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Strategies in Obtaining Substance Abuse Data on Hard to Reach or “Hidden” Populations

Strategies in Obtaining Substance Abuse Data on Hard to Reach or “Hidden” Populations. Carlos A. O. Pavao, MPA Southeast Regional CAPT October 6, 2011. Learning Objectives.

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Strategies in Obtaining Substance Abuse Data on Hard to Reach or “Hidden” Populations

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  1. Strategies in Obtaining Substance Abuse Data on Hard to Reach or “Hidden” Populations Carlos A. O. Pavao, MPA Southeast Regional CAPT October 6, 2011

  2. Learning Objectives • Get a general overview of cultural competency is integral to effective implementation of SAMHSA’s Strategic Prevention Framework. • Provide an opportunity to discuss the different definitions of “hard to reach” populations and why it may be important to assess their needs. • Discuss who are the how “hard to reach” populations. • Share strategies for gathering data on “hard to reach” populations.

  3. SAMHSA’s Strategic Prevention Framework

  4. SAMHSA’s Strategic Initiatives http://store.samhsa.gov/shin/content//SMA11-4629/01-FullDocument.pdf

  5. SAMHSA’s Strategic Initiatives • Prevention of Substance Abuse and Mental Illness • Trauma and Justice • Military Families • Recovery Support • Health Reform • Health Information Technology • Data, Outcomes, and Quality • Public Awareness and Support Leading Change: A Plan for SAMHSA’s Roles and Actions 2011-2014 http://store.samhsa.gov/shin/content//SMA11-4629/01-FullDocument.pdf

  6. How do we define culture?

  7. Culture A set of distinctive spiritual, material, intellectual and emotional features of society or a social group. It encompasses, in addition to art and literature, lifestyles, ways of living together, values systems, traditions and beliefs . United Nations Education, Scientific, and Cultural Organization, 2010

  8. Rationale for Cultural Competence • Demographic realities • Disparities in care outcomes based on race • Improved quality of services • Legislative, regulatory and accreditation mandates • Needs and interests of constituents, state and stakeholders • Gives the service a competitive edge

  9. Elements of Culture • Culture contains elements that are both impersonal and personal, for example: • Aesthetics, art, music • Ceremony • Myths • Etiquette • Language Gonzalez, V.M., Gonzalez, J.T., Freeman, V., & Howard-Pitney, B. (1991).

  10. What Culture is Not • An individual’s personality • Static, it can change and adapt • The language a person speaks • An ethnic or racial group • Solely related to geography Adapted from Gonzalez, V.M., Gonzalez, J.T., Freeman, V., & Howard-Pitney, B. (1991).

  11. Cultural Competency A set of behaviors, attitudes and policies that come together in a system, agency, or program or among individuals, enabling them to function effectively in diverse cultural interactions and similarities within, among, and between groups. U.S. Department of Health and Human Services

  12. Cultural Continuum Adopted from the National Center for Cultural Competence

  13. Cultural Destructiveness Adopted from the National Center for Cultural Competence

  14. Cultural Incapacity Adopted from the National Center for Cultural Competence

  15. Cultural Blindness Adopted from the National Center for Cultural Competence

  16. Cultural Pre-Competence Adopted from the National Center for Cultural Competence

  17. Cultural Competence Adopted from the National Center for Cultural Competence

  18. Other Models to Consider

  19. Multiculturalism vs. Kaleidoscope Race Ethnicity Multiculturalism Cultural Competence Racism Oppression Disability

  20. Center for Capacity Building on Minorities with Disabilities Research (CCBMDR)

  21. 2011 IOM Report on LGBT 2011 IOM Report: The Health of Lesbian, Gay, Bisexual, and Transgender (LGBT) People Building a Foundation for Better Understanding

  22. Defining Characteristics of Hard to Reach or “Hidden” Populations

  23. Defining Characteristics of “Hard to Reach” Populations • Demographic • Cultural • Behavioral and Attitudinal • Structural (Brackertz, N. (2007). Who is hard to reach and why? ISR Working Paper. Available: www.sisr.net/publications/0701brackertz.pdf.)

  24. Demographics • Quantity and characteristics of group • Guiding Questions: • Where are the groups found? • How many are there? • What do members of the group have in common? (Brackertz, N. (2007). Who is hard to reach and why? ISR Working Paper. Available: www.sisr.net/publications/0701brackertz.pdf.)

  25. Cultural • Way of life of the group or individual • Guiding Questions: • Are there established information networks? • Are there ethnic or cultural characteristics, such as language, in common? • Are there individuals or organizations that we can partner with? (Brackertz, N. (2007). Who is hard to reach and why? ISR Working Paper. Available: www.sisr.net/publications/0701brackertz.pdf.)

  26. Behavioral and Attitudinal • Relationship between attitudes and behavior • Guiding questions: • Who do they trust? Who do they distrust? • What methods might be most effective for engaging them in the research process? (Brackertz, N. (2007). Who is hard to reach and why? ISR Working Paper. Available: www.sisr.net/publications/0701brackertz.pdf.)

  27. Structural • Social or organizational processes or structures affecting access • Guiding questions: • Are there invalid or unsupported assumptions being made by staff, policy makers, etc.? • Are there issues of cultural competency? • Are there organizational processes that create barriers to accessing information? Carlos Pavao T/TA Specialist (Brackertz, N. (2007). Who is hard to reach and why? ISR Working Paper. Available: www.sisr.net/publications/0701brackertz.pdf.)

  28. Challenges to Gathering Information on “Hard to Reach” Populations • Inconsistent use of terminology • narrowly or broadly defined • passively or actively hidden • Implication of homogeneity

  29. Deciding on Data Collection Strategies Consider methods including the pros and cons of each: • Primary vs. secondary data source? • Quantitative vs. qualitative approach? • Sampling strategy?

  30. Case Studies Maine’s experience with collecting data on LGBTQ and Refugee communities

  31. Resource • National Center for Cultural Competence • Based at Georgetown University • Focus on health and mental health services • Web site resources http://www11.georgetown.edu/research/gucchd/nccc/ • Collaboration and partnerships • Training and consultation • Self assessment instruments • Curriculum modules

  32. Final Questions and Comments

  33. For more information Carlos A. O. Pavão, MPA SAMHSA CSAP's Southeast RegionCAPT 160 Clairemont Avenue, Suite 200 Decatur, GA 30030 Tel: 678-954-5823 Email: cpavao@edc.org

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