May 2005

Grant Results

National Program

Fighting Back(R)

SUMMARY

From 1990 to 2001, Working Together-Fighting Back® attempted to reduce the demand for illegal drugs and alcohol in Ward 7 and the eastern part of Ward 6 of the District of Columbia.

The project, part of the Robert Wood Johnson Foundation (RWJF) national program Fighting Back: Community Initiatives to Reduce Demand for Illegal Drugs and Alcohol, used a comprehensive approach that combined prevention, treatment, aftercare, education, health care, vocational and employment training, and family and community support.

Key Results

  • Implemented Project STAR, a substance abuse and life skills education program, in District of Columbia junior high schools.
  • Established a community resource center, which housed:
    • Substance abuse counseling, assessment and treatment referral services.
    • Programs to promote self-sufficiency, improve family functioning and guarantee child safety (e.g., job and training services).
  • Established the Providence Hospital/Marshall Heights Community Development Organization Intensive Outpatient Treatment Program.
  • Established the Strengthening Families Program, a family-skills training program to prevent substance abuse.
  • Established Project ASSERT, a program to train doctors and others how to identify and intervene with patients with alcohol and drug problems and other high-risk behaviors.

Funding
RWJF provided eight grants totaling $5,494,644 from March 1990 to January 2002.

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THE PROBLEM

By 1989, drug abuse and sales had created a state of emergency in Washington, according to the Marshall Heights Community Development Organization, a not-for-profit community-based organization that focuses on stimulating Ward 7's economic potential. The District of Columbia had become known as the "murder capital," "PCP capital" and "crack capital."

There were also alcohol-related problems. Drug and alcohol problems were prevalent in the far Northeast and Southeast sections of the city (which include Wards 7 and 6), which had a population of 103,000 (about 17 percent of the city's population). Wards 7 and 6 included the highest number of households on public assistance and the second highest unemployment rate in the city. The following statistics demonstrate the nature and extent of the problem:

  • From 1987 to 1988, the homicide rate in Ward 7 and the eastern part of Ward 6 jumped 200 percent among adults and 150 percent among juveniles, according to the Washington Police Department.
  • 87 percent of 185 juvenile narcotic-related offenses in 1988 were primarily for the distribution of, or possession with intent to distribute, cocaine and phencyclidine (PCP).
  • In 1986, 276 deaths in the District of Columbia involved drugs, an increase from 105 such deaths in 1977.

Existing treatment programs in Ward 7 and the eastern part of Ward 6 were overburdened, did not serve youth and lacked aftercare services.

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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® to assist communities of 100,000 to 250,000 people to implement a variety of antidrug strategies to address their local problems.

Fighting Back communities implemented 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. Community projects received funding starting in 1990.

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THE PROJECT

The Fighting Back project in Washington, called Working Together-Fighting Back, began in 1990 under the auspices of the Marshall Heights Community Development Organization. The overall objective of the project was to reduce the demand for illegal drugs and alcohol in Ward 7 and the eastern section of Ward 6, which were adjacent to one another, but separated from the rest of the city by the Anacostia River. (In 1996, the District of Columbia redefined its wards and the eastern section of Ward 6 became part of Ward 7.)

The primary strategy was to be comprehensive and include a wide range of activities and programs: prevention, treatment, aftercare, education, health care, vocational and employment training, and family and community support.

Phase 1 of Fighting Back

During Phase 1 of Fighting Back, program sites were required to show that they could reduce the demand for illegal drugs and alcohol by combining their resources into a unified effort. Expected outcomes included: (1) a measurable and sustained reduction in the initiation of drug and alcohol abuse among children and adolescents; and (2) reductions in drug- and alcohol-related deaths, injuries, health problems, on-the-job problems and crime. RWJF realized that some of the anticipated outcomes could only materialize in the longer term.

During the first two grants (ID#s 016524 and 017924), the project team planned the Fighting Back project, including establishing a Citizens Task Force composed of community leaders to govern the project. During the third through fifth grants (ID#s 019766, 021713 and 024540), the project team focused on youth and conducted activities related to:

  1. Prevention/intervention/early identification.
  2. Community empowerment.
  3. Treatment.
  4. Public awareness.

Phase 2 of Fighting Back

In 1996, RWJF concluded that tighter targeting and focusing of the program in some of the existing sites might facilitate an adequate test of the program's unified, community-based approach. In 1997, the National Program Fighting Back moved into Phase 2, in which program sites were required to concentrate on their most important substance abuse problems, using a strategic plan that focused on measurable objectives and obtaining measurable changes in those areas.

During the sixth and seventh grants (ID#s 031928 and 032964), Working Together-Fighting Back narrowed its focus to addicted women, adolescents and men who lived in and around four public housing communities in Ward 7. The last grant (ID# 041258) funded the project to transfer its treatment program to Providence Hospital and develop an aftercare program.

Other Funding

Over the course of the project, Working Together-Fighting Back collaborated with government agencies/departments, hospitals, schools and others. Through November 2001, the project attracted more than $17.9 million in funding, including grants from the W.K. Kellogg Foundation ($4.2 million), Annie E. Casey Foundation ($3.5 million), Freddie Mac Foundation ($1.4 million), District of Columbia Department of Human Services ($916,683) and U.S. Department of Housing & Urban Development ($750,000).

