Maryland Strategic Prevention Framework (MSPF) Core Essentials Training.

Maryland Strategic Prevention Framework

(MSPF)Core Essentials Training

• 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

Training AgendaI. Overview – The Big Picture

II. Community Assessment Review & Report out

III. Community Problem Solving

IV. Logic Model

IV. Comprehensive Interventions

V. MSPF Processes

VI. Close and Evaluations

The branch of CADCA that is responsible for:

What is the National Coalition Institute?

1

Dissemination & Coalition

Relations

Training & TA

Evaluation & Research

How Does NCI Operate?

All trainings built around the Strategic Prevention Framework

The Institute helps coalitions “get smarter faster”

The “BIG PICTURE”

Community-Level Change

Evidence-Based Strategies

Role of the Coalition

Public Health Approach to Prevention

Host Agent Agent

EnvironmentEnvironment

Community Coalitions

Substance-Related Consequences and Use

Intervening Variables/ Contributing Factors

Evidence Based Strategies, Programs, Policies & Practices

High incidence of alcohol use by Maryland youth under age 21

Enforcement of alcohol-related laws Commercial and social availability of alcohol to youth Community attitudes toward alcohol use Youth perceptions of the dangers of alcohol use Youth perceptions of the social acceptability of use Family use and attitudes towards alcohol use

Rigorous enforcement of MLDA and other alcohol laws Compliance checks Community mobilization to address community and

institutional underage drinking norms and attitudes Normative education emphasizing that most adolescents don’t

use ATOD Parent programs stressing setting clear rules against drinking,

enforcing those rules and monitoring child’s behavior High incidence of binge drinking by youth ages 18-25

Enforcement of alcohol-related laws Commercial and social availability of alcohol to youth Community attitudes toward alcohol use Youth perceptions of the dangers of alcohol use Youth perceptions of the social acceptability of use Family use and attitudes towards alcohol use Early onset of alcohol and/or drug use

Establishment or more enforcement of underage drinking party, keg registration, adult provider and social host laws

Alcohol excise taxes to reduce economic availability Education programs that follow social influence models and

include setting norms, addressing social pressure to use, and resistance skills

Multi-component programs that involve the individual, family, school and community

Interventions that identify and provide treatment for adolescents already using

High incidence of alcohol- crashes

Enforcement of drinking and driving laws Judicial drinking and driving decisions and practices Commercial and social availability of alcohol Community attitudes toward drinking and driving Perceptions of the risk of being caught and punished for

drinking and driving Availability and access to treatment in the community

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 Court Watch Community wide media campaigns and task forces Police, judiciary, server, and business training Court-ordered and enforced treatment for DUI offenders

MSPF Community Logic Model

Substance Abuse

Consequences

Strategies (Policies, Practices,Programs)

Figure 1. Outcomes-Based Prevention

Substance Abuse

Consumption Patterns

Risk & Protective

Factors and Other

Underlying

Conditions

Strategies Targeting Individualized Environments

Socialize, Instruct, Guide, Counsel

Family School

Health Care

Providers

INDIVIDUALS

Faith Community

Strategies Targeting the

Shared Community Environment

Support, Enhance

Resources

RegulationsNorms

Systems

ENTIRE COMMUNITY

Underage DrinkingRigorous enforcement of MLDA and

other alcohol lawsCompliance checksCommunity mobilization to address

community and institutional underage drinking norms and attitudes

Normative education emphasizing that most adolescents don’t use ATOD

Parent programs stressing setting clear rules against d


Alcohol Crashes• Rigorous enforcement of

drinking and driving laws• Awareness regarding the

increased risk of being caught and punished for drinking and driv

• Enforcement campaigns with sobriety check points

• Court Watch• Community wide media

campaigns and lice, judiciary, server, and business

10

Binge Drinking• Establishment or more

enforcement of underage drinking party, keg registration, adult provider and social host laws

• Alcohol excise taxes to reduce economic availability

• Education programs that follow social

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)

Impact a Defined Community

Engage All Sectors of the Community

Address conditions & settings in the

community

Promote Comprehensive

Strategies

Achieve Positive Outcomes

Role of the Coalition in Achieving Community-level

Change

Difference Between Coalitions and ProgramsCoalitions Programs

ScaleCoalitions 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 causesCoalitions 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.

ActorsCoalition 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

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”

Strategic Prevention Framework

Community Problem Solving

Best Processes1 for Implementing the Strategic Prevention Framework

8. Developing and Using Strategic

and Action Plans

6. Arranging Resources forCommunity Mobilization

5. Developing Leadership

4. Assuring Technical Assistance

12. Documenting Progress andUsing 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

1Best 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

Core Competency: Community Assessment

Priorities

The Needs Assessment provides information on: Problem of

alcohol, tobacco and

other drug use

Consequences of

alcohol, tobacco and other drug

use

Root causes

Intervening Variables

(risk factors) of

the problemLocal conditions

provide evidence of the root causes in OUR community

Demographics provide information

about the population of the

defined community

COMMUNITY

Community Assessment

Needs Assessment Data Collection

Priority

• 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

Priorities

CountyUnderage Drinking

Binge Drinking

Alcohol Related Crashes

Baltimore County- Dundalk

Carroll- Westminster

Cecil

Harford- Bel Air

Somerset

St. Mary’s

1. Coalition Name and Community

2. Describe the community assessment process conducted by the coalition:

a. How was the coalition involved?

b. Accomplishments and Challenges

3. Describe the priority (s) identified by your coalition.

Community Assessment – Report Out (2 minutes)

READY

SHOOT

AIM

Problem

Analysis

But Why?

