1. Maryland Strategic Prevention Framework (MSPF) Core Essentials Training 1

2. Understand and communicate the role of the coalition in achieving community-level change Engage coalition & community members to conduct a problem analysis and develop a logic model Work with the coalition to plan and implement comprehensive strategies to address local conditions Build capacity and engage in planning activities Establish a network of prevention professionals Training Objectives 2

3. Training Agenda I.Welcome II.Introductions III.Overview: The Big Picture IV.Community Problem Solving V.Logic Model VI.Interventions VII.MSPF Strategic Planning VIII.Wrap-up 3

4. The “BIG PICTURE” Community-Level Change Evidence-Based Strategies Role of the Coalition 4

5. Public Health Approach to Prevention Host Agent Environment Community Coalitions 5

6. Strategies Targeting Individuals Socialize, Instruct, Guide, Counsel Family School Health Care Providers INDIVIDUALS Faith Community Strategies Targeting the Community Environment Support, Enhance Resources Regulations Norms Systems ENTIRE COMMUNITY 6

7. Underage Drinking Rigorous enforcement of alcohol laws Compliance checks Community mobilization to address underage-drinking tolerance Normative education emphasizing that most adolescents don’t use ATOD Evidence Based Strategies, Programs, Policies & Practices Alcohol Crashes Rigorous enforcement of drinking and driving laws Awareness regarding increased risk of being caught and punished Enforcement campaigns with sobriety check points Court watch activities Community wide media campaigns about increased enforcement efforts 7 Binge Drinking Rigorous enforcement of underage drinking party, keg registration and social host laws Alcohol excise taxes to reduce economic availability Responsible beverage server training 7

8. Community Coalitions “A coalition is a formal [voluntary] agreement and collaboration between groups or sectors of a community in which each group retains its identity but all agree to work together through a community building process toward a common goal of building a healthier community.” Community Anti-Drug Coalitions of America (CADCA) 8

9. Impact a Defined Community Engage All Sectors of the Community Address conditions & settings in the community identified by the data Promote Comprehensive Strategies Achieve Positive Outcomes Role of the Coalition in Achieving Community-level Change 9

10. Difference Between Coalitions and Programs CoalitionsPrograms Scale Coalitions measure success by examining community-level indicators. This applies to all coalition outcomes (short & long- term). Programs measure change in individuals who have been directly affected by the intervention(s). Addresses multiple causes Coalitions seek to ensure that all causes of identified problems are addressed Programs are more focused on single strategies, e.g., parenting classes or peer mentoring. Actors Coalition activities are diffused and taken by all members with staff playing a coordinating or supporting role. Program staff lead the process and are responsible for implementing interventions. Workbook Page 44 10

11. Coalition Sharing The “BIG PICTURE” 1.How has the “BIG PICTURE” been shared with your coalition? 2.What challenges / successes have you had in communicating the “BIG PICTURE” to your coalition? 3.As a table, identify one “lesson learned” that will help others communicate the “BIG PICTURE” 11

12. Strategic Prevention Framework Community Problem Solving 12

13. Best Processes 1 for Implementing the Strategic Prevention Framework 8. Developing and Using Strategic and Action Plans 6. Arranging Resources for Community Mobilization 5. Developing Leadership 4. Assuring Technical Assistance 12. Documenting Progress and Using Feedback 11. Making Outcomes Matter 10. Sustaining the Work A. Assessment B. Capacity D. Implementation C. Planning E. Evaluation 7. Developing a framework or model of change 1 Best processes identified through a literature review conducted by Dr. Renee Boothroyd, University of Kansas – used with permission. 9. Implementing Effective Interventions 3. Defining Organizational Structure and Operating Mechanisms 1. Analyzing Information About the Problem, Goals and Factors Affecting Them. 2. Establishing Vision and Mission. Workbook Page 13

14. Underage drinking (alcohol misuse) by youth ages 12-20 Binge drinking by young persons, ages 18-25 Alcohol-related crashes involving youth ages 16-25 Priorities 14

