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Learn about shared risk & protective factors, ACEs, social determinants of health, and how they influence various outcomes such as chronic diseases, substance use, and interpersonal violence. Explore ways to implement this approach for preventing multiple forms of violence and injury.
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Shared Risk and Protective Factors 101 Lindsey Myers, MPH Branch Chief, Violence and Injury Prevention - Mental Health Promotion Branch Prevention Services Division
Define shared risk and protective factor (SRPF) approach • Explore different ways to think about SRPFs • Facilitate shared learning on how to implement SRPF approach Workshop Goals
Risk factors: characteristics or situations that increase the probability that a child or adolescent will become victimized by or perpetrate violence. Protective factors: characteristics or situations that cushion a child or adolescent from perpetrating or being victimized by violence. Risk and Protective Factor Definitions
ACEs Can Have Lasting Effects on Behavior & Health (Infographic) How Do ACEs Affect Our Lives? Source: CDC, Adverse Childhood Experiences Study. Available at: http://www.cdc.gov/violenceprevention/acestudy/
Adverse Childhood Experiences (ACEs) As ACEs “score” goes up, so does risk for… RISKY BEHAVIORS • Physical inactivity, smoking, drug/alcohol abuse, early sexual activity CHRONIC DISEASES • Obesity, COPD, asthma, diabetes, liver disease, heart disease OTHER HEALTH OUTCOMES • Teen pregnancy, STDs, miscarriage, depression, suicide, ivp perpetration, Survivors of Violence are at Risk for Other Negative Health Behaviors and Outcomes Source: Centers for Disease Control and Prevention, Adverse Childhood Experiences Study. Available at: http://www.cdc.gov/violenceprevention/acestudy/
CONNECTING THE DOTS Many forms of violence and injury are connected and share same risk and protective factors. Focus efforts upstream on common factors.
SOCIAL ECOLOGICAL MODEL
Neighborhood Risk Factors Source: Wilkins, N., Tsao, B., Hertz, M., Davis, R., Klevens, J. (2014). Connecting the Dots: An Overview of the Links Among Multiple Forms of Violence. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention Oakland, CA: Prevention Institute.
Neighborhood Protective Factors Source: Wilkins, N., Tsao, B., Hertz, M., Davis, R., Klevens, J. (2014). Connecting the Dots: An Overview of the Links Among Multiple Forms of Violence. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention Oakland, CA: Prevention Institute.
What is in a name? Shared Risk and Protective Factors ACES Social Determinants of Health
Why Use a Shared Risk and Protective Factor Approach • Prevent multiple outcomes at once • Build new partnerships • Leverage resources and funding • Diversify funding for sustainability • Expand pool of strategies
QUESTION(S) YOU HAVE ABOUT SHARED RISK AND PROTECTIVE FACTORS ONE BENEFIT/SUCCESS YOU WOULD LIKE TO SHARE ONE CHALLENGE YOU HAVE REGARDING TAKING A SHARED RISK AND PROTECTIVE FACTOR APPROACH
Shared Risk and Protective Factor Approach WORKSHOP PART II
Messaging to Get People on Board • Infrastructure--Use What You Got • Leveraging Resources/Funding • Evaluate Implementing a Shared Risk and Protective Factor Approach
VIP OUTCOMES OPIOID OVERDOSES BULLYING SUICIDE CHILD MALTREATMENT MOTOR VEHICLE INJURIES & FATALITIES SUBSTANCE USE/MISUSE OLDER ADULT FALLS SEXUAL VIOLENCE TRAUMATIC BRAIN INJURY INTERPERSONAL VIOLENCE
Define what you are actually talking about--then talk about that • Let the outcome language drop (unless it helps) • Let your ego go too • Talk about what your partners talk about • Keep reframing MESSAGING TO GET PEOPLE ON BOARD
Work to create healthy, thriving and resilient communities free from violence and injury. Change context at the organizational, community and societal levels to improve the environments where we live, work, learn and play. Pool resources and share work to change these environments that will impact all of our outcomes. VIOLENCE & INJURY PREVENTION - MENTAL HEALTH PROMOTION
Where we live, work, learn and play determines nearly 80% of our health. ENSURING EQUITY Environmental, social and economic factors largely determine the choices we have available. Virginia Commonwealth University
By addressing each priority, we build resilience and prevent multiple forms of violence and injury. BUILDING RESILIENCE
Social isolation/lack of social support • Neighborhood livability/walkability • Connecting youth with trusted adults • Coordination of resources and services among community agencies CONNECTEDNESS
Societal income inequity • Diminished economic opportunities/high unemployment rates • Neighborhood Poverty ECONOMIC STABILITY & SUPPORTS
Weak educational, economic, and social policies/laws • Community or social norms that encourage substance use and/or discourage seeking help • Access to mental health and substance abuse services BEHAVIORAL HEALTH
Norms about seeking help as a parent or caregiver • Harmful norms around masculinity and femininity • Cultural norms that support aggression toward others SOCIAL NORMS
Current Programs/Funding Sources • Hiring/Onboarding to De-Silo Work • Build capacity no matter what funding you have • SRPF Work Groups INFRASTRUCTURE USE WHAT YOU GOT!
GOAL Give communities skills they need to empower all youth to thrive by preventing substance use and promoting mental health. Funding FY 2018-19: $9,000,000 Marijuana Tax Cash Funds COMMUNITIES THAT CARE
Staff appropriately and strategically • SRPF Lens when prioritizing and identifying opportunities • Integrate into local opportunities LEVERAGE RESOURCES AND FUNDING
Shared positions within the branch • Centralized fiscal, contracting, policy and communications at the division level (admin pool costs) • Funding for large projects coming from multiple sources, but paying for distinct activities Braiding and Layering Funding Sources
LEVERAGED FUNDING CTC MCH MJ CFPS TGYS RPE OSP CDOT EFC Core SVIPP
Youth media campaign • Built Environment • Food Security • Resource and Referral Cross-Cutting Project Examples
Measure risk and protective factors shared across outcomes • Use metrics that you can get a hold of • Measure multiple outcomes EVALUATION
https://cohealthviz.dphe.state.co.us/t/PSDVIP-MHPPUBLIC/views/VIP-MHPdashboardAPW/DashboardHome?iframeSizedToWindow=true&%3Aembed=y&%3AshowAppBanner=false&%3Adisplay_count=no&%3AshowVizHome=nohttps://cohealthviz.dphe.state.co.us/t/PSDVIP-MHPPUBLIC/views/VIP-MHPdashboardAPW/DashboardHome?iframeSizedToWindow=true&%3Aembed=y&%3AshowAppBanner=false&%3Adisplay_count=no&%3AshowVizHome=no
THANKS! More questions? Lindsey Myers lindsey.myers@state.co.us