Strategic Plan Consideration

*The Seven Steps to Building a Successful Prevention Program*Adapted by the Southeast CAPT from the web site of the Western Center for the Application of Prevention Technologies. http://captus.samhsa.gov/home.cfm

Absolute MUST KNOW for Evidence-Based Prevention!!!

Step 1: Community ReadinessIs your community ready for prevention?(Assess community readiness)

Step 2: Needs AssessmentWhat are your community’s greatest needs for prevention?(Conduct a needs assessment)

Step 3: PrioritizingWhich risk and protective factors are your priorities?(Translate needs indicator data into risk and protective factors)

Step 4: Resource AssessmentWhat resources already exist in your community that address the risk and protective factors that you have prioritized? (Conduct a resource assessment)

Step 5: Targeting EffortsWhere will you target your prevention efforts?(Select universal, selective, or indicated populations)

Step 6: Best PracticesWhich prevention strategies have been shown through research to be effective?(Select scientifically-defensible best practice to implement)

Step 7: EvaluationHow will you evaluate your prevention program?(Conduct evaluation planning, implementation, analysis, and use results for future program planning)

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Step 1: Community ReadinessIs your community ready for prevention?(Assess community readiness)

What is community readiness and why is it important?Community readiness is the extent to which a community is adequately prepared to implement a drug abuse prevention program. A community must have the support and commitment of its members and the needed resources to implement an effective prevention effort. Because community readiness is a process, factors associated with it can be objectively assessed and systematically enhanced.

Nine stages of community readinessExcerpt from Community Readiness for Drug Abuse Prevention: Issues, Tips and Tools, 1997, National Institute of Drug Abuse, p. 13-15Through extensive research on community development and substance abuse prevention efforts, Oetting and colleagues (Oetting et al. 1995) have identified nine stages of readiness through which communities develop: the higher the stage of development, the greater the degree of readiness. The following are descriptions of the nine stages and the characteristics of communities at each stage:

Stage 1: Community Tolerance/No KnowledgeCommunity norms actively tolerate or encourage the behavior, although the behavior may be expected of one group and not another (e.g., by gender, race, social class, or age). The behavior, when occurring in the appropriate social context, is viewed as acceptable or as part of community norm. Those who do not engage in the behavior may be tolerated, but might be viewed as somewhat deviant.

Stage 2: DenialThere is usually recognition that the behavior is or can be a problem. Community norms usually would not approve of the behavior, but there is little or no recognition that this might be a local problem. If there is some idea that it is a problem, there is a feeling that nothing needs to be done about this locally, or that nothing can be done about it.

Stage 3: Vague AwarenessThere is a general belief that there is a local problem and that something ought to be done about it. Knowledge about local problems tends to be stereotypical and vague, or linked only to a specific incident or two. There is no immediate motivation to do anything. No identifiable leadership exists, or leadership lacks energy or motivation.

Stage 4: PreplanningThere is clear recognition that there is a local problem and that something should be done about it. There is general information about local problems, but ideas about etiology or risk factors tend to be stereotyped. There are identifiable leaders, and there may be a committee, but no real planning.

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Stage 5: PreparationPlanning is going on and focuses on practical details. There is general information about local problems and about the pros and cons of prevention programs, but it may not be based on formally collected data. Leadership is active and energetic. The program may have started on a trial basis. Funding is being actively sought or has been committed.

Stage 6: InitiationEnough information is available to justify a prevention program, but knowledge of risk factors is likely to be stereotyped. A program has been started and is running, but it is still on trial. Staff are in training or just finished with training. There may be great enthusiasm because limitations and problems have not yet been experienced.

Stage 7: Institutionalization/Stabilization One or two programs are running, supported by administration, and accepted as a routine and valuable activity. Staff are trained and experienced. There is little perceived need for change or expansion. Limitations may be known, but there is not much sense that the limitations suggest a need for change. There may be some form of routine tracking of prevalence. There is not necessarily permanent funding, but there is established funding that allows the program the opportunity to implement its action plan.

Stage 8: Confirmation/ExpansionStandard programs are viewed as valuable and authorities support expanding or improving programs. New programs are being planned or tried out in order to reach more people, those thought to be more at risk or different demographic groups. Funds for new programs are being sought or committed. Data are obtained regularly on extent of local problems and efforts are made to assess risk factors and causes of the problem.

