1 Strategic Prevention Framework 101 November, 2013 Shari Sprong, MA, MS Aleya Martin, MPH Health Resources in Action.

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Strategic Prevention Framework 101 November, 2013

Shari Sprong, MA, MS

Aleya Martin, MPH

Health Resources in Action

Prevention

"Prevention is an active, assertive process

of creating conditions and/or personal

attributes that promote the well-being of

people.” (William A. Lofquist)

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Prevention Continuum

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Behavioral Health Continuum of Care Model

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• Public Health Approach

• Data-Driven Community-Based Strategic Planning Process

• Outcomes-Based Prevention

Key Principles of the SPF

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Strategic Prevention FrameworkSupports Accountability, Capacity, and Effectiveness

Assessment Profile population needs,

resources, and readiness to address needs and gaps

Capacity Mobilize and/or build capacity

to address needsPlanning Develop a Comprehensive

Strategic PlanImplementation

Implement evidence-based prevention programs and activities

EvaluationMonitor, evaluate, sustain, and improve or replace those that fail

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AssessmentProfile population needs, resources, and readiness to address needs and gaps

EvaluationMonitor, evaluate, sustain, and improve or replace those that fail

ImplementationImplement evidence-based prevention programs and activities

PlanningDevelop a Comprehensive Strategic Plan

CapacityMobilize and/or build capacity to address needs

Strategic Prevention FrameworkSupports Accountability, Capacity, and Effectiveness

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1. Assessment

Diagnosis:

• Needs and risk & protective factors assessment

• Resource inventory

• Prioritization of community issues

Data Triangle

Archival Data

Attitudes/Behaviors,Risk/Protective Factors

Community Perspective, Community Readiness

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Data Analysis

• Levels– Establish baseline

• Trends– Over time

• Patterns– By age, gender, race/ethnicity

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Resource Inventory

• Current community resources

• Who is being serviced

• Overlaps vs. gaps

Increase Collaboration – Decrease Duplication

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Prioritization of Community Issues

• Synthesize all 3 sources of data and resource inventory

• Identify areas of focus (1 – 2)

• Craft a problem statement– Drug (or other issue)– Target population– Baseline rate

Risk & Protective Factors

• Definition: Characteristics that increase (risk) or decrease (protective) the likelihood of a negative outcome.

• Domains:– Community– School– Family– Individual/Peers

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Assessment Activity

But Why?

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AssessmentProfile population needs, resources, and readiness to address needs and gaps

EvaluationMonitor, evaluate, sustain, and improve or replace those that fail

ImplementationImplement evidence-based prevention programs and activities

PlanningDevelop a Comprehensive Strategic Plan

CapacityCapacityMobilize and/or build capacity to address needs

Strategic Prevention FrameworkSupports Accountability, Capacity, and Effectiveness

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2. Capacity Building: The ability to mobilize community & resources

Build an inclusive community movement/coalition

• Membership

• Structure/function

• Engage community, include key decision makers & those affected by the problem

Levels of Involvement

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Sample Organizational Chart

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Capacity Building

Program vs. Coalition

• Scale

• Focus

• Staff responsibility

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Capacity Building

Educate the group

• Leadership

• Effective prevention

• Cultural competence

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Capacity Building

Identify and secure resources

• Human resources

• Technical resources

• Management and evaluation resources

• Financial resources

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AssessmentProfile population needs, resources, and readiness to address needs and gaps

EvaluationMonitor, evaluate, sustain, and improve or replace those that fail

ImplementationImplement evidence-based prevention programs and activities

PlanningDevelop a Comprehensive Strategic Plan

CapacityMobilize and/or build capacity to address needs

Strategic Prevention FrameworkSupports Accountability, Capacity, and Effectiveness

3. Planning

• Multiple strategies in multiple domains

• Logical

• Data- driven

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Planning

What is a Comprehensive Strategic Plan?

• Vision & Mission Statements• Problem Statement• Strategic Goals & Objectives • Outcomes • Logic Models • Evidence-Based Strategies• Action Plan & Timeline• Evaluation Plan

Planning

Design comprehensive interventions to impact risk and protective factors

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• 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

Planning

Planning Logic Model: Logical connection between the

problem, the Risk & Protective Factors and Strategies Implemented

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Planning Activity

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AssessmentProfile population needs, resources, and readiness to address needs and gaps

EvaluationMonitor, evaluate, sustain, and improve or replace those that fail

ImplementationImplement evidence-based prevention programs and activities

PlanningDevelop a Comprehensive Strategic Plan

CapacityMobilize and/or build capacity to address needs

Strategic Prevention FrameworkSupports Accountability, Capacity, and Effectiveness

