: Gateway to Prevention and Recovery will utilize the STOP grant to build the capacity of the existing Drug Free Communities (DFC) Coalition Pottawatomie Alliance Toward Community Health (PATCH) to address underage drinking in north Pottawatomie County, Oklahoma. Three key evidence-based interventions will be utilized to prevent underage drinking: 1) coordination with local law enforcement to both engage in evidence-based training and complete community based compliance checks; 2) Creation of a STOP Task Force to bring sectors together to comprehensively address this issue across the region; 3) Provision of evidence-based prevention programming to students in partner school districts. Goals and Measurable Objectives: Goals: 1) Decrease youth substance use in the region by coordinating law enforcement agencies, utilizing evidence-based training and strategic activities. 2) Decrease youth substance use by amplifying conversations and evidence-based education surrounding youth alcohol use. 3) Decrease youth substance use by utilizing cross-sector data to track progress. 4) Provide evidence-based prevention programs to youth ages 12-20. Objectives: By September 2026: 1) Decrease reports of Past 30-day Alcohol Use by Youth by 10%. 2) Increase reports of Perception of Risk/Harm by Youth by 10%. 3) Increase reports of Perception of Parental Disapproval of Use. 4) Increase Perception of Peer Disapproval of Use by Youth by 10%. 5) Decrease reports of underage DUIs by 10%. Number Served: Annually: 600; Total Project: 2,400

STANDS (Schools Together Allowing No Drugs) serves Scott County, Tennessee, a rural county nestled in East Tennessee, bordering Kentucky to its north and situated in the foothills of the Appalachian Mountains. Our community is made up of rural country areas, with a population of 21,850. The STOP Grant will impact all youth and young adults in Scott County, to prevent and reduce under age alcohol use. The specific population of focus for this grant will be youth ages 12-20 who are at high risk for alcohol use; specifically, the underserved population (at risk), LGBTQ+ youth, youth in rural areas, students ages 18-20 at the community college and local level. We further aim to destigmatize high-risk groups through cultural competency due to the unacceptance of marginalized groups within the region. These groups include but are not limited to the LGBTQ+ community, those who are homeless/at-risk of homelessness, and individuals living in poverty. Implementing prevention strategies based on the Strategic Prevention Framework model in the community will reduce underaged drinking by 4 percent, reduce social availability of alcohol among youth, and will increase youth and parental perception of the harm of underage drinking through programming and campaigns. STAND, funded by the Drug-Free Communities Support Program over the past ten years, has strengthened successful local prevention strategies. STAND's comprehensive approach includes community education on underage drinking consequences, increasing the perception of harm associated with underage drinking, supporting local law enforcement efforts, targeting socioeconomic impacted areas and at-risk subpopulations. STAND will achieve this by launching comprehensive social media campaigns to raise awareness of underage drinking dangers, and fostering community partnerships to prioritize underage drinking prevention in the county. These strategies aim not only to reduce underage drinking but also to build stronger partnerships among local government and community organizations for sustained impact. With a focus on long-term sustainability, the plan involves engaging multiple community sectors to coordinate underage drinking prevention efforts and drive change across the county.

