Transcript Key Leader Orientation - Oct 20

Key Leader Orientation
[DATE]
Introductions
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Agenda
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Why are we here?
Why does this matter?
Coalition’s role
What is CPWI?
The research foundation
Next steps
Setting the Stage
Goal: Provide an overview of the Prevention Redesign
Initiative and why we are beginning this process.
Objectives:
• Understand the picture of our community – Why
Here?
• Understand CPWI and Strategic Prevention
Framework (SPF) are and how it helps communities.
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Why are we here today?
What is prevention?
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If you look only at the people in the water…
Treatment and intervention providers
work with individuals and then…
…they use those experiences to
project need for services
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Going Upstream is harder…
You look at the whole community
and its groups and individuals…
Community as a whole
(environmental
prevention)
Groups based on risk
Individuals based on risk
…and then prioritize which services
best fit the identified needs
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Why does this matter?
10% less memory in the alcohol dependent youth compared to the
healthy youth. Source: Brown et al., 2000
15-year old male
non-drinker
15-year old male
heavy drinker
These brain
images show
the impact of
alcohol on the
brain and
specifically
illustrating
memory
function.
Image from Susan Tapert, PhD, University of California San Diego. Courtesy of Parents Matter Presentation by Robin Erz,
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Why does this matter?
…Adverse Childhood Experience, includes…
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Why does this matter?
…Washington State Epidemiological Outcome Workgroup and the Prevention
Enhancement Policy Consortium found that alcohol use has more impact on young
people than tobacco or marijuana
Ranking
Alcohol
Tobacco
Marijuana
Meth
Prevalence
1st -youth 3rd -youth 2nd -youth
5th -youth
Rates
(youth)*
Economic
1st
3rd
Illicit drugs: 2nd
Impacts
Social Impact • Deaths: alcohol greater impact than illicit drugs
• Drinking and driving: Age dependent
• Traffic injuries and fatalities: Age dependent
• School related consequences: Mixed
OVERALL
1st
3rd
2nd
5th
Prescription
Drug
4th -youth
4th
Notes: *Substances are ranked from the highest prevalence to the lowest. The