May 2005

Grant Results

National Program

Fighting Back(R)

SUMMARY

The Fighting Back® project in Kansas City worked from 1990 to 2003 to reduce the harms associated with substance abuse by consolidating existing programs and resources into a communitywide system of prevention, early identification, treatment, aftercare and relapse prevention services.

The project was part of the Robert Wood Johnson Foundation (RWJF) national program Fighting Back: Community Initiatives to Reduce Demand for Illegal Drugs and Alcohol.

Key Results

  • Trained 28 residents as neighborhood "mobilizers," who referred approximately 194,000 people to prevention services and about 50,000 people to treatment services, and distributed information on substance abuse to about 500,000 people.
  • Linked community policing, social services and neighborhood mobilizers into a team that worked to eliminate crack houses, public drunkenness and family violence.

Key Findings

  • Use of alcohol among eighth, 10th, and 12th graders in the target area declined between 1996–1997 and 2000–2001.
  • Use of marijuana among eighth and 10th graders in the target area declined between 1996–1997 and 2000–2001; use of marijuana among 12th graders increased.
  • Emergency-room visits for alcohol abuse decreased, and emergency-room visits for drug abuse rose between 1997 and 2001.
  • Drug-related homicides in the target area decreased from 32 percent of all arrests in 1987 to 25 percent of all arrests in 1999.

Funding
RWJF provided six grants totaling $6,119,330 for this project from March 1990 to August 2003.

 See Grant Detail & Contact Information
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THE PROBLEM

In 1989, 195,000 residents lived in a 55-square-mile area of central Kansas City that contained some of the worst slums and highest crime in the city. Alcohol and drug abuse was a long-standing problem in this part of the city. The following statistics demonstrate the nature and extent of the problem:

  • Arrests for possession of illegal drugs were up 81 percent for the first seven months in 1989 compared with the same period in 1988, according to the Kansas City police. Other police department statistics revealed:
    • Fifty-five percent of fatal accidents in the first half of 1989 were alcohol-related, compared with 32 percent in 1988.
    • Forty-three percent of all homicides in 1988 were drug-related and another 40 percent had some drug-related connection.
  • Twelve (12) percent of 12th-grade students at one inner-city Kansas City high school used cocaine and 10 percent used crack, double the metropolitan averages, according to the Adolescent Resources Corporation, an RWJF-funded organization (ID# 014416) that worked to create an adolescent-friendly environment in Kansas City.
  • Admissions to publicly funded treatment centers increased 72 percent for alcohol abuse and 908 percent for cocaine abuse from 1986 to 1989, according to the Missouri Division of Alcohol & Drug Abuse.

In 1986, the Metropolitan Kansas City Task Force on Alcohol and Drug Abuse was established to develop a community blueprint for action on alcohol and drug abuse. The Greater Kansas City Community Foundation and Affiliated Trusts, a public foundation that led initiatives aimed at community issues (e.g., at-risk youth and neighborhood development), provided technical assistance to the task force.

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RWJF STRATEGY

Promoting health and reducing the personal, social and economic harm caused by substance abuse is one of RWJF's goal areas. In May 1986, RWJF began a two-year analysis of the national problem of substance abuse. This led to the National Program Fighting Back®, launched in 1989 to assist communities of 100,000 to 250,000 people in implementing a variety of antidrug strategies to address their problems.

Fighting Back was a communitywide approach that involved business, health care, the public school system, local government and its agencies, the police, community groups, local media and the clergy.

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THE PROJECT

The Fighting Back project in Kansas City began in 1990 under the auspices of the Greater Kansas City Community Foundation. The overall objective of the project, called Fighting Back in Kansas City, was to reduce the harms associated with substance abuse by consolidating existing programs and resources into a communitywide system of prevention, early identification, treatment, aftercare and relapse prevention services, and environmental improvements. The primary strategies were to:

  • Use a grassroots approach to problem solving while working with residents, government, law enforcement, and the education and health care systems.
  • Use multiple, measurable initiatives to prevent substance abuse. Fighting Back in Kansas City focused on children, youth and young adults.

During the first two grants (ID#s 016522 and 017923), Kansas City planned its Fighting Back project. The Greater Kansas City Community Foundation established Project NeighborH.O.O.D., a not-for-profit grassroots organization, to administer the project and a Citizens Task Force composed of community leaders to oversee it. During the third and fourth grants (ID#s 019732 and 024537), the project created programs to raise awareness of substance abuse and available services, consolidate substance abuse services, and involve neighborhoods in awareness and intervention activities.

In 1997, the Fighting Back national program moved into Phase 2, in which project sites focused on their most important substance abuse problems in order to obtain measurable changes. During the fifth and sixth grants (ID#s 031965 and 039784), Fighting Back in Kansas City focused on:

  • Improving identification, screening and referral to treatment through key community institutions.
  • Improving the quality of, access to, and retention in treatment.
  • Data collection and dissemination on substance abuse trends.

