Prevention Planning

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Prevention Planning

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Prevention Planning
Why create a plan for action? Planning allows us
to create an objective profile of our community,
identify how to focus resources and efforts, and
to implement more effective strategies
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Activity7-Up
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Community Prevention Systems

• Bring the power of individual citizens and
  institutions together
• Create a comprehensive plan that everyone in the
  community has a stake in and owns
• Hold community institutions accountable

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Focus for Communities

• Consumption and consequences (prevent the problem
  associated with use)
• Across the lifespan (not just youth)
• Based on evidence-based research and empirical
  data
• Outcomes measured at the population level (not
  just program level)

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How Can We Create a Comprehensive Plan?

• By using SAMHSAs Strategic Prevention Framework
  (SPF) which outlines the elements that should be
  included in a comprehensive planning model

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Focus of the Strategic Prevention Framework

• Community development
• Strategic planning
• The change process at the community level

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Key Principles of the Strategic Prevention
Framework

• Public health approach
• Strategic planning process
• Data used throughout the process to inform
  decisions
• Outcomes-based prevention

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Outcomes-based Prevention

• Effective prevention is grounded in a solid
  understanding of alcohol tobacco and other drug
  consumption and consequence patterns
• Documenting the nature and extent of consumption
  (e.g., underage drinking) and consequences
  (motor-vehicle crashes) at the start is critical
  for determining intervening variables and
  aligning strategies to address them

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Outcomes-based Prevention
Substance abuse related problems
Intervening Variables
Programs, Policies Practices
Planning, Monitoring, Evaluation, and Replanning
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SAMHSAs Strategic Prevention FrameworkSupports
Accountability, Capacity, and Effectiveness
Assessment Profile population needs, resources,
and readiness to address needs and gaps
Capacity Mobilize and/or build capacity to
address needs
Planning Develop a Comprehensive Strategic Plan
Implementation Implement evidence-based
prevention programs and activities
Evaluation Monitor, evaluate, sustain, and
improve or replace those that fail
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ActivityGuided Walk
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SAMHSAs Strategic Prevention FrameworkSupports
Accountability, Capacity, and Effectiveness
Assessment Profile population needs, resources,
and readiness to address needs and gaps
Capacity Mobilize and/or build capacity to
address needs
Planning Develop a Comprehensive Strategic Plan
Implementation Implement evidence-based
prevention programs and activities
Evaluation Monitor, evaluate, sustain, and
improve or replace those that fail
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Step 1 Assessment

• What is Assessment?
• Assessment of substance use and related problems
  of substance use
• Assessment of resources, gaps, and readiness
• Leads to recommendations regarding community
  priorities

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Why do we need to do an assessment?

• It answers the question, What is going on in my
  community?
• More specifically, it identifies
• How big and what type of a substance use problem
  do I have in my community?
• What resources currently exist in my community
  that are addressing the identified problems
  related to substance abuse?
• What is supporting the substance abuse problem in
  my community?
• How ready is my community for prevention?

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How do I conduct an assessment?

• Create a needs assessment profile
• Define your community
• Implement a community readiness tool
• Assess available resources and gaps in services

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Questions to Consider

• Has your community used ATOD consequence data in
  the past as part of its Assessment process?
• Is community level consequence data readily
  available? What is the utility of the currently
  available data?
• How does community readiness impact prevention
  planning and interventions?

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SAMHSAs Strategic Prevention FrameworkSupports
Accountability, Capacity, and Effectiveness
Assessment Profile population needs, resources,
and readiness to address needs and gaps
Capacity Mobilize and/or build capacity to
address needs
Planning Develop a Comprehensive Strategic Plan
Implementation Implement evidence-based
prevention programs and activities
Evaluation Monitor, evaluate, sustain, and
improve or replace those that fail
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Step 2 Capacity What is it?

• Types and levels of resources needed to address
  identified needs including

• Human resources
• Technical resources
• Financial resources

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Capacity Why Is it Important?

• The resources, people, partnerships, coalitions,
  and skills are essential to the successful
  implementation of prevention plans

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Capacity What does it involve?