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RESULTS

Over the course of these eight grants Working Together-Fighting Back:

  • Worked to implement Project STAR (Student Taught Awareness and Resistance) in District of Columbia junior high schools. The program covered use and abuse of various legal and illegal substances, socialization skills and dealing with peer pressure to use cigarettes, drugs and alcohol. More than 4,000 students participated.
  • Established a Youth Advisory Board to increase youth involvement in decision-making and shaping prevention activities for youth. Twenty-five youths served as project consultants and peer leaders who promoted substance abuse prevention.
  • Worked to implement the Fundi Freedom School, an alternative learning experience, in five elementary schools. The after-school and summer Fundi Freedom School encouraged academic excellence and leadership skills through cultural and educational enrichment while keeping children safe. Some 750 children participated.
  • Established a community resource center. The John A. Wilson Community Resource Center, later renamed the East of the River Family Strengthening Collaborative, housed: (1) Working Together-Fighting Back; (2) substance abuse counseling, assessment and treatment referral services; and (3) programs to promote self-sufficiency, improve family functioning and guarantee child safety (e.g., job and training services).
  • Established the Providence Hospital/Marshall Heights Community Development Organization Intensive Outpatient Treatment Program. This program provides substance abuse education; individual, group and family counseling; life-skills management; health and nutrition education; and a structured aftercare program (including relapse prevention, Narcotics Anonymous and Alcoholics Anonymous, and counseling).
  • Established the Strengthening Families Program, a family-skills training program to prevent substance abuse. This course is designed to reduce risk factors for substance abuse and other problem behaviors in high-risk children, ages seven to 11. It focuses on improving family relationships, parenting skills and children's social and life skills.
  • Established Project ASSERT, a program to train doctors and others how to identify and intervene with patients with alcohol and drug problems, as well as those with high-risk behaviors. This program sought to increase access to substance abuse treatment and provide the necessary referrals in emergency rooms, outpatient clinics and primary care offices. Project ASSERT trained 79 doctors, nurses, other health care providers and social service providers.
  • Worked to expand health care coverage under Medicaid, which increased the number of people eligible for substance abuse treatment. Project staff worked with the District of Columbia Medicaid staff to increase the percentage of residents who were eligible for Medicaid. The District of Columbia extended Medicaid eligibility to families with incomes below 200 percent of the federal poverty level and childless adults with incomes below 50 percent of the federal poverty level.
  • Conducted an ongoing public awareness campaign. Project staff increased awareness of drug and alcohol abuse through promotional materials (e.g., T-shirts), special events (e.g., walk-a-thons) and media coverage (e.g., in the Washington Post, and local television and radio shows).

Communications

Project staff disseminated information about Working Together-Fighting Back through reports, brochures and fliers (see the Bibliography). The project was covered by local media.

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LESSONS LEARNED

  1. Ensure that policy-makers understand the problem a project is addressing and its impact. Many D.C. City Council members did not understand how substance abuse was related to health care costs and other health problems. Helping legislators to understand this would have created "a better road for Fighting Back, the patients and the city," said Project Director Loretta Tate. (Project Director)
  2. To effectively reduce substance abuse, community norms against behaviors that support substance abuse are necessary. When substance abusers return to their communities after treatment, the community must support them. Working Together-Fighting Back included family and community support. (Project Director)

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AFTER THE GRANT

Some components of Working Together-Fighting Back continue under the auspices of the Marshall Heights Community Development Organization and other organizations. For example, the Marshall Heights Community Development Organization continues to run the East of the River Family Strengthening Collaborative, and Providence Hospital continues to run the outpatient treatment program. The Marshall Heights Community Development Organization incorporated the comprehensive approach to substance abuse developed under Fighting Back into all of its activities.

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GRANT DETAILS & CONTACT INFORMATION

Project

Working Together-Fighting Back(R)

Grantee

Marshall Heights Community Development Organization, Inc. (Washington,  DC)

  • Amount: $ 99,983
    Dates: March 1990 to February 1991
    ID#:  016524

  • Amount: $ 50,000
    Dates: March 1991 to February 1992
    ID#:  017924

  • Amount: $ 599,916
    Dates: March 1992 to February 1993
    ID#:  019766

  • Amount: $ 1,208,573
    Dates: March 1993 to August 1994
    ID#:  021713

  • Amount: $ 1,429,749
    Dates: September 1994 to April 1997
    ID#:  024540

  • Amount: $ 153,880
    Dates: June 1997 to September 1997
    ID#:  031928

  • Amount: $ 1,697,623
    Dates: November 1997 to October 2000
    ID#:  032964

  • Amount: $ 254,920
    Dates: May 2001 to January 2002
    ID#:  041258

Contact

Loretta Tate
(202) 396-1201
l.tate@mhcdo.org

Web Site

http://www.mhcdo.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.)

Book Chapters

Falco M. "Helping High-Risk Kids." In The Making of Drug-Free America. New York: Time Books, 1992.

Articles

Gabriel GJ. "Fighting Back Update." Community Development Bulletin, 10(2): 1, 1990.

Gabriel GJ. "Fighting Back Update." Community Development Bulletin, 11(1): 1, 1991.

Reports

Fighting Back News and Information from the MHCDO Substance Abuse Prevention Program. Washington: Marshall Heights Community Development Organization, May 7, 1990, May 16, 1990, April 1992 and June 1992.

Marshall Heights Community Development Organization Annual Report 1992. Washington: Marshall Heights Community Development Organization, 1992.

Marshall Heights Community Development Organization Fighting Back Initiative Report to the Community. Washington: Marshall Heights Community Development Organization, 1994.

Marshall Heights Community Development Organization 1994 Annual Report. Washington: Marshall Heights Community Development Organization, 1994.

Marshall Heights Community Development Organization 1995 Annual Report. Washington: Marshall Heights Community Development Organization, 1995.

Fighting Back Initiative Community Report, 1999. Washington: Marshall Heights Community Development Organization, 1999.

Fighting Back Epidemiology Report, 1999. Washington: Marshall Heights Community Development Organization, 1999.

Audio-Visuals and Computer Software

Across the River, A Community Dialogue, a 1:56 minute videotape. Washington: Hedrick Smith Productions, 1995.

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

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