I n t e g r i t y - S e r v i c e - E x c e l l e n c e Headquarters U.S. Air Force 1 CoRC 101 Dr. Milton H. Cambridge Demand Reduction Prevention and.

I n t e g r i t y - S e r v i c e - E x c e l l e n c e

Headquarters U.S. Air Force

1

CoRC 101

Dr. Milton H. Cambridge

Demand Reduction Prevention and Outreach

Coordinator

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Overview

Review CoRC Foundational Principles Comprehensive Community Approach Leadership Driven ! CAIB/IDS 4 Tiered Approach Universal/Primary Prevention Selected/Secondary Prevention Targeted/Tertiary Prevention CoRC Metrics CoRC CONOPS and Toolkits: www.afcrossroads.com

7 Steps of Prevention Planning Process CoRC Logic Model

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Overview

“Best Practices/Lessons Learned”

Ideas for Improving CoRC Implementation

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Community Approach toPopulation Health Services

0%

100% Excellent

Poor

Prevention and Education

Leadership Supports Health Behavior Change

Installation Policies Enhance Health

Primary Care

Early Intervention

Specialty Care

Treatment of Disease

Helping Agency Support (IDS)

HEALTHHEALTHPOPULATIONPOPULATION

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Community PreventionModel for Population Health

CommunityAirmen/Families

Military TreatmentFacility

Wing LeadershipInstallation Support

IDS

Academia Public Affairs

Unit CCs/First SgtSquadrons

Assuring the ConditionsFor Population Health

The Future of the Public’s Health in the 21st Century, November 2002

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CoRC Conceptualization

Culture/NormsEnvironment

Families

Primary CareLife Skills

ADAPT/DDR

Wing LeadershipInstallation Support

CAIB/IDS

ResearchEducation

Media

PolicyDeterrence

Prevention

Early InterventionReducing Substance Misuse: Not Just a Medical Issue

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CoRC:AF Functional Community Players

Public Affairs

Legal

SecurityForces

Medical Treatment

FacilityChaplains

Mission

Support/

Services

Senior LeadershipCC/1st Sergeants

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2. 2. INDIVIDUAL LEVEL

3.BASE COMMUNITY

4. LOCAL COMMUNITY1. LEADERSHIP

INTEGRATED4-PRONGED COMMUNITYAPPROACH

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CoRC Basics1. Leadership Driven Program: Message and support from top down

2. Individual Level Opportunities for Change Assessment/Screening of risk in all personnel Education/awareness Brief Interventions and treatment when needed Responsibility and commitment

3. Base Community Opportunities for Change Develop range of alternate activities Consistent and equitable detection/enforcement Media campaign promoting responsibility Monitor AF metrics/consider base specific metrics

4. Local Community Opportunities for Change Assess threat and availability of drugs and alcohol Develop coalition with community agencies

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Surgeon General’s Toolkit:Bucket 1

Universal/Primary Prevention 

Population outreach: Screening population/surveillance

Take “temperature” of risk on base Education and feedback at teachable moments

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Selected/Secondary Prevention

Targeted, individualized, non-anonymous alcohol and drug screening at Primary Care and Flight Medicine

PHA: Everyone screened annually, feedback provided, and referred as needed

Routine Care: Options for screening, brief intervention and referral as part of routine care

Surgeon General’s Toolkit:Bucket 2

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Targeted/Tertiary Prevention

Screening, Assessment & Brief Intervention Designed for behavioral health outside of ADAPT

Family Advocacy and Life Skills Support Centers

Tools to identify and treat “sub-clinical” alcohol misuse

Improved identification of substance use disorders

Options for screening at each new intake

Improved decision treeWhen to refer to ADAPT and when to

incorporate into existing treatment plan

Surgeon General’s Toolkit:Bucket 3

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Subject Matter Consultation Guidance for ADAPT and DDR PMs about their role as

CC consultants for CoRC implementation Booklet with core consultant competencies References and Resources Resources and opportunities for training

Surgeon General’s Toolkit:Bucket 4

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The 7 Steps of Program Planning

Assess the Readiness of the Community

Assess the Levels of Risks and Protective Factors

Translate the Risk and Protective Factors into Priorities

Examine the Resources in the Community

Select a Target Population

Apply “Best Practices and “Guiding Principles”

Evaluate the Program

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AF Readiness Level

Substance Misuse: A Clear and Present Danger

Alcohol Misuse is involved in 33% of Suicides 57% of Sexual Assaults 28.5% of Domestic Violence Incidents 44% of PMV Accidents

33% of AD (17-24) commit 81% of ARIs

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AF Readiness Level

AD AF FY 04 – 0.45% Drug Positive Rate

Equals – 1,572 AD Airmen Drug Positive

Discharge over 1500 Airmen because Drug Positives

Costs – 36 – 79K to produce each trained Airmen

Cost to the AF – Over 93 Million Dollars per Year

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AF Readiness Level

CSAF- Must Reduce ARIs and Drug Positives via The Culture of Responsible Choices (CoRC)- July 2005

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Risk Factors AF- Wide

Age (17-24) *

Male*

Availability of Alcohol and Drugs*

Underage Drinking/Binge Drinking*

Single Status

High OPS TEMPO/Deployments

Stress

Sensation-Seeking

High Priority Risk Factors*

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Protective Factors AF- Wide

AF is a Family*

Excellent Health Care System*

Healthy Alternatives*

Fitness Activities First Term Airmen Centers

Network of Helping Professionals*

Opportunities for Education and Training*

High Priority Protective Factors*

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Protective Factors AF- Wide

“Wingman’s Culture”*

“Culture of Airmen”*

Suicide Intervention Program*

Enforcement of Underage Drinking Laws*

AF Zero Tolerance Policy*

Strong Leadership*

Implementation of CoRC* www.afcrossroads.com

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Examine Resources

Leadership

ADAPT/DR

Base Prevention Coalitions i.e. CAIB, IDS, Cross-Functional Oversight, CoRC Steering Committee under the IDS

Primary Care, Security Forces, OSI, Chaplains, Public Affairs, Health Educators, Family Advocacy, Outreach Managers and Other Helping Professionals

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Examine Resources

Off Base Coalitions- Community Anti Drug Coalitions of America (CADCA)

www.CADCA.org Department of Justice Enforcing Underage Drinking Laws

(EUDL) Grants

Community Prevention Agencies

Churches, Schools, etc.

