RWJF Scholar examines neighborhood-based death rates from opiate-based painkiller overdoses, compared with heroin overdose deaths.
San Antonio Fighting Back® worked from 1990 to 2003 to plan and implement a comprehensive system of substance abuse prevention, treatment and aftercare services in the southeast quadrant of San Antonio.
The project, part of the Robert Wood Johnson Foundation (RWJF) national program Fighting Back: Community Initiatives to Reduce Demand for Illegal Drugs and Alcohol, primarily acted as a neutral facilitator among various community coalitions in order to establish a continuum of services addressing substance abuse, drug-related crime and violence.
RWJF provided eight grants totaling $6,636,924 for this project from March 1990 to August 2003.
The focus of San Antonio Fighting Back® has been the southeast quadrant of San Antonio, an area of 24 square miles, defined by the attendance zones of two high schools in the San Antonio Independent School District.
In 1991, its population was 106,209; 45 percent were Hispanic, 31 percent were Anglo-American, and 28 percent were African-American. The majority were blue-collar, although a significant number of middle-class residents remained in the quadrant. Between 29 percent and 34 percent of the residents of this area had incomes at or below the national poverty line. An estimated 25 percent of the adult population was illiterate, and the dropout rate among all youth was 39 percent.
When San Antonio Fighting Back began, there were few firm statistics on the alcohol and drug abuse problem in San Antonio. However, the following was known:
Promoting health and reducing the personal, social and economic harm caused by substance abuse is one of RJWF'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. Sites received funding starting in 1990.
San Antonio Fighting Back began in 1990 under the auspices of the United Way of San Antonio & Bexar County. The overall objective of San Antonio Fighting Back was to plan and implement a single, communitywide comprehensive program of substance abuse prevention, treatment and aftercare services in the southeast quadrant of San Antonio. The primary strategy was to serve as a neutral facilitator of coalitions to establish a continuum of care to effectively address substance abuse, drug-related crime and violence by using consolidated resources.
Organization and planning for the project was spearheaded by a coalition of San Antonio's civic leaders, city agencies, local organizations and the United Way of San Antonio and Bexar County. San Antonio Fighting Back efforts focused on building community relationships and designing targeted initiatives to reduce the demand for drugs and alcohol in a demonstration site that historically has been underserved.
San Antonio Fighting Back faced significant difficulty in establishing a governing committee that the community accepted as representative of their interests. In the second year of planning, the committee was adjusted to include representatives from each ethnic group in the target community, faith communities and a new project director. Rather than attempting to apply the same program to the entire target area, parallel, culturally sensitive programs were proposed for its different ethnic groups.
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.
Alfred McAlister, Ph.D., an expert in prevention research, helped design the strategy for Phase 1 (grant ID#s 016529, 019768, 021716, 024532, and 031941; March 1990 through August 2001). San Antonio Fighting Back identified five factors that previous research has shown are strongly associated with the early use of drugs. These factors (1) social norms supporting substance use and abuse; (2) school and employment experiences; (3) family processes; (4) cost and availability of drugs and alcohol; and (5) the neighborhood and community environment were targeted for public health interventions that, as in other Fighting Back sites, used individual, environmental, cost and availability strategies to address each problem.
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 Fighting Back national program 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 obtaining measurable changes in local objectives.
San Antonio Fighting Back entered Phase 2 in 1998. During the sixth and seventh grants (IDs# 033106 and 039034), San Antonio Fighting Back moved away from broad-based activities to focus on three specific problems in the target area and to emphasize the measurement of outcomes of efforts addressing those problems. The problems were:
During the last grant (ID# 043102), San Antonio Fighting Back worked to expand demand for substance abuse treatment by establishing coalitions to increase awareness of and demand for treatment and increase access to and availability of substance abuse treatment. In 2002, San Antonio Fighting Back became an independent not-for-profit organization.
Over the course of the project, San Antonio Fighting Back collaborated with many local, state and federal organizations, including schools, government agencies/departments, the faith community, foundations, community-based organizations, neighborhood organizations, the business community, the media and corporations.
