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Culture of Responsible Choices (CoRC) MTF Toolkit for Implementation

Culture of Responsible Choices (CoRC) MTF Toolkit for Implementation . Insert your name here. Where the AF stands…why CoRC?. The Problem. Impact of drug use and alcohol misuse Clear and present danger to the mission Reduces readiness Wastes critical resources

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Culture of Responsible Choices (CoRC) MTF Toolkit for Implementation

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  1. Culture of Responsible Choices (CoRC) MTF Toolkit for Implementation Insert your name here

  2. Where the AF stands…why CoRC?

  3. The Problem • Impact of drug use and alcohol misuse • Clear and present danger to the mission • Reduces readiness • Wastes critical resources • Erodes our Core Values/the Culture of Airmen

  4. DoD/Air Force Heavy Alcohol Use* Trend 2002 DoD Survey of Health Related Behaviors Among Military Personnel Increase from 1998 * > 5 drinks on the same occasion at least once a week in the past 30 days

  5. Heavy Alcohol Use* Past 30 Days, Ages 18–55 *standardized 2001 NHSDA Note: 18-25 yr estimate significantly different from civilian estimate at 95% confidence * > 5 drinks on the same occasion each week in the past 30 days

  6. Total AF: Alcohol Related Events

  7. Total AF: Underage Drinking

  8. Substance Misuse: A Clear and Present Danger • Must reduce Alcohol Related Events! • 80+% ADAPT referrals not Abusing/Dependent on Alcohol • “Alcoholism” cannot/should not be our sole focus! • Alcohol misuse is involved in: • 33% of suicides • 57% sexual assaults • 28.5% domestic violence cases • 44% PMV accidents • 33% of our members commit 81% of our ARI’s (17-24 year olds)

  9. AF Illicit Drug Use • AD AF FY04 0.45% Drug Positives (1,572 total) • Discharge ≃ 1500 Airmen a year b/c of drug positives • $36-79k avg. cost to produce each trained Airman • Demand Reduction (Detection and Deterrence) • Detection is important to the mission • But once caught, we lose an airman • Deterrence is vital to the mission • Effective prevention results in saving an airman • Comprehensive approach to further reduce use

  10. The best models for change…

  11. Community Approach toPopulation Health Services Excellent 100% Leadership Supports Health Behavior Change Installation Policies Enhance Health Prevention and Education Helping Agency Support (IDS) POPULATION Primary Care HEALTH Early Intervention Specialty Care Treatment of Disease 0% Poor

  12. Research Says…. • Comprehensive community approach ideal: • Leadership Driven, Environmental Change, Information, Early Identification and Intervention, Policy/Deterrence, & Alternative Activities • Key: Identify those at of risk • Population based screening/assessment • Good evidence for brief interventions • Tailored feedback (in-person and mailed), Brief Interventions, Primary Care, Web-based programs, etc… Based on SAMHSA and NIAAA recommendations for prevention and early intervention in youth & young adults

  13. Changing the Culture • Culture change requires emphasis on prevention: • Leadership sets the tone -Commanders’ program! • Wide range of prevention efforts • Broad community involvement • Medics offer enhanced screening and early intervention • Create prevention opportunities outside of MTF • Should be responsibility (not morality) based • Standardize elements & evaluation • Implementation must be locally tailored/flexible

  14. 2. INDIVIDUAL LEVEL 3.BASE COMMUNITY 4. LOCAL COMMUNITY 1. LEADERSHIP INTEGRATED 4-PRONGED COMMUNITY APPROACH

  15. The Road from 0-0-1-3 to CoRC…..

  16. 0-0-1-3: Basics • Science-based community program from F.E. Warren • 0-0-1-3 is a slogan that is part of a larger program • 0 underage drinking, 0 DUIs, 1 drink/hour, 3 drinks per sitting max • Wing Commander’s Program • ADAPT is a team player--not the lead • All installation IDS/CAIB members had a role • Public Affairs, Security Forces, Services, Command Master Chief/First Sergeants, and Chaplains have particularly involved roles • 4 core levels of change: • Strong Leadership, Individual, Base, & Community