Stage 9: ProfessionalizationDetailed and sophisticated knowledge of prevalence, risk factors and etiology exists. Some programs may be aimed at general populations, while others are targeted at specific risk factors and/or at-risk groups. Highly trained staff are running programs, authorities are supportive, and community involvement is high. Effective evaluation is used to test and modify programs.

Oetting and colleagues (Oetting et al. 1995) have found that as communities achieve successively higher stages, they realize greater improvement in their degree of readiness. Therefore, to increase a community's readiness for prevention programming and thereby improve the likelihood that a prevention effort will succeed, it is important to give careful consideration to these nine stages of community readiness development during the process of conducting an objective assessment of community readiness.

Oetting, E.R.; Donnermeyer, J.J.; Plested, B.A.; Edwards, R.W.; Kelly, K.; and Beauvais, F. Assessing community readiness for prevention. International Journal of Addictions, 30(6):659-683, 1995.

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For more information and tools on community readiness, the National Institute on Drug Abuse has available, "Community Readiness for Drug Abuse Prevention: Issues, Tips and Tools. To obtain a copy, contact National Technical Information Services at (800) 553-6847 (publication number PB# 97-209605). This book is part of a 5 book packet which costs $83 plus $5 handling.

The links below will help you assess your community's readiness for prevention as well as provide you with strategies to improve community readiness.  (From NIDA's "Community Readiness for Drug Abuse Prevention:  Issues, Tips and Tools (1997).)

Community readiness assessment surveyThis survey will assist you in determining where your community is in terms of

readiness for prevention. This survey, developed by Goodman and Wandersman at the University of South Carolina, uses key leaders to look at three areas: awareness, concern, and action across community levels. Key leaders respond to questions in these three areas both on a personal level and a perceptual level of their organization's responses. 

Community readiness strategiesOnce you have assessed your community's readiness for prevention, you can use

some of these strategies to improve your community's readiness. These strategies are included in NIDA's "Community Readiness for Drug Abuse Prevention: Issues, Tips and Tools."

Next step: Needs Assessment

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Step 2: Needs AssessmentWhat are your community’s greatest needs for prevention?(Conduct a needs assessment)

What is a community assessment (needs assessment)?A community assessment is a systematic process for examining the current conditions of a situation (such as substance abuse) and to identify the level of risk and protection in your community.

Why do we need to complete a community assessment?• A community assessment will assist you in:• Creating an objective profile of your community• Determining the geographic and demographic areas that are at greatest risk• Ensuring you are putting your time and money where it will have the greatest impact• Showing policy makers the need for funding your prevention programs• Identifying research-based strategies to implement in your community

How do we complete a community assessment?How do we complete a community assessment?1. Collect data.2. Analyze the data.3. Select the priority risk factors (step 3 of the web-site).

1. Collect data.Data collection is the first phase of conducting a community assessment. At this point, data needs to be identified and assembled in order to determine how prevalent each risk factor and protective factor is in your community. It is important that you examine risk factors because this will tell you which factors are prevalent in your community that are increasing the risk that your youth will be involved in substance abuse, teenage pregnancy, youth violence, school drop-out, and delinquency. If you only examine the prevalence of a particular problem (e.g. the number of kids abusing drugs), you won't know what you can do to impact and/or prevent the problem. However, if you can figure out which risk factors (that increase the likelihood of a problem occurring) are prevalent in your community, then you can identify and implement strategies to reduce those risks and thus reduce the problem behavior. Similarly, by examining the level of protective factors that exist in your community, this will tell you how prevalent factors are which buffer the effects of risk factors.

Two kinds of data can be collected:

Archival data, or data that already exists

Survey data, or data that you create

Archival indicators, data that already exists, have been identified through research to enable you to determine how prevalent risk factors are in your community. Click here for

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a list of validated archival indicators. These are the indicators which have been shown through research to be good proxy measures for risk factors. We need archival indicators because we can't go to our local health department and look up the statistics on "family management problems" because a family management problems statistic does not exist. Consequently, we must use "proxy" measures to determine how prevalent family management problems and other risk factors are. Here are some sources of archival data:National Data:

CSAP's PREVLINE -- Contains links to 20 data sources

Office of National Drug Control Policy -- Lists 25 links to data sets, along with the sponsoring agency, description of information available, population, geographic areas, and frequency/year started

