Outreach to and Identification of Women 147

tions should present a balanced message that does not blame women for
their addiction problems, but instead recognizes the need for personal
responsibility. To do otherwise only supports the woman's denial.
Materials should communicate an understanding of the stress that
many women face in their everyday lives (e.g., poverty, discrimination,
violence, unemployment, sexual or emotional abuse, problems with chil
dren) and acknowledge cultural or gender roles that contribute to or help
lessen such stresses. Women often use alcohol or other drugs to "self
medicate" to deal with the effects of these stress factors. However, the
lifestyle of substance abuse, particularly the use of illegal drugs, is itself a
stressor. Outreach materials should inform women that there are ways to
reduce and cope with stress, including understanding the factors over
which they have no control.
All written materials about the program, such as pamphlets,
brochures, and posters, should be culturally sensitive, easy to read, and
relevant to women targeted for services. Because some substance-abusing
women may have learning deficits or reading difficulties, the language program should
should be simple and illustrations should be frequently used. Large print
should be used in materials directed at older women. Materials should be
published in Spanish and in other languages as appropriate for the target
populations. Describe the services and activities offered by the program,
or through referral, that meet women's needs. These may include the following:

· information on the substance abuse treatment modalities

used in the program. Be specific about whether the program

is inpatient or outpatient, the duration of the program, and

what child care services are available;

· a description of comprehensive health care and social

services provided for women and children and special

services for pregnant and postpartum women, such as assistance in obtaining entitlements for themselves and their children, infant care and developmental education, parenting training, pre- and postnatal health care for pregnant women, and nutrition education during pregnancy;

· counseling and support group options for women, by
women;

· referral and resource information, including telephone
numbers that women can call for food, shelter, medical care,
and other forms of help in addition to treatment; and
· information on facility accessibility and referral resources
to wheelchair users and women with other disabilities.
Many programs have purchased telecommunication devices
(TDDs) so that women who are deaf can contact the
program.

In addition to basic print materials, programs may develop and market public service announcements (PSAs) for radio and television. Collaborating with a local high school, community college, university, radio/television/cable station, or other businesses with a media center to produce professional quality audio and video PSAs that focus on substance abuse has been a highly successful approach. Success stories need to convey to women that they can confront addiction problems and begin their recovery process. If resources are available, develop a PSA targeted to women and adolescent girls in the criminal justice system that informs them about their rights and the services available. Produce a brochure and a PSA about the effects of alcohol and other drugs on an unborn child for distribution to pregnant women, mothers, and women of childbearing age. Advisory board members, advocacy groups (organized around the issues of women and substance abuse), alumnae association members, staff, and female clients can help develop and critique outreach materials.

Programs can employ or request voluntary services from artists in
the community to help design posters and flyers for the program. Many programs use art created by alumnae. Often, public relations and advertis-
ing firms may be willing to provide services to nonprofit organizations as a
way of contributing to the community and reaping a tax benefit. The
program can also conduct focus groups, formal or informal, with women
who reflect the demographics of the target community to pretest the con-
cepts and information developed for PSAs and print materials. This helps
to ensure their relevance and effectiveness and create a sense of "owner-
ship" among women in the community.

4.3.4 Delivering the Message: The Message Must Reach the Women
Targeted for Services

In most cases, one-on-one personal contact will be the most effec
tive way to encourage substance-abusing women to enter treatment. These
personal contacts may be formal (e.g., making a presentation at a club
meeting or at a community-based women's health service organization) or
informal (e.g., striking up conversations with women in the places where
they gather in the community). Examples of strategies for delivering the
message include the following:

Print Materials

· distribute materials in locations such as schools, grocery

stores, malls, college campuses, places of worship, homeless

shelters, food banks, runaway houses, battered women's

shelters, senior citizen centers, day care facilities, welfare

and public aid offices, detention centers, youth and recre

ation centers, major employers, the YWCA, health clubs,

local police stations, probation and parole offices, soup

kitchens, laundromats, beauty parlors, restaurants, bars, and

gas stations; have local supermarkets print messages on grocery bags or insert flyers in the bags;

display posters describing the program's services with phone numbers on telephone poles throughout the community, in compliance with local regulations regarding posters; post brochures and posters on bulletin boards in convenience stores; encourage local businesses to include flyers in salary envelopes;

leave materials for distribution in doctors' offices (especially ob/gyn clinics, family practitioners and pediatricians), public health clinics, physical rehabilitation hospitals, emergency rooms, WIC offices, and other locations providing health care and social services for women; print buttons and t-shirts with the program's logo on them to advertise the program. Distribute them to women and girls involved in other programs and institutions through a social event arranged with the institutions, such as a movie and a discussion session with refreshments; and distribute materials at meetings of clubs, churches, and schools (e.g., Junior Leagues, Parent Teacher Associations).