15. Priorities County Underage Drinking Binge Drinking Alcohol Related Crashes Baltimore City Frederick County 15

16. READY SHOOT AIM Problem Analysis 16

17. But Why? Priority 17

18. Priority But Why? 1 But Why? 2 But Why? 3 But Why? 4 Intervening Variables (Root Causes) 18

19. Retail availability/access to alcohol Social availability/access to alcohol Level of enforcement and adjudication of alcohol laws Social norms (perception of peer behavior) Low perceived risks of alcohol use - youth Pricing of alcohol Promotion of alcohol Intervening Variables 19

20. But Why? Priority But Why Here? Intervening Variables Contributing Factors (Local Conditions) 20

21. Problem Analysis Criteria for good “But, why here?” Contributing Factors (Local Conditions) 1. Specific (not another risk factor) 2. Identifiable 3. Actionable 21

22. 1. Clearly stating the priority (Problem statement). 2. Identifying the Intervening Variables 3. Identifying why these intervening variables exist in your community (i.e. Contributing Factors) 2.6 Logic Model 22

23. Priority But Why?But Why Here? 23

24. When should Intervening Variables & Contributing Factors make it to your logic model? Should be driven by: Data from your community Current events or political opportunities for change Community expectations or demands Logic Model 24

25. Priority But Why? But Why Here? Underage Drinking Promotion (Marketing) Store windows on Main Street are covered with alcohol ads. Alcohol industry sponsors main three community events. 25

26. Two Ways to Critique Your Logic Model 1.Line Logic Is there a credible connection between each element? (science, community experience, logic?) 2.Completeness Check Are all the pieces present? Are there any missing intervening variables or important contributing factors? Logic Model 26

27. Good Interventions: 1.Achieve Outcomes 2.Build Community 3.Strengthen Partners Meet Four Criteria: 1.Fit with local diagnosis 2.Capacity to Implement 3.Evidence of Effectiveness 4.Part of a Comprehensive Plan Developing Interventions 27

28. Seven behavior change strategies: 1.Provide Information 2.Build Skills 3.Provide Support 4.Enhance Access / Reduce Barriers 5.Change Incentives / Disincentives 6.Change the Physical Design of the Environment 7.Change Policies or Regulations Developing Interventions Workbook Page 43 28

29. Store windows on Main Street are covered with alcohol ads Alcohol industry sponsors three community events Intervention/Action Leaflets Training L. E. Partnership Recognition Alternative Ads Sign Removal City Ordinance Promotion Underage Drinking 29

30. 1.Provide Information: Presentations, workshops, brochures, billboards, social norms campaigns, town hall meetings, Web-based communications, etc. 2.Enhance Skills: Workshops/seminars designed to teach skills needed to achieve population-level outcomes. 3. Providing Support: Assisting others to conduct training, obtaining funding for equipment, training, reach specific target audiences. Seven Strategies for Community Change 30

31. 4. Changing Access/Barriers Access: -Provide instructions/training in multiple languages - Give scholarships to training programs - Provide training at vendor locations Barriers: - Enhance law enforcement operations for dealing with MIP - Remove tobacco machines from public venues - Place pseudoephedrine behind the counter 31

32. Incentives: Provide awards to businesses/organizations who pass Compliance Checks Public Recognition (as part of a overall effort) Disincentives: Increase Citations/Fines Increase Excise Taxes Use/Lose Laws 5.Changing Consequences (Incentives/ Disincentives) 32

33. 6.Physical Design - Lighting in parks - Signage - Alcohol Outlet Density/Proximity - Advertising (Restrictions) - Product Placement - Packaging 33

34. 7. Modify/Change Laws, Policies, Procedures, By-Laws Laws: Social Host Liability, Keg Registration Policies: 24/7 Zero Tolerance policy in a school district, Drug Free Workplace Policies, Mandatory Merchant Education with License Re-Application Procedures: MIP Arrest Processing by Law Enforcement, By-Laws: Civic organization use of alcohol, collaboration & networking CADCA Environmental Strategies Guide: Page 8 34