Priority

Priority

But Why?1

But Why?2

But Why?3

But Why?4


(Root Causes)

Underage Drinking (alcohol misuse) ages 12-20:

•Retail availability/access to alcohol •Social availability/access to alcohol•Level of enforcement and adjudication of alcohol laws•Social norms (youth, family and community norms)•Low perceived risks of alcohol use - youth•Pricing of alcohol•Promotion of alcohol

Intervening Variables (Root Causes)

But Why?

Priority

But Why Here?


(Root Causes)

Contributing Factors

(Local Conditions)

Problem Analysis

Criteria for good “But, why here?” Contributing Factors (Local Conditions)

1. Specific (not another risk factor)2. Identifiable3. Actionable

Retail availability/access to alcohol

Social availability/access to alcohol

Level of Enforcement and Adjudication of Alcohol Laws

Social norms (youth, family and community norms) and attitudes regarding youth

alcohol use

Low perceived risks - Youth perceptions of the risk of alcohol use

Pricing of Alcohol

Promotion of Alcohol

But Why?

Priority

But Why Here?


(Root Causes)

Contributing Factors

(Local Conditions)

You’ve already created your logic model by:

1. Clearly stating the priority (Problem statement).

2. Surfacing the Intervening Variables (Root Causes)

3. Identifying why these root causes exist in your community – Contributing Factors

(Local conditions)2.6

Logic Model

PriorityBut Why? But Why Here?

When should Intervening Variables & Contributing Factors make it to your logic model?

1. Data from your community

2. Prevention science

3. Current events or political opportunity

4. Community expectations or demands

Logic Model

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.

Two Ways to Critique Your Logic Model1. 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 risk factors or

important local conditions?

Logic Model

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

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

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

4. Changing Access/BarriersAccess:

- 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

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)

6. Physical Design

- Lighting in parks

- Signage

- Alcohol Outlet Density/Proximity

- Advertising (Restrictions)

- Product Placement

- Packaging

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

Intervention Mapping—Worksheet

Behavior Change Strategy Intervention

Providing Information

Building Skills

Providing Support

Changing Barriers/ Access

Changing Consequences/ Incentives

Changing the Physical Design of the Environment

Changing Policy

Priority:

Intervening Variables (But Why?):

Contributing Factor (But Why Here?):

ExampleContributing 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

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


57


Intervention Mapping—Worksheet

Behavior Change Strategy Intervention

Providing Information

Building Skills

Providing Support

Changing Barriers/ Access

Changing Consequences/ Incentives

Changing the Physical Design of the Environment

Changing Policy

Priority:

Intervening Variables (But Why?):

Contributing Factor (But Why Here?):

WB:

Goodness of FitWill the Strategy change the Contributing Factor?

Goodness of FitContributing 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

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.

Strategic Planning


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

Contributing Factor

“But, why here?”

Information

Build Skills

Provide Support

Reward / Consequence

Access / Barriers

Policy Change

Physical ChangeIntervening Variable

“But why?”

Priority

Intervention/Action

- Data 1 & Source

- Data 2 & Source

Information

Build Skills

Provide Support


Access / Barriers

Policy Change

Physical Change

Intervention/Action

Information

Build Skills

Provide Support


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


Contributing Factor


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: 24% of 8-12 graders report “use of alcohol within the last 30 days of the survey”


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: 25% of 8-12 graders report report “alcohol is easy or very easy to get”


Example: Short-term Objective (Contributing Factor)Decrease in retailers selling alcohol to minors as

measured by the retailer compliance checks by 2014.Baseline 2011: 45% of retailers failed compliance checksTarget 2013: 100% of retailers passed compliance checks

Coalition Objectives

Priority: Underage Drinking

Long-term Objective:

Measure: 30-day use of alcohol reported by 10th graders on ABC Youth Survey

Baseline 2010: 36% Target 2016: _____%


Intervening Variable: Availability of Alcohol

Intermediate-term Objective:

Measure: Perceived availability of alcohol “reported as very easy to get” by 10th graders on the ABC Youth

Survey

Baseline 2010: 52% Target 2013: _____%


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

Strategic Planning


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

“Form Follows Function”

Building Coalition Capacity

Building Coalition Capacity (Form)

Building coalition capacity includes addressing:

• Coalition Membership• Coalition

Organization/ Structure

• Leadership • Cultural Competence

WB:

Taking it home:

1. How should you engage your coalitions?

2. How should your coalitions be included in the planning?

3. When should you do it?

4. Who should be involved in implementation?

5. What additional training and T/A do they need?

Next Steps

Action Steps

82

ResourcesCADCA – Community Anti-Drug Coalitions of

America

www.cadca.org

Help & Technical Assistance – Contact:

800-54CADCA x240

[email protected]

http://www.cadca.org/

Maryland Strategic Prevention Framework (MSPF) Core Essentials Training.

Documents

community problem

defined community

healthier community

coalition slide

coalition community

communitylevel change

communitylevel indicators

community building process