Key Leader Orientation [DATE]

Introductions 2

Agenda Why are we here? Why does this matter? Coalition’s role What is CPWI? The research foundation Next steps 3

Objectives Understand how the prevention-science helps build positive futures for youth and prevent problem behaviors. Understand the CPWI Strategic Planning Framework. Understand the value of a community coalition. Involve stakeholders, other key leaders, community members and youth. Plan for the next steps. 4

Setting the Stage Goal: Provide an overview of the Prevention Redesign Initiative and why we are beginning this process. Objectives: Understand the picture of our community – Why Here? Understand CPWI and Strategic Prevention Framework (SPF) are and how it helps communities. 5

Why are we here today? 6 What is prevention?

Treatment and intervention providers work with individuals and then… …they use those experiences to project need for services If you look only at the people in the water… 7

You look at the whole community and its groups and individuals… …and then prioritize which services best fit the identified needs Community as a whole (environmental prevention ) Groups based on risk Individuals based on risk Going Upstream is harder… 8

Why does this matter? 9 10% less memory in the alcohol dependent youth compared to the healthy youth. Source: Brown et al., 2000 These brain images show the impact of alcohol on the brain and specifically illustrating memory function. Image from Susan Tapert, PhD, University of California San Diego. Courtesy of Parents Matter Presentation by Robin Erz, 15-year old male non-drinker 15-year old male heavy drinker

Why does this matter? …Adverse Childhood Experience, includes… 10

Why does this matter? RankingAlcoholTobaccoMarijuanaMeth Prescription Drug Prevalence Rates (youth)* 1 st -youth3 rd -youth2 nd -youth5 th -youth4 th -youth Economic Impacts 1 st 3 rd Illicit drugs: 2 nd Social Impact Deaths: alcohol greater impact than illicit drugs Drinking and driving: Age dependent Traffic injuries and fatalities: Age dependent School related consequences: Mixed OVERALL 1st3rd2nd5th4th 11 Notes: *Substances are ranked from the highest prevalence to the lowest. The first number indicates the ranking for youth and the second number indicates the ranking for adults (+18). **Substances are ranked based on trends. The first number indicates the ranking for youth and the second number indicates the ranking for adults (18+). With the exception of youth marijuana use, there has not been any discernible increasing or decreasing trends in these five substances. Youth marijuana use, therefore, was given the highest ranking. …Washington State Epidemiological Outcome Workgroup and the Prevention Enhancement Policy Consortium found that alcohol use has more impact on young people than tobacco or marijuana

Why does this matter? Predictions??

Why does this matter? Our youth use too much alcohol. And our prevention efforts need to reduce that consumption. 13 Replace with image of your local data here…

Why does this matter? 14 During the past 30 days, on how many days did you use marijuana or hashish? (results of any use) Youth in this community are using marijuana more than others in the state. Replace with image of your local data here…

Wows and Wonders

What's My role Here? Why do we care? Why should I be here? 16

You are an Architect In this process we use resources (YOU) to address these issues in your community with solutions you design. Don’t worry there is a simple process for us to do this! 17

Introduction to Prevention Redesign Initiative (CPWI) Purpose CPWI - Strategic Prevention Framework Community selection Training approach and research support 18

Getting Started Assessment Planning Implementation Evaluation Adapted from SAMHSA Strategic Prevention Framework

CPWI Framework based on… The Strategic Prevention Framework (SPF) was developed by the federal SAMHSA based on a proven effective prevention planning system ‘Communities That Care’® (CTC). 20

Key Strengths Promotes healthy youth development by engaging all areas of the community. This planning process is community. Guides communities to select community actions, policies and programs with demonstrated effects. Specifies outcome objectives to ensure accountability for resources used. 21

CPWI Purpose The DSHS Division of Behavioral Health and Recovery (DBHR) is committed to its partnerships. DBHR is committed to provide effective prevention services. DBHR anticipate CPWI will help leverage resources and focus and concentrate its efforts. CPWI will – have a deeper impact, – better measure those impacts, and – build support for additional investments in prevention. 22

CPWI Objectives Selected communities will: Designate a community coordinator. Use evidence-based capacity building. Implement proven environmental strategies and targeted direct services, programs and policies through a prevention coalition. Partner with school-based prevention/intervention specialists. Evaluate chosen programs, policies and community-level change, and participate in statewide evaluation. Receive technical assistance from DBHR. Support state efforts to reduce youth access to alcohol, drugs and tobacco. 23

Community Selection Process “High need and some readiness for change” 24 …this community was chosen because…

Community Selection Process ADD Local Rationale HERE 25

Highline Coalition Brief History Add Local History HERE 26

Moving Forward ADD Local Timeline here. 27

Building a Plan for our Community 1.Getting Started 2.Capacity Building 3.Assessment 4.Planning 5.Implementation 6.Reporting and Evaluation 28 Note: You can chose to go into more depth with your key leaders or just provide this overview. However it is important that coalition member get the more in-depth information.

