New Mexico Strategic Prevention Framework State Incentive Grant

1. New Mexico Strategic Prevention FrameworkState Incentive Grant May 2006 Don Maestas, New Mexico Department of Health Michael Coop, Coop Consulting, Inc. Paula Feathers, SW CAPT

2. New Mexico�s SPF New Mexico�s Prevention System is directed by the Behavioral Health Services Division, Department of Health For more than ten years this system has been sustained and improved through the use of: A strong data-driven needs assessment process A strong workforce development system A comprehensive, grass-roots planning effort that has recently resulted in the state�s third 5 Year Prevention Plan A focus on evidence-based programs and on rigorous �home grown� programs that have entered the NREPP system A rigorous evaluation system that has measured statistically significant positive change in 30-day adolescent substance use for several years

3. New Mexico�s SPF New Mexico welcomed the opportunity to participate in the SPF. The SPF is the next logical move for our state � we believe that by utilizing the strong data-driven planning model we will produce different, better, results. We need to do more and do better for our citizens, and we expect prevention and subsequent outcomes to look different in our state by using this approach. Our prevention infrastructure is ready for this challenge. We expect to change community level indicators -- to reduce underage drinking, binge drinking, risky drinking and driving, and traffic mortality rates.

4. NM SPF Milestones Published State Epi Profile 2005 Chose State Level Priority Indicator Issued a competitive RFP in October 2005 Awarded funds in December 2005 Utilized county level severity data for award decisions

5. Community SPF Award Process Applicants used county level data to develop initial local logic model Proposal required rigorous approach to participate in SPF and tested the ability of applicants to use data to create a strong logic model Funds were allocated to 13 communities

6. Community SPF Award Process Target populations were identified by the data Proposal review process added points to score based on data for county of applicant (high need counties) � top 1/3 of counties with highest mortality rates, and top 1/3 of counties with highest number of deaths (Severity + Burden)

7. Community SPF Award Process Eight projects were funded as high need � high capacity � these received a full award, which includes implementation of selected strategies after assessment and capacity building � starting next week Five projects were funded as high need � low capacity, with no implementation until next fiscal year SPF processes are now being integrated into all other prevention funding

8. SPF SIG New Mexico Community Logic ModelReducing alcohol-related youth traffic fatalities

9. NM�s Community Logic Model New Mexico developed its Community Logic Model at the state level, to guide all SPF SIG efforts The Epi Workgroup developed this with the assistance of PIRE and CSAP over several months of exchange, input, and literature review � this was a critical �group� process, reviewed at many levels

10. NM�s Community Logic Model Communities were asked to do extensive assessment work in each area of the logic model � consequence, consumption, and intervening variables

11. NM�s Community Logic Model Consequences: Defined as the ultimate outcome � mortality � crashes may serve as proxy measure Grantees are expected to analyze the who, where, when of alcohol-related motor vehicle fatalities and crashes Grantees are expected to locate local data to create a picture that is deeper than just county-level data

12. NM�s Community Logic Model Consumption: In this model, is understood as the precursor to DWI behaviors Must be studied by age, gender, and ethnic groups, with distinct data for underage use and for binge drinking Multiple sub-populations in the community must be assessed in whatever ways are available

13. NM�s Community Logic Model Intervening Variables: Understood to be the factors believed to directly contribute, as a �system,� to �use� its consequence Intervening variables must be grouped but also understood individually Intervening variables are inter-related in their impact in a community While difficult to measure, they must nonetheless be assessed with some rigor for effective planning and targeting of resources, then monitored routinely

14. NM�s Community Logic Model Obtaining data at the local level for these issues is challenging but must be done Our attitude is -- these data are for planning They may not be perfect, but they are better than anyone has collected in the past and they give us more clarity than we have had before on this behavior � our plans and strategies will be better than they have been before

15. How are we using our logic model (to drive the steps of the framework)? The logic model drives the data-driven planning process The roll-out of the local awards is phased over a six month period The six months provides opportunity to create capacity at all levels of local system Intensive 2 day long workshops are provided at every step, guided by SEW with 1 day training by SWCAPT � they focus completely on process and what has been learned so far � �report formats� guide content and shape local process

16. How are we using our logic model? For two months, our local communities pursue a structured data collection process focused on the seven intervening variables � this includes surveys, focus groups, community forums, stakeholder interviews, and existing local data collection � all structured by a set of instruments and collection guidance A report is completed based on the results of this data collection period � the report groups all data collected and analyzed by intervening variable

