Sustainability: Planning for the Future

2. Sustainability: Planning for the Future Pam Imm, Ph.D. Associate, Center for the Application of Prevention Technologies Southwest Resource Team March 22, 2012 Regional Technical Expert Panel Webinar

3. Learning Objectives • Participants will review relevant State and community models for planning, evaluation and sustainability. • Participants will review selection issues (decision points) related to environmental strategies. • Participants will examine challenges of current funding/required tasks. • Participants will learn factors related to sustainability.

4. Strategic Prevention Framework (SPF)

5. Best Practices Fit Conditions Capacity (Needs & Resources) Sustain Plan Process Outcome Improve Evaluation Evaluation Getting to Outcomes ™ Getting to Outcomes Conceptual Map Goals

6. Getting to Outcomes (GTO) Ten step model for general prevention www.rand.org/publications/TR/TR101 Spanish version: www.rand.org/publications/TR/TR101/2 Getting to Outcomes for Underage Drinking Prevention www.rand.org/publications/TR/TR403

7. What is Getting to Outcomes System of Accountability Questions that if addressed produce desired outcomes.

8. Poll Question • How many of you have heard of or used the Getting to Outcomes model to work the Strategic Prevention Framework steps?

9. Accountability Questions 1. How will communities get organized? (COMMUNITY ORGANIZATION) 2. What are the underlying needs and conditions that must be addressed? (NEEDS/CONDITIONS) 3. What goals and desired outcomes should be developed based on the identified needs? (GOALS)

10. Accountability Questions • What evidence-based environmental strategies will help meet your goals? (Evidence Based Prevention) 5. How do you assess the current levels of capacity and develop plans for enhancing? (CAPACITY) 6. How will you ensure that the current strategies “fit” the context? (FIT) 7. What is the plan for implementation? (PLAN)

11. Accountability Questions • How will the quality of the plan be monitored? (PROCESS EVALUATION) • How well are the strategies working? (OUTCOME QUESTION) • How are continuous quality improvement (CQI) strategies incorporated? (CQI) • If the strategies are successful, how will they be sustained over time? (SUSTAIN)

12. Crosswalk between SPF and GTO

13. Organizations/Coalitions (#1) • State/Tribe and community level work not always linked well. • SPF-SIG coalitions vary in their capacities. • Sizes of States/Tribe/communities vary in sizes and in types of people (e.g., Tribal). • Inclusivity is important especially in community-based efforts.

14. Needs and Conditions (#2) • Various strategies for collecting data on priority areas (e.g., underage drinking). • Methods for selecting sites varied. • Needs/resources assessments were not as thorough as they could be. • Challenge of regularly updating epidemiology profiles.

15. Poll Question • Did your State/Tribe identify SPF SIG sites primarily from the Request for Proposal (RFP) process or from data showing high consequences or consumption patterns, or both?

16. Strategies for Prioritizing Needs • Determine what conditions/factors are major sources of serious consequences? • What conditions/factors are modifiable within the timeframe and budget? • What conditions/factors are easily measurable? • Which environmental strategies show the greatest likelihood for positive results?

17. Strategies for Prioritizing Needs • What conditions/factors are not being addressed effectively with other initiatives? • Know existing laws/ ordinances that are already “on the books” for each strategy. • Pay attention to the political processes underlying many of the environmental strategies.

18. Goals/Outcomes (#3) • Goals and populations of focus were clear. • Identification and measurement of desired outcomes challenging. • Changes in environmental outcomes takes times. • State Epidemiology Outcomes Workgroups (SEOW) varied in their interactions with State and communities.

19. Evidence-Based Strategies (#4) • Environmental strategies requires a change in focus for States/Tribes and communities. • Need for sufficient reach and dosage for comprehensive plan. • Resources: Getting to Outcomes, Mayatech, PIRE, previous programs (Communities Mobilizing for Change on Alcohol (CMCA)), Surgeon General’s Report

20. Poll Question • What evidence-based programs, other than CMCA, did your State/Tribe use to affect population level change?

21. Capacity (#5) • Human, technical, fiscal, relational • Determine plan for enhancing capacities enhanced • Training • Technical assistance • Guidance Documents/reports • Additional resource development

22. Fit (#6)

23. Plan (#7) • Planning tools to use from federal, State/Tribe, or others • Training and technical assistance • Change/turnover in staff • Modifications of plans need to be made • Modifications should be documented

24. Monitor Plan (#8) • Monitoring environmental strategies perceived as more difficult. • Fidelity, quality, dosage. • Requires deeper understanding and more buy in from partners (law enforcement). • Rely on access of existing data (timeliness)

25. Outcome Question (#9) • Relies on reporting baseline and changes in outcomes. • Outcomes take time and sustained effort. • Difficult to definitely attribute your intervention if no comparison community. • Document contribution of results.

26. Continuous Quality Improvement (#10) • Ask and answer the first 9 accountability questions. Goals

27. Sustainability (#10) • Make sure you are getting outcomes. • Develop a sustainability committee/plan. • Consider what you want to sustain. • Be prepared to negotiate. • Develop champions and new leadership. • Develop a financial self-sufficiency plan.

28. Question • How many of your States/Tribe or sub recipients have developed a sustainability committee?

29. Models of Sustainability • Research on sustainability of prevention interventions is relatively new and sparse. • A resource sheet will be sent to you.

30. Models of Sustainability • Infrastructure • Programs/Interventions • Outcomes Models FOCUS on:

31. Research Factors Related to Sustainability • Effectiveness • Problem area still exists • Intervention is compatible with the lead agency (endorsed from the top) • Program champions are in place • Adaptable to local needs • Clear strategies for gradual financial self-sufficiency American Journal Public Health Fall 2011

32. 10.1A

33. Question • What tools are/have you provided your sub recipients to plan for sustainability?

34. Initial Sustainability Planning • Step 1 – Develop a sustainability team • Step 2 – Document current sustainability of programs, practice, strategies, policies • Step 3 – Develop existing and new partnerships

35. Initial Sustainability Planning • Step 4 – What additional strategies/programs need to be sustained? Where is this data? • Step 5 – Gradual plan for financial self sufficiency

36. Plan for Financial Self Sufficiency

37. Ways to get money/resources Let’s generate examples • Share • Ask • Charge • Earn

38. Questions and Discussion • What additional questions and/or comments are there today? • Raise your hand or type your question in the chat box to the left of your screen.