The 'elevator speech'… We will be able to say… We can affect community and family outcomes, which lead to Reduction of Youth Substance abuse and other related problem behaviors With Strategies and Programs, such as Community Mobilization Enforcement of alcohol laws Parenting Classes Early Childhood Education Peer Education By Addressing Intervening Variables and Risk/Protective Factors, in Community DomainFamily DomainSchool Domain Peer/Individual Domain 29

Benefits of Community Action Plan Key Elements: Broad community involvement & ownership Data-driven assessment of risk, protection, behavior and resources Mutually agreed-upon focus and priorities Research-based programs, policies and practices, building on existing resources Outcome-based plan and evaluation strategy 30

Process and Timeline 6 – 9 months Assess needs, resources, readiness and gaps Develop community strategic prevention plan 1 Year Implement evidence- based prevention strategies 2-4 Years Changes in targeted intervening variables 5-10 Years Increase in positive youth development Decreases in problem behaviors years Vision 31 Process Evaluate Measurable Outcomes

Cultural Competency “Cultural competency is not the tenth thing on the list in getting things done; it’s the way we manage the other nine.” -Dr. Robert Hayles 32

Cultural Competency Understanding culture is a process Cultural Knowledge – knowledge of some cultural characteristics, history, values, beliefs and behaviors of a different group. Cultural Awareness – Openness to the idea of changing cultural attitudes. Cultural Sensitivity – knowledge of cultural differences without assigning values to the differences. Cultural competence – Ability to bring together different behaviors, attitudes and policies and work effectively in cross- cultural settings to produce better results. -CADCA’s National Coalition Institute Cultural Competence Primer. 33

Cultural Competency and Community Engagement Communities determine their own needs. Community members are full partners in decision making. Communities should economically benefit from collaboration. Community engagement should result in the reciprocal transfer of knowledge and skills among all collaborators and partners. 34

Sustainability What is sustainability? 35

Sustainability Question 1: What are you sustaining? Efforts – Strategies and Activities Structure to support the efforts (internal and external) 36

Sustainability Question 2: What do you need to sustain it? Policies Resources People Funding Outcomes 37

Sustainability Question 3: How will you get it? Clear direction People Data 38

Lunch Discussion What do you think sustainability means to you? How can you contribute to the sustainability of this effort? What do you need from this effort to be able to support it? 39

Overview: Prevention Framework Goal: Provide an overview of the research framework that supports prevention efforts and CPWI Strategic Planning Framework process. Objectives: Describe the research foundation of the CPWI process. Explain how the prevention-science research base helps build positive futures for youth and prevent problem behaviors. 40

“Begin with the end in mind.” -Stephen Covey Childhood is not the end we need to focus on. Positive, healthy adulthood is the end we must keep in mind. 41

Spectrum of Prevention 42

Prevention Framework The Public Health Approach. Intervening Variables, Risk and Protective Factors and The Social Development Strategy. Contributing Factors and selection of Evidence-based prevention strategies. 43

The Public Health Approach Research-based predictors of health problems Modifies predictors to prevent behavior problems Can affect the entire social environment Works through collaboration Can create long-lasting results 44

The Public Health Approach 45 Problem……Response

Health Promotion Framework Health Promotion Framework Consequence Death from heart disease Health Indicator Heart Disease Intervening Variable High blood pressure Genetics Sedentary Lifestyle High fat dietTobacco use Strategies Blood pressure meds, diet, stress reduction, etc. Knowing family history Exercise. Increase physical activity Lower the fat in your diet Reduce, curtail, quit 46 Problem……Response

Must include a least one for each box below. Can add additional factors. Must include all below. Can add additional consequences. Must include a least one from each box below. Can add additional factors. Must include all below. Can add additional problems. Must include a least one for each box below. Can add additional activities. Must include at least one for each box below. Can add additional indicators.

