Episode #1: Prevention Partnerships Across State Lines (Siouxland CARES)

Guest: 

• Rachel Lundgren, Director, Siouxland Cares

Location: 

• Sioux City, Iowa 

About:

• In this first episode, hear how one community coalition works to address substance misuse, bullying, and mental health to strengthen their tri-state area. Rachel Lundgren, the Director of Siouxland CARES, also shares how youth are involved across their prevention activities. 
   
  As a reminder, the views expressed here do not necessarily represent the views of SAMHSA or the U.S. Department of Health and Human Services. 

Transcript

TOM: Welcome to our new podcast series: Communities Talk About Prevention. We're glad you're here.

I'm your host, Tom Colthurst. I’ve served many roles in supporting the prevention of alcohol, tobacco, and other drug use, both within community public health and higher education settings. For several years, I’ve also supported SAMHSA’s Communities Talk initiative.

Today, you’ll hear how organizations have planned and hosted events or activities to support substance use prevention at a local level. Most importantly, they’ll share tips on what worked for them, which we hope will inspire you to get involved in prevention in your own community. 

This podcast is brought to you by the Substance Abuse and Mental Health Services Administration, also known as SAMHSA. Communities Talk is a national initiative sponsored by SAMHSA. 

As a reminder, the views expressed here are not necessarily those of SAMHSA or the U.S. Department of Health and Human Services. Let’s begin!

Tom: Well, good morning, or good afternoon, Rachel. Thank you for joining us today. And to get us started, could you introduce yourself and tell us a little bit about the organization you work for?

Rachel: Absolutely, thanks so much, Tom. My name is Rachel Lundgren, and I’m the director of Siouxland Cares. We’re a community coalition in Sioux City, Iowa. We serve the whole tri-state area around Sioux City. So the metro area is about 150,000 population, to give you a picture of where we are. That’s Iowa, South Dakota, and Nebraska that we serve.

And Siouxland Cares actually stands for Community-wide Awareness, Resources, Education, and Support. And we’re a community coalition. Our vision that we’ve set forth is to empower our community members to help make Siouxland a safe and healthy place for our youth. We actually were formed 35 years ago as a result of the United Way in the area, did a needs assessment, and one of the top areas that came to focus was underage substance use.

And from that we formed a coalition, and 35 years later we have, gosh, around 370 volunteers and community partners that work toward making Siouxland safer for our youth and families, especially related to substance misuse, bullying, and just wellness.

TOM: How do underage drinking and substance use affect your tri-state service area?

Rachel: The good news is that we’ve actually seen a steady decline over the past 20 to 30 years in substance misuse. We get to do a survey of the area. We generally do middle school and high school youth. And in 2004, we saw that about 30 percent of the sixth, eighth, 10th, and 12th graders in our area said that they had been binge drinking. And in our most recent survey that we put out in 2019, only 6 percent of the sixth, eighth, and 11th graders reported binge drinking. So that’s the great news, that we have seen decreasing in drinking, which we have seen across the country as well. There’s been lots of positive efforts.

However, we do know that it does still remain an issue. We’re very fortunate to get to coordinate the Mayor’s Youth Commission for Sioux City, so we have access to youth and can talk to them about the issues that they’re facing, and we always ask them, what are some things that you think we should address? And every year substance misuse comes up. Alcohol, especially vaping has come up quite a bit lately. Our surveys still show that quite a few youth, about 35 percent, said that it’s easy to access, or not difficult to access alcohol or vaping products. 

I also am still concerned that about 16 percent of the 11th graders reported recently that they’d ridden with a driver of a vehicle who was under the influence of alcohol. So we are still concerned about the use of substances in our community, especially for the young people. In terms of our community for across the age groups, we see a slightly higher than state average for tobacco use and a slightly lower than state average for excessive drinking. However, we do know that Iowa compared to other states is already a little bit above for excessive drinking.

So we know that, even though we focus more on youth, we also have to definitely provide education for adults, because they model for the youth and we want our whole community to be healthy.

TOM: Thank you, Rachel. I was impressed that you have that youth survey with all that data on your website with data going back to 1999. And I was able to chart the trends, and just as you said, there are some indications that your work or the community’s work and commitment are paying off. For example, in 1999, just 27 percent of the young people said that it was difficult to access alcohol, but by 2019, the last year of the survey, it was up to 65 percent. 

