1 Kentucky’s 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 SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse Prevention

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3 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”

4 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

5 Public Health Approach 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.

6 Outcomes-Based Prevention consumption and consequence patterns  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.

7 Infusing Data throughout SPF SIG Decision Making use data across all steps  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.

8 The Strategic Prevention Framework

9 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

10 Data Analysis Committee

11 Kentucky’s 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 Professor, 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

12 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

13 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.

14 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

15 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

16  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?” Focusing Questions

17 Strategic Planning Committee

18 SPC Membership  Individuals with statewide perspective, including:  Senior level policy advisors from relevant state agencies  Senior level researchers

19 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.”

20 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.

21 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)

22 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”

23 Communities with High Needs and Low Resources: Prospective Target Communities (“hot spots”) for SPF SIG Projects Methamphetamine Green River, Barren River, Pennyrile Diverted Prescriptions Leslie, Letcher, Elliott, Clay, McCreary, Clinton Inhalants Lyon, Monroe, Clay Tobacco Gallatin, Breathitt, Leslie, Owsley, Perry Underage Drinking Lyon, Carroll, Owen, Nelson, Henry

24 Final SPF SIG Target Counties

25 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