Presentation at County Administrators Meeting IOM & SPF: What are they – and What implications do they have for us. Presented by Joël Phillips Community Prevention Institute January 26, 2006

2 NEW TERMS = NEW APPROACH IOM - (Institute of Medicine) Continuum of Care SPF - Strategic Prevention Framework IMPORTANCE Both concepts will dominate Prevention Planning/Policies Need to understand how they will impact field Know about availability of Resources to assist Counties.

3 PREVENTION CONTINUUM – (U.S.I.) - A Brief History Public Health Model – “Commission on Chronic Health Care” - Introduces Primary, Secondary, Tertiary Prevention (Disease/Health) R. Gordon: Introduces U.S.I. concept to better distinguish between Populations in need of Primary Prevention (Disease/Health) 1994Institute of Medicine – commissioned study examining Mental Disorders Use U.S.I. + Treatment + Aftercare (Continuum) (Mental Health) 2000CSAP introduces term to substance abuse prevention (By directives went to States) (Substance Use – but not fully developed)

4 The Continuum of Care Protractor Different levels of prevention are distinguished by the level of risk of disorder/distress in various populations groups targeted.

5  Universal Prevention Measures: Address the entire population. Aim is prevent/delay use of AOTD. Deter onset by providing individuals with information/skills  Selective Prevention Measures: Targets subsets of the population considered at risk by virtue of their membership in a particular segment of the population. Key Selective Prevention targets the entire subgroup regardless of the degree of risk of any individuals in the group.  Indicated Prevention Measures: Targets individuals who are exhibiting early signs or consequences of AOD use.

6 IOM Prevention Circles within Circles Universal Populations Selected Subgroups Indicated Individuals

7 Potential Selected Populations  Homeless  Young Offenders  Foster Youths  Drop-outs  Students with social/academic problems  Rave party-goers  Others

8 Degree of Risk Intensity of Intervention Universal Selected Indicated Low Moderate High LowModerateHigh

9 Summary IOM approach requires:  Better understanding of our community – communities within communities.  Tired approach in thinking about prevention services. U.S.I  Thoughtful application of prevention approaches to the three types of populations. But it gives us:  Better focus on AOD problems and individuals involved/impacted by AOD use.  Potentially better measurements of success.

10 Strategic Prevention Framework SPF PURPOSE  Formalize a planning and implementation approach  Decrease substance use and abuse  Promote Mental Health  Prevent Mental Health disorders and reduce co-morbidity and relapse

11 Strategic Prevention Framework Process STEP 1 – ASSESSMENT Profile population needs, resources, and readiness to address the problems and gaps in service delivery STEP 1 – ASSESSMENT Profile population needs, resources, and readiness to address the problems and gaps in service delivery STEP 2 – CAPACITY BUILDING Mobilize and/or build capacity to address needs STEP 2 – CAPACITY BUILDING Mobilize and/or build capacity to address needs STEP 3 – PLANNING Develop a Comprehensive Strategic Plan STEP 3 – PLANNING Develop a Comprehensive Strategic Plan STEP 4 – IMPLEMENTATION Implement evidence-based prevention programs and infrastructure development activities STEP 4 – IMPLEMENTATION Implement evidence-based prevention programs and infrastructure development activities STEP 5 – EVALUATION Monitor process, evaluate effectiveness, sustain effective programs/activities, and improve or replace those that fail STEP 5 – EVALUATION Monitor process, evaluate effectiveness, sustain effective programs/activities, and improve or replace those that fail

12 i. Views health promotion across the spectrum of Prevention – Intervention – Treatment. ii. Requires Prevention and Treatment services (AOD/MH) to work together. iii. Focus on community based approaches iv. Planning for outcomes underlies the SPF approach. v. Outcomes measures have been identified (NOMS)  10 Domain Area impacting Mental Health, Prevention, Treatment. SPF Assumptions

13 SPF IOM EXAMPLE Apply SPF StepsIOM Concepts 1. Assessment - Data Collection - Data Analysis What do we know about our populations - Who are most vulnerable - What are their characteristics - What risks / behaviors are present in their lives. (Measurement?)

14 SPF IOM EXAMPLE Apply SPF StepsIOM Concepts 1. PLANNING - Resource Issue - Selecting policies, strategies, program services that FIT best with IOM population under consideration What do we develop prevention services for: - Which vulnerable population - What specific needs / issues are being addressed

15 PHONE FAX

16 TA/TRAINING SERVICES (CPI) 1.Review of current practices (needs-based planning) 2.Assessments of community readiness to implement SPF Strengths Areas for Improvements 3.Develop of SPF process specific to community needs (sub-populations) 4. Ongoing TA/Trainings specific to community needs