National Criminal Justice Reference Service -- Contains links to many sources of crime statistics, both National and State data

Centers for Disease Control and Prevention -- Contains links to many sources, including the Youth Risk Behavior Surveillance System survey

State of the Nation's Cities Report (HUD) --  A database on American cities and suburbs (includes data on items such as employment, income, land development)

You can also identify the prevalence of risk and protective factors in your community through surveys. This may be a preferred alternative if little archival indicator data is available to you. However, surveys can also function as a good supplement to the archival indicator data you collect. By having both archival and survey data, you can compare the two to see where differences and similarities lie.

Steps for Collecting Data:

Identify what data is currently available for each risk and protective factor, beginning with the list of archival indicators.

Determine which factors need additional data. Click here for a worksheet to assist you in completing this step.

Develop a plan to collect the additional data that is needed. Click here for a worksheet to assist you.

Collect that additional data.

2. Analyze the Data.How do we analyze all of the data we have collected?Once you have collected indicator data, it is time to analyze the data. Your data analysis will assist you in identifying which risk and protective factors need to be prioritized in your community action plan, as well as provide justification for grant applications, support existing policies and programs, and assist you in selecting new prevention programs to implement.

The following are questions that need to be asked of the data

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What does the raw data tell you? At first glance, what do the data tell you? Do the raw numbers impress you as being low? Average? High? Any red flags?

How do the data compare to previous years? Is there a trend? By comparing numbers for previous years, you can begin to get a picture of how the data has been changing over time. Is it increasing? Decreasing? Staying the same? How have trends changed in relation to population changes?

How do our data compare with other similar data (national, state, county, etc.)? Are the trends similar? Are the rates about the same? Are they going up or down?

What can be interpreted from the data? After reviewing the raw data, the data trends, and the data comparisons (if available), what can you interpret from your analysis? What is happening? Do you know why it is occurring? What could have caused the trend? What does the observed level or trend tell you about this risk or protective factor? What other factors or events could account for the data?

Are there relationships among risk factors that you can identify based on the data you have? Examine your data across risk factors and across protective factors.

Should you prioritize this risk factor? The more information obtained about the indicator data, the easier this question will be to answer. See next step.

Next step: Translating Data into Priorities

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Step 3: Translating Data into Priorities Which risk and protective factors are your priorities?(Translate needs indicator data into risk and protective factors)

(Adapted with permission from Developmental Research and Programs' "Communities That Care©" Risk Assessment. All rights reserved.)

Once you have completed the collection and analysis of the data collected for your community assessment, it is time to prioritize which risk and protective factors need to be addressed in your community. The following questions will assist you in identifying your priorities:

Looking across the data you have collected, are there risk factors or protective factors for which you have no data? If so, identify these factors, determine if and

where the appropriate data can be collected, and add this information to your data analysis to strengthen your overall assessment. Remember, the assessment is the foundation for your prevention action plan. The more thorough you are in completing this step, the more effective and accurate you will be in designing solutions.

Which risks are most prevalent in your community? Which protective factors are most lacking? Based on: trends, comparisons with other similar data (national,

state or other communities); comparisons across factors; and your interpretation of the data and possible explanations.

At what developmental periods are children most at risk in your community?

Is there an identifiable "cluster" of risk factors that, addressed together, could provide a synergistic response?

Which two to five risk factors, identified as most prevalent in your community, do you think your community should tackle first? Which protective factor

should you tackle first?

Next step: Resource Assessment

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Step 4: Resource AssessmentWhat resources already exist in your community that address the risk and protective factors

that you have prioritized? (Conduct a resource assessment)

What is a resource assessment?A resource assessment is a systematic process for examining the current resources in your community which are reducing risk factor and increasing protective factors. It answers the question: "What's going on in my community?"

What are "resources"? They are anything that can be activated to reduce the likelihood that individuals or communities will begin or continue to abuse alcohol, tobacco, and other drugs.

Why do we need to complete a resource assessment?A resource assessment will assist you in:

Identifying gaps where new services should be implemented

Avoiding duplication in services

Building collaboration among service providers

Modifying existing programs to meet prevention needs

Identifying existing resources to sponsor new programs

Ensuring you are putting your time and money where it will have the greatest impact

Ensuring you are creating a comprehensive prevention strategy for your community

Ensuring you are effectively impacting the priority risk and protective factors that you identified when completing your community assessment (Steps 2 and 3).