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4. Implementation Putting your plans into practice

• Multiple strategies in multiple domains

• Fidelity

• Staffing

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Implementation

Role of Coalition

• Oversight of work

• Mutual accountability

• Monitoring

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AssessmentProfile population needs, resources, and readiness to address needs and gaps

EvaluationMonitor, evaluate, sustain, and improve or replace those that fail

ImplementationImplement evidence-based prevention programs and activities

PlanningDevelop a Comprehensive Strategic Plan

CapacityMobilize and/or build capacity to address needs

Strategic Prevention FrameworkSupports Accountability, Capacity, and Effectiveness

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• Community is unit of analysis – not the individual

• Trends over time

• Use evaluation results to realign strategies, as needed

Monitor progress and impacton selected change indicators

5. Evaluation

Measuring Community Outcomes

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Logic Model Template

Theory of Change

Problem Statement Strategies Activities Outcomes

Problem But why? But why here?

Short Term Intermediate Long-Term

[1

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Logic Model Template

Theory of Change

Alcohol related crashes among HS youth will decrease by decreasing the binge drinking rates among athletes and other youth and decreasing the high rates of drinking and driving.

Problem Statement Strategies Activities Outcomes

Problem But why? But why here?

    Short Term Intermediate Long-Term

     High Rates of Alcohol Related Crashes among HS students 10/year       High Rates of Binge Drinking among HS students 23%   High Rates of Drinking and Driving among HS drivers 17%      

Early Initiation first Use 30% used before 13  

Limited Activities in town for HS youth to get to using public transportation

Collaborate with Transportation Department to increase access to public transportation to HS activities Meet with interfaith youth group to provide field trips with access to activities outside of town

5 bus routes changed       5 field trips coordinated on weekends to out of town destinations

Increase access to exisiting activities for HS youth (nondriving) Youth are involved in meaningful activities

Decrease in % of HS youth who report initiating use before age 13 30% to 25%

     Decrease Binge Drinking Rate from 23% to 15%

    Decrease rates of Drinking and Driving17% to 10%

   ULTIMATEReduce number of alcohol related crashes by 50% (5/year) 

Social Norms Encourage Binge Drinking  90% students believe most athletes binge drink

Vocal minority of Athletea regularly boast about weekend drinking

Implement Atlas and Athena EBS  Social Norms Marketing Campaign at High School

3 sports teams selected to pilot Atlas and Athena curriculum Design Social Norms media campaign based on youth survey data and athletes norms

10 senior level captains and coaches hold after practice A&A sessions reaching 60 JV athletes Accurate athlete binge drinking norms communicated via positive majority messages saturating school and reaching 80% of students.

High School misperception of athletes binge drinking rates decreases to 70%  90% to 70%

 Little Enforcement of Drinking and Driving  10 or fewer arrests of youth for DUI/year

No checkpoints for DUI during high risk times for youth on weekends

Meet and Strategize with Chief of Police to increase DUI check points

Police agree to DUI checkpoints 2 Saturday evenings per month

At least 2 DUI checkpoints /month on weekends occur

10% increase in number of arrests for youth DUI

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Strategic Prevention Framework

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Cultural Competence

• Eliminates service & participation disparities

• Improves effectiveness & quality of programs, policies and practices

Meets the Needs of the People With

Whom You Are Working

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• Think sustainability from the beginning

• Look to community resources to sustain outcomes

• Sustain prevention by making it everyone’s job

Sustain outcomes, not programs

Sustainability

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Bringing It Home

How can you start doing some of this

now, to prepare you for future funding

opportunities?

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Contact Information

Aleya [email protected] Health Resources in Action (HRiA)617-451-0049 x53395 Berkeley StreetBoston, MA 02116

Shari [email protected] Resources in Action (HRiA)617-451-0049 x50295 Berkeley StreetBoston, MA 02116

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Steps Required to Implement the SPF

Assessment:• Create and maintain coalitions and partnerships• Assess community needs and resources• Analyze problems and goals• Develop a framework or model of change

Capacity:• Increase participation and membership• Build leadership• Enhance cultural competence• Improve organizational management and

development

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Steps Required to Implement the SPF

Planning:• Develop strategic and action plans

Implementation• Develop interventions• Advocate for change• Influence policy development• Write grant applications for funding

Evaluation• Evaluation initiatives• Sustain projects and initiatives

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Measuring Community Outcomes

School-Based

Strategy

Program 1

Family-Based

Strategy

Community-Based

StrategyProgram 2

Program 1

Program 2

Program 1

Program 2

Inputs Outputs Short TermOutcomes

IntermediateOutcomes

Long TermOutcomes