Major partners include the United Way of San Antonio & Bexar County, the San Antonio Police Department, San Antonio Independent School District, Edgewood Independent School District, Harlandale Independent School District, Alamo Area Treatment Consortium, San Antonio Parks and Recreation Department and San Antonio Public Housing Authority.
Through August 2003, San Antonio Fighting Back attracted more than $119 million in funding; this included funding which San Antonio Fighting Back helped local agencies and organizations secure but did not directly administer. External funding came from the federal government (about $68 million), the state of Texas and the city of San Antonio (about $49 million), and foundations (about $1.2 million). Major contributors included the following federal departments: Justice, Housing and Urban Development, Health & Human Services, Education, and Labor; the Corporation for National Community Services; and the United Way of San Antonio and Bexar County.
Project staff reported these accomplishments under Phase 1 and Phase 2 of Fighting Back. San Antonio Fighting Back:
As reported in San Antonio Fighting Back, United Way 2000 Community Report on Substance Abuse Indicators for the East and Southeast Target Area (2000):
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, San Antonio, 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 San Antonio:
Project staff published community reports and newsletters, produced videotapes and a Web site, and made presentations about San Antonio Fighting Back at regional substance abuse prevention meetings. By partnering with the Partnership For a Drug-Free America, San Antonio Fighting Back conducted an extensive media campaign that included more than 15,000 public service announcements. (See the Bibliography for details.)
San Antonio Fighting Back continues to operate as an independent not-for-profit organization, with major funding from the United Way of San Antonio and Bexar County. San Antonio Fighting Back is continuing most of the programs begun under the RWJF grants and is also working to reduce underage drinking. Initiatives include participating in Texas Standing Tall, a statewide program to change policies to reduce underage drinking, and Too Smart to Start, a project in collaboration with the San Antonio schools to encourage students not to start drinking. San Antonio Fighting Back also serves as a resource for the schools.
The federal Strategic Prevention Framework State Incentive Grants, a $45 million program to help states build a solid foundation for delivering and sustaining effective substance abuse and/or mental health services, was designed based on San Antonio Fighting Back, according to Beverly Watts Davis, former project director and now director of the federal Center for Substance Abuse Prevention, which is administering the grants. The program will award five-year grants (starting in 2004) of up to $3 million each to states that use data-driven decision-making in their projects.
San Antonio Fighting Back(R)
United Way of San Antonio & Bexar County (San Antonio, TX)
Beverly Watts Davis
Darryl Boyce's Story
Darryl Boyce, 24, has been associated with San Antonio Fighting Back for half of his young life, first as a volunteer, now as an employee. He is currently coordinator for the Bicultural Organization for Leadership Development (BOLD) and Workforce Investment Act Coalition. For Darryl, Fighting Back has served as a crucial lifeline, a way to turn from self-destruction to self-actualization. He describes his previous life:
"I'm originally from Manhattan, and I got here in 1989. Both my parents were addicted to crack cocaine. My father sold it. That's how they became addicted to it. Then my mom sort of changed her life to take care of us. She moved my two brothers and my sister here to San Antonio. I was 10 and living in Atlanta with my grandmother, but I was getting into trouble. My grandmother sent me to Texas to be with my mom, because my mom had cleaned her life up. My father still wanted to do all the things that he was doing, selling drugs and using them.
"When my mom got here, she decided to kick the drug habit. She did it through prayer. But she picked up another bad habit, which was drinking. And she knew what that was doing, so [then] she left that alone. My father's serving time in New York City for armed robbery, and he won't be out of jail for the next 12 years. My youngest brother is in jail for murder. And my middle brother is in jail for drugs, although he's coming home next week. Drugs are just a part of my life.