EPIC works to build a healthy and safe community, reducing the risks of alcohol, tobacco and other drugs while promoting the healthy attitudes and behaviors of youth in Southeast Missouri. Over the next four years EPIC will specifically target underage drinking with a plan to 1) build on our EPIC designation project, which already includes EPIC Schools by finalizing the new EPIC Business project and 2) partner with a local university student club who will serve in an advisory capacity to establish a campus-wide organization, work for policy change, and help organize a social norming campaign on campus and the community at large. The predominant culture in our county embraces alcohol use as a societal norm which contributes to high rates of use among young people. Specific local conditions contributing to this problem include Cape Girardeau being home to Southeast Missouri State University (SEMO) and a conservative, business friendly community with elected officials who often consider alcohol and tobacco prevention to be at odds with business. EPIC has designed and implemented the successful EPIC Schools project where schools put in place polices that help prevent youth substance abuse. Policy requirements are established by EPIC in order to get the official ""EPIC"" designation and those awarded the designation are then recognized in local media outlets. The schools must develop strong policies and practices to prevent youth alcohol abuse on their campuses. To further our efforts in the community we will finalize the development of the EPIC Business project where local businesses that sell alcohol can become “EPIC” when they meet requirements such as alcohol sales compliance, responsible beverage service training and up-to-date technological scanning of identification cards. EPIC will also join with the Psychology Club at SEMO who will serve as an advisory group to help establish an organization on campus that will hold alcohol-free events, change policy surrounding the new rule that allows alcohol in the dorms, and establish and implement a positive community norming campaign on the SEMO campus addressing underage drinking that exists on campus and in the community at large. We expect to reach as many as 30,000 people by projects end. More specifically EPIC plans to work to reduce underage drinking in the community by increasing the age of first use and perception of harm of alcohol as measured by Search Institute's Developmental Asset Profile (DAP) and to decrease perception of availability of alcohol by changing perceptions of local high school students also as measured by the Search Institute’s DAP, the Missouri Student Survey and as measured in focus groups. Our target population is Cape Girardeau County youth age 12 to 20. We anticipate that will reach at a minimum, 1000 students each year. Media exposure of these community efforts will change social norms as people begin to realize that the norm in our community among businesses, organizations and schools is to support a healthy community and prevent unhealthy, high-risk behaviors like underage drinking.

Iron County Health Coalition will partner with local schools and law enforcement agencies to implement the STOP Act Program in Iron County, Missouri. The goals of this project are 1) Reduce underaged drinking; 2) Foster a community environment that actively discourages underaged drinking by promoting positive social norms; and 3) Reduce the accessibility of alcohol to underaged youth and young adults. Strategies that will be applied to this program include implementation of evidence-based programs Too Good for Drugs and Prevention Plus Wellness; Responsible Beverage Server Training; and Positive Social Norms Campaigns. The progress of this project will be measured by the Missouri Student Survey.

Cheltenham CTC proposes utilizing a behavioral health approach with data-driven prevention strategies in order to prevent the onset and reduce the progression of youth alcohol use. This approach is comprehensive and will (1) strengthen the capacity of the coalition through training and technical assistance, (2) continually collect data and evaluate strategies, (3) compliment the evidence-based school prevention programs by implementing community-based, culturally-relevant and responsive policies and best practices, (4) impact community-level change by utilizing effective prevention messaging such as the ""Talk They Hear You"" to educate community members and change norms, and (5) engage youth in leadership opportunities to address barriers to behavioral health services. The population of focus for this project is middle and high school youth in Cheltenham Township, PA. The student body at the schools served by Cheltenham School District is 25.9% White, 53.4% Black, 5.3% Asian or Asian/Pacific Islander, 8.9% Hispanic/Latino, 0.1% American Indian or Alaska Native, and 0.2% Native Hawaiian or other Pacific Islander, with 6.3% of students identifying as two or more races (usnews.com). There are about 25% of school district students who qualify for free or reduced lunch. Based on these demographics, more than 50 percent of our population of focus is from an underserved community and demonstrates the need for culturally relevant community-based substance prevention services and resources. Cheltenham Communities That Care will prevent and reduce alcohol use among youth through the following: Goal 1: Increase the prevention infrastructure and capacity of Cheltenham Communities That Care • Train 100% of coalition members in SPF • Annual Coalition Assessment will demonstrate a 10-point increase in its structure and functioning. • Complete a Prevention-Focused Strategic Plan using community-level data to inform behavioral health inequities. • Action plan developed by Youth Subcommittee to address behavioral health disparities among youth. • Implement a minimum of six (6) evidence-based programs, campaigns, policies and/or practices to prevent youth alcohol use. • Develop a Sustainability Plan. Goal 2: Reduce alcohol use among youth aged 11-20. • Reduce 30-day alcohol use among youth by 20% • Reduce the rate of binge drinking among youth by 20% • Increase perception of harm of alcohol use among youth 20% • Decrease willingness to try alcohol among youth by 15%

