Kentucky

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Kentuckys Commonwealth Alliance for Substance
Abuse Prevention (SPF SIG)
Needs and Resource Assessment, Community
Selection, and Strategic Planning

Bob Illback, Margaret Pennington, Ben
Birkby REACH of Louisville
DEPARTMENT OF HEALTH AND HUMAN SERVICESSubstance
Abuse and Mental Health Services
AdministrationCenter for Substance Abuse
Preventionwww.samhsa.gov
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(No Transcript)
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SPF SIG Goals

• Prevent the onset and reduce the progression of
  substance abuse, including childhood and underage
  drinking
• Reduce substance abuse-related problems in
  communities
• Build prevention capacity and infrastructure at
  the State and community levels
• SAMHSA envisions the SPF SIGs being implemented
  through partnerships between States and
  Communities

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Key Principles of the SPF SIG

• Public Health Approach
• Outcomes Based Prevention
• Use Data throughout the process to inform
  decisions
• Follows a Strategic Planning Process SPF SIG

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Public Health Approach

• The SPF SIG takes a public health approach to
  prevent substance related problems.
• A public health approach focuses on change for
  entire populations (collections of individuals
  who have one or more personal or environmental
  characteristic in common).
• Population-based public health considers an
  entire range of factors that determine health.

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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 that need to
  be addressed.
• Understanding the nature and extent of
  consumption (e.g., underage drinking) and
  consequences (e.g., motor-vehicle crashes) from
  the beginning is critical for determining
  prevention priorities and aligning strategies to
  address them.

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Infusing Data throughout SPF SIG Decision Making

• SPF SIG strives to use data across all steps of
  the Strategic Prevention Framework (SPF).
• Deliberate process to collect, analyze,
  interpret, and apply lessons from substance use
  and consequence data to drive state efforts
  across the entire SPF.
• Ongoing and integrated data analyses are critical
  to
• identify problems and set priorities,
• assess and mobilize capacity for using data,
• inform prevention planning and funding decisions,
• guide selection of strategies to address problems
  and goals,
• monitor key milestones and outcomes and adjust
  plans as needed.

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The Strategic Prevention Framework
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Characteristics of the SPF SIG

• Community Level Change Community is Unit of
  Analysis
• Community Level efforts funded by the SPF SIG
  include all five steps of the SPF
• Capacity and infrastructure that can be sustained
  over time
• The SPF focuses on a systematic process, not
  just a funding and program implementation
  decisions
• Dynamic Process requires grantees to ask
  questions and use information for decision making

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Data Analysis Committee
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Kentuckys Data Analysis Committee
Dr. Richard Clayton, Professor and Associate
Dean School of Public Health and Center for
Prevention Research University of Kentucky Mr.
Ron Crouch, Director KY State Data
Center University of Louisville Dr. Ellen Hahn,
Associate Professor College of Nursing University
of Kentucky Dr. Robert Illback, Senior
Evaluation Researcher REACH of Louisville Professo
r, Spalding University Dr. Carl Leukefeld,
Professor Director Center on Drug and Alcohol
Research (CDAR) Chair, Department of Behavioral
Sciences University of Kentucky Dr. David
Mathews, Clinical Director Kentucky River
Comprehensive Care Center Dr. Teri Wood Chronic
Disease Epidemiologist Kentucky Department for
Public Health
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Data Analysis Committee Task

• Bring systematic, analytical thinking to the
  causes and consequences of the use of substances
  in order to effectively and efficiently utilize
  prevention resources
• Promote data-driven decision making at all stages
  in the Strategic Prevention Framework
• Promote cross systems planning, implementation,
  and monitoring efforts
• Provide core support to the SPF Advisory Council
  and Strategic Planning Committee

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Community Selection

• Accurately assess substance-abuse related
  problems using epidemiological data
• Identify the magnitude of the (substance abuse)
  problem and where it is greatest
• Identify risk and protective factors
• Assess community assets and resources, gaps in
  services and capacity, and readiness to act.

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Criteria for Selecting Indicators

• Reflect critical substance use related problem or
  consumption pattern
• Valid
• Periodic collection
• Consistent measurement
• Available/Limited burden
• Disaggregated geographically, by age, gender
  and/or race/ethnicity

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Data Collection

• Identify community-specific indicators of
• Substance use-related consequences
• Illness
• Injury
• Legal
• Problems in living
• Patterns of consumption
• 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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Focusing Questions

• Which problems have the greatest impact? Where
  can we intervene to reduce substance-related
  burden?
• Are there any unique geographic or subcultural
  issues or patterns related to these problems?
• What problems are most amenable to change? What
  are the potential barriers to change? Is the
  community ready for a change effort? Why or why
  not?
• What efforts are on-going in these areas? What
  additional resources do we have (or need)? What
  gaps in services or programming are there?
• What organizational, fiscal, and leadership
  issues are important to be successful?
• What problems have the greatest potential for
  small wins?

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Strategic Planning Committee
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SPC Membership

• Individuals with statewide perspective,
  including
• Senior level policy advisors from relevant state
  agencies
• Senior level researchers

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Primary Tasks

• To develop and obtain consensus on a
  Comprehensive Substance Abuse Prevention Plan for
  Kentucky, which will include special emphasis on
  underage drinking.
• To implement and monitor the plan.

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Other Tasks

• Improve information utilization at both state
  and community levels.
• Establish mechanisms to select community-level
  projects based on the empirical evidence
  (including the assessment of community readiness)
  and sensitivity to multicultural subtleties.
• Make decisions about target community selection.
• Conduct in-depth planning with target
  communities.
• Distribute funds to community projects in
  support of evidence-based programs and practices.
• Monitor community-level initiatives.
• Track change over time.

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Decision-Oriented Framework for Implementation of
the Strategic Prevention Framework Initiative in
Kentucky

• Schedule of meetings between 9/05 and 1/06
  sequenced the following decisions
• Determined statewide priorities (5 substances)
• Determined counties of high need
• Determined counties with low resources (3-5
  counties per substance)
• Determined counties of high readiness (1-2
  counties per substance)

(See Handout)
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Priority Concerns

• Other meetings addressed the priority concerns
  of
• The impact of Culture, Age and Ethnicity on ATOD
  use
• The need for a shared understanding of what
  constitutes an Evidence-based Strategy

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Communities with High Needs and Low Resources
Prospective Target Communities (hot spots) for
SPF SIG Projects
Inhalants Lyon, Monroe, Clay
Methamphetamine Green River, Barren River,
Pennyrile
Tobacco Gallatin, Breathitt, Leslie, Owsley, Perry

Underage Drinking Lyon, Carroll, Owen, Nelson,
Henry
Diverted Prescriptions Leslie, Letcher, Elliott,
Clay, McCreary, Clinton
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Final SPF SIG Target Counties
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Community Support

• Selection has ended support has begun.
• Site visits to begin Steps 1 and 2
• Collaborative involvement in county-level plans
  (refine, review, and refine)
• Technical assistance with each of the 5 steps