"All my life, all I knew was drugs. I learned everything, from cooking dope to selling it. I knew how to package, I knew who to get it from. So when I got to San Antonio, I started doing that. I was 11, 12 years old, selling drugs, right across the street from the community center. I was also in a gang East Terrace Gangsters. At that time in San Antonio, if you weren't in a gang, you were nobody. Then Ms. Tippens, here at Fighting Back, came to my school. And she says, 'Darryl, I know what you've been doing. You need to leave the gang alone, leave the dope alone and come volunteer with me.' And I was like, 'Volunteer? I'm making four, five, six hundred dollars a day selling dope. Why should I volunteer?' So she says, 'Well, you're going to come. You're going to volunteer.'
"She brought up what was going to happen if I got busted selling dope. And the other thing she brought up (this was the summer of '90) was that I had seven, eight friends who were killed guys who sold dope with me, sold dope for me. We were all in the same gang. That sort of grabbed me. I thought about it for awhile and I decided I needed to change. So I called her, she picked me up after school, brought me here to the community center, and she began to mentor me. And I just started enjoying it. I began to like doing what I'm doing.
"When I came to Fighting Back, one of the first things Linda [Ms. Tippens] taught me about was organizing. I attended a lot of neighborhood association meetings through Weed & Seed and the other programs that Fighting Back had. And I learned a lot. So, I tried to use that in my life as much as possible. By the time I got to high school, I had already quit doing and selling dope. But I was still in the gang. And the gang they kind of looked at me as, you know, 'Well, he's trying to do better.' So they pretty much left me alone, and I was able to bring what I learned out in the streets to the school. My ninth-grade year, they were having class elections, and because I learned organizing from Fighting Back, I was able to use some of my organizing skills to become class president. And I said, 'If I can do this at school, let's see what I can do in the community.'
"Well, it started off with BOLD Bicultural Organization for Leadership Development. We helped take down some of the negative alcohol and tobacco billboards that were on the East or Southeast side of San Antonio. We had something called billboard countdown. We basically went to the billboard companies and asked them to take down their negative alcohol and tobacco billboards. And they were all like, 'No. No. No. This is how we make our money.' So we organized and put the media on them. They really hated that. We were the youth, the voice for our community, saying 'Hey, your billboards are polluting our community. We want you to take them down.' We also had a list of demands that included job training. You know, 'You're in our community, making money off our community; we want you to train some of us to do what you're doing.'
"Well, in 2000, Congress made it illegal for them to put up negative alcohol and tobacco billboards two hundred yards from schools, cemeteries, churches and places where kids congregate. And the billboard companies also gave us $200,000 to put up positive billboards. We had a billboard contest, where we had youth make all these positive billboards. One had a picture of the world with a syringe close to it, and a Band-Aid over it, saying 'Don't Use Drugs.' That billboard [message] was plain as day.
"About two or three weeks ago, I saw a billboard that hadn't been taken down even two, three years after the law changed. You can still see it from the highway. Now I'm organizing youth councils through the San Antonio Housing Authority to do something about it. We want our youths to speak for themselves. We want them to have a voice in resident councils in the community and this is their chance.
"Before I met Fighting Back, I had to watch my back, basically. I was doing a lot of wrong. Now that I'm here, I'm a little bit more educated to what's going on. I know what affects my community. I know what affects me as a person. And I know what's going to affect my seven-month-old son, Avante Keyshawn Boyce."
Wray Hood's Story
Wray Hood was serving as president of the Coliseum/Willow Park Neighborhood Association in 1992 when she first came in contact with San Antonio Fighting Back. Here she describes how her involvement with the Fighting Back Coalition's Weed & Seed program helped change her neighborhood for the better:
"At that time, my neighborhood had begun to decline, with many people moving out, others dying, leaving those properties to be rented by slumlords to people who cared less for the neighborhood. And then, too, the area just west of our neighborhood was overrun and inundated with vacancy, vagrancy and everything else undesirable that one could think of the empty, ugly structures were rotted and bedraggled. At night, and sometimes even during the day, vagrants or people dealing drugs were causing trouble for residents. The area was full of trash, debris, old mattresses, bed springs, sofas, overgrown by weeds, inhabited by vermin and scorpions and I'm sure, snakes, too.