So something must be paying off. So why did you decide to get involved with the Community Talk program from SAMHSA?

Rachel: You know, we’ve been participating since 2010, which was a little bit before I was involved in Siouxland Cares, but our previous Executive Director, Linda Phillips, was very plugged in, both in our region and locally, and then also nationally about what was going on and how we could partner. I think that partnering with organizations and trying to get messages that are bigger than just Siouxland Cares’ message has always been a really big, important part of our organization. And I’m just very glad that we’ve been able to participate for many years.

TOM: And what was your activity most recently in 2021?

Rachel: So, in 2021, our topic was underage drinking and mental health. And we did an online Zoom version of our town hall meeting. 

TOM: And why did you choose that particular format? 

Rachel: So, we picked that format because we had already switched, like many people, to have to have quite a few of our meetings online with COVID-19. That seemed to be the most popular, using the Zoom platform for many of our meetings that we’d used. Also, we talked with the youth and a lot of the classes that they’d used had been on Zoom, so they felt pretty comfortable with the platform. Adults had also expressed that it was something they felt comfortable with.

We also, from some of our previous meetings, have learned that by also broadcasting it on Facebook, people who were not available to attend the meeting at the time could then watch it later, which has always been something that we’ve struggled with to make sure that parents who want to attend but have other things in the evening can be able to still get that information. We partnered with another organization in our community called Growing Community Connections, and they do a monthly large Zoom meeting. So, they had capacity in case we went over the hundred that we are limited to in our Zoom to be able to accommodate a larger group who participated.

Growing Community Connections also very kindly gave us some tech support. They have individuals who could monitor the chat in the background and give our speakers a little bit of warning if they were getting closer to the time that they were done. So, it just seemed to work the best from feedback from our community and what we had available. 

TOM: So, you did get a small planning stipend from SAMHSA. Was that important and how did you go about using it?

Rachel: Yes, absolutely. So, we stretched that stipend for our staff to be able to get community feedback from focus groups with our youth. We also were able to create some short advertising videos with that staff time. We loved having a couple of our local representatives. We had a council person from Sioux City, a city manager from south Sioux who made little videos inviting the community to attend. 

We also were able to use that time to create the organization of the event, recruit our presenters, create the evaluation, and we had follow-up little videos that we did as well to answer any questions that didn’t get answered during the video. And then by having all of that time and staff help, we were able to secure more in-kind support from the community, such as Growing Community Connections being able to provide the room. Also, our expert speakers then also were able to provide their time freely. And we were really grateful for that planning stipend to be able to give us the opportunity to do that.

TOM: Could you briefly outline the agenda for that 90-minute activity?

Rachel: Yes. So from what we’d done with previous town halls, we generally would have breakout sessions. We decided not to do that for this activity just because we found in some meetings when we did breakout sessions some of our attendants would drop down and we wanted to keep the attendance for the full meeting. So, we decided to have the first half of the meeting be presenters sharing information about substance misuse, especially alcohol and also mental health. And then we had a panel discussion in the second half of the meeting.

For our first half of the meeting, we had Dr. Ed Bottei of the medical, he’s the Medical Director of Iowa Poison Control Center. Unfortunately, Ed did recently pass away. He was a wonderful gentleman, and we were so grateful to have his participation. He did a great job discussing alcohol’s effect on the brain, both short-term and long-term. And then we did also have Jennifer Jackson, who is the Executive Director of Heartland Counseling, be able to share about impact of substances, but also just mental health in general and a concerning suicide trend that we’d seen at the time that we continue to focus on.

We gave opportunity then for parents and youth to ask questions. And then in the second half we had more panelists come on for a real question-and-answer session. And so, we had law enforcement to be able to talk in case any questions came up about the legality. So, we had the Chief of Police from South Sioux City attended, a school resource office – officer from South Sioux City attended, and then also from Sioux City they had a community outreach officer.

We did also invite another therapist who has experience working with those with substance use disorders as well as those experiencing trauma or have experienced trauma and also worked closely with the Native American community. That gave us a lot of information to get through in an hour and a half. Also, we, earlier in the evening, had a separate meeting for our younger children who wanted to participate, so elementary, middle school.

