Transcript RAISING the BAR: Developing community capacity to address

RAISING the BAR:
Developing community capacity to
address substance abuse
in rural Tennessee counties
Kris Harper Bowers
Substance Abuse Projects Coordinator
East Tennessee State University
Office of Rural and Community Health and
Community Partnerships
Tackling Substance Abuse in Rural Tennessee
Appalachian Counties
Why?
Where?
How?
Who?
What happened?
The ARC/ETSU Connection
• ARC has had a commitment to health policy issues since the 1960’s
with precedent for cross border health demonstration projects
– Appalachian Health Policy Advisory Council (2000)
– Health research papers
– Coalition on Appalachian Substance Abuse Policy
– 2008 Annual Conference of Governors
– Partnership with SAMHSA and ORHP for meeting 8/19/08
• Funding for substance abuse
– 2006 ETSU conference
– Challenge Grants to Communities
– NORC research into substance abuse prevalence 2008
– Competitive Substance Abuse Grant Competition Rounds I & II
– TN Flex-E Grant
Partners
• Appalachian Regional Commission
• Tennessee Department of Economic and
Community Development
– Development Districts
• 8 Tennessee Counties and their Communities
• East Tennessee State University’s Office of
Rural and Community Health and Community
Partnerships
Nonmedical Use of Pain Relievers in Past Year among Persons Aged 12
or Older, by Substate Region: Percentages, Annual Averages Based on 2006,
2007, and 2008 NSDUHs
Substance Abuse and Mental Health Services Administration, Office of Applied Studies (2010). Substate estimates from the 20062008 National Surveys on Drug Use and Health. Rockville, MD. Web only report is available at:
http://oas.samhsa.gov/substate2k10/toc.cfm
General Objectives*
This project expects to contribute to
and will
preserve job opportunities that exist in the Appalachian
region by promoting a stable and drug free work force.
by providing needed
confidence, leadership, and resources to concerned
stakeholders in each participating county.
* from ARC Strategic Plan for Appalachia, 2005–2010
Goal
Reduce negative aspects of substance abuse in
these counties by
– participatory leadership development
– targeted skills enhancement
– strategic planning
– financial encouragement through challenge grants
Specific objectives
• Encourage economic change in
counties adversely affected by
substance abuse issues
• Promote community involvement in
substance abuse prevention activities
• Create effective, better-informed
community response to drug use
Flow of Program Activities
County Profile
Assessments
Meet with local
development
districts
Invitational meeting with 8
county teams; establish an
advisory group
Phase 1 – Local
stakeholder meetings
Evaluation of
outcomes and
process
Phase 2 – Multi-county
team development and
capacity building
activities
Phase 3 - Challenge
grants to address
priorities
Challenge Grants
• Teams/coalitions submit requests for small
grants of up to $5000 for completion of one
strategy from their community plan
• Teams would provide cash or in-kind matching
• Evaluation
– Project
– Economic impact
Local Communities
• Identify key stakeholders from health,
government, judiciary, law enforcement,
mental health, education, media, youth, faith,
addiction community, etc.
• Hold meeting of stakeholders (2 delegates to
grant advisory committee)
• Assess community needs
• Create strategic community plan
• Implement plan
Community Readiness Assessment
• Community Key Leader Survey
– Awareness
– Concern
– Action across community levels
• Strategic Prevention Framework
– Assessment
– Capacity
– Planning
– Implementation
– Evaluation
Using the Health Belief Model to Explore Community
Action in Substance Abuse Issues
Community Perceptions
Modifying Factors
Personal
characteristics
and knowledge of
substance abuse
Definition of
Substance
Abuse
Stakeholders
Perceived
susceptibility
and
seriousness
of substance
abuse
Coalitions
Perceived
threat from
substance
abuse
Cues that promote
community action
Likelihood of Action
Benefits versus
barriers to changing
community’s
substance abuse
Likelihood of
commitment
to community
action
Community
Action
Strategic Planning
• Based on Strategic Prevention Framework
– Assess prevention needs based on epidemiological
data,
– Build prevention capacity,
– Develop a strategic plan,
– Implement effective community prevention
programs, policies and practices, and
– Evaluate efforts for outcomes.
Modified Strategic Framework
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Define Common Beliefs – What do we believe?
Identify Problems – Where are we?
Goals - Where do we want to go?
Strategies – What can we do to get there?
Outcomes – How do we know we’re getting
there?
– Impacts – Long term effects from actions
– The Logic Model
Eight Counties
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Rural
Tennessee
Appalachian
Distressed
– Unemployment
– Poverty level
– Per capita income
Fewer resources
∴ Drug problems are greater
Clay County
•Established Drug Hot Line with sheriff’s office –
student initiative
•Drug prevention puppet show
•Town hall debate with local officials
•Established community coalition
Cocke County
•ArtScape intergenerational arts day for at-risk youth
•Increased participation in coalition
•Successful grant application for policy change in
county
Fentress County
•Increased community sector involvement
•Youth camp for at-risk youth
•Town Hall meetings
•
•Reorganization
Hancock County
•New coalition members
•Pool party parent/child “teach-in”
•Strategic planning chili supper
•Fall Festival community needs assessment
•Lock boxes and drug security information distributed
•Yard signs, news articles, media presence
Johnson County
•Youth involvement in leadership and
planning community events
•Health Rocks curriculum coalition staff
training
Scott County
•School prevention curriculum and supplies
•Media awareness
•Newspaper
•Outdoor advertising campaign
•Direct mail
Grundy County
•Leadership model for CAMP program for 15 at-risk
youth with many community sectors involved
•100% negative drug screens at 6 months
•Provided information at Health Fair, Take-Back event,
community events, and in local media
•Coalition evolution
Pickett County
•Coalition established
•Office - equipment, officers, regular meetings, etc.
•Leadership training for officers
•Tabletop display created for fairs and community
events
•Visibility: brochure, T-shirts, website
•Senior Center drug disposal speaker from hospital
•Additional funding from local sources
Next?
• Economic Impacts Study Report
• Coalition Training – December 13-14, 2010
• Increased Coalition activities
Economic Impacts
Personal and cultural
• Lives lost due to accidental overdose.
• Increased medical expenses for drug related
accidents
• People are afraid to come down town with children.
• Youth don’t see better options when they see the
negative impacts around them.
• Limited opportunities for drug treatment in rural
areas.
• Not completing treatment because of
transportation and getting and maintaining
employment.
Community
• Increased crime, which increases court costs,
police expenses, jail expenses, insurance costs,
and destruction of property.
• People travel out of town to spend money
because of drugs and illegal activity in town.
• People, especially young people, leave to get
jobs . Or they sell drugs to make money.
• There is much looking the other way in local
government agencies.
Commercial
• Business owners identified revenue loss due to
substance use by employees as well as poor
performance.
• High rate of substance use adversely affects
decisions of businesses to move to the
community.
• Loss of hours due to substance abuse at home
and on the job results in unanticipated time off.
• Lost jobs and decreased production due to
absent workers.
Contact
Kristine Harper Bowers
Substance Abuse Projects Coordinator
ETSU Office of Rural and Community Health and Community
Partnerships
PO Box 70412
Johnson City, TN 37614
423-439-7156
423-439-7720 fax
[email protected]
www.etsu.edu/kellogg/Substance%20Abuse.asp