Strategic Prevention Framework Training

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Strategic Prevention Framework Training

• Florida Substance Abuse Response Guide (SARG)
• Phase I
• August 15, 2007

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• Martin Luther King, Jr.
• Our nettlesome task is to discover how to
  organize our strength into compelling power.
• Johann Wolfgang Von Goethe
• Every man has enough power left to carry out that
  of which he is convinced.

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Strategic Prevention Framework isOutcome Based
Prevention

• Starts with a focus on and attention to the SPF
  goals (reducing use and related problems)
• Increases the likelihood of targeting significant
  problems (data-guided)
• Identifies and targets key risk and protective
  factors/causal factors contributing to
  consequences and consumption
• Links strategies to key risk and protective
  factors/causal factors and ultimately
  consequences/consumption
• Builds a basis for ongoing monitoring and
  evaluation activities to track and improve
  prevention efforts
• Lead with results, not with programs

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How?

• Florida
• Substance Abuse Response Guide
• Step by Step Manual
• Forms to help guide the process
• Tools to make evaluation planning easier
• Sets minimum standards
• Creates a Florida Lexicon for Coalition Work
• Online Training by Fall
• Coaches trained in the manual

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We Need You

• Ongoing analysis of substance abuse trends and
  patterns on
• Consequences
• Consumption
• Contributing Factors
• Data Driven Comprehensive Community Action Plans
• Engagement of key sectors and individuals

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I-D-E-A-L Coalition

• Inclusive perspective, perceptions I can talk
• Diverse background, history I can be who I am
• Effectiveness I know/can prove what I am doing
• Action oriented walking the talk
• Leader filled empowered and accountable

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Encouragement

• Convening for the purpose of educating and
  providing networking opportunities among health
  and human services (think Community Wheel)
• Facilitating impartial and progressive
  methodologies to positively affect systemic
  change
• Monitoring community trends affecting quality of
  life issues
• Encouraging open dialogue about key community
  issues
• Advocating for the efficient and effective use of
  community resources and good public policy

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Encouragement

• Fostering diverse partnerships among all sectors
  of the community
• Mobilizing the community to support measurable
  outcomes and an effective evaluation of all
  substance abuse programming
• Engaging leaders and citizens by developing and
  implementing community improvement strategies
  through priority-setting and consensus building
• Collecting, analyzing, interpreting, and sharing
  indicator data with the community                 
       
• Coordinating and/or conducting community level
  activities (environmental strategies) to support
  the reduction in use and abuse of substances and
  their related consequences.

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Key Elements
Action Plans
Collaboration
Shared focus on the problem
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First step - Data

• Were asking you to collect information on
• Consequences evidence of the problem
• Consumption the behavior that is related to the
  problem
• Intervening Variables those things that
  contribute to the problem (contributing factors)
• Capacity resources (human, technical and
  financial) available to address the problem

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Consequences

• Consequences Defined as the ultimate outcome
  lack of school success, sexually transmitted
  disease, alcohol related accidents (crashes),
  teen pregnancy, violence
• Grantees are expected to locate local data to
  create a picture that is deeper than just
  county-level data, based on populations involved
  in consequences
• Discussion point why consequences??

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Substance-Related Consequences (Examples)
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Underage Drinking

• Consumption The behavior that is the precursor
  to consequences (i.e. binge drinking)
• 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
• Discussion Why consumption?

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Consumption Patterns

• Overall consumption
• Acute, heavy consumption
• Consumption in risky situations
• Drinking and driving
• Smoking around young children
• Consumption by high risk groups
• Youth, college students, older groups
• Pregnant women

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Underage Drinking

• 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
• Why Intervening Variables?

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Contributing Factors

• Community Level Factors
• Availability of substances (price, retail,
  social)
• Promotion of substances
• Social Norms regarding use (community, family and
  peer)
• Enforcement of Policies and Social Norms
• Individual Level Factors
• Perceptions of risk and harm
• Positive attitude toward drug use

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Contributing Factors

• Availability
• Economic Availability - Price
• Retail Availability - ATOD accessibility from
  retail sources (money is exchanged).
• Social Availability ATOD accessibility from
  non-retail sources (money rarely exchanged --
  family and friends).
• Promotion- Attempts to increase the
  attractiveness of drinking, smoking or using
  illicit drugs and/or the substances themselves

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Contributing Factors

• Norms - Informal standards or values regarding
  the acceptability or unacceptability of certain
  behaviors, including substance use.
• Enforcement - Of laws and regulations beyond the
  passage of the law.
• Individual characteristics - Genetics, values,
  attitudes, and social associations that influence
  individual decisions to use