Central NH STOPs Harm from Underage Drinking Central NH STOPs Harm will address our community’s top health concerns: mental health and substance misuse among youth. Our project will prevent and reduce alcohol use among 12- to 20-year-olds through community-level change strategies by creating innovative ways to limit access to alcohol, change the culture and context within which decisions about substance use are made, and shift the consequences associated with youth substance use. CADY, Inc., a vibrant community prevention coalition, serves the rural Central Region of New Hampshire (NH) comprised of 18 towns with a total population of about 33,544 and home to Plymouth State University (PSU). Youth Risk Behavior Survey (YRBS) data tell us that Central NH youth are using substances earlier and at higher rates than the rest of NH. More than a third of our youth ages 12 to 20 use alcohol and are exposed to its risks and harms. When it comes to 30-day use of alcohol, Central NH high school students rank 16.5% higher than the state average, and 35% higher than the state average for binge drinking (SAMHSA, 2023). Binge drinking by Central NH youth and college students is a serious public health concern in our region and statewide. Emerging research drives growing concern about a new measure of alcohol use: high-intensity drinking, at levels two or more times binge levels. High intensity drinking has much more dangerous and severe short- and long-term consequences than other patterns and is especially common in college settings. In recent years, as the opioid problem has reached crisis levels in NH, resources and attention have focused on opioids. Critical though this problem is to the health and welfare of our community, alcohol remains the most prevalent substance concern that affects the largest number of our youth and families. Through this collaborative initiative, we will address community norms regarding youth alcohol use, reduce opportunities for underage drinking by limiting access and creating changes in enforcement efforts, reduce the prevalence of negative consequences associated with underage drinking, and build capacity to support disparate populations. The goals of our project are (1) Reduce opportunities for underage drinking and binge drinking by creating changes in underage and binge drinking perceptions and enforcement efforts; (2) Increase risk-protective community norms through social marketing and positive social norming; (3) Reduce percentage of youth under age 13 who drink alcohol through empowerment strategies that build resilience and perceptions; and (4) Build capacity and infrastructure to support disparate populations, including veterans, rural youth, LGBTQIA+ youth and young adults. Our measurable objectives are to reduce youth alcohol use, decrease their access to alcohol and opportunities for binge and high-intensity drinking, and build youth’s perceptions that drinking, and binge drinking is harmful and unacceptable, as measured by Youth Risk Behavior Survey data. Central NH STOPs Harm will serve as many as 10,000 youth and young adults over the entire project period, with an emphasis on building capacity to increase outreach efforts tailored to meet the unique needs of disparate populations.