35. 35

36. Example Contributing Factor: Emphasis and availability of alcohol at the local festivals/fairs. 1.Provide Information—Educate event organizers about the issue 2.Build Skills—Train event staff to check and monitor IDs - free 3.Provide Support—Identify non-alcohol sponsors for events 4.Access / Barriers—Establish ID bracelet system for access 5.Incentives / Disincentives—Paid advertising for events 6.Physical Design—Roped-off beer garden away from center 7.Policies or Regulations—Change alcohol serving policy at public events 36

37. Environmental Strategies can: Reach entire populations Impact the overall environment Create lasting change in community norms and systems Produce “quick wins” Instill commitment toward long-term impact Evidence Based Strategies, Programs, Policies & Practices 37

38. Evidence Based Strategies, Programs, Policies & Practices 38

39. Underage Drinking Rigorous enforcement of MLDA and other alcohol laws Compliance checks Community mobilization to address community tolerance of underage drinking Evidence Based Strategies, Programs, Policies & Practices 39

40. Evidence Based Strategies, Programs, Policies & Practices Binge Drinking Establishment or increased enforcement of drinking parties, keg registration, dram shop and social host laws Alcohol excise taxes to reduce economic availability Multi-component programs that involve the individual, family, school and community 40

41. Evidence Based Strategies, Programs, Policies & Practices Alcohol Crashes Rigorous enforcement of drinking and driving laws Awareness regarding the increased risk of being caught and punished for drinking and driving Enforcement campaigns with sobriety check points Community wide media campaigns and task forces Police, judiciary, server, and business training Court-ordered /enforced treatment for DUI offenders 41

42. Goodness of Fit Will the Strategy change the Contributing Factor? 42

43. Coalitions must think comprehensively even if they cannot act comprehensively. Grantors do not fund the greatest need, they fund an opportunity to make a difference. 43

44. Strategic Planning Community Assessment Logic Model Comprehensive Strategies Community- level Outcomes Goal Reduce substance abuse among youth Short-Term Objectives Decrease retail outlets selling alcohol to minors as measured by compliance check results by 25% by 2011. Intermediate Objectives Increase “youth perception of harm from alcohol use” by 25% as measured by the ABC Youth survey by 2011. Long-term Objectives Decrease underage drinking in ABC County by 5% as measured by the ABC Youth survey by 2014. Evaluation 44

45. Contributing Factor “But, why here?” Information Build Skills Provide Support Reward / Consequence Access / Barriers Policy Change Physical Change Intervening Variable “But why?” Priority Intervention/Action - Data 1 & Source - Data 2 & Source Information Build Skills Provide Support Reward / Consequence Access / Barriers Policy Change Physical Change Intervention/Action Information Build Skills Provide Support Reward / Consequence Access / Barriers Policy Change Physical Change Intervention/Action - Data 1 & Source - Data 2 & Source - Data 1 & Source - Data 2 & Source - Data 1 & Source - Data 2 & Source - Data 1 & Source - Data 2 & Source - Data 1 & Source - Data 2 & Source Long-Term Objectives (3-10 years) Intermediate Objectives (1-4 years) Short-Term Objectives (6-24 months) Strategic Planning Intervening Variable “But why?” Contributing Factor “But, why here?” Contributing Factor “But, why here?” 45

46. Coalition Objectives What will be changed? By when? By how much? Baseline? How will it be measured? Example: Long-term Objective (Priority) Decrease underage drinking by 10% as measured by the ABC Youth survey (reported 30-day use) by 2013. Baseline 2011: 34% of 8-12 graders report “use of alcohol within the last 30 days of the survey” Target 2017: 30% of 8-12 graders report “use of alcohol within the last 30 days of the survey” 46

