Presented By: Tracy Johnson, Central CAPT Planning Presented By: Tracy Johnson, Central CAPT 1 1

“What is the SPF?” (one or two sentences) you’ll want to ask yourself the following questions: What is the problem? What do you have to work with to address the problem? What is the plan for doing the work? What are we going to do to get the work done? How will we know if we have succeeded? The answers to these questions will depend on the data you collect, which brings us to the central tool in SPF prevention, epidemiology.

Key Principles of the SPF Based on a public health approach Focused on outcomes-based prevention Widens the scope to population-based prevention Follows a strategic planning process that uses epidemiological data throughout the process to drive decision-making Think about continuum activity here Don’t do outcomes-based prevention Stand up and move, want a survey of where people are on the key concepts/principles Where do you think community members would fall on these continuums? 3 3

SAMHSA’s Strategic Prevention Framework Steps Cultural Competence & Sustainability Assessment Evaluation Capacity Good implementation involves much more than simply carrying out the components of the program. To do it right, you need to plan and document. Planning is pivotal to a successful outcome. Planning helps to increase the effectiveness of your effort—to focus energy, to ensure that staff and other stakeholders are working toward the same goals, and to assess and adjust programmatic direction, if needed. If done carefully, planning will make the evaluation tasks much easier. Implementation Planning 4 4

Planning Involves: Creating a logic model Developing a comprehensive, logical, and data-driven plan to address: The problem(s) and related risk and protective factors and other underlying conditions Gaps in resources and capacity Further identification of risk and protective factors and other underlying conditions The selection of strategies that will impact the risk and protective factors and other underlying conditions and the problem Tip: Review slide with audience. Before the next slide, ask the group: Who uses Logic Models? How frequently? What is the benefit of these? What is the difference between a logic model and an action plan? (Clarify that a logic model is a conceptual framework for intervention, while an action plan operationalizes the logic model, providing specific tasks with timelines.) 5 5

SPF Logic Model for Reducing High Risk Drinking 18-25 Consequence/ Consumption Patterns Risk and Protective Factors Strategies Social norms accepting and/or encouraging underage drinking Media advocacy to increase community concern about underage drinking Young Adult Binge Drinking To coincide with the first benchmark, let’s look at an example of a SPF logic model for reducing high risk drinking Social marketing 6

SPF Logic Model for Reducing High Risk Drinking 18-25 Strategies Consequence/ Consumption Patterns Risk & Protective Factors Low perceived risk of alcohol Media advocacy to increase community concern Social norms accepting and/or encouraging underage drinking Social marketing Young Adult Binge Drinking Enforce underage retail sales law Low enforcement Easy social access Social event monitoring and enforcement Young Adult Drinking and Driving Parental Monitoring/ Family Cohesion Parental education Promotion and pricing Restrictions on alcohol advertising Availability of screening/early intervention Early Intervention 7

Goals Goals are the long-term measurable changes that you are trying to achieve based on your needs and resources assessment & the state- identified priorities. Developing your theory of change is an instrumental part of establishing your goals (final outcomes) and your objectives (immediate and intermediate outcomes). 8

Example of a Logic Model - Goals Goal Objectives Strategies Activities Outcomes There is a decrease in underage drinking by 14-18 year olds 9

Objectives Objectives are the specific, measurable results that you plan to achieve with specific strategies. They serve as the basis by which to evaluate your initiative: A good objective includes Who or what is to change a date by when the change will be accomplished describes how much change you hope to see whether that indicator will increase or decrease who will be affected Who or what is to change A date/timeframe by when change will be measured In hat direction will the changes occur (increase or decrease)? How much change (%) is anticipated

Example of a Logic Model - Objectives Goal Objectives Strategies Activities Outcomes Retail Availability By June 2008 a 15% decrease in the number of youth who gain access to alcohol through retail establishments There is a decrease in underage drinking in 14-18 year olds 11

