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Kentucky’s Commonwealth Alliance for Substance Abuse Prevention (SPF SIG)

Needs and Resource Assessment, Community Selection, and Strategic

PlanningBob Illback, Margaret Pennington, & Ben

Birkby

REACH of Louisville

DEPARTMENT OF HEALTH AND HUMAN SERVICESSubstance Abuse and Mental Health Services AdministrationCenter for Substance Abuse Preventionwww.samhsa.gov

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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”

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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

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Public Health Approach

The SPF SIG takes a public health approachpublic 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.

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Outcomes-Based Prevention

Effective prevention is grounded in a solid understanding of alcohol tobacco and other drug consumption and consequence patterns 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.

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Infusing Data throughout SPF SIG Decision Making

SPF SIG strives to use data across all stepsuse 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.

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The Strategic Prevention Framework

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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

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Data Analysis Committee

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Kentucky’s Data Analysis Committee

Dr. Richard Clayton, Professor and Associate DeanSchool of Public Health and Center for Prevention ResearchUniversity of Kentucky

Mr. Ron Crouch, DirectorKY State Data CenterUniversity of Louisville

Dr. Ellen Hahn, Associate ProfessorCollege of NursingUniversity of Kentucky

Dr. Robert Illback, Senior Evaluation ResearcherREACH of LouisvilleProfessor, Spalding University

Dr. Carl Leukefeld, Professor & DirectorCenter on Drug and Alcohol Research (CDAR)Chair, Department of Behavioral SciencesUniversity of Kentucky

Dr. David Mathews, Clinical Director Kentucky River Comprehensive Care Center

Dr. Teri WoodChronic Disease EpidemiologistKentucky Department for Public Health

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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

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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.

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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

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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

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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

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Strategic Planning Committee

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SPC Membership

Individuals with statewide perspective, including:

Senior level policy advisors from relevant state agencies

Senior level researchers

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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.”

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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.

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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)

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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”

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Communities with High Needs and Low Resources: Prospective Target Communities (“hot spots”) for SPF SIG Projects

MethamphetamineGreen River, Barren River, Pennyrile

Diverted PrescriptionsLeslie, Letcher, Elliott, Clay, McCreary, Clinton

InhalantsLyon, Monroe, Clay

TobaccoGallatin, Breathitt, Leslie, Owsley, Perry

Underage DrinkingLyon, Carroll, Owen, Nelson, Henry

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Final SPF SIG Target Counties

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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