In 2000, Move UP, a merger of Project NeighborH.O.O.D. and the Ad Hoc Group Against Crime, took over administration of Fighting Back in Kansas City. (Move UP is the operating name of the Community Movement for Urban Progress.)

Other Funding

Over the course of the project, Fighting Back in Kansas City collaborated with neighborhood groups, schools, government agencies/departments and churches. Through August 2003, the project attracted more than $3 million in additional funding, including $1.1 million in grants from COMBAT (a 0.25 percent sales tax that supports prevention and treatment initiatives and provides resources to law enforcement and local prosecutors), the Greater Kansas City Community Foundation ($650,000), the Hall Family Foundation ($375,000) and the federal Weed & Seed program (a drug-related crime prevention program to "weed" out crime and "seed" the area with programs and agencies that create a safer community: $275,000).

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RESULTS

Fighting Back in Kansas City reported these accomplishments over the course of these six grants:

  • Galvanized the community to tackle substance abuse. The project trained 28 residents as neighborhood "mobilizers," who guided substance abusers into treatment, supported their families, made referrals to prevention services, organized neighborhood coalitions and provided substance abuse education. Neighborhood mobilizers referred approximately 194,000 people to prevention services and about 50,000 people to treatment services, and distributed information on substance abuse to about 500,000 people.
  • Established a Community Action Network. Three Community Action Network Centers linked community policing, social services, and neighborhood mobilizers into a team that worked to eliminate crack houses, public drunkenness and family violence.
  • Established five "gates" to substance abuse prevention and treatment services in the community. The five gates — law enforcement, courts, schools, faith community and Truman Medical Center's emergency room — were designed to improve access to a continuum of services. Law enforcement addressed crimes related to drug and alcohol use and worked to promote changes in policy and systems. The Truman Medical Center's emergency room developed and implemented an intervention program to screen patients for alcohol and drug problems and make appropriate referrals to treatment services. The drug court linked substance abusers who were involved with the criminal justice system to prevention and intervention services. The schools trained school staff to recognize signs of substance abuse and to intervene. The faith community developed drug-free support programs within churches.
  • Established an ongoing substance abuse surveillance system. The Community Epidemiology Work Group collected, analyzed, and disseminated data on substance abuse patterns and trends.
  • Created an ongoing public awareness campaign — using television, promotional materials, special events and media coverage. This campaign raised awareness of substance abuse and available resources. Project staff produced a television show, distributed more than 31,000 fliers and brochures and sponsored special events. Local newspapers published more than 300 articles about the project.
  • Reached a compact with the owners of neighborhood stores in the community regarding alcohol sales. In 1995, a Community Covenant agreement was signed between neighborhood alcohol retailers and Project Neighborhood whereby retailers agreed not to sell alcoholic beverages of any kind to minors nor to willfully sell alcohol illegally in the community. A monitoring strategy that involved law enforcement surveillance (sting operations) was implemented to determine the impact of the Community Covenant. The result revealed a significant difference.
  • Overall, Kansas City initiated eight or more actions to restrict alcohol availability and expand treatment.

Findings

As reported in the project's report, Fighting Back in Kansas City: a Five-Year Trend Analysis: 1997–2002:

  • Use of alcohol among eighth, 10th, and 12th graders in the target area declined between 1996–1997 and 2000–2001. In 1996–1997, 48.6 percent of eighth graders, 44.2 percent of 10th graders and 52.8 percent of 12th graders had used alcohol in the last 30 days. In 2000–2001, 30 percent of eighth graders, 38.3 percent of 10th graders and 50 percent of 12th graders had used alcohol in the last 30 days.
  • Use of marijuana among eighth and 10th graders in the target area declined between 1996–1997 and 2000–2001; use of marijuana among 12th graders increased. In 1996–1997, 28 percent of eighth graders, 27.7 percent of 10th graders and 24.4 percent of 12th graders had used marijuana in the last 30 days. In 2000–2001, 23.6 percent of eighth graders, 22.1 percent of 10th graders and 26.5 percent of 12th graders had used marijuana in the last 30 days.
  • Emergency-room visits for alcohol abuse decreased, and emergency-room visits for drug abuse rose, between 1997 and 2001. There were 250 emergency-room visits for alcohol abuse in 1997 and 204 visits in 2001. There were 239 visits for drug abuse in 1997 and 472 visits in 2001.
  • Drug-related homicides in the target area decreased from 32 percent of all arrests in 1987 to 25 percent of all arrests in 1999.

An article published in Injury Prevention, "Effects of a Community-Based Initiative Aimed at Increasing Substance Abuse Treatment and Reducing Alcohol Availability on Alcohol-Related Fatal Crashes," compared five Fighting Back sites that initiated eight or more actions to restrict alcohol availability and expand treatment (Kansas City, Mo., Milwaukee, Wis., San Antonio, Texas, Santa Barbara, Calif. and Vallejo, Calif.) with communities with similar rates of fatal crashes in the 10 years before the program began. Among the findings for Kansas City:

  • Fatal crashes involving a driver or pedestrian with a blood alcohol level of .01 percent or higher decreased 15 percent 10 years after initiation of the program, compared to 10 years preceding the program. In matched comparison communities that had a similar proportion of fatal crashes before the program began (Columbia, Mo., Springfield, Ill., St. Louis), there was a 3 percent increase over the 10-year period.

