Tackling Prevention in Rural Montana

When it comes to planning Communities Talk activities to prevent underage drinking and other substance misuse, rural communities often face a unique set of challenges. Montana’s Hi-Line—named for the old railroad line that runs along the northern part of the state from North Dakota to Idaho—is no exception.

"Our community is not just our immediate town," explained Susan Brurud, a prevention specialist with the Havre Encourages Long Range Prevention (HELP) Committee. "Our prevention consortium covers the entire Hi-Line region, which stretches across several counties in north-central Montana."

Established in 1979 in Havre, Montana, the HELP Committee is supported by the Hill County Health Consortium’s Substance Abuse and Misuse (SAAM) Coalition. Local factors make it important for the HELP Committee to address parents as a key audience in its underage substance use prevention efforts. For example, Montana law allows parents or guardians to serve alcohol to youth in a private location (e.g., home or a private party).

Montana’s geographical proximity to Canada also makes staying ahead of underage drinking more challenging. Canada has a legal drinking age of 18 in certain provinces including Alberta, which sits directly above Hill County. As Havre’s actual city limits are small, it is easy for youth to cross these borders and gain access to alcohol. And alcohol is not the only substance posing a threat to this community: Youth in the Hi-Line region also report a significant amount of marijuana use.

Data from the 2019 Montana Youth Risk Behavior Survey (YRBS) highlights the importance of substance use prevention among youth—including those 13 and younger—in Hill County. When asked about alcohol, 15-19.9% of the county’s high school students reported having had a drink before age 13. And more than 25% of Hill County high school students reported having used marijuana before age 13.

Finding Partners Who Bring Families to You

The HELP Committee received SAMHSA funding for its first-ever Communities Talk activity in November 2019. To get the ball rolling, the committee immediately engaged the Keystone Club, a high school-aged youth leadership and service team that’s part of the Boys & Girls Club of the Hi-Line in Havre.

The first challenge this team faced was one experienced by many community-based organizations who host Communities Talk activities: encouraging turnout. Especially in a community spread out over a wide area, it can be difficult to motivate families to add another event into their busy schedules. By deciding to join forces with the Boys & Girls Club’s quarterly "family night" to hold its 2019 Communities Talk activity, however, the HELP Committee and Keystone Club were able to maximize family participation. Because the club already hosted quarterly family dinners that attracted an engaged family network, this community partnership was crucial to the HELP Committee’s ability to reach its intended audience of parents and families.

Training Teens to Communicate with Parents

In the lead-up to the family night, the HELP Committee held three prep sessions for the Keystone Club youth. As part of their training, the youth practiced discussing substance refusal skills via role-playing, switching between the roles of youth and parent. They also familiarized themselves with resources from SAMHSA’s "Talk. They Hear You." campaign. These included printed posters and PSAs that the HELP Committee shared on social media ahead of the family night to spark conversations between parents and children about substance use.

"It helped to prepare with my HELP Committee leader before," said Hannah Olson, high school student and Keystone Club president. "I got confident going into it and giving out information to the parents."

Also during these prep sessions, the HELP Committee shared brain scan images of marijuana-using and non-marijuana-using youth to show how long-term marijuana use affects the developing brain.

"It was a real moment for the kids to be able to see the science," stated Brurud. "If we give these kids a real education—not scare tactics, but the science—it really works."

Prepping Parents to Talk About Alcohol

At the Boys & Girls Club’s family night, held on November 13, 2019, the Keystone Club organized a table on behalf of the HELP Committee, where they distributed information to parents about the social host ordinance in Havre and fines associated with providing alcohol to underage youth.

In addition, the "Talk. They Hear You." PSAs were playing on TV monitors so families could view them as they were waiting for their dinner, which helped start conversations at the Keystone Club table. There, high schoolers spoke with parents about the importance of starting the conversation with their children about expectations regarding alcohol. They even invited parents to practice by asking them questions as if they were their child. Thanks to their training prior to the event, the youth were already comfortable with substance refusal skills when the time came to share these lessons with parents. They also helped parents download the "Talk. They Hear You." app so they could practice speaking with their teens about alcohol.

