Substance Abuse & Mental Health
Services Administration
Center for Substance Abuse Prevention
A Life in the Community…
for Everyone
1
Marcus Bouligny
South East Center for the Application of
Prevention Technologies (SECAPT)
State Assignments: Georgia and Alabama
Administered by PIRE
Funded by SAMHSA
Mbouligny@Pire.org
415.516.1332
2
Center for the Application of
Prevention Technologies (CAPT)
• The primary mission of SAMHSA/CSAP's
National Centers for the Application of
Prevention Technologies (CAPT) is to
bring research to practice by assisting
states/jurisdictions and community-based
organizations in the application of the
latest evidence-based knowledge to their
substance abuse prevention programs,
practices, and policies.
3
4
The Role of Prevention
To create healthy communities in
which people have a quality life:
• Healthy environments at work & in school
• Supportive communities & neighborhoods
• Drug and crime-free
5
Role of Government
The role of the Federal Government
and States is to...
Implement systems which
Support community efforts to
Reduce substance abuse &
related problems
6
Alphabet Soup
• ONDCP: Office of National Drug Control Policy
• SAMHSA: Substance Abuse and Mental Health
Services Administration
• CSAP: Center of Substance Abuse Prevention
• CAPT: Center for the Application of Prevention
Technologies.
• SPF: Strategic Prevention Framework
• SIG: State Incentive Grant (prevention systems)
7
Today’s Outcomes
1. Basic understanding of the SPF –
Steps 1 - 5
2. Basic understanding of the use of
data in the SPF
 Create a learning community to
better understand what the SPF
means to the communities we serve
8
Today’s Agenda
I.
II.
III.
IV.
V.
VI.
What is the SPF?
Why use the SPF process?
How did we get to the SPF? (retrospective)
SPF Key Principals (overview of Steps 1 – 5)
Concentrated data on the SPF
A. Outcomes of using data in the SPF Process
B. Small group case study (activity)
C. Review
Q&A
9
What is the SPF ?
• A tool for the program planning process
• An excellent start to achieving your
population wide outcomes
• Required by the SAMSHA (FEDS) for grant
applications for State Incentive Grants (SIGSIG) and other Federal Grants…
10
Strategic Prevention Framework
Why use the SPF?
• An effective Strategic Planning Process
• Community Development Process
• The Change Process at the State &
Community Level
• Giving the power and opportunity for change
to the community
11
Strategic Prevention Framework
12
Infusion of the
Strategic Prevention Framework
State Systems
General Public
Prevention Infrastructure
Awareness and
Outreach
Community Coalitions
Action Mechanism
13
Quiz # 1:
Prescription for Programs or
Prescription for Process
14
Getting to the SPF
Brief History:
1950’s through mid-1960’s
 Drugs were viewed as a way to escape
pain and avoid reality. They were more
than just a problem of the ghetto.
 Strategies used were mainly scare tactics.
 Activities used were films and speakers.
15
A Brief History:
Late 1960’s
 Drugs were used to intensify life, to have
psychedelic experience.
 We have moved from “Scare Tactics” to
“Information”.
 Continued to use film and speakers as main
delivery tool.
16
A Brief History:
Early 1970’s
 A variety of drugs were used for a variety
of reasons; widened drug use
 We switched from “information” to “drug
education.”
 We used curricula based on factual info.
17
A Brief History:
Mid to late 1970’s
 Drug users became more sophisticated,
and society developed an increasing
tolerance for drugs.
 Strategies then moved from just
“education” to “effective education” and
“alternatives to drug use.”
 Curricula was now based on
communication, decision-making, values
clarification and self-esteem.
18
A Brief History:
Late 1970’s to early 1980’s
Parents formed community
organizations which combated the
incidence of drug abuse.
We used affective education and
alternatives, but added training.
Activities included social skills, refusal
skills training, parenting education, etc.
19
A Brief History:
Late 80’s to Today
It was realized that drug use was highly
complex.
The gap between research and
application was gradually being
bridged.