"So we worked with Fighting Back. We were able to get the attention of the city, county and state and even some federal attention. We had a bus, and we loaded everybody up to show them what was going on in the neighborhood. Then we went before city council and they were willing to foreclose on the owner of those properties. That's how we got the wheels of justice turning. That was the first of many victories. We ended up gaining 55 to 60 brand-new homes in that area with the help of Greater San Antonio Builders that came forth and built those new homes.
"The [Fighting Back] Weed & Seed people worked with us, we used their guidance, we used their insight and their counseling. We've had them come out and help us cut down undesirable vegetation in and around elderly people's homes. We successfully shut down one of the nightspots I guess you can call it a pub or a joint and Fighting Back was right there with us. They gave us legal help. Weed & Seed has helped us paint houses for elderly people. The state of our neighborhood now, compared to when we started out with Weed & Seed, is better by far, because we were able to get rid of that terrible, forsaken area down there."
David Coronado's Story
David Coronado is the adviser for Youth Crime Watch at Rhodes Middle School. The program was originally funded by San Antonio Fighting Back. After a year of support, Fighting Back was forced to cut funding to the program at Rhodes due to a lack of funds. However, because of the commitment and passion of Coronado and others at the school, the program continues, and is accomplishing a lot against daunting odds. Coronado talks about what the program has meant to him and his students:
"I started Youth Crime Watch here three years ago and the kids really loved it. We did a lot of really positive things with our community, the school and also with the students. We participate in a lot of community service projects. We work on people's houses surrounding the school we paint their houses, pick up trash, cut yards. We do campus cleanups here at the school, too, where we pick up trash and paint the school. We've gone to the nursing homes in our community and helped decorate for the different holidays. We've taken up collections and donations for the Salvation Army, held clothing drives and food drives, did a fund-raiser for the Leukemia Society and raised $800 for Pennies for Patients.
"The Crime Watch part works like this: The kids report any type of incident they see at the school fights, kids who are carrying drugs. They bring it to my attention and then we turn it over to the police officer on campus. Out of my 26 members, I had 16 of them make AP honor roll. It's changed a lot of their lives, as far as their attitude, grades and behavior at home. The parents have seen the changes in the students' behavior and so have the teachers.
"When we lost Fighting Back's help, we talked it over with the kids and decided to keep the program running and we've been doing it for two years now on our own. We don't get any kind of funds or anything. It depends a lot on donations. I had to hustle and try to get all the stuff that we need. I have actually written letters to the principals, trying to make sure that we keep this program up and running because it's made a big difference."
Coronado is passionate about his work and fiercely committed to the young people he counsels. As an example, he speaks of Sammy, a former vice president of the program:
"Sammy was brought to me because he was failing classes, he had an attitude, just didn't care much about anything. He didn't have a goal in life. Then he turned himself around completely. His grades went from Ds and Fs to Bs and Cs. He ended up doing better with his family at home. His parents came in and talked to me about how he participates now with his younger brothers and sisters, where before he used to always just fight with them. He started doing chores around the house, without asking for something in return. He ended up being a real strong leader in all our community service projects, getting the other kids involved.
"And when he went on to high school, he had a goal to be a person who ran a community service center. He wanted to help other youths the way I had helped him. It was a big change for him someone who never wanted to help anybody but himself and always thought about himself, turned around and now wanted a future in helping those in need. He had felt like there was nobody there for him. He felt like everybody was always telling him he wasn't going to make it; he was no good; he was a loser. He ended up finding the right program and it turned him around. And being the type of person he was, he wasn't embarrassed to say that he was part of the Youth Crime Watch.
"When I was growing up, I was a person like Sammy. I had a rough childhood and there were not programs like this. I know what it's like when people tell you that you're nobody; you ain't going to make it. So when I came into the school district, I told myself that I would work with these students. When these kids come to me, I know what they're going through. And when Sammy came to me, it was just another goal for me to make sure that this kid succeeded. And at the end, it makes me proud."