How do we complete a resource assessment?

Before conducting a resource assessment, you must complete a community assessment and identify priority risk and protective factors (Step 2 and Step 3).

Collect information on existing resources in your community which may be addressing the priority risk and protective factors that you identified through your community assessment.

Analyze the resources to determine how effectively they are impacting your priority risk and protective factors.

Determine where the gaps in services are in your community.

Next step: Targeting Efforts

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Step 5: Targeting EffortsWhere will you target your prevention efforts?(Select universal, selective, or indicated populations)

What is a resource assessment?Now that you have completed your community assessment, identified priority risk and protective factors, assessed your community's existing resources, and identified the gaps, it is time to take one more look at your target population.

Since you know in which area you want to place your time and funding (your priority risk and protective factors) and you know which gaps you need to fill (from your resource assessment), you can now identify what type of target population you need to address: universal, selective, or indicated (click on these words for definitions).

To determine what type of population your program/strategies should reach, answer the following questions:

Can your priority risk/protective factors and resource gaps be addressed at the universal level? Or would those risk/protective factors and gaps be better addressed

with selective or indicated populations? For example, if your priority risk factor is family management problems but you know through your resource assessment that several local programs already offer parenting classes aimed at the general population, then you may want to look at implementing a parenting program for selective or indicated populations.

Do you need a program/strategy that impacts the broader community (e.g., a city, a school), not a particular segment of that community? If so, you may want to

implement a universal program/strategy.

Do you need to implement a program/strategy with greater intensity and duration for a specific population with identified risks? If so, you may want to choose a selective or

indicated program/strategy to implement.

If you are looking at implementing a selective or indicated program/strategy, do you have adequate funding? (Many selective and indicated programs/strategies require

more funds than do universal programs/strategies.)

Once you have answered the above questions and have determined what type of population you will target, make sure you are clear as to: what age group(s) you want

to address; whether you are targeting both genders or just one; in which developmental stage your target group is; and from which culture your target group is.

Next step: Best Practices

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Step 6: Best PracticesWhich prevention strategies have been shown through research to be effective?(Select scientifically-defensible best practice to implement)

What are guiding principles and best practices?Best practices are those strategies, activities, or approaches which have been shown through research and evaluation to be effective at preventing and/or delaying substance abuse.

Guiding principles are recommendations on how to create effective prevention programs. When a community already has a prevention program or strategy in place, the guiding principles can be used to gauge the program's potential effectiveness. They can also be used to design an innovative program/strategy when none of the best practices are appropriate to the community's needs.

Before you select a best practice or apply the guiding principles, your community must conduct an assessment (risk assessment) to identify the risk and protective factors that need to be addressed in your community. Once you have identified which risk and protective factor(s) to address through your assessment, you can use the links below to select the best practice(s) and/or guiding principles to address your community's needs.

Definition of "best practice": In this web-site "best practices" are those strategies and programs which are deemed research-based by scientists and researchers at the National Institute for Drug Abuse (NIDA), the national Center for Substance Abuse Prevention (CSAP), National Center for the Advancement of Prevention (NCAP), National Office of Juvenile Justice and Delinquency Prevention (OJJDP) and/or the national Department of Education (DOE). These are strategies and programs which have been shown through substantial research and evaluation to be effective at preventing and/or delaying substance abuse. If you are familiar with the rating scale presented in the document, "Science-Based Practices in Substance Abuse Prevention: A Guide" prepared by P.J. Brounstein, J.M. Zweig, and S.E. Gardner, the best practices in this web-site would fall into the categories of types 3, 4, and 5. Click here for more information on this rate scale. (PLEASE NOTE: Each best practice has not been labeled either 3, 4, or 5. The authors of the document did not specificy specific types to specific programs. Therefore, this information does not exist.)

We have also included a category called "Promising Practices" in areas of the web-site where there are few programs that have enough outcome data (or that have been sufficiently evaluated) to be deemed best practices.

Definition of "promising practices": Promising practices are programs and strategies that have some quantitative data showing positive outcomes in delaying substance abuse over a period of time, but do not have enough research or replication to support generalizable outcomes. These practices would fall into the rating scale (mentioned above) of types 1 and 2.