Partnerships were formed; replication
of research-based models & application
of research-based approaches.
20
The Prevention Field Today
 Prevention specialists use research to
create evidence-based programs and
practices. The Strategic Prevention
Framework, a model for transforming
research into successful outcomes.
 Prevention efforts targeted across multiple
domains are facilitated by the use of
environmental strategies.
21
Quiz # 2: Pair up! You will have 30 seconds
to answer the following questions…
• The underlined terms on the last six slides are
part of what SAMSHA definition?
• Which term does not belong?
Information
Drug Education
Scare Tactics
Alternatives
Community Organizing
Environmental Strategies
Problem Identification and Referral
22
Key Principals of the SPF
23
Strategic Prevention Framework
Key Principles of the SPF
• Data-Driven Strategic Planning Process
to inform decisions
• Public Health Approach (community
scope)
• Outcomes-Based Prevention
24
Focus for States and
Communities
• Consumption & Consequences
(prevent the problem associated with
use)
• Across the lifespan (not just youth)
• Based on evidence-based research &
empirical data
• Outcomes measured at the population
level (not just program level)
If we prevent use, we prevent the problem!!
25
Strategic Prevention Framework
Cultural Competence – Meets the Needs
of the People You Are Working With
• Eliminates service & participation
disparities
• Improves effectiveness & quality of
programs, policies and practices
26
Cultural Competency
27
Strategic Prevention Framework
Sustainability - Sustain outcomes,
not programs
• Think sustainability from the beginning
• Look to the system to sustain
outcomes
• Sustain prevention by making it
everyone’s job
28
Strategic Prevention Framework
Assess - Using data to determine
substance use & related
problems
• Assessment of substance use and related
problems
• Prioritization of Problems by State and
Community
• Documents the extent, scope and nature of
substance abuse and related problems
E-1
29
Strategic Prevention Framework
Data Analysis
• Levels
– Establish baseline
• Trends
– Over time
• Patterns
E-1
– By age, gender, race/ethnicity
– Mortality Vs Morbidity (Q of L)
30
Substance Use
•
•
•
•
Overall consumption
Acute, heavy consumption
30 day use
Consumption in risky situations
– Drinking and driving
– Bars
• Consumption by high-risk groups
– Youth
E-1
31
Consequences of use
Examples…
E-1
32
Assemble Data Collection Review Team and
Define Substance Abuse Problem
• Assemble a Data Team
• Establish Prevalence Baseline Data
• Establish Incidence Baseline Data
• Establish an Initial Goal Statement
E-1
33
Strategic Prevention Framework
State/Community Epidemiological
Workgroups
• Systematic, analytical thinking to the causes
and consequences substance use
• Promote data-driven decision making at all
stages in the SPF
• Promote cross systems planning,
implementation, and monitoring efforts
E-1
34
Data discussion
• Get into groups of five.
• Each group will represent one step of the SPF
Process 1 – 5. Answer the following questions:
– How can data enhance / aid our step of the SPF? (list
a minimum of three supports)
– How will you obtain the data that you will use in your
step?