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Examine Resources

Center for Substance Abuse Prevention (CSAP)

Model Programs Online Prevention Training Centers For The Advancement of Prevention Technologies

(CAPTs) Strategic Prevention Framework (SPF) National Survey on Drug Use and Health (NSDUH)

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Examine Resources

NIAAA 2002 – “A Call to Action” Changing the Culture of Drinking on College Campuses”

National Academy of Sciences, Institute of Medicine (IOM) – “Reducing Underage Drinking: A Collective Responsibility”

Research Triangle Institute (RTI) – “Survey of Health-Related Behaviors Among Military Personnel” (1980 – 2005)

IC & RC

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Examine Resources

Other ADAPT and DR Folks

Networking

AF Best “Practices and Lessons Learned”

ADADT/DR World-wide Conferences

CoRC Tactical Communication Plan – Dec 2006

CoRC Steering Committee

CAIB/IDS

CoRC CONOPS and Toolkits www.afcrossroads.com

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Examine Resources

All 72 SG toolkit documents found at: www.afcrossroads.com

Bucket 1: Resources for universal/primary prevention through population-level outreach and screening

Bucket 2: Resources for selected/secondary prevention through targeted, individualized, non-anonymous alcohol and drug screening at Primary Care/Flight Medicine during PHA and routine care

Bucket 3: Resources for Behavioral Health targeted prevention through assessment for alcohol related problems (misuse, abuse, and dependence) and drug use at all Life Skill's intakes

Bucket 4: Resources for ADAPT/DDR staff to use in their role as the Commanders' substance use subject matter experts

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CoRC Target Populations

Primary – 17-24 AD

Secondary - > 24 AD

Tertiary – Civilians, Retirees, and Family Members

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Best Practices

CoRC is based on the adaptation of the Best Practice and nationally acclaimed F.E. Warren’s “0-0-1-3” Responsible Drinking Program

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Guiding Principles

2005 CORONA Tasker

Community Prevention Model to Population Health

CoRC 4 Tiers

CSAP 6 Prevention Strategies

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Guiding Principles

Prevention Research

NIAAA 2002- “A Call to Action: Changing the Culture of Drinking on College Campuses

IOM 2003 – “Reducing Underage Drinking: A Collective Responsibility”

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Evaluation

CoRC Metrics

25% reduction in ARMs from Baseline Year

25% reduction in Drug Positives from Baseline Year

Other Measures

Process, Outcome and Impact Program Evaluation

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CoRC Logic Model

What are the Risk and Protective Factors to be addressed ? (The Goals)

Reduce ARMs by 25%

Reduce Drug Positive by 25%

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CoRC Logic Model

What services and activities will be provided ?

6 CSAP Prevention Strategies: Dissemination of Information, Prevention Education,

Alternative Activities, Community-based Processes, Environmental Approaches, and Problem Recognition and Referral

Urinalysis – “Smart Testing”

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CoRC Logic Model

Who will participate in or be influenced by the program ?

AD 17-24

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CoRC Logic Model

How will the activities lead to expected outcomes ?

If CoRC is implemented AF-wide according to the CONOPs than AD 17-24 will be more informed

With Strong Command support and if all 6 CSAP Prevention Strategies and “Smart Testing” are implemented than we will achieve the CoRC goals AF-wide

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CoRC Logic Model

What immediate changes are expected for AD ? (The short-term outcomes)

A 25 % reduction in ARMs and UA+s

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CoRC Logic Model

What changes will CoRC ultimately like to create? ( The long-term impacts)

A change in the AF Culture

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Summary: 7 steps for a Prevention Planning Process

Assess the Readiness of the Community

Assess the Levels of Risks and Protective Factors

Translate the Risk and Protective Factors into Priorities

Examine the Resources in the Community

Select a Target Population

Apply “Best Practices and “Guiding Principles”

Evaluate the Program

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CoRC

Best Practices: Kadena Air Base, PACAF

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Best Practices

Davis Monthan AFB - EUDL Project, Leadership Tier

Barksdale AFB - Individual Tier

Little Rock AFB - Base Community Tier

Malstrom AFB - EUDL Project, Local Community Tier

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Other Best Practices/Lessons Learned

A monthly listing of those turning 21 are sent to First Sergeants from Alpha roster- ACC

Placing 0-0-1-3 stickers on menus and doors of local establishments –ACC

Attending Underage Drinking Task Force and University Task Force Meeting to share ideas and gain synergy – ACC

Responsible Choices through Education, Support and Accountability – USAFE

Integrating CoRC into the Air Commando Culture - AFSOC

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Ideas for Improving CoRC Implementation

Strong Leadership Commitment !!! Implement under CAIB/IDS Appoint Base-level CoRC POC Do a local Needs Assessment Comprehensive Community Approach

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Ideas for Improving CoRC Implementation

Add a Best Practices/Lessons Learned section to CoRC Website

Use CoRC CONOPS to train Periodically Update Toolkits on CoRC Website Increase the pool of Resources at the CoRC Website

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Questions ?