Presentation at County Administrators Meeting

IOM & SPF:What are they – and

What implications do they have for us.

Presented byJoël Phillips

Community Prevention Institute January 26, 2006

2

NEW TERMS = NEW APPROACH

IOM - (Institute of Medicine) Continuum of Care

SPF - Strategic Prevention Framework

IMPORTANCE

Both concepts will dominate Prevention Planning/PoliciesNeed to understand how they will impact fieldKnow about availability of Resources to assist Counties.

3

PREVENTION CONTINUUM – (U.S.I.)- A Brief History -

1957 Public Health Model – “Commission on Chronic Health Care”- Introduces Primary, Secondary, Tertiary Prevention

(Disease/Health)

19831987 R. Gordon: Introduces U.S.I. concept to better distinguish

between Populations in need of Primary Prevention (Disease/Health)

1994 Institute of Medicine – commissioned study examining Mental Disorders

Use U.S.I. + Treatment + Aftercare (Continuum)(Mental Health)

2000 CSAP introduces term to substance abuse prevention (By 2002-03 directives went to States)

(Substance Use – but not fully developed)

4

The Continuum of Care Protractor

Different levels of prevention are distinguished by the level of risk of disorder/distress in various populations groups targeted.

5

Universal Prevention Measures: Address the entire population.

Aim is prevent/delay use of AOTD. Deter onset by providing individuals with information/skills

Selective Prevention Measures: Targets subsets of the population considered at

risk by virtue of their membership in a particular segment of the population.

Key Selective Prevention targets the entire subgroup regardless of the degree of risk of any individuals in the group.

Indicated Prevention Measures:Targets individuals who are exhibiting early signs

or consequences of AOD use.

6

IOM PreventionCircles within Circles

Universal PopulationsUniversal Populations

SelectedSubgroups

IndicatedIndividuals

7

Potential Selected Populations

Homeless Young Offenders Foster Youths Drop-outs Students with social/academic

problems Rave party-goers Others

8Degree of Risk

Inte

nsity

of I

nter

vent

ion

Universal

Selected

Indicated

Low

Moderate

High

Low Moderate High

9

Summary

IOM approach requires: Better understanding of our community –

communities within communities. Tired approach in thinking about prevention

services. U.S.I

Thoughtful application of prevention approaches to the three types of populations.

But it gives us: Better focus on AOD problems and individuals

involved/impacted by AOD use. Potentially better measurements of success.

10

Strategic Prevention FrameworkSPF

PURPOSE

Formalize a planning and implementation approach

Decrease substance use and abuse Promote Mental Health Prevent Mental Health disorders and

reduce co-morbidity and relapse

11

Strategic Prevention Framework Process

STEP 1 – ASSESSMENTProfile population needs, resources, and readiness to

address the problems and gaps in service delivery

STEP 2 – CAPACITY BUILDINGMobilize and/or build capacity to address needs

STEP 3 – PLANNINGDevelop a Comprehensive Strategic Plan

STEP 4 – IMPLEMENTATION Implement evidence-based prevention programs and

infrastructure development activities

STEP 5 – EVALUATIONMonitor process, evaluate effectiveness, sustain

effective programs/activities, and improve or replace those that fail

12

i. Views health promotion across the spectrum of Prevention – Intervention – Treatment.

ii. Requires Prevention and Treatment services (AOD/MH) to work together.

iii. Focus on community based approachesiv. Planning for outcomes underlies the SPF

approach.v. Outcomes measures have been identified

(NOMS) 10 Domain Area impacting Mental Health,

Prevention, Treatment.

SPF Assumptions

13

SPF IOMEXAMPLE

Apply SPF Steps IOM Concepts1. Assessment - Data Collection - Data Analysis

What do we know about our populations - Who are most vulnerable - What are their

characteristics - What risks /

behaviors are present in

their lives. (Measurement?)

14

SPF IOMEXAMPLE

Apply SPF Steps IOM Concepts1. PLANNING - Resource Issue - Selecting policies, strategies, program

services that FIT best with IOM population under consideration

What do we develop prevention services for: - Which vulnerable population - What specific needs /

issues are being addressed

15

www.cars-rp.orgPHONE 916-983-9506FAX 916-983-5738jphillips@cars-rp.org

16

TA/TRAINING SERVICES (CPI)

1. Review of current practices (needs-based planning)

2. Assessments of community readiness to implement SPF

StrengthsAreas for Improvements

3. Develop of SPF process specific to community needs

(sub-populations)

4. Ongoing TA/Trainings specific to community needs