Prevention Framework The Public Health Approach. Intervening Variables, Risk and Protective Factors and The Social Development Strategy. Intervening Variables, Risk and Protective Factors and The Social Development Strategy. Contributing Factors and selection of Evidence-based prevention strategies. 48

Intervening Variables Intervening Variables: Characteristics that are strongly predictive of underage drinking and substance abuse. They are characteristics of the community that are likely to influence youth alcohol use. Examples: – Alcohol Availability (Ease of access; usual sources; retailers) – Promotion of alcohol – Alcohol laws (enforcement; penalties) – Community norms (acceptability among peer and community) – Risk and protective factors 49

Risk Factors Predictors of Problem Behaviors and Positive Youth Outcomes Risk Factors exist in four domains: Community, Family, School, and Peer/Individual. For example: Risk Factors are predictive of higher levels of adolescent substance abuse, delinquency, teen pregnancy, school drop-out and violence. 50

Risk Factors Community Risk Factors SADTPSDOVD&A Availability of Drugs  Availability of Firearms  Community Laws and Norms Favorable Toward Drug Use, Firearms, and Crime  Media Portrayals of Violence  Transitions and Mobility  Low Neighborhood Attachment and Community Disorganization  Extreme Economic Deprivation  Family Risk Factors Family History of the Problem Behavior  Family Management Problems  Family Conflict  Favorable Parental Attitudes and Involvement in the Problem Behavior  School Factors Academic Failure Beginning in Late Elementary School  Lack of Commitment to School  Peer/Individual Factors Early and Persistent Antisocial Behavior  Rebelliousness  Friends Who Engage in the Problem Behavior  Favorable Attitudes Toward the Problem Behavior  Early Initiation of the Problem Behavior  Constitutional Factors  51 Notes: The next set of slides is two different ways to make the same point. It is recommended that you chose the one that works best for you and do not use all five. If your group is familiar with R/P factors you can use this slide as a quick reminder rather than next four slides. It is suggested to either use this slide or next four not all.

Risk and Protective Factors Research has shown: Common risk and protective factors predict diverse behavior problems. Risk and protective factors work similarly across racial lines. Both risk and protective factors should be used in prevention efforts. 52

Risk Factors Protective Factors Sense of purpose/future orientation Resistance and Social Skills Bonding and Attachment Academic FailureAvailability of Drugs Community Norms and Laws 53 Adapted from Dr. Michael Compton, Ph.D., (editor of Clinical Manual of Prevention in Mental Health), and Dr. Ruth Shim, Ph.D., Morehouse University School of Medicine

Risk Factors Protective Factors Academic FailureAvailability of Drugs Community Norms and Laws Family History Sense of purpose/future orientation Resistance and Social Skills Bonding and Attachment 54 Adapted from Dr. Michael Compton, Ph.D., (editor of Clinical Manual of Prevention in Mental Health), and Dr. Ruth Shim, Ph.D., Morehouse University School of Medicine

At risk for underage drinking, school drop-out, teenage pregnancy, and depression… 55

Community Laws & Norms Favorable toward use Availability of Drugs Academic Failure in Early Elementary Bonding and Attachment Resistance and Social Skills Sense of purpose/future orientation Underage Drinking School Drop-Out School Drop-Out Depression Teenage Pregnancy Teenage Pregnancy Problems Bonding and Attachment Resistance and Social Skills Sense of purpose/future orientation Risks Protection Risk and Protective Factors Adapted from Dr. Michael Compton, Ph.D., (editor of Clinical Manual of Prevention in Mental Health), and Dr. Ruth Shim, Ph.D., Morehouse University School of Medicine

Community Laws & Norms Favorable toward use Availability of Drugs Academic Failure in Early Elementary Bonding and Attachment Resistance and Social Skills Sense of purpose/future orientation Underage Drinking School Drop-Out School Drop-Out Depression Teenage Pregnancy Teenage Pregnancy Problems Bonding and Attachment Resistance and Social Skills Sense of purpose/future orientation Risks Protection Risk and Protective Factors Adapted from Dr. Michael Compton, Ph.D., (editor of Clinical Manual of Prevention in Mental Health), and Dr. Ruth Shim, Ph.D., Morehouse University School of Medicine Notes: The next two slides are a different way to make the same point. It is recommended that you chose the one that works best for you and do not use them all.

Prevention Framework The Public Health Approach. Intervening Variables, Risk and Protective Factors and The Social Development Strategy. Contributing Factors and selection of Evidence-based prevention strategies. Contributing Factors and selection of Evidence-based prevention strategies. 58

Contributing Factors Contributing Factors are related specifically to intervening variables and are intended to supply a more community-specific explanation of the problem identified via each prioritized intervening variable. 59

Contributing Factors: Why Here? Lack of Enforcement of Underage Drinking Laws Adult/parents’ belief that underage drinking is a “rite of passage” Lack of Adult/parents’ support for enforcement Lack of Justice system’s vigorous prosecution of underage drinking violators Lack of Facilities to hold juveniles under the influence 60

Look at the Data Book 61 Add screen-shot image of your local data book here.