The Kalamazoo County Substance Abuse Task Force (KCSATF) is seeking a $60,000 Sober Truth on Preventing Underage Drinking Grant (STOP Act) through the Department of Human Services and the Substance Abuse and Mental Health Services Administration. The Coalition services Kalamazoo County, Michigan, a county composed of both urban and rural areas with a population of 262,985. The strategies funded through this application will focus on youth and community members in census tracts that have high alcohol outlet density. This subpopulation also has higher crime and poverty rates as well as a higher number of minority residents as compared to the county. KCSATF also places a strong emphasis on services and priorities to diverse populations that have been underserved and historically under-resourced with increased focus on Black, Hispanic/Latinx and LGBTQI+ youth. Services provided in neighborhoods where Kalamazoo youth are at greatest risk for dangerous and life-threatening behavior. KCSATF works with participants who live in the City of Kalamazoo (41% below ALICE- Asset, Limited Income constrained, employee, 2021), particularly youth living in families who live below the ALICE threshold. Participants who reside in the areas of Kalamazoo with the highest poverty levels are often at much greater risk for social-emotional health issues and substance use disorder, and therefore at the greatest need for services. KCSATF uses approaches aimed to improve wellbeing through high quality programs, practices, and policies that are recovery-oriented, trauma-informed, and equity-based to improve behavioral health. The coalition has built a solid infrastructure, and this grant will enhance our current capacity with the vision of decreasing underage drinking in our community by specifically addressing youth access to alcohol, peer influence and social norms related to alcohol. The coalition has the following goals for this project: (1) Increase and strengthen collaboration with underserved and historically under-resourced to prevent and reduce substance use among youth (2) Reduce underage drinking and youth substance use by mitigating community risk factors and strengthening protective factors for youth (3) Increase youth perception of peer and parental disapproval of substance use. The Coalition will achieve its goals by implementing several activities. A few examples include: Facilitating a youth-driven planning process resulting underage drinking campaign; Implement alcohol vendor education and compliance checks in risk areas, Implement a Project Sticker Shock campaign to increase adult awareness of the legal consequences of purchasing alcohol for minors; Provide training and skill building activities for parents, schools and other youth-serving organizations; Host a several Town Hall Meeting on underage drinking; and Enhance Skills and provide support to Task Force Staff and the Youth leadership Team. All of these strategies are essential for creating population-based change.

This project is designed to provide a comprehensive approach to youth substance misuse, focusing underage drinking prevention. Utilizing the seven strategies of prevention, we will implement strategies that provide information, enhance skills, provide support, change access/barriers, change consequences, address physical design and policy change to reduce use and availability and increase perception of risk. Oakland County is the second-most populous county in Michigan with nearly 1.3 million people in 62 cities, villages and townships. The county reflects diversity in population, socioeconomic status and geography. The region’s population is becoming increasingly diverse, with growth among minority, racial and ethnic groups. The Black/African American population has grown to 14%, Asian population is 9% and Hispanics account for approximately 5% of the population. People between the ages of 18 and 65 account for approximately 56% of the population, with persons under 18 accounting for 20%, under 5 accounting for 5% and 65 and older accounting for 19%. (census.gov). Oakland County has a diverse socioeconomic makeup, ranging from affluent suburban communities to lower income and poverty in some of our rural and urban communities. Based on Kids County Data Center, 8% of children ages 0-17 live in poverty and 37% of youth receive free or reduced lunch for economically disadvantaged students. Some communities see free and reduced lunch percentages upwards of 70% to 90%. The population that will be impacted will be Oakland County youth aged 7-19 and their families. Oakland County has 28 local school districts that serve the diverse needs of approximately 183,000 students, which is approximately 14% of the total population. Diversity is reflected in the student population with 20% African American, 9% Asian and 7% Hispanic/Latino. Based on the Federally Approved 2022/2023 Alliance Youth Prevention Survey (AYPS), for 7th, 9th, and 11th grade students, 42% identified as male, 46% female, 4% other/not listed, 0.6% unsure, and 3% preferred not to answer. Additional 77% identified as straight, 3% gay or lesbian, 7% bisexual, 5% other/not listed, 1% unsure, 6.57% PNTA. The Alliance will address the following goals and measurable objectives: Goal 1: Strengthen coalition capacity/infrastructure to address underage drinking at the community level. Objective 1: By 9/29/2028, increase collaboration among sectors, community members and organizations by 10% as measured by the number of individuals and community sectors participating in prevention efforts. Goal 2: Reduce underage drinking and related problems while increasing protective factors and promoting mental wellness. Objective 1: By the end of the 2028 fiscal year, reduce past 30-day alcohol use by 4% among Oakland County middle and high school students as measured by the bi-annual MIPHY and AYPS surveys and focus groups. Objective 2: By the end of the 2028 fiscal year, increase perception of risk by 5% among Oakland County middle and high school students as measured by the bi-annual MIPHY and AYPS surveys and focus groups. Objective 3: By the end of the 2028 fiscal year, decrease availability by 4% among Oakland County middle and high school students as measured by bi-annual MIPHY and AYPS surveys and focus groups.