  17. Prevention: 0-0-1-3 Results  68%  64%  93%

  18. 0-0-1-3’s Savings in Resources • *68% decrease in alcohol related incidents • 8% increase in available-for-duty rate (or 38 more airmen) • ≃ 230 duty days not lost to Alcohol-Related Incidents • *70% decrease in Article 15s • CCs / Shirts with more time for mission / morale / welfare • Contrary to popular myths, Services showed a profit! • MWRF NIA increased $173K / Club profit of $13K *Comparison of First Quarter 2004 to First Quarter 2005

  19. From F.E. Warren to AF Program • March 05: Chief of Staff of the Air Force (CSAF) • Task:Develop an AF plan & product based on 0-0-1-3 • HQ AF Personnel (DP): primary POCs for CoRC • Other functional groups are collaborators • CoRC built from best of science and AF programs • Launch Air Force wide in April 2006

  20. CoRC:AF Functional Community Players Public Affairs Legal Security Forces Mission Support/ Services Senior Leadership CC/1st Sergeants Chaplains Medical Treatment Facility

  21. CSAF: Basics for CoRC • Guiding principles • Commander’s program • Responsible drinking vs. abstinence only • Incident deterrence • Attention to prevention: alcohol misuse and abuse • Emphasize Common Airman Culture • Program goals over first year (baseline year FY04) • Decrease alcohol-related incidents (ARIs) by 25% - Underage drinking, DUIs, crimes, etc. - Reevaluate goal after year 1 • Decrease confirmed drug positives by 25% • Reevaluate goal after year 1 WORK HARD – PLAY SMART!

  22. CoRC Basics 1. Leadership Driven Program: Message and support from top down 2. Individual Level Opportunities for Change • Assessment/Screening of risk in all personnel • Education/awareness • Brief Interventions and treatment when needed • Responsibility and commitment 3. Base Community Opportunities for Change • Develop range of alternate activities • Consistent and equitable detection/enforcement • Media campaign promoting responsibility • Monitor AF metrics/consider base specific metrics 4. Local Community Opportunities for Change • Assess threat and availability of drugs and alcohol • Develop coalition with community agencies

  23. CoRC:Roles and Responsibilities • HQ Personnel (DP): Deliver Concept of Operations • Functional groups developed area specific Toolkits • MTF role at the base level: • Enhanced screening and early intervention • Participation in outreach • Serve as subject matter expert consultants to the CC

  24. Surgeon General’s Toolkit:Bucket 1 Universal/Primary Prevention • Population outreach: • Screening population/surveillance • Take “temperature” of risk on base • Education and feedback at teachable moments

  25. Surgeon General’s Toolkit:Bucket 2 Selected/Secondary Prevention • Targeted, individualized, non-anonymous alcohol and drug screening at Primary Care and Flight Medicine • PHA: Everyone screened annually, feedback provided, and referred as needed • Routine Care: Options for screening, brief intervention and referral as part of routine care

  26. Surgeon General’s Toolkit:Bucket 3 Targeted/Tertiary Prevention • Screening, Assessment & Brief Intervention • Designed for behavioral health outside of ADAPT • Family Advocacy and Life Skills Support Centers • Tools to identify and treat “sub-clinical” alcohol misuse • Improved identification of substance use disorders • Options for screening at each new intake • Improved decision tree • When to refer to ADAPT and when to incorporate into existing treatment plan

  27. Surgeon General’s Toolkit:Bucket 4 Subject Matter Consultation • Guidance for ADAPT and DDR PMs about their role as CC consultants for CoRC implementation • Booklet with core consultant competencies • References and Resources • Resources and opportunities for training

  28. See Surgeon General’s Toolkit for Details about Each Bucket

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