• Mobilizing resources
• Engaging stakeholders
• Partnerships with the community
• Building coalitions
• Developing readiness
• Focus on cultural competency, sustainability and
  evaluation

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Questions to Consider

• Who are some of the key stakeholders in your
  community?
• Are all of the key stakeholders actively involved
  in planning and implementing successful
  prevention interventions?
• Who is involved in evaluating the capacity to
  meet identified needs?
• Is cultural competence deliberately assessed as
  part of current capacity evaluations?

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SAMHSAs Strategic Prevention FrameworkSupports
Accountability, Capacity, and Effectiveness
Assessment Profile population needs, resources,
and readiness to address needs and gaps
Capacity Mobilize and/or build capacity to
address needs
Planning Develop a Comprehensive Strategic Plan
Implementation Implement evidence-based
prevention programs and activities
Evaluation Monitor, evaluate, sustain, and
improve or replace those that fail
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Step 3 Develop a Comprehensive Strategic Plan

• What is a Comprehensive Strategic Plan?
• A comprehensive, logical, and data driven plan to
  address the problems identified in Step 1 using
  the capacity built or mobilized in Step 2
• The plan includes Strategic Goals, Objectives,
  and Performance Targets, as well as Logic Models
  and in some cases Action Plans

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Why Do I Need a Strategic Plan?

• The Strategic Plan lays the groundwork for
• Implementation activities, including
• Capacity Expansion
• Training
• Development of monitoring and evaluation systems
• The identification of strategies
• The selection of evidence-based programs,
  policies, and practices to be implemented
• The evaluation plan

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Institute of Medicine (IOM) Prevention
Classification

• UNIVERSAL
• Programs address the entire population
• (e.g. all 5th graders, all community members)
• SELECTIVE
• Programs focus on groups exposed to greater
  levels of risk
• (e.g. children of alcoholics, highly mobile
  populations)
• INDICATED
• Programs are designed for individuals who exhibit
  risk-related behaviors
• (e.g. students already experimenting with drugs)

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How Do I Create a Strategic Plan?

• Include a vision for prevention activities based
  on
• Documented needs
• Identified resources and strengths
• Measurable objectives and performance measures
• Baseline data
• Include a long-term strategy to sustain policies,
  programs, and practices
• Adjust plans as the result of ongoing needs
  assessment and monitoring

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Questions to Consider

• What type of prevention intervention planning has
  occurred in your community in the past?
• What types of resources will your community need
  in order to develop a strategic plan?

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SAMHSAs Strategic Prevention FrameworkSupports
Accountability, Capacity, and Effectiveness
Assessment Profile population needs, resources,
and readiness to address needs and gaps
Capacity Mobilize and/or build capacity to
address needs
Planning Develop a Comprehensive Strategic Plan
Implementation Implement evidence-based
prevention programs and activities
Evaluation Monitor, evaluate, sustain, and
improve or replace those that fail
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Step 4 Implementation What is it?

• Taking action as guided by the Strategic Plan
  developed in Step 3
• Developing detailed action plans for elements of
  your intervention, including balancing fidelity
  of implementation with adaptation
• Developing a final detailed evaluation plan that
  includes process and outcome measurements and
  continual monitoring of implementation fidelity

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Fidelity and Adaptation

• A sdtuy at Cmabrigde Uinervtisy raleveed that the
  biarn can raed stenences with mexid up wrods just
  fnie as lnog as the frist and lsat lrettes of
  ecah word are in the cercort pclae.
• Aazmning, huh?
• Maintain core components
• Consult the developers
• Evaluate the adaptations

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Implementation Planning Why?

• Crafting detailed action plans for the elements
  of your prevention intervention provides a step
  by step guide for how you will implement your
  plans

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Questions to Consider

• What types of skills, knowledge and/or resources
  will your community need in order to select
  appropriate prevention strategies?
• What processes has your community used for
  selecting appropriate prevention strategies in
  the past?
• What will you need in terms of skills, knowledge
  or other resources to provide the necessary
  support to communities in your service area to do
  select appropriate prevention strategies?