47. Coalition Objectives What will be changed? By when? By how much? Baseline? How will it be measured? Example: Intermediate Objective (Intervening Variable) Decrease perceived availability of alcohol by 25% as measured by the ABC Youth survey by 2014. Baseline 2011: 50% of 8-12 graders report “alcohol is easy or very easy to get” Target 2014: 37.5% of 8-12 graders report “alcohol is easy or very easy to get” 47

48. Coalition Objectives What will be changed? By when? By how much? Baseline? How will it be measured? Example: Short-term Objective (Contributing Factor) Decrease in retailers selling alcohol to minors as measured by the retailer compliance checks by 2014. Baseline 2011: 55% of retailers passed compliance checks Target 2013: 100% of retailers passed compliance checks 48

49. Coalition Objectives Priority: Underage Drinking Long-term Objective: Measure: 30-day use of alcohol reported by 10 th graders on ABC Youth Survey Baseline 2010: 36%Target 2016: _____% 49

50. Coalition Objectives Intervening Variable: Availability of Alcohol Intermediate-term Objective: Measure: Perceived availability of alcohol “reported as very easy to get” by 10 th graders on the ABC Youth Survey Baseline 2010: 52%Target 2013: _____% 50

51. Coalition Objectives Contributing Factor: Retailers selling alcohol to minors Short-term Objective: Measure: Failed compliance checks by retailers reported by Alcohol Beverage Control. Baseline 2010: 35% of retailers failed their compliance checks Target 2012: _____% of retailers failed their compliance checks 51

52. How Behavior Change Happens IF… We increase awareness about risks associated with social hosting THEN… Parents will become concerned 52 IF… Parents become concerned THEN… They won’t host parties for their kids IF… Parents don’t host THEN… Youth will have reduced social access to alcohol IF… There is reduced youth social access to alcohol THEN… Youth won’t binge drink as much Your logic model should be informed by series of “if-then” relationships that indicate your program’s theory of how change will occur.

53. How? Convene an inclusive planning group. Describe:  The action.  Who will carry it out.  When it will be completed or its duration.  Resources needed (money, information, etc.)  Communication – who should know about it. Review periodically to insure progress. Action Planning 53

54. How? 1.Create measures for each step of your logic model. Good measures: a.Are sensitive (valid) b.Are proximate (close / same level) c.Can be collected multiple times (feasible) Coalition Evaluation 54

55. Contributing Factors “But, why here?” Information Build Skills Provide Support Reward / Consequence Access / Barriers Policy Change Physical Change Intervening Variables “But why?” Priority Contributing Factor “But, why here?” Intervention/Action - Data 1 & Source - Data 2 & Source Contributing Factor “But, why here?” Information Build Skills Provide Support Reward / Consequence Access / Barriers Policy Change Physical Change Intervention/Action Information Build Skills Provide Support Reward / Consequence Access / Barriers Policy Change Physical Change Intervention/Action - Data 1 & Source - Data 2 & Source - Data 1 & Source - Data 2 & Source - Data 1 & Source - Data 2 & Source - Data 1 & Source - Data 2 & Source - Data 1 & Source - Data 2 & Source Community Level Data Map Measures to your Logic Model Intervening Variables “But why?” 55

56. Building Coalition Capacity (Form) Building coalition capacity includes addressing: Coalition Membership Coalition Organization/ Structure Leadership Cultural Competence 56

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58. 58 1.Assess your coalition’s capacity 2.Develop a data driven logic model 3.Write SMART objectives 4.Select strategies that best fit your contributing factors Wrap-up

59. Resources CADCA – Community Anti-Drug Coalitions of America: www.cadca.org MSPF Website: http://adaa.dhmh.maryland.gov/mspf/SitePages/Home.aspx MSPF Help & Technical Assistance – Contact: Nicole SealfonAdam Tate nsealfon@rx.umaryland.edunsealfon@rx.umaryland.edu atate@rx.umaryland.eduatate@rx.umaryland.edu 410.706.0178 410.706.7614 59