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Community Role

• Goal Develop outcome-based logic models that
  outline a strategic response for addressing state
  priorities as locally defined
• Understand problem to be addressed
• Assess Contributing Factors (Intervening
  variables) for planning purposes that best fit
  community context and definition of the problem
• Determine priority contributing factors to
  address with interventions
• Choose/implement strategies (effective and
  relevant) to address contributing factors

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Outcome-Based Prevention
Programs/ Policies/ Practices
Substance-Related Consequences and Use
Intervening Variables (Contributing Factors)
Implementing the Strategic Prevention
Framework Planning, Monitoring, Evaluation and
Replanning
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SPF SIG Goals

• Prevent onset and reduce the progression of
  substance use, including underage drinking
• Reduce substance-related problems in communities
• Build prevention capacities/infrastructure at
  State and community levels

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The Community Logic Model Key Tool for
Community Planning

• Community logic model serves as a map of the
  problem (substance use and related consequences)
  and the factors leading to that problem
• Community logic model represents systematic plan
  attacking local problem within a specific context
• Community logic model starts by defining problem
  not choosing the solutions (program, practices,
  or policies)

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Community Logic Model

• Essential tool for comprehensive, effective
  community prevention effort
• Links substance abuse problem to underlying
  factors based on research and local data
• Provides explicit rationale for selecting
  programs, policies and practices to address
  specific community substance abuse problem

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Community Logic Models Fit Unique Community Needs

• Different communities may experience similar
  substance abuse problems
• The underlying factors that contribute most to
  these problems will likely vary
• Communities must tailor the logic model to fit
  their particular context, needs, capacities, and
  readiness

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Why we use the Logic Model
Action Plans
Collaboration
Shared focus on the problem
Substance-Related Consequences and Use
Programs/ Policies/ Practices
Intervening Variables (contributing factors)
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Think Strategically

• Consider the inter-relationships among these
  contributing factors
• Examples
• Promotions target certain groups with alcohol of
  different strength, may influence perceptions of
  risk of harm from use
• There is high number of alcohol outlets and a
  limited number of enforcement activities
• Enforcement efforts are not apparent, thus there
  is low perceived risk of getting caught
• Consequences of getting caught are not enforced
  or are not severe, so cost is not high enough to
  encourage desired behavior
• Adults perceive low risk of harm to provide
  alcohol in a low risk environment (e.g. take away
  keys)

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SPF Community Logic Model
Community Logic Model
Reducing alcohol
related youth traffic fatalities
-
Substance
-
Each contributing factor provides an opportunity
or potential point of entry for types of
interventions or strategies (policies, practices,
programs) that may change the targeted problem
Strategies
Substance
Contributing
Related
Use
Factors
(Examples)
Consequences
Easy RETAIL ACCESS to
Underage
Alcohol for youth
Enforce underage
BINGE
retail sales laws
DRINKING
Low ENFORCEMENT of
alcohol laws
Social Event
Underage
High rate of
Monitoring and
Easy SOCIAL ACCESS to
Enforcement
DRINKING
alcohol
-
Alcohol
AND DRIVING
related crash
mortality
Low PERCEIVED RISK of
Media Advocacy to
alcohol use
Among 15 to
Increase Community
Young Adult
Concern about
24 year olds
BINGE
SOCIAL NORMS accepting
Underage Drinking
DRINKING
and/or encouraging
youth drinking
Restrictions on
PROMOTION of alcohol
Young Adult
alcohol advertising in
use (advertising, movies,
youth markets
DRINKING
music, etc)
AND DRIVING
Bans on alcohol price
Low or discount PRICING
promotions and
of alcohol
happy hours
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SPF Process

• Step 1 Call to Action
• The results
• 48 Set one priority for this project, including
  evidence of how the priority was set
• 55 complete the 2007 online coalition survey
• 42 coalitions set underage drinking 2 adult
  binge drinking 2 alcohol related crashes 2
  inhalant use

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SPF Phase I

• Problem Assessment
• Get a few community experts together to help
• Pull together existing data
• Look for patterns and trends
• Be ready to tell me in an elevator to the 5th
  floor the following

Data Hounds
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Elevator Talk

• In three minutes be able to explain
• The problem (consequence)
• Why it is a problem How big it is
• Where it is in your community (geography)
• Who it is impacting (target population)