Additional Sample Objective Retail Availability By June 2008, there will be a 25% increase in number of clerks that check IDs in retail establishments that sell alcohol By June 2008, there will be a 50% increase in retail clerks who know how to identify fake IDs in retail establishments that sell alcohol 12

Example of a Logic Model - Strategies Goal Objectives Strategies Activities Outcomes There is a decrease in underage drinking among 14-18 year olds in the community of Lincoln Retail Availability By June 2008 a 15% decrease in the number of youth who gain access to alcohol through retail establishments Merchant Education Compliance Checks Strategies or services that will be conducted to achieve the desired objectives We know both from research and our experience in the field that true change requires multiple strategies (education, working with liquor stores, skill building, enforcement) across multiple settings (school, community, at home) not one shot deals For DAS funded initiatives Early Intervention & Education are the primary strategies for community-based services and these strategies are to be supplemented w/ collaboration, communication, alternatives. Shoulder Taps

Selecting Prevention Strategies Key Questions How will the selected strategies address the risk and protective factors and objectives identified in the assessment process? Are the strategies evidence-based? What other strategies/programs exist in your community to address the identified problem? Can the strategies selected achieve your desired outcomes? The bottom line is: if you choose a strategy, make sure it is a good match to what you are trying to achieve. 14 14

Sample Criteria for Selecting Strategies Effectiveness Matching strategy/program requirements with agency capacities Resources Cultural assumptions Target population Organizational climate Community climate Evaluability Future sustainability Source: CSAP’s Northeast CAPT. (2004). Enriching Prevention Using Evidence Based Practices Retrieved July , 2003. Which of these is most important regarding how strategies are selected now? When determining “match” or “fit,” there are a number of factors to consider. Tip: Review slide with participants. Selecting appropriate strategies for your community ideally involves a collaborative process. You need to bring to the table people from your agency, from the target population you wish to serve, and from the community or setting where the program will be implemented. This process can be time intensive, but in the end it can help you avoid pitfalls associated with choosing a program that is not well-suited to local needs and conditions. If you can’t bring multiple perspectives to the table, try to talk to these different people ahead of time to gather as much information as possible before you attempt to choose a particular approach. 15 15

Selecting Best Fit Prevention Interventions Identify Types of Strategies Select Specific Programs, Practices & Policies Ensure Effectiveness Best Fit Prevention Interventions What you see reflected here is both the process that you use to select strategies, as well as the different criteria used for selecting strategies. The purple boxes reflect the process that you use to select strategies, including: Identifying the types of strategies Selecting specific programs, practices and policies Making sure that the programs, practices and policies are effective The blue boxes at the bottom of the slide indicate the types of fit, including: Conceptual Practical Effective These three types of fit collectively will help to ensure that you select the Best Prevention Intervention. Demonstrate Evidence of Effectiveness Demonstrate Practical Fit Demonstrate Conceptual Fit Relevant? Practical? Effective? 16 16

Activities Activities are the specific steps and actions that are necessary to implement each strategy 17

Example of a Logic Model - Activities Goal Objectives Strategies Activities Outcomes There is a decrease in underage drinking among 14-18 year olds in the community of Lincoln Retail Availability By June 2008 a 15% decrease in the number of youth who gain access to alcohol through retail establishments Merchant Education - Determine content of program -Determine incentives -Assess who to train, barriers to training -Outreach to merchants Determine if voluntary or mandatory Determine incentiveves for training participants Outreach activities Determine ME program Assess who to train, barriers to training Training of Merchants Compliance Checks Connect with AG office to determine if there are state compliance checks Recruit and train appropriate people for checks Determine what deterrent, e.g. fine, etc. Determine tracking systems or rates (how many stores, whom) Shoulder Taps www.epi.umn.edu/alcohol

Short-Term Outcomes What are the measurable changes you expect to see in the identified risk and projective factors (i.e. objectives) Outcomes should contain the following elements: What will change? For Whom? By how much (magnitude of change) By when (what time period) will the change occur? 19