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NOTE: No single best practice will be successful at preventing substance abuse in your community. To be as comprehensive as possible, best practices addressing prevention strategies (CSAP strategies) in all areas of your community (family, school, individual, peer, society/community) should be implemented. Remember: there is no "magic bullet" in prevention!

Get more information on:

Guiding Principles (Part of Step 4)

Department of Education's Principles of Effectiveness

Best PracticesAfter you have completed a needs (risk) assessment and have identified the area you need to address, you can access a list of best practices through the Needs Resources of Effective Programs:

http://modelprograms.samhsa.gov

Additional Resource Materials

Also try visiting the other CAPT sites for more information. We recommend Central CAPT's search page on best practices.https://www.epidcc.samhsa.gov/

Next step: Evaluation

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Step 7: EvaluationHow will you evaluate your prevention program?(Conduct evaluation planning, implementation, analysis, and use results for

future program planning) https://www.epidcc.samhsa.gov/

This site is designed to be a "how-to" guide to planning and implementing an evaluation of your prevention program. If you start by clicking on Section I of the outline below, you will be led through the step-by-step process of developing an evaluation. You can also use the outline to navigate the site and locate specific kinds of evaluation information. There are 7 major sections.

Within each section you will find worksheets, tools, and examples of how to conduct user-friendly evaluations of substance abuse prevention programs using the risk and protective factors model. These worksheets and tools can also be accessed in the last section of this site: Section X: Evaluation Tools & Measures.

I.  What is Evaluation & Why Do It?

II.  Using a Logic Model for Evaluation Planning     A. Who should develop the logic model?     B. Benefits of a Logic Model          Logic Model Worksheet

III.  How to Build Your Program Logic Model     A. What You Need to Know to Build your Logic Model          1.   What risk and protective factors does your program address?          2.   What services and activities will your program provide?          3.   Who will participate in your program?          4.   How will these activities lead to outcomes?          5.   What are your program's long and short term goals?

a.   What immediate changes are expected?b.   What changes would your program ultimately like to create?

     B. Reviewing your Logic model

IV.  How to Plan Your Evaluation     A. General Considerations     B. Developing the Plan          1.   What are you going to evaluate?          2.   What do you want to know about the program?

a.   Defining the purpose of the evaluationb.   Defining the users of the evaluationc.   Defining the evaluation questions

          3.   Focusing the Evaluationa.  Timing and program development

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b.  Scope of the programc.  Pragmatic considerations

V.  Evaluating Your Program Using the Logic Model    A. General Issues in Evaluation Methods                    1.   Types of information          2.   Quantitative and Qualitative information          3.   Identifiying measureable indicators          4.   Making decisions about methods    B. Evaluating Issue Focus    C. Evaluating Program Activities and Outputs    D. Evaluating Coverage    E. Evaluating Program Assumptions    F. Evaluating Outcomes

1.   Some common methodsa.   Post-test onlyb.   Post-test with a comparison groupc.   Pre-Postd.   Pre-Post with comparison group

2.   Distinctions between long and short term outcomes3.   Measuring Client Satisfaction

VI.  Analyzing, Using & Interpreting Evaluation Information    A. Basic Aggregation and Analysis Strategies    B. Descriptive Information    C. Testing for Changes Pre-Post    D. Using and Interpreting Information

1.   How will the information be interpreted-by whom?2.   How will the evaluation be communicated and shared?

VII.  Implementing the Evaluation    A. Who's responsible for the evaluation    B. How to know if you need an Evaluation Consultant or Contractor   C. Finding and selecting a good consultant

VIII.  Glossary

http://captus.samhsa.gov/national/resources/resources.cfm

IX.  Links to evaluation resources

http://captus.samhsa.gov/home.cfm

X. Evaluation Tools & Measures

https://www.epidcc.samhsa.gov/

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A. Logic Model Worksheet B. Hypothetical Logic Models from CSAP Best Practices C. Developing Questionnaires D. Developing Behavioral Surveys E. Interviewing F. Using Tests and Assessments G. Using Observational Data H. Conducting Focus Groups I. Using Case Studies J. Using Program Records K. Using Community Archival and Indicator Data L. Measuring Goal Importance M. Measuring Client Satisfaction N. Instruments for Risk and Protective Factors

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