The purpose of this study is to develop, validate, and refine an innovative approach to alcohol prevention and treatment needs assessment in small areas (census tracts). The project will utilize social indicator- based scales that are theoretically and empirically associated with alcohol prevention and treatment issues to develop separate prevention needs and treatment needs classifications for each census tract in Erie County. To validate the needs assessments, random digit dial (RDD) techniques will be used to recruit 2,250 subjects (aged 15-40), 125 from each of 18 randomly selected tracts. The needs assessment classifications will be revised based on the results of the validation survey. The tracts will be reclassified using the recalibrated indicators. The final needs classification system will be validated using a brief RDD telephone survey of 150 persons from each of 6 selected tracts. The project's aims are: 1) To develop indicator-based classifications of alcohol prevention needs and treatment needs for small areas. 2) To validate the classifications by showing that high, intermediate, and low treatment and prevention needs tracts are significantly different on measures relevant to these concepts. 3) To recalibrate the needs classifications to optimally reflect the differences found in the validation survey. 4) To evaluate whether separate prevention and treatment needs classifications are needed. 5) To validate the final needs classification. In addition, state-of-the-art geographic information systems technology will be used to map the needs classifications and to match the needs assessments with population data from the census. This project will develop a valid and generalizable methodology for allocating alcohol treatment and prevention resources at a time when many counties and planning areas are beginning to utilize geographic information systems for planning purposes. Thus, this project will provide a method that can be readily adapted for improving health services at the local level.
