Overview of Strategic Prevention Framework (SPF) for GRAA Grantees

1. Overview ofStrategic Prevention Framework (SPF) for GRAA Grantees Presented by Penny Deavers, GRAA Lead and T/TA Specialist for CAPT, SE Resource Team April , 2011

2. Strategic Prevention Framework

3. Infusion of theStrategic Prevention Framework State Systems Prevention Infrastructure General Public Awareness and Outreach Community Coalitions Action Mechanism

4. SPF & Prevention History • Changes in Prevention • Planning Over Time 1999-2011 Evidence-based strategies. Emphasis on implementing effectively with fidelity 1990’s Funding was available for the creation of community-based coalitions

5. SPF & Prevention History Prevention planning today: 2004-2011Strategic Prevention Framework planning process- assessing, capacity building, planning, implementation and evaluation

6. Strategic Prevention Framework Why the SPF? • Strategic planning process • Community development process • The change process at the state & community level

7. Key Principles of the SPF • Public health approaches, widened to population-based prevention. • Outcomes-based prevention that starts with the end in mind. • Prevention is targeted across the lifespan (not just youth). • Data-driven planning process

8. Focus for States and Communities • Consumption & consequences (prevent the problem associated with use) • Across the lifespan (not just youth) • Based on evidence-based research & empirical data • Outcomes measured at the population level (not just program level)

9. “The height of insanity is doing the same thing over and over again and expecting different results.”

10. “We Don’t Do It That Way Around Here” Each individual community • has its own way of doing things • is unique, and that quality is valued • knows the real “in and outs”

11. Change… It is important to recognize and preserve unique qualities while finding new ways for systems to work together.

12. The Plan Includes Systems at State & Community Levels • public and private entities • state agency directors • community volunteers • youth • boards that make policy • parents who make house rules

13. Strategic Prevention Framework Step #1: Assessment • Assessment of substance use and related problems • Prioritization of Problems by State and Community • Documentation of the extent, scope and nature of substance abuse and related problems

14. Infusing Data Throughout SPF • SPF strives to use data across all steps • Deliberate process to collect, analyze, interpret, and apply lessons from substance use and consequence data to drive state efforts across the entire SPF

15. Infusing Data Throughout SPF (cont’d.) • Ongoing and integrated data analyses are critical to: • identify problems and set priorities • assess and mobilize capacity for using data • inform prevention planning and funding decisions • guide selection of strategies to address problems and goals • monitor key milestones and outcomes and adjust plans as needed

16. What Are We Assessing? • Assessment of substance use and related problems (i.e. needs) leading to recommendations for state and community priorities • Assessment of capacities, resources and gaps • Assessment of readiness

17. Why Should I Assess Resources? • Identify gaps in services • Identify duplication of services • Build collaboration among service providers • Modify existing services to meet needs

18. Words of Wisdom What you get out of a needs assessment is directly related to what you put into it…

19. Translating Data into Priorities • Looking across the data you have collected, are there risk factors or protective factors for which you have no data? • Which risks are most prevalent in your community? Which protective factors are most lacking? • At what developmental periods are children most at risk in your community? • Is there an identifiable “cluster” of risk factors that, addressed together, could provide a synergistic response? • Which 2-5 risk factors should your community tackle first? Which protective factor should you tackle first?

20. Key Milestones in Step 1 Include: • Development of problem statements • Identification of potential geographic target areas and populations • Assessment of readiness, external factors, and potential barriers to success • Assessment of organizational, fiscal, and leadership capacity • Assessment of cultural competence • Analysis of service gaps

21. SPF Step #1 RequirementsProfile Population Needs, Resources, and Readiness Community Requirements: • Accurately assess substance-abuse related problems using epidemiological data • Identify the magnitude of the (substance abuse) problem and where it is greatest • Identify risk and protective factors • Assess community assets and resources, gaps in services and capacity, and readiness to act.

22. Strategic Prevention Framework Step 2: Capacity • Community Level • Engage Key Stakeholders • Key Tasks May Include: • Assessing community the prevention system • Convening community leaders & stakeholders • Building coalitions • Training and technical assistance • Leveraging resources

23. State level Knowledge of cultural protocols in sub-populations Workforce knowledge, skills and competencies Infrastructure, such as coalitions Sub-populations’ capacity in prevention (e.g., Boys and Girls clubs) Data systems Examples of Capacities

24. Community level Number of community organizations collaborating on addressing ATOD-related problems Leadership within the coalition and the community to engage in solving ATOD and other related problems Prevention knowledge at the community level Resources that are allocated and available to address ATOD problems Examples of Capacities (cont’d.)

25. Another Thought on Change It's not that some people have willpower and some don't. It's that some people are ready to change and others are not. • James Gordon, M.D.

