As more grassroots approaches to health research are introduced to combat local social problems, simultaneously there echoes a call to examine their potential contributions to social change. This study builds on previous work, in which coalition members of a local prevention organization, Partners in Prevention of Substance Abuse (PIPSA), were interviewed regarding their conceptions of underage drinking. With an emerging emphasis on prevention efforts becoming more localized and intimate, it has become increasingly important to extend collaboration efforts to include clients' perspectives in program design. In this vein, this qualitative study broadens prior work by including focus groups with local youth in hopes of gaining insight into their conceptions of underage drinking, their awareness of local underage drinking, and potential strategies for future prevention activities. Discourse between coalition members and local youth were then compared to highlight potential program limitations in reaching their target population.