Example of a Logic Model - Activities Goal Objectives Strategies Activities Short-term Outcomes There is a decrease in underage drinking among 14-18 year olds in the community of Lincoln Retail Availability By June 2008 a 15% decrease in the number of youth who gain access to alcohol through retail establishments Merchant Education - Determine content of program -Determine incentives -Assess who to train, barriers to training -Outreach to merchants Compliance among merchants will increase by 30% by 2008 as measured compliance rate checks Determine if voluntary or mandatory Determine incentiveves for training participants Outreach activities Determine ME program Assess who to train, barriers to training Training of Merchants Compliance Checks Connect with AG office to determine if there are state compliance checks Recruit and train appropriate people for checks Determine what deterrent, e.g. fine, etc. Determine tracking systems or rates (how many stores, whom) Shoulder Taps www.epi.umn.edu/alcohol

Long-Term Outcomes Describe the extent of the change (the percentage of increase or decrease) you hope for; Identify the target population or group you want to impact; Specify the behavior, condition, or knowledge you hope to change; and, Include a timeframe in which the change can be expected. 21

Example of a Logic Model - Activities Goal Objectives Strategies Activities Short-term Long-term Outcomes Outcomes There is a decrease in underage drinking among 14-18 year olds in the community of Lincoln Retail Availability By June 2008 a 15% decrease in the number of youth who gain access to alcohol through retail establishments Merchant Education -Determine content of program -Determine incentives -Assess who to train, barriers to training -Outreach to merchants Compliance among merchants will increase by 30% by 2008 as measured rates checks A decrease in 30 day use among youth ages 14-18 as measured by the YRBS Determine if voluntary or mandatory Determine incentiveves for training participants Outreach activities Determine ME program Assess who to train, barriers to training Training of Merchants Compliance Checks Connect with AG office to determine if there are state compliance checks Recruit and train appropriate people for checks Determine what deterrent, e.g. fine, etc. Determine tracking systems or rates (how many stores, whom) Shoulder Taps www.epi.umn.edu/alcohol

Guiding Principles related to planning Cultural Competency Sustainability Participatory Involvement Continuous Quality Improvement You are to add the four guiding principles here.

Cultural Competence and Planning “A set of behaviors, attitudes and policies that come together in a system, agency, or program or among individuals, enabling them to function effectively in diverse cultural interactions and similarities within, among, and between groups.” Sources: U.S. Department of Health and Human Services

Culturally Competent Goals, Objectives, Strategies, Activities, & Evidence Based Approaches How do we ensure that cultural awareness exists in effective program planning? How do the decisions made by the planning process directly affect people’s lives? How would you involve your priority population in their development?

Culturally Competent Goals, Objectives, Strategies, and Activities ■ Is the process reflective of the interests of the priority population? ■ What are some of the cultural beliefs and attitudes towards prevention and how may they be different in diverse sub-populations? ■ Do they account for cultural elements such as language, attitudes, rites of passage, gender roles, values, norms, customs, etc? ■ Are there cultural considerations that need to be considered in the adaptation and tailoring of evidence-based approaches?

Elements of sustainability in SPF step 3 Planning What elements of sustainability are present in step 3 How do we know if those elements are present (what indicators might be present) >>>What are some guiding questions…

Action areas for SPF step 3 Planning … 1. Structures and Formal Linkages 2. Policies and Procedures 3. Resources 4. Expertise 5. Quality and Accountability 6. Effectiveness (step 3) 7. Reach and Alignment (step 3) 8. Relationships 9. Champions 10. Ownership Here introduce the concept of 3 Keys and 10 related Actions to be unlocked. Actions = Key turning the lock. Each of the 10 Actions listed can be unlocked by one of the 3 Keys.

Guiding questions Does the strategy address problems identified through the data-driven process? Does the strategy match the characteristics of the target population? What, if anything, needs to be done to increase alignment between the needs of the target population and the strategies implemented to address these needs?