We didn’t record and put that online just so they felt comfortable asking questions, but it gave us an opportunity to work with younger kids, with families, and still address some of the more serious topics.

TOM: Now you attracted over 200 people to this town hall meeting.

Rachel: Yeah.

TOM: That was the in-person part of it. How did you go about promoting it?

Rachel: So, we were very fortunate with the Mayor’s Youth Commission to already have access to quite a few youth who were able to, first of all, attend themselves and have their families attend, and then also broadcast it out within their schools. They did a great job of that. As I mentioned earlier, we did record some videos of community leaders inviting individuals to attend. The South Sioux City Schools and the Dakota Valley Schools — which are bigger community school districts that don’t have the Mayor's Youth Commission — sent out information to their parents, which we were very grateful for them to share that as well.

And then Growing Community Connections, which we partnered with, has over 600 partners who also were able to share the information. So, we were very fortunate for all the community support and getting the word out about the meeting.

TOM: And what did you see as follow-up steps. What came out of the meeting?

Rachel: So right away after the meeting we did film just a couple short videos related to vaping, because some of the questions that were sent in were about vaping, which was not necessarily the topic, but it did come up, and any kind of substance misuse questions we wanted to answer. So, we just put a couple of those videos on social media and sent them out. We’d interviewed some individuals from our local treatment centers and then also from the Health Department.

After that, also, there were more questions related to the mental health topics that had come up, so we did do a second, smaller town hall meeting specifically about those topics that came up that was not in the same scale as this, probably had about 30 to 40 people, but just to answer some of those questions. And then we also will be looking to do another town hall meeting this year, actually, once again, not on the same scale as the Communities Talk, but to address some of the alcohol questions that came up and then also bullying did come up in some following-up questions. So, lots of conversations were started because of the meeting.

TOM: Interesting that vaping was one of the topics. Help me understand the law in Iowa. What is the retail availability of vaping? Is retail compliance check something that you do?

Rachel: So, we do help with the compliance checks. In Sioux City they actually have another organization that provide the youth. We in South Sioux City, however, in Nebraska do the compliance checks for vaping and tobacco. And actually, previously we’d only done alcohol. It was just this past year that we added the tobacco and vaping compliance checks. Once the age was lifted to 21, it made it much easier for us to be able to provide youth that still, you know, were obviously much younger than 21, were not tricking businesses when we go into them, but to be able to monitor to make sure that they understand that you have to be 21 to purchase these products and also to check that they’re training their employees. 

We did our first one this past year in 2021, and we had only 70 percent compliance with the places that we stopped. So, we have also been continuing to provide education to those businesses. Before we did the compliance checks the first time for vaping in South Sioux City, me and an officer did visit all the retail establishments, provide them a letter, let them know we’re going to be doing these checks, and see if they had any questions, encouraging the use of scanners as well for IDs. 

So, we want the businesses to be successful because we want them to be checking IDs. And so, we definitely want to continue with those compliance checks to make sure that staff are being educated and that they have the tools they need to prevent those sales.

TOM: I noted not only in terms of the panelists for your town hall meeting, but in your annual report and other information on your website, your advisory board, etc., that you do have a good share of law enforcement participation. Could you comment on how that partnership works? And I know there are multiple police jurisdictions in your service area.

Rachel: Yes. And I think we’ve been very, very fortunate with how open law enforcement in our community has been to partner with all of our community agencies. In specifically Sioux City, the amount of community policing is amazing. They attend hundreds of community events every year. They’re more than willing to engage with us in any way that they think is going to benefit the community. In South Sioux City we really enjoyed having the partnership of doing those compliance checks. And also working just with the SROs and the schools for getting feedback from them about what they’re seeing within the schools, especially related to vaping and alcohol.

And even in South Dakota, which is a little bit smaller school districts that we worked with, they sometimes will have SROs or Sherriff departments who communicated with us about what they’re seeing in the schools. So, we’ve been very grateful to have that partnership and also to have open communication about what kind of, I guess response to substances. They partner with some of the local organizations to provide education sometimes rather than just punitive responses to things like vaping or alcohol use by young people, so very grateful for them. 

TOM: You mentioned an SRO officer and I think I know what that means, but help me –

Rachel: It’s a school resource officer. Some communities do have school resource officers within their schools and others do not.