26. Capacity Building Action Steps • Determine internal capacity and readiness: human, technical and financial • Determine community readiness • Assess external capacity: human, technical and financial

27. Capacity Building Action Steps 1. Determine internal capacity and Readiness including cultural competency: human, technical and financial • Breadth and depth of cultural competency • Administrative skills: long- and short-term planning skills, communication skills, problem solving, etc. • Abilities for: networking, reaching out to community, community mobilization • Technological resources for information management and evaluation • Financial resources for implementation and operational expenses

28. Capacity Building Action Steps 2. Determine community readiness • Identify potential partners for team building • Determine availability of local support (foundations, United Way…) • Establish visibility in the community with media and key stakeholders • Mobilize potential partners and stakeholders • Ensure maximum collaboration within coalition to conserve resources and maximize results

29. Capacity Building Action Steps 3. Assess external capacity: human, technical and financial • Examine awareness of substance abuse problem • Determine relevant community norms • Identify key stakeholders, their skills, commitment, and access to resources • Develop approaches to address gaps in community readiness

30. Key Milestones of Step 2 Include: • Creation of sustainable partnerships • Introduction of training and education to promote readiness, cultural competence, leadership, and data collection, monitoring, and evaluation capacity • Meetings and workshops with key stakeholders, coalitions, and service providers

31. SPF Step #2 Requirements • Capacity: mobilize and/or build capacity to address needs • Community requirements • Engage key stakeholders at the State and community level to plan and implement successful prevention activities that will be sustained over time • Key tasks may include: • Convening community leaders and stakeholders • Building coalitions • Training stakeholders, coalitions, and service providers • Organizing agency networks • Leveraging resources

32. Strategic Prevention FrameworkStep 3: Planning Design comprehensive interventions to impact causal factors Substance-related problems Intervening Factors Evidence-Based Strategies

34. Step #3: Developing a Comprehensive Strategic Plan • Develop strategic goals, objectives, and performance targets • The strategic plan lays the groundwork for: • The identification of strategies • The selection of evidence-based programs, policies, and practices

35. Strategic Prevention Framework Comprehensive strategies include: • Programs • Policies • Practices

36. Select Evidence-Based Program Evidence-based programs are theory-driven, have activities related to theory, and have been well-implemented and well-evaluated. • Prevent or reduce substance abuse or violence and disruptive behavior • Change knowledge, attitudes, and beliefs that lead to substance abuse and violent behavior • Promote or strengthen behaviors and skills

37. Program/Strategy Chosen Should: • Be consistent with identified needs • Directly address goals • Be evidence-based • Be assessed periodically • Be consistent with local policies • Demonstrate effectiveness • Be implemented with fidelity

38. What DOES NOT Work? • Scare tactics • Segregating aggressive or anti-social students • Programs that focus on self-esteem alone • One-time “presentations” with no follow-up

39. Identification of Strategies • Examine existing programs that address the underlying conditions • Determine how the underlying logic fits the underlying conditions • Reflect characteristics of target populations • Ask others about the programs • Assess resources needed to implement • Involve evaluator

40. Restrictions on happy hours Taxes Minimum purchase age Licensing requirements Home delivery bans Keg registrations Social norms campaigns Smoke-free policies Compliance checks Restrictions on advertising Warning labels Bans on use in certain places Legal selling age BAC limits Examples of ATOD Environmental Strategies

41. Choosing Strategies • Don’t forget…….Strategies MUST: • Address the problem identified • Address the causal factor(s) believed to be involved

42. Strategy Does Not Match Cause or Problem Alcohol easily available in bars Little enforcement of drinking driving laws Middle school curriculum Mentoring Program Motor Vehicle Related Crashes

43. Strategy Does Matches Problem and Cause Alcohol easily available in bars Little enforcement of drinking driving laws No service to intoxicated patrons Sobriety checkpoints Motor Vehicle Related Crashes

44. SPF Plan Requirements • Develop a Comprehensive Strategic Plan, informed by needs assessment data, that: • Articulates a vision • Involve key stakeholders in the planning process • Describes how resources will be allocates • Identifies and addresses chosen priorities • Articulates goals and objectives for obtaining expected outcomes • Identifies appropriate strategies/interventions for achieving expected outcomes

45. SPF Plan Requirements (cont’d) • The plan should also: • Identify and address needed capacity development • Include a plan for evaluating the project • Include a plan for sustaining outcomes after the grant ends • The Strategic Plan must be data-driven and focused on addressing the most critical substance prevention needs of the Tribe.

46. Strategic Prevention FrameworkStep 4: Implementation • Logical connection between the problem, the Intervening Factors and Strategies Implemented Intervening Factors Strategies Related Problems Substance Use Low Perceived Risk of Alcohol Use Curriculum to Increase Knowledge about Risk High Rates of Binge Drinking High Rate of Youth Alcohol-Related Crashes Social Norms Encouraging Binge Drinking Media campaign to correct perceptions of ‘normal’ consumption High Rates of Drinking and Driving Little Enforcement of Drinking and Driving Enforcement Checkpoints

47. SPF Step #4 Requirements…Implement evidence-based prevention programs and infrastructure development activities • Community Requirements: • Use the findings of needs assessments to guide selection and implementation of evidence-based policies, programs, and practices • Strategies must be evidence based • Federal Model Program List • Peer reviewed journal with proven effectiveness • Documented effectiveness

48. Successful Implementation Elements • The intervention be delivered by skilled personnel (staff or volunteers) • The intervention be received by the proper audience • The intervention be delivered to a sufficient number of people over a sufficient period of time • The intervention be delivered as designed

49. Outcomes-Based Prevention Substance-related problems Intervening Variables Strategies/ Programs Planning, Monitoring, Evaluation and Re-planning

50. Strategic Prevention FrameworkStep 5: Evaluation • Community is unit of analysis – not the individual • Trends over time Monitor progress and impact on selected change indicators…