CoRC 101

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CoRC 101

• Dr. Milton H. Cambridge
• Demand Reduction Prevention and Outreach
  Coordinator

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Overview

• Review CoRC Foundational Principles
• Comprehensive Community Approach
• Leadership Driven !
• CAIB/IDS
• 4 Tiered Approach
• Universal/Primary Prevention
• Selected/Secondary Prevention
• Targeted/Tertiary Prevention
• CoRC Metrics
• CoRC CONOPS and Toolkits www.afcrossroads.com
• 7 Steps of Prevention Planning Process
• CoRC Logic Model

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Overview

• Best Practices/Lessons Learned
• Ideas for Improving CoRC Implementation

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Community Approach toPopulation Health Services
Excellent
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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
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Poor
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Community PreventionModel for Population Health
Community Airmen/Families
Military Treatment Facility
Wing Leadership Installation Support IDS
Unit CCs/First Sgt Squadrons
Assuring the Conditions For Population Health
Public Affairs
Academia
The Future of the Publics Health in the 21st
Century, November 2002
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CoRCAF Functional Community Players
Public Affairs
Legal
Security Forces
Mission Support/ Services
Senior Leadership CC/1st Sergeants
Chaplains
Medical Treatment Facility
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1. LEADERSHIP
INTEGRATED 4-PRONGED COMMUNITY APPROACH
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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

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Surgeon Generals ToolkitBucket 1

• Universal/Primary Prevention
•  
• Population outreach
• Screening population/surveillance
• Take temperature of risk on base
• Education and feedback at teachable moments

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Surgeon Generals ToolkitBucket 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

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Surgeon Generals ToolkitBucket 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

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Surgeon Generals ToolkitBucket 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

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The 7 Steps of Program Planning

• Assess the Readiness of the Community
• Assess the Levels of Risks and Protective Factors
• Translate the Risk and Protective Factors into
  Priorities
• Examine the Resources in the Community
• Select a Target Population
• Apply Best Practices and Guiding Principles
• Evaluate the Program

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AF Readiness Level

• Substance Misuse A Clear and Present Danger
• Alcohol Misuse is involved in
• 33 of Suicides
• 57 of Sexual Assaults
• 28.5 of Domestic Violence Incidents
• 44 of PMV Accidents
• 33 of AD (17-24) commit 81 of ARIs

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AF Readiness Level

• AD AF FY 04 0.45 Drug Positive Rate
• Equals 1,572 AD Airmen Drug Positive
• Discharge over 1500 Airmen because Drug Positives
• Costs 36 79K to produce each trained Airmen
• Cost to the AF Over 93 Million Dollars per Year

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AF Readiness Level

• CSAF- Must Reduce ARIs and Drug Positives via The
  Culture of Responsible Choices (CoRC)- July 2005

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Risk Factors AF- Wide

• Age (17-24)
• Male
• Availability of Alcohol and Drugs
• Underage Drinking/Binge Drinking
• Single Status
• High OPS TEMPO/Deployments
• Stress
• Sensation-Seeking
• High Priority Risk Factors

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Protective Factors AF- Wide

• AF is a Family
• Excellent Health Care System
• Healthy Alternatives
• Fitness Activities
• First Term Airmen Centers
• Network of Helping Professionals
• Opportunities for Education and Training
• High Priority Protective Factors

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Protective Factors AF- Wide

• Wingmans Culture
• Culture of Airmen
• Suicide Intervention Program
• Enforcement of Underage Drinking Laws
• AF Zero Tolerance Policy
• Strong Leadership
• Implementation of CoRC
• www.afcrossroads.com

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Examine Resources

• Leadership
• ADAPT/DR
• Base Prevention Coalitions i.e.
• CAIB, IDS, Cross-Functional Oversight,
• CoRC Steering Committee under the IDS
• Primary Care, Security Forces, OSI, Chaplains,
  Public Affairs, Health Educators, Family
  Advocacy, Outreach Managers and Other Helping
  Professionals

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Examine Resources

• Off Base Coalitions- Community Anti Drug
  Coalitions of America (CADCA)
• www.CADCA.org
• Department of Justice Enforcing Underage Drinking
  Laws (EUDL) Grants
• Community Prevention Agencies
• Churches, Schools, etc.