"I could’ve tried to run that table, but no one wants to talk to me," said Brurud. "You put a couple of youth there, however, and they bring a very specific power. Their voice opens the ears and minds of parents and community partners."

Finally, Keystone Club members shared the same brain scan images they had seen in their training, along with statistics about marijuana use in the county.

All in all, between 175 and 200 people attended the family night, with a 60/40 split of youth to parents. Youth of all ages—not just high school students—attended. This gave members of the Keystone Club the opportunity to answer questions not only from parents, but also younger children.

Continuing the Conversation

The HELP Committee is excited to see what the Keystone Club will do next, even in the midst of COVID-19. Prior to the pandemic, the youth and the committee had been meeting regularly. In April, these meetings turned into monthly Zoom calls for the youth and HELP Committee to discuss wellness and prevention, focusing on a different substance each month. On these calls, the teens often initiate conversations about issues they’re seeing in school and social media.

"We want to know what they’re hearing, what they’re seeing," said Brurud. "Parents and teachers don’t always know the trends to be looking out for. That’s why we’re always telling the youth ‘you’re our front-line warriors, our information-gatherers, and our recon!’"

Brurud went on to explain that COVID-19 has required the HELP Committee and Keystone Club members to think outside the box to move forward with their prevention goals. In an attempt to organize a prevention-focused activity that could take place virtually if needed, the Keystone Club decided on a drug-free red-carpet event. Currently, club members are engaging youth across two counties and two reservations to make 60-second drug-free video messages. They plan to hold a premiere event in spring 2021 during National Drug and Alcohol Facts Week^® to showcase the videos, with the winning PSA to run in a local movie theater.

Other ongoing prevention efforts include:

• Social Host Ordinances: Thanks to the HELP Committee’s work with the city, there now is a social host ordinance in Havre requiring parents and other caring adults to take reasonable steps to prevent the underage consumption or possession of alcohol at social gatherings. The SAAM Coalition also is advocating for a social host ordinance to be adopted in Hill and Blaine counties, as well as on the Rocky Boy Reservation. These would be the first counties in Montana to adopt a social host ordinance.
• Sticker Shock Campaign: Supported by the HELP Committee and SAAM Coalition, the Boys & Girls Club of the Hi-Line’s high school and middle school service groups organized a countywide project to limit youth access to alcohol. By placing youth-designed stickers on pizza boxes and alcohol cases in participating stores, the Sticker Shock Campaign reminded community members that it is illegal to provide alcohol to anyone under the age of 21.
• Thumbs UP! Campaign: The HELP Committee and SAAM Coalition developed the Thumbs UP! Campaign after reviewing county data from a 2016 prevention needs assessment survey. The data showed that more than 80% of county youth answered "no" or "No!" to the question "My neighbors notice when I am doing a good job and let me know about it." The Thumbs UP! Campaign asks community members to simply give youth a thumbs-up when they see them engaging in any positive behavior, from raking a yard to biking in the park. Several other Montana counties have begun using the campaign in their communities.
• Virtual Q&A Session: Led by Keystone Club President P.J. Morsette, the youth coalition collected questions from their peers about marijuana and its effect on the teen brain. They then hosted a virtual Q&A session in October 2020. During the session, the University of Washington’s Jason Kilmer, Ph.D., addressed these questions live. A recording of the virtual event is available at https://www.youtube.com/watch?v=uMy01Lap5ag.

For more ideas on how to prevent and reduce underage drinking virtually, head to www.stopalcoholabuse.gov/communitiestalk.

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¹ Montana Office of Public Instruction. (2020). 2019 Montana Youth Risk Behavior Survey, Alcohol and Other Drug Use, Montana Maps. Retrieved from https://opi.mt.gov/Portals/182/Page Files/YRBS/2019YRBS/2019MT-Alcohol and Other Drug Use.pdf?ver=2020-04-07-120638-763.

² Ibid.

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