Sources of Data We Use in Assessing Communities Data Assessment Local data Healthy Youth Survey Social Indicator data & Community Survey 62

Reviewing Community Data 63 XYZ Community

Selecting and Implementing Strategies and Programs Using information from the data and resources assessment the Coalition will move to selecting the best fit strategies. Resources for selecting: – Evidence-based practices list (DBHR) – CTC manuals – NREPP 64

Evidence-based Prevention Strategies Programs, policies or practices that have demonstrated effectiveness in: Reducing specific risk factors and enhancing protective factors Enhancing positive behaviors and reducing negative behaviors 65

Module 3: Building an Effective Coalition Goal: Understanding keys to effective community coalition and roles of members and key leaders Objectives: – Define a coalition and roles. – Identify ways to involve community members, youth, key political, social, and cultural leaders from the community to recruit for involvement and support of the CPWI effort. 66

What is a Coalition? 67 Coalition A formal arrangement for cooperation and collaboration Members represent and function on behalf of Members act within their own sphere of influence New members are invited Sectors

Sample Local Organization Community Coalition Workgroups formed early in the process Assessment Work Group Resources Assessment Work Group Youth Involvement Workgroups formed later in the process Community outreach and public relations Funding and sustainability Coalition maintenance Coordinator Leadership Committee Fiscal Agent 68 Note: The next slides is a different way to make the same point. It is recommended that you chose the one that works best for you and do not use both.

Roles and Responsibilities 69 Coalition Members Community Coalition Coordinator DBHR ESD & Counties P-I Prevention-Intervention Specialists How can we help? Guide p. 6 OSPI

Next Steps Goal: Review the next steps in the planning process. Objectives: Confirm and assign tasks. Develop and agree on a work plan and timeline. 70

These problems… School performance (% of courses passed) (HYS Academic) Youth Delinquency (either HYS Perception of Risk, or Alcohol related arrests of year olds, depending on coalition’s strategy) Mental Health (HYS depression) These problems… School performance (% of courses passed) (HYS Academic) Youth Delinquency (either HYS Perception of Risk, or Alcohol related arrests of year olds, depending on coalition’s strategy) Mental Health (HYS depression) Action Outcomes What is the problem? Why ? Why here? But why here? So what? How will we know? What are we doing about it? These types of problems… Any Underage Drinking (10th grade 30-day use) Underage Problem and Heavy Drinking (10 th grade) [Add Yours Here] These types of problems… Any Underage Drinking (10th grade 30-day use) Underage Problem and Heavy Drinking (10 th grade) [Add Yours Here] …with these common factors… Community engagement/Coalition development: [Coalition Name] [Add Yours Here] Community engagement/Coalition development: [Coalition Name] [Add Yours Here] School-based Prevention/ Intervention Services: Student Assistance Program School-based Prevention/ Intervention Services: Student Assistance Program Direct Services: [Add Yours Here] Direct Services: [Add Yours Here] Public Awareness: [Add Yours Here] Public Awareness: [Add Yours Here] Environmental Strategies: [Add Yours Here] Environmental Strategies: [Add Yours Here] …can be addressed thru these strategies… Coalition Logic Model Alcohol Availability: Retail or Social Access Promotion of Alcohol Alcohol Laws: Enforcement; Penalties; Regulations [Add Yours Here] Alcohol Availability: Retail or Social Access Promotion of Alcohol Alcohol Laws: Enforcement; Penalties; Regulations [Add Yours Here] Community Disorganization/ Community Connectedness Low Commitment to School Favorable Attitudes Friends Who Use Perception of Harm [Based on individual assessment] Low Commitment to School Favorable Attitudes Friends Who Use Perception of Harm [Based on individual assessment] Risk & Protective Factors: [Add Yours Here] Risk & Protective Factors: [Add Yours Here] …specifically in our community… Long-Term Outcome: Consequences Long-Term Outcome: Consequences Intervening Variables (Risk/Protective Factors) Intervening Variables (Risk/Protective Factors) Evaluation Plan Behavioral Health Problems (Consumption) Behavioral Health Problems (Consumption) Strategies & Local Implementation Strategies & Local Implementation Local Conditions and Contributing Factors Reporting/Eval Plan/Implementation Local Assessment State Assessment …and we will use these tools to measure our impact… Direct Services: Assigned Program pre/post and process measures; HYS Prevention/ Intervention Services: pre/post Community engagement/Coalition development: Annual Coalition Survey Sustainability Documentation Community engagement/Coalition development: Annual Coalition Survey Sustainability Documentation Environmental Strategies: Process measures Community Survey; HYS Environmental Strategies: Process measures Community Survey; HYS Public Awareness: Process measures Community Survey Public Awareness: Process measures Community Survey (10-15 years) (5-10 years) (2-5 years) (6 months – 2 years) 71

Strategic Plan Suggested Timeline 72 Insert your planned timeline here.

Next Steps 73

Accomplishments to date ADD COALITION’S ACCOMPLISHMENTS HERE

Wrap up Thank you Next steps

Next coalition meeting Date: Time: Location: 76