TOM: Is the police much of a source on alcohol problem indicators among youth? I know you have the survey data, but are you hearing from police about unruly party laws, about impaired driving? Do you hear anything from the Iowa Alcohol Beverage Division about infractions or retailer misconduct? 

Rachel: Yes, actually we’ve gotten a lot of information and data in the past, and not necessarily is all that information on the Siouxland Cares website, but we actually work very closely, we contract with Source for Siouxland, which is another organization that’s community planning and data. So, we collect a lot of that data for Source for Siouxland that then they share on the Source for Siouxland website. So, anyone who’s in our area utilizes that to look at some indicators that are beyond just the youth alcohol use. 

And we also have a tri-state drug taskforce in our area that we’ve also gotten a lot of feedback from them about substances that they’ve collected and sometimes looked at that in terms of what other things are we seeing in the community. For example, we saw an increase in meth from that tri-state drug taskforce. We also were seeing an increase in child abuse complaints at the time, so looking at how some of those can tie together is very important.

TOM: Well, it’s interesting to hear you talk about statewide networking. So, you are plugged into statewide networks and perhaps even national groups, organizations similar to yourself.

Rachel: Yes, absolutely. And then in Iowa too there’s an AC4C coalition. So, the coalition of, a lot of prevention coalitions within the community – or across the state. And so that gives us great opportunity to hear about what’s happening in other areas of the state, and we’ll also be working with them on a new media campaign that they’re doing, and it’s just great to be able to work across the state. And we work in three states too, so we get to hear a lot about what’s going in the area around us.

TOM: That’s good to hear. Would you have tips for other groups either within your state or your tri-state or nationally who are contemplating looking at the next cycle of Communities Talk? What advice would you have for them?

Rachel: I think collaboration has really been the key to success that we’ve had with this event and with others. The time that you can spend building relationships with other organizations in the community is invaluable. We are very lucky, I think, with just the climate that we have in our community that a lot of the nonprofits are very open to partnering. We have a lot of focus with law enforcement, with other organizations on what can we do as a community. 

And I think by really focusing on what can we do together, how can each of these different areas impact a specific focus, it really can help move forward. Also, we definitely try to be data-driven, so we focus on what things are coming up, what items are bubbling up within our data, as well as not just the hard data we get back, but just feedback from young people who we talk to. We love to have focus groups and get feedback from those in the community who we’re really trying to impact. 

They say nothing about us without us, so really reaching out to those in the community has been very important.

TOM: Now that’s through the Mayor’s Advisory, Youth Advisory process?

Rachel: Yes, so we have the Mayor’s Youth Commission that we facilitate. And the great thing with that too is not only do we work with those youth — we have about 140 youth through that program — but also, they’re from all the different schools in Sioux City. We have a couple too in the surrounding areas who go to school in Sioux City but don’t live in Sioux City. So, they’re also connected to a lot of youth in their different communities.

And then we did recently end the program, but we previously also had the Teen Court Program in South Sioux City that gave us access to youth as well.

TOM: A-ha. And I noted from your website that you are dealing with a couple of colleges and universities in your area too.

Rachel:  Yeah.

TOM: That sometimes presents another dimension of problems, particularly with regard to student underage drinking. Can you comment on what you’ve been learning about that particular segment of the youth audience?

Rachel: Absolutely. So, we’ve been really fortunate that two of our schools in the area participate in the Basics Program, which is a program, specifically we use it for the, all the freshmen who come into both Western Iowa Tech Community College and Briar Cliff University. They take it preventatively. First you check up to go online for them to learn a little bit about their own drinking or not drinking habits.

They fill out this kind of survey and get interactive responses. And then on both campuses, they also have the full Basics Program for anyone who has a violation of the alcohol policy. So, we fund that e-checkup to go — technology for them to use, and we also trained their counselors in Basics for them to be able to provide counseling sessions for those underage who did have an alcohol violation on campus. 

And that was a great partnership we had previously with Rosecrance Jackson Centers, and when they had a grant that ended, that funded it, we picked up the funding and have had a really great time working with those two campuses in prevention.

TOM: And each, as I understand it, happens typically at the beginning of the fall semester, the so-called “red zone” when young people may be coming to higher education for the first time and free from the constraints of the home, and that’s a pretty precarious time nationally, the literature tells us. So, your program hits them right at the beginning then.