WestCare Texas, Inc. (WCTX) and the Family Assistance and Community Empowerment (FACE) Coalition will serve youth aged 12-20 years and their parents who live, work, play, worship, and attend school in zip codes 78040 and 78046 in Laredo and Webb County, Texas. The demographics of this age group consist of 95% Hispanic/Latino, 4% White, < 1% Black, < 1% Asian, < 1% American Indian, < l % Native Hawaiian, and < 1% multi-cultural. DFC GOAL 1 and STOP GOAL 1 – STRENGTHEN COLLABORATION by enhancing and expanding current efforts of the FACE Coalition to increase community awareness and implement evidence-based strategies, policies, and programs, which aligns with SAMHSA 's Resource Guide entitled Implementing Community-Level Policies to Prevent Alcohol Misuse and SAMHSA’s Strategic Plan FY2023-2026, Priority 3, specifically to decrease underage drinking by 40% among youth ages 12-20 who live, work, play, worship, attend school in zip codes 78040 and 78046 in Laredo and Webb County, Texas. DFC GOAL 2 and STOP GOAL 2 – REDUCE UNDERAGE DRINKING among 1200 youth (300 annually) ages 12-20 who attend middle and high schools, colleges, and job training programs in zip codes 78040 and 78046 by 10% annually and 40% over the project period, which aligns with the recommendations of the 2023 Report to Congress on the Prevention and Reduction of Underage Drinking. The required activities will be implemented through the Strategic Prevention Framework.

The Youth Running Strong Task Force will implement evidence-based interventions to combat underaged drinking in the Navajo Nation communities in Southern Apache County, Arizona including Sanders Unified School District. The goals of this project are to establish positive cultural norms that foster confidence and pride, strengthen youth by fostering positive parental and adult engagement, and foster healthy behaviors among youth and young adults. The evidence-based programs that will be implemented in this project are Keep a Clear Mind and Prevention Plus Wellness.

The Coalition for Urban Youth and Family Development (CUYFD) serves the Westside of Detroit, Michigan. Detroit is located in southeastern Michigan, straddling the Detroit River and situated in the Great Lakes region of North America. Our community is made up of lower income urban areas, with a population of 21,850. The STOP Grant will impact all youth and young adults in West Detroit to prevent and reduce under age alcohol use. The specific population of focus for this grant will be youth ages 12-20 who are at high risk for alcohol use; specifically, the underserved population (at risk), LGBTQ+ youth, students ages 18-20 at the community college and local level. We further aim to destigmatize high-risk groups through cultural competency due to the unacceptance of marginalized groups within the region. These groups include but are not limited to the LGBTQ+ community, those who are homeless/at-risk of homelessness, and individuals living in poverty. Implementing prevention strategies based on the Strategic Prevention Framework model in the community will reduce underaged drinking by 4%; establish and increase the number of liquor store owners displaying social host laws; and will increase youth and parental perception of the harm of underage drinking through programming and campaigns. CUYFD , funded by the Drug-Free Communities Support Program over the past ten years, has strengthened successful local prevention strategies. CUYFD's comprehensive approach includes community education on underage drinking consequences, increasing the perception of harm associated with underage drinking, supporting local law enforcement efforts, targeting socioeconomic impacted areas and at risk subpopulations. CUYFD will achieve this by launching comprehensive media campaigns to raise awareness of underage drinking dangers, and fostering community partnerships to prioritize underage drinking prevention in the county. These strategies aim not only to reduce underage drinking but also to build stronger partnerships among local government and community organizations for sustained impact. With a focus on long-term sustainability, the plan involves engaging multiple community sectors to coordinate underage drinking prevention efforts and drive change across the county.