35
Strategic Prevention Framework
Capacity Building - Mobilize
Communities & Resources
• Community Level
• Engage Key Stakeholders
• Key Tasks May Include:
•
•
•
•
•
E-2
Assessing community the prevention system
Convening community leaders & Stakeholders
Building coalitions
Training and technical assistance
Leveraging resources
36
Strategic Prevention Framework
37
Infusion of the
Strategic Prevention Framework
State Systems
General Public
Prevention Infrastructure
Awareness and
Outreach
Community Coalitions
Action Mechanism
38
Strategic Prevention Framework
Planning -
Substancerelated
problems
E-3
Design comprehensive
interventions to impact causal
factors
Intervening
Factors
Evidence Based
Strategies
39
Strategic Prevention Framework
Intervening Factors / R-Factors
• Community Level Factors
– Availability of substances
– Promotion of substances
– Social norms regarding use
– Enforcement of policies and social norms
• Individual Level Factors
– Perceptions of risk
– Perceptions of harm
E-3
40
Community Risk Factors
Intervening Factors
• Availability of alcohol/other drugs
• Community laws and norms
favorable toward drug use
• Transitions and mobility
• Low neighborhood attachment and community
disorganization
• Extreme economic deprivation
Family Risk Factors
Intervening Factors
• Family history of substance abuse
• Family management problems
• Family conflict
• Parental attitudes and
involvement in drug use
School Risk Factors
Intervening Factors
• Academic failure beginning in elementary school
• Lack of commitment to school
Individual/Peer
Risk Factors
• Early and persistent antisocial behavior
• Rebellion
• Friends who use drugs
• Favorable attitudes toward drugs
• Early initiation of drug use
• Gang involvement
• Constitutional factors
Environmental
Conditions
Individual
Attributes
E-3
45
Strategic Prevention Framework
• Comprehensive Strategies Include:
- Programs
- Policies
- Practices
• Strategies should be evidence based
(from entire body of prevention
research)
– Federal Model Program List
– Peer reviewed journal with proven
effectiveness
–
Documented
effectiveness
E-3
46
Systems Model for ATOD Prevention
Community
Norms
ATOD
Problems
ATOD
USE
Enforcement
E-3
Promotion
Retail
Availability
Social
Availability
Economic
Availability
47
Strategic Prevention Framework
Implement - Logical connection between
the problem, the intervening factors and
strategies implemented
Related
Problems
High rate of
youth
alcoholrelated
crashes
E-3
Substance
Use
High rates of
binge
drinking
High rates of
drinking and
driving
Intervening
Factors
Strategies
Low
perceived
risk of
alcohol use
Curriculum
to increase
knowledge
about risk
Social norms
encouraging
binge
drinking
Media
campaign to
correct
perceptions
of ‘normal’
consumption
Little
enforcement
of drinking
and driving
Enforcement
checkpoints48
Examples of Logic Model
Our efforts /
Process
Problem
R&P
Factor
USE
Strategy:
Outputs:
Intervening
Variables:
Ban
tobacco
advertising
where youth
exposed
# ads in local
newspaper
# billboards
near school
Decrease
youth exposure
to tobacco ads
E-3
Substance
Use:
Decrease in
initiation of
smoking
Outcomes:
Short / Proximal
Decrease in
babies born
to smoking teen
mothers
Long / Distal
Decrease in lung
cancer, other
smoking-related
deaths
49
Intervening Factors / R & P Factor in
the individual domain
50
Strategic Prevention Framework
Evaluate - Monitor progress and impact
on selected change indicators
• Community is unit of analysis – not
the individual
• Contribution – not attribution
• Trends over time
• National Outcome Measures (NOMs)
uniform measures for all
federally-funded programs
51
E -5
Strategic Prevention Framework
Measuring For Success
• Programs
- Inputs ($,Time, Resources)
- Outputs (Numbers – Served &Programs )
- Short Term Outcomes – Knowledge,
Attitudes/Beliefs, Skills
• Community Comprehensive Strategies
- Long Term Outcomes – Behavior Changes (NOMS)
• Community Change
– Incidence & Prevalence Rates (Survey Data)
52
Lots to do for one prevention person
53
Collaborative Approach
• Moving from silo programs and services to
a systems approach
• Gathering: state / community / local data
• Allowing data to inform decisions about
target outcomes and interventions
54
Measuring Community Outcomes
Inputs
Outputs
Short Term
Outcomes
Program 1
Agency
A
Long Term
Outcomes
Program 2
Community
Change
Agency
B
Agency
C
Program 1
Program 2
Incidence &
Prevalence of
Problems
Program 1
Program 2
Program
Measures
Behavior
Outcome
Measures
55
Quiz #3
Name the five steps of the SPF
56
Data case study
It’s good to say that you will use data in your
process, but how do you actually get it?
• Activity: Assembling the Data Collection
Review Team
57
You Make the Difference
58