Rachel: Yes. And Western Iowa Tech too. Since they are a community college, they also do it in the second semester for other people who are joining because Briar Cliff also has people join the second semester, but Western Iowa Tech sees a greater number joining that second semester as well, so all of their first experience classes, whether they’re first or second semester, when the young people get on campus they participate. And then also we use the Basics for anytime anyone has an alcohol violation.

TOM: Let me pick up on something that I heard in the panel discussion from your town hall meeting. Officer Cleveland, one of the police officers participating in that panel discussion, mentioned TikTok, Instagram, and Facebook, and kind of brought up the whole social media thing and how that has almost an addictive property and brings young people in. Is the alcohol advertising that happens on social media something that comes to your attention? Do the young people talk about that at all?

Rachel: The big things we hear talked about probably are influencers using substances while they’re either – maybe they’ll be just having a conversation and they happen to be using it. The big thing that we see advertised by influencers that we hear about is vaping. I know that the alcohol still does happen, but the one item that does come to our attention a lot with young people is vaping, a video specifically about vaping that sometimes influencers will put out.

But, I do know that just from what I’ve seen too, there will be lots of TikTok videos or other types of social media videos or images that have a lot of alcohol in them. And some of them might be sponsored, some of them we’re not sure, but we have talked with some of the youth too about just noticing what’s going on within those videos aside from what they’re talking about as well.

TOM: Well, looking forward, what would you be looking at if there were another Community Talks opportunity?

Rachel: The town halls have gone over really well. So, I think that we’d want to stick, at least partly, with the town hall. With the success that we had with the online format, a conversation we’ve had about quite a few things is maybe have two events: have a live event for individuals who prefer to be in-person, and then also have an opportunity for the Zoom event, and to have it continue on social media to be able to be accessed by parents and youth who can’t attend the event.

So, I could see for the next one having some sort of in-person event for those who can attend, and then also having that information being available an online event as well.

TOM: So as often in these sorts of things, this is your now opportunity to tell SAMHSA, to tell colleagues, to tell others that are contemplating doing something similar, what advice, what pointers would you care to share?

Rachel: I would just strongly encourage, if you are thinking about participating, do it. There’s no downside to working toward making your community a better place, a healthier place. And we’ve had so many things that have come up positively since the event that I definitely think it would be a great choice for any kind of individual or organization who’s interested in it. I think there’s also, as I mentioned before, lots of opportunities to partner with other individuals in your area.

I think with the advent too of more technology and Zoom, it gives you the opportunity as well to have different audiences than you might have had before and also different speakers. I know you can also have information from experts, who are not even physically able to be in your area, provided to your community that otherwise you might not be able to access. 

And then also just using it as an opportunity to have families communicate with each other. I think some of my favorite feedback we got on our evaluation was from one woman who shared that she was so happy that her family viewed it together because she was able to ask her son questions, and then her son also throughout the next few days had questions both for herself and for her husband, and that fostered great communication with him, and I know we’re always focused on what are the risk factors and preventative factors that we can address.

And so, if we can strengthen families and strengthen conversations, we’re really happy, and I think that this funding and opportunity to get media, tools, and support from SAMHSA is just a fantastic opportunity to do that. 

TOM: Well, thank you, Rachel. And I commend you for what you’re doing in Sioux City and the tri-state area. I commend your website, your annual report, your youth survey, the success story that you posted on the SAMHSA Community Talks website with its link to the Facebook full 90-minute town hall meeting. And I wish you all the best in the future.

Rachel: Thank you so much, Tom.

TOM: Thanks for joining us. Before we end today’s episode, I’d like to welcome SAMHSA’s Marion Pierce to share a few final words.

MARION: Hello. I’m Marion Pierce, a public health analyst with SAMHSA’s Center for Substance Abuse Prevention, also known as CSAP. This podcast series features participants from SAMHSA’s Communities Talk initiative. Communities Talk supports community-based organizations and institutions of higher education across the U.S. SAMHSA provides these groups with stipends to help them host activities designed to educate youth, families, and communities about the effects of substance use and misuse. For more information about Communities Talk, visit us on the web at stopalcoholabuse.gov/communitiestalk. Thank you for listening, and remember, no action is too small when you’re talking about prevention.