Charles Flowers' Story
Rev. Charles Flowers and his wife, Janice Marie, are the founders of Christian Boot Camp (CBC), a 32-day in-residence summer boot camp for teens. Here he describes the camp, and how San Antonio Fighting Back has helped it succeed:
"These kids come [to camp] for a number of reasons. Some want to challenge their limits, mentally, spiritually and physically. Others have been appointed to us by their parents because they have caused trouble at home. They're not in trouble with the law [but] only because the trouble has not been discovered by the law. Then we get a smaller group of people who actually have been on probation and have a probation officer. The probation officer will unofficially say, 'If you go to CBC and finish it, it will be good for you. If you don't finish it, it won't be good for you.'
"A large portion of the curriculum has to do with community service. We believe hands that build something are less apt to tear it down, so we make their hands busy in the community. We dedicate half of each day, for 32 days, to community service. At first, I didn't know where to find the areas in the community that needed our service or the resources with which to do it the paintbrushes, sanders, machinery, lawn mowers. So, I went to San Antonio Fighting Back and I talked with Ms. Linda Tippens. Ms. Tippens found us community service projects to do. That was our first introduction to San Antonio Fighting Back, in '95. And she's continued to do that from that day to this. She even hooked us up with the city, who found us even more areas where we could do community service.
"In '97 we started to charge a fee for the first time, because our numbers were growing so. We started with 28 teens in 1995, grew to 61 teens in 1996 and had 87 in 1997. It was just too much for us without some kind of financial assistance. In 1998, San Antonio Fighting Back started to financially support CBC with a three-year commitment of $30,000 to $35,000 per year. That provided us an opportunity to buy uniforms, purchase food, make some additions and modifications to the program, such as a ropes course the trainees go through. Because San Antonio Fighting Back came on board with the funds, we've gotten the attention and assistance of a couple of other foundations that have kicked in and started funding us when those three years were up.
"San Antonio Fighting Back has continued partnering with us financially since then, and I really can't express my thanks enough. Since 1999, they have funded our participation in their Young Offenders Program. Young people between 17 and 29 come to us by way of the courts, either on felony or misdemeanor probation. Their conditions of probation are amended to include the completion of Christian Boot Camp, so it provides them an incentive to finish, because if they don't finish, they get an MPR a motion to revoke the probation and a violation report that puts them back in the corrective judicial cycle. There would be no CBC involvement in the Youth Offenders Program if San Antonio Fighting Back weren't financially backing us. Four young offenders participate in CBC on average each year. At the beginning of it, there are a lot of tears because they don't want to be there. At the end, there are a lot of tears because they don't want to go."
(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)
San Antonio Fighting Back: Success Comes in Cans: 1996 Community Report. San Antonio: San Antonio Fighting Back, 1996.
Celebrating the Journey: San Antonio Fighting Back Community Report 1998. San Antonio: San Antonio Fighting Back, 1998.
Bridging the Gap: San Antonio Fighting Back, the United Way 2000 Community Report. San Antonio: San Antonio Fighting Back, 2000.
San Antonio Fighting Back, the United Way 2000 Community Report on Substance Abuse Indicators for the East and Southeast Target Area. San Antonio: San Antonio Fighting Back, 2000.
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): 8490, 2005. Abstract available online.
San Antonio Fighting Back. Video about San Antonio Fighting Back. San Antonio: San Antonio Fighting Back, 1995.
San Antonio Fighting Back Inner-City Games. Video about San Antonio Fighting Back's inner-city games. San Antonio: San Antonio Fighting Back, 1995.
San Antonio Fighting Back Boot Camp. Video about San Antonio Fighting Back's boot camp program for youth offenders. San Antonio: San Antonio Fighting Back, 1995.
www.safb.org. San Antonio Fighting Back's Web site contains information about the program, including its history, target area, programs and substance abuse indicators. San Antonio: San Antonio Fighting Back.
Report prepared by: Antonia Sunderland
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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