Media

write articles for the local newspaper on women, addiction, and health issues. Submit them to mainstream newspapers and periodicals as well as to publications for special population groups. Include information about the signs and symptoms of substance abuse and ways to get help;

encourage local newspapers and radio and television (TV) stations to advertise the program free of charge. Using local media in rural areas can-be a particularly effective outreach

strategy because local newspapers and radio and TV stations reach women across large rural counties. Some newspapers may even provide free space;

hand deliver the program's PSAs to TV and radio stations and try to meet with the person responsible for scheduling PSAs. Work with the station programmers to place the PSAs during programs that are most frequently viewed or listened to by the target populations;

schedule the program's medical director or other staff members who are sensitive to women's issues as guests on local radio and television talk shows or call-in programs. This can be particularly effective in reaching older women, many of whom are devotees of talk shows; and

use media outlets with specific target populations. For example, have program personnel fluent in Spanish speak on Spanish language radio and television programs to describe services for Hispanic women. Advertise program services in appropriate language on local radio stations that reach American Indian reservations.

Events

hold information/education sessions in community settings, such as places of worship, community centers, schools, senior citizen centers, and other safe, familiar environments for potential clients;

have a stand or booth at local health fairs, church gatherings, street fairs, and other community events- Answer questions and distribute information on women with substance abuse problems and the services that are available for them and their families;

hold a potluck supper or an open house at a neighborhood center or public housing community and invite neighborhood women to attend. Arrange to have a recovering

woman talk about her experience with substance abuse problems; and

· be sure events are held in locations that are accessible to

persons in wheelchairs. Offer to provide sign language

interpreters and other accommodations.

4.3.5 Professional and Community Contacts

The success of program outreach efforts will depend in large part on the strength of relationships with community-based groups and local, state, and federal service agencies. These groups and agencies will serve as major referral and support sources for the treatment program. The types of agencies to be contacted include: 1) public health and social services; 2) community-based programs for women; 3) the criminal justice system (e.g. the local probation and parole agency, public defenders, detention centers, and jails); 4) major employers; 5) charitable institutions (e.g. the Salvation Army, YWCA, Girl Scouts); and 6) places of worship. To develop liaisons with these organizations it would be appropriate to: 1) send a letter requesting a meeting and enclosing program materials; 2) meet with the appropriate personnel and explain the services provided by the program; 3) arrange to give a presentation or hold an event at the organization; and 4) maintain contact with the organization.

Other specific strategies include the following:

· invite health care providers working in the community to

agency functions, community events, outdoor bazaars, and

block parties;

· establish a relationship with child protection agencies to

help identify women who need substance abuse treatment

services and assist recovering women with family reintegration,

if appropriate; and

· educate the housing authority about the importance of not

evicting women with substance abuse problems, and pro

mote the alternative of having women seek treatment and

continuing care services.

4.3.6 Reaching Women's Support Groups

The message must also reach and educate the substance-abusing woman's support group (family, significant others, friends, coworkers) and social systems (spiritual leaders, shelter personnel, law enforcement officials, physicians, pharmacists, visiting nurses, teachers, home health care aides, probation, and correctional officers, etc.). Specifically, an outreach program can reach support groups in the following ways:

· arrange for, facilitate, and/or recommend educational

programs for physicians and other health care providers.

Topics may include how to diagnose substance abuse and

how to refrain from prescribing minor tranquilizers,

benzodiazopines or sedative hypnotics for women who

abuse alcohol and other drugs;

· encourage families, friends, and coworkers of substance

abusing women to contact the treatment program even if

the women deny having a problem or resist help. These

individuals may need counseling or other support for them

selves. If the program does not have support available for

the client's family or friends, the program can refer them to

a support group for help (e.g. AI-Anon);

· develop a clear and specific list of symptoms of mental

illness evidenced in women who abuse substances for

physicians, psychiatrists, and psychologists. Delineate

possible substance abuse connections in commonly misdiag

nosed ailments such as depression, anxiety, and confusion.

Share the list with other health care and treatment providers

so they can refer women with dual disorders to substance

abuse treatment programs;

154 Outreach to and Identification of Women

compile a roster of women program graduates and/or family members who can be organized into a community support network that will encourage women who need substance abuse treatment to enter a program; and

collaborate with local hospitals and other service providers, including other treatment providers, and agencies to cosponsor events related to women's health, economic issues, parenting responsibilities, family health, and empowerment.