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SAMHSAs Strategic Prevention FrameworkSupports
Accountability, Capacity, and Effectiveness
Assessment Profile population needs, resources,
and readiness to address needs and gaps
Capacity Mobilize and/or build capacity to
address needs
Planning Develop a Comprehensive Strategic Plan
Implementation Implement evidence-based
prevention programs and activities
Evaluation Monitor, evaluate, sustain, and
improve or replace those that fail
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Step 5 Monitor, Evaluate, Sustain, and Improve
or Replace those that Fail

• What does the Evaluation Step include?
• Process evaluation
• Collection of required outcome data
• Review of policy, program, and practice
  effectiveness
• Development of recommendations for quality
  improvement

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Why Do I Need Evaluation?

• Evaluation is crucial in prevention because it
  tells us
• What works
• What doesnt work
• What to improve
• How to improve it

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How Do I Accomplish This Step?

• Collect and analyze evaluation data as delineated
  in evaluation plan
• Write evaluation report
• Provide recommendations on quality improvements
  based on evaluation data

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Two Common Threads Throughout the Strategic
Prevention Framework

• Cultural competence and sustainability are at the
  center of the Strategic Prevention Framework
  because they are integral to each step of the
  framework

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SAMHSAs Strategic Prevention FrameworkSupports
Accountability, Capacity, and Effectiveness
Assessment Profile population needs, resources,
and readiness to address needs and gaps
Capacity Mobilize and/or build capacity to
address needs
Planning Develop a Comprehensive Strategic Plan
Implementation Implement evidence-based
prevention programs and activities
Evaluation Monitor, evaluate, sustain, and
improve or replace those that fail
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The SPF and Cultural Competence

• Why cultural competence?
• To eliminate service and participation
  disparities for people of diverse racial, ethnic,
  and linguistic populations
• To consider culture, gender, ability levels, and
  sexual orientation in all aspects of the SPF
• To improve the effectiveness and the quality of
  the programs, policies and practices chosen to
  achieve outcomes

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Cultural Competence

• Can be defined as a set of congruent behaviors,
  attitudes and policies that come together in
  system, agency or among professionals and enable
  that system agency or those professionals to work
  effectively in cross-cultural situations.
• (The Lewin Group, 2002)

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The SPF and Sustainability

• Applies to more than funding
• Sustaining outcomes, not programs
• Think sustainability from the beginning
• Look to the system to sustain outcomes
• Sustain prevention by making it everyones job!

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Elements of Sustainability

• Structures and formal linkages
• Champion and leadership actions
• Resources
• Administrative policies and procedures
• Expertise
• Ownership among stakeholders

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How Can the SPF Steps Be Completed?

• Epidemiology Workgroupcollects and distributes
  appropriate data
• Capacity Workgroupidentifies skills and
  processes needed to do comprehensive planning
  (community training and TA)
• Strategies Workgroupidentifies evidence-based
  policies, practices, and programs that make sense
  for communities

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The SPF Principles

• Prevention is a continuum
• Prevention is prevention is prevention
• Successful prevention decreases risk factors and
  enhances protective factors
• Prevention requires adoption of known effective
  prevention practices within a framework that
  works

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The SPF Principles (continued)

• Systems of prevention services work better than
  service silos
• Common data sets across service systems can help
  assess prevention efficacy and promote
  accountability
• Recognizes the importance of States and
  communities
• Comprehensively address substance abuse

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Case Studies

• Form your case study groups
• Identify the substance-abuse related behavior of
  focus in your sample community
• Select a priority risk factor for your sample
  community
• Identify an existing program in the community
  that addresses that risk factor
• Discuss how you could use the communitys
  capacities to support implementation of that
  program

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Planning for Action

• Which steps do you think are the ones most often
  neglected?
• Why do you think they are neglected?
• Why is it important that all the steps be
  followed thoroughly?
• What are some things you can do to assure that
  the process is followed in your own communities?

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Prevention Planning

• Allows us to act with intent, be thoughtful, and
  use our resources wisely

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Prevention Planning
Why create a plan for action? Planning allows us
to create an objective profile of our community,
identify how to focus resources and efforts, and
implement more effective strategies
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QUESTIONS and DISCUSSION