17. How are we using our logic model? For months 3 � 4, our local communities focus on assessing capacity around each intervening variable � then creating a capacity plan around each intervening variable, as each group of natural partners for an intervening variable has unique strengths, weaknesses, etc. Readiness has been assessed to some degree by SEW survey Capacity has grown as a result of assessment activity At the end of month four, a 12 month capacity plan is submitted with timelines and benchmarks

18. How are we using our logic model? Months 5 and 6 are spent developing a strategic plan � again, for each intervening variable � and utilizing on-going community forums and town hall meetings, lead by the local SPF core team A key focus is prioritizing of intervening variables, based on learnings of the previous activity, data, and capacity A 12 month strategic plan is submitted with implementation strategies, timelines and benchmarks, including what has been learned about on-going assessment and monitoring needs, and on-going capacity building activity

19. How are we using our logic model? Implementation of strategic plans will begin this month The final step is to use the intervening variables to structure our state level evaluation plan and determine what indicators can be collected at the community and state level to show outcomes over 5 years � SEW and SPF Evaluator are together engaged in that process � a planning retreat next week will establish the framework around each intervening variable and balance the collection of archival data and new sample data

20. Outcome Evaluation Monitor Process Evaluation

22. Intervening Variables Intervening Variables are not things you can point to � instead, they are made up of �Contributing Factors� Each Intervening Variable will have multiple contributing factors, each of which could be measured, studied, and addressed by one or more strategies A logical plan must be developed to collect data on these contributing factors, and then the community must seek to understand them, as a �system�, and how they impact substance use Only then can strategies be effectively planned

23. Intervening Variables

24. Intervening Variables Easy Retail Access Low Enforcement Low Perceived Risk Social Access Social Norms Promotion Discount Pricing

25. Strategic Planning Objectives Prioritize Intervening Variables according to severity and existing capacity. Identify benchmarks, recruitment strategies, and action steps for capacity in each Intervening Variable. Identify action steps for continual assessment of each Intervening Variable.

26. Strategic Planning Objectives Identify a goal for each Intervening Variable and objectives that address contributing factors for each Intervening Variable Identify strategies that are: population appropriate, evidence-based, theory derived, or based on practical knowledge, and consider community readiness for each Intervening Variable � state provided materials on evidence based strategies, by level of �rigor� and grouped by Intervening Variable

27. Strategic Planning Objectives Ensure cultural competence and sustainability throughout the strategic planning process. Identify a process to review progress towards benchmarks and action steps included in the strategic plan.

30. Lessons Learned Assessment data are for Planning! Capacity Building must be strategically planned for EACH Intervening Variable Intervening Variables interact and thus all require attention Don�t discuss strategies until a lot of work has been accomplished to collect data and build capacity 20% for local evaluator as co-facilitator of data-driven planning process makes the rapid roll-out possible State role is to provide very clear and specific guidance to shape the SPF steps process in efficient and effective ways and nurture the progression of communities from one step to the next

31. How NM is Using SPF Planning Process to Shape the Community Prevention Continuum SPF SIG 20% Block Grant Prevention Set-aside Governor�s Portion of SDFS State General Fund Starting July 1, all non-SPF contractors will begin a 6 month to 1 year SPF process, starting with assessment, to identify priorities, create capacity, plan, and submit a new strategic plan

32. Shaping the System: Leveraging Everything SPF SIG Environmental Strategies, Problem Focused Coalition-Driven Mobilization to Focus on Community Priorities � new �SPF� projects (other funding) Universal (IOM) �Direct Services� Risk & Protection, Resiliency, Youth Development � Adolescent, especially to delay �age of onset� As Prioritized by Communities to Address Problems: Selected �Direct Services� � R & P, Adolescent, Families of Young Children Indicated �Direct Services� � R & P, Adolescent (All tied by effective Problem ID & Referral)

33. In our six years of �evidence-based� program focus � at which we became very good, we lost a coalition emphasis, and eventually couldn�t really say what coalitions do SPF provides a way for coalitions to become vital again, to mobilize across segments of the community to address a problem that community members care about NM SPF �purchases� a core group of active, engaged advocates who use data to prioritize, create a vision for something better, and organize others to create change that impacts the entire community

34. We�ve always said we�re doing this � using data to determine what we do -- but we never did � selecting a science-based or evidence-based program was always done separate from looking at our needs assessment, and the two processes weren�t connected We knew the answer before we heard the question! SPF provides a logical and systematic method to do what we know we�ve always said we should do � this really is different if you follow the process, trust the community process SPF is what we should have been doing all along

35. Thank you! All training PowerPoints and materials can be found at: http://captus.samhsa.gov/ Click on Southwest CAPT, then on the State of New Mexico.