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Examine Resources

• Center for Substance Abuse Prevention (CSAP)
• Model Programs
• Online Prevention Training
• Centers For The Advancement of Prevention
  Technologies (CAPTs)
• Strategic Prevention Framework (SPF)
• National Survey on Drug Use and Health (NSDUH)

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Examine Resources

• NIAAA 2002 A Call to Action Changing the
  Culture of Drinking on College Campuses
• National Academy of Sciences, Institute of
  Medicine (IOM) Reducing Underage Drinking A
  Collective Responsibility
• Research Triangle Institute (RTI) Survey of
  Health-Related Behaviors Among Military
  Personnel (1980 2005)
• IC RC

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Examine Resources

• Other ADAPT and DR Folks
• Networking
• AF Best Practices and Lessons Learned
• ADADT/DR World-wide Conferences
• CoRC Tactical Communication Plan Dec 2006
• CoRC Steering Committee
• CAIB/IDS
• CoRC CONOPS and Toolkits
• www.afcrossroads.com

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Examine Resources

• All 72 SG toolkit documents found at
  www.afcrossroads.com
• Bucket 1 Resources for universal/primary
  prevention through population-level outreach and
  screening
• Bucket 2 Resources for selected/secondary
  prevention through targeted, individualized,
  non-anonymous alcohol and drug screening at
  Primary Care/Flight Medicine during PHA and
  routine care
• Bucket 3 Resources for Behavioral Health
  targeted prevention through assessment for
  alcohol related problems (misuse, abuse, and
  dependence) and drug use at all Life Skill's
  intakes
• Bucket 4 Resources for ADAPT/DDR staff to use in
  their role as the Commanders' substance use
  subject matter experts

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CoRC Target Populations

• Primary 17-24 AD
• Secondary - gt 24 AD
• Tertiary Civilians, Retirees, and Family Members

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Best Practices

• CoRC is based on the adaptation of the Best
  Practice and nationally acclaimed F.E. Warrens
  0-0-1-3 Responsible Drinking Program

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Guiding Principles

• 2005 CORONA Tasker
• Community Prevention Model to Population Health
• CoRC 4 Tiers
• CSAP 6 Prevention Strategies

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Guiding Principles

• Prevention Research
• NIAAA 2002- A Call to Action Changing the
  Culture of Drinking on College Campuses
• IOM 2003 Reducing Underage Drinking A
  Collective Responsibility

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Evaluation

• CoRC Metrics
• 25 reduction in ARMs from Baseline Year
• 25 reduction in Drug Positives from Baseline
  Year
• Other Measures
• Process, Outcome and Impact Program Evaluation

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CoRC Logic Model

• What are the Risk and Protective Factors to be
  addressed ? (The Goals)
• Reduce ARMs by 25
• Reduce Drug Positive by 25

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CoRC Logic Model

• What services and activities will be provided ?
• 6 CSAP Prevention Strategies
• Dissemination of Information, Prevention
  Education, Alternative Activities,
  Community-based Processes, Environmental
  Approaches, and Problem Recognition and Referral
  
• Urinalysis Smart Testing

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CoRC Logic Model

• Who will participate in or be influenced by the
  program ?
• AD 17-24

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CoRC Logic Model

• How will the activities lead to expected outcomes
  ?
• If CoRC is implemented AF-wide according to the
  CONOPs than AD 17-24 will be more informed
• With Strong Command support and if all 6 CSAP
  Prevention Strategies and Smart Testing are
  implemented than we will achieve the CoRC goals
  AF-wide

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CoRC Logic Model

• What immediate changes are expected for AD ? (The
  short-term outcomes)
• A 25 reduction in ARMs and UAs

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CoRC Logic Model

• What changes will CoRC ultimately like to create?
  ( The long-term impacts)
• A change in the AF Culture

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Summary 7 steps for a Prevention Planning Process

• Assess the Readiness of the Community
• Assess the Levels of Risks and Protective Factors
• Translate the Risk and Protective Factors into
  Priorities
• Examine the Resources in the Community
• Select a Target Population
• Apply Best Practices and Guiding Principles
• Evaluate the Program

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CoRC

• Best Practices Kadena Air Base, PACAF

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Best Practices

• Davis Monthan AFB - EUDL Project, Leadership Tier
• Barksdale AFB - Individual Tier
• Little Rock AFB - Base Community Tier
• Malstrom AFB - EUDL Project, Local Community
  Tier

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Other Best Practices/Lessons Learned

• A monthly listing of those turning 21 are sent to
  First Sergeants from Alpha roster- ACC
• Placing 0-0-1-3 stickers on menus and doors of
  local establishments ACC
• Attending Underage Drinking Task Force and
  University Task Force Meeting to share ideas and
  gain synergy ACC
• Responsible Choices through Education, Support
  and Accountability USAFE
• Integrating CoRC into the Air Commando Culture -
  AFSOC

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Ideas for Improving CoRC Implementation

• Strong Leadership Commitment !!!
• Implement under CAIB/IDS
• Appoint Base-level CoRC POC
• Do a local Needs Assessment
• Comprehensive Community Approach

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Ideas for Improving CoRC Implementation

• Add a Best Practices/Lessons Learned section to
  CoRC Website
• Use CoRC CONOPS to train
• Periodically Update Toolkits on CoRC Website
• Increase the pool of Resources at the CoRC
  Website

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• Questions ?