Communications

Project staff produced community reports and other publications, created a Web site and sponsored workshops and conferences. The Kansas City Star, the Kansas City Globe and other local media covered the project. (See Bibliography for details.)

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LESSONS LEARNED

  1. Nonprofit community organizations can rally communities to make a difference. After inadequate neighborhood involvement in the early planning, Move UP mobilized neighborhoods in the target area to reduce substance abuse and its related harms. (Project Director)
  2. Reducing the demand for alcohol and drugs requires changes in the community, substance abuse program evaluation and local funding. Move UP focused on mobilizing neighborhoods to solve their problems (e.g., identifying crack houses); collecting, analyzing and disseminating data about substance abuse programs (which was the beginning of a data-driven approach to alcohol and drug programming in Kansas City); and securing local funding by demonstrating the importance of neighborhood groups in the community. (Project Director)

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AFTER THE GRANT

Move UP continues to administer Fighting Back in Kansas City, which has been expanded beyond the original target area and now includes the entire urban core area of the city. The project is funded by local, state and federal grants. In 2003, a resource development director was hired to focus on raising funds to sustain the program.

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GRANT DETAILS & CONTACT INFORMATION

Project

Fighting Back(R) in Kansas City

Grantee

The Community Movement for Urban Progress (Kansas City,  MO)

  • Amount: $ 100,000
    Dates: March 1990 to February 1991
    ID#:  016522

  • Amount: $ 50,000
    Dates: March 1991 to February 1992
    ID#:  017923

  • Amount: $ 1,542,886
    Dates: March 1992 to August 1994
    ID#:  019732

  • Amount: $ 1,564,555
    Dates: September 1994 to May 1997
    ID#:  024537

  • Amount: $ 1,861,889
    Dates: July 1997 to July 2000
    ID#:  031965

  • Amount: $ 1,000,000
    Dates: August 2001 to August 2003
    ID#:  039784

Contact

Kelly Bowland
(816) 842-8515
kbowland@moveup.org

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Books

Gordon JU (ed.). A Systems Change Approach to Substance Abuse Prevention. Lewiston, NY: Edwin Mellen Press, 1997.

Articles

Hingson RW, Zakocs RC, Heeren T, Winter MR, Rosenbloom D and Dejong W. "Effects on Alcohol-related Fatal Crashes of a Community-based Initiative to Increase Substance abuse Treatment and Reduce Alcohol Availability." Injury Prevention, 11(2): 84–90, 2005. Abstract available online.

Reports

Community Capacity Building Project. Kansas City, MO: Institute for Urban Development and Research, 1994.

Gordon JU. Spiritual Advocacy for Value Exchange. Kansas City, MO: Project NeighborH.O.O.D., 1995.

Robinson R. Community Awareness & Perceptions. Kansas City, MO: Project NeighborH.O.O.D., 1995.

Outcome-Based Program Evaluation in Substance Service. Kansas City, MO: Institute for Urban Development and Research, 1994.

Teen Baseline Facilitator Manual. Kansas City, MO: Project NeighborH.O.O.D., 1996.

Treating and Restoring the African-American Community: A Study in Africentric Substance Abuse Treatment. Kansas City, MO: Nichols and Associates, 1996.

Anderson S. Neighborhood Mapping & Business Alliance Development Conclusions and Recommendations. Kansas City, MO: Project NeighborH.O.O.D., 1998.

Gordon JU. A Manual for Staff Development. Kansas City, MO: Community Movement for Urban Progress, 2000.

Dimensions of Substance Abuse and the Harm It Causes. Kansas City, MO: Community Movement for Urban Progress, 2000.

Fighting Back in Kansas City: A Five-Year Trend Analysis: 1997–2002. Kansas City, MO: Community Movement for Urban Progress, 2002.

Student Perceptions on Substance Abuse. Kansas City, MO: Community Movement for Urban Progress, 2003.

Community Needs Assessment. Kansas City, MO: Community Movement for Urban Progress, 2003.

Community Covenant. Kansas City, MO: Project NeighborH.O.O.D., 1995.

Audio-Visuals and Computer Software

Collaboration in Action, a 10-minute videotape. Kansas City, MO: Project NeighborH.O.O.D., 1995.

World Wide Web Sites

www.moveup.org (no longer available). The Community Movement for Urban Progress Web site. Contains information about Fighting Back in Kansas City. Kansas City, MO: Project NeighborH.O.O.D., 1995.

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Report prepared by: Lori De Milto
Reviewed by: Richard Camer
Reviewed by: Molly McKaughan
Program Officer: Paul S. Jellinek
Program Officer: Floyd Morris

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