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Community Data Partners

• Local Entities and Stewards Who Can Assist with
  Local Data Collection
• Information or other value this Steward can bring
  to the data collection/analysis process
• Value representation from this entity could bring
  to a data/needs assessment team of the coalition
• Comments

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Committee Tracking

• This is the first of several youll need.
• Committee Member
• Affiliation
• Role/Responsibility                               
                                           

What is a DEN?
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FloridaUnderage Drinking Logic Model
Consequence
Consumption
Intervening Variables (contributing factors)
Individual Attitudes and Beliefs about Alcohol
Use
Examples Lack of school/work success Alcohol
Related crashes, injuries, deaths Risky Sexual
Behavior, Teen pregnancy, STDs Falls and other
injuries Violence, including Suicide Attempts,
Death Crime Addiction, Co-occurring disorders
Youth early initiation of alcohol use
Social Norms favorable to alcohol use
Youth 30 day alcohol use
Easy Social Availability
Youth Binge Drinking
Easy Retail Availability
Low or discount pricing of alcohol
Drinking in risky situations and contexts
Laws, policies dont limit access, possession,
use
Promotion of alcohol use (advertising, movies,
music, etc.)
Low enforcement and adjudication of alcohol laws
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Consequences

• Consequences are the social, economic and health
  problems associated with the use of alcohol and
  illicit drugs. Any social, economic or health
  problem can be defined as a substance use problem
  if the use of alcohol, tobacco or drugs increases
  the likelihood of the problem occurring.

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Consumption

• Substance use/consumption is the way in which
  people drink, smoke and use drugs (e.g., acute or
  heavy consumption, consumption in risky
  situations and consumption by high risk groups)
  and is causally related to particular
  substance-related consequences

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Intervening Variables

• Intervening variables/causal factors/risk factors
  are research-based constructs that have been
  identified as being strongly related to and
  influencing the occurrence and magnitude of
  substance use and related risk behaviors and
  their subsequent consequences. These variables
  are where we will focus our prevention strategies
  because changes are then expected to effect
  consumption and consequences.

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Identify your local condition

• Enforcement
• Retail Access and Availability
• Social Access and Availability
• Price
• Promotion
• Perceived Risk

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Social Norms

• Family Norms
• Community Norms
• Peer Norms

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Contributing Factors

• Contributing factors are more specific dimensions
  or aspects of intervening/causal/risk factors
  (constructs) which collectively can be used to
  measure the construct to which they are linked.
  They indicate the local conditions that are
  impacting the intervening variables.

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Sample Local Contributing Factors to the
Intervening Variable of Retail Access/Availability
Retail Access/Availability Retailers
responsibility/accountability product
placement/display security responsible beverage
service practices outlet density hours/days of
retail sales.
1. High number of alcohol outlets 2. Convenience
stores selling to minors 3. Lack of security of
product display 4. Limited responsible beverage
service practices
Retail Access/ Availability
Potential Data Sources Outlet density
compliance sales data observation scan placement
practices of sample of convenience stores
observations at bars/restaurants.
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Summary of Data Collection Methods

• Focus Groups
• Expert Interviews
• Environmental Scans
• Surveys

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Appendix G

• This is your friend.
• Download it.
• Complete as much of it as you can.
• Keep it current.
• Youll be using it again and again.

COMS-SOMS-NOMS
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Next Steps

• FSU working to finalize your contracts
• Hire Coordinator
• Appoint Assessment Committee
• Begin data assembly for review and analysis
• Identify data gaps and begin work to collect
  missing data
• Work as a coalition to develop your local logic
  model

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Next Training

• What Phase II Resource and Capacity Assessment
• When Sept. 5, 130-430 p.m.
• Where Your local District/Circuit office
• Materials Well email them to you in a couple of
  weeks
• What Phase III Strategy Selection
• When Oct. 2, 130-430 p.m.
• Where Prevention Conference, Antiqua 1
• Materials Available on site

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Many thanks

• Carol Hays, SECAPT, developing SARG and Resource
  Assessment tools
• Harold Holder, SECAPT, and Jo Birkmeyer, SECAPT,
  compiling research on EB strategies
• FL Substance Abuse Prevention Advisory Council,
  providing input for resource assessment
• Sherese Bleechington, CSAP Fellow working with
  Florida Department of Children and Families,
  assisting Carol Hays with Resource Assessment
• Floridas Community Coalitions, connecting the
  dots for their communities

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Call Your Coach

• Senta Goudy
• Florida SPF SIG Coordinator
• 850-413-6666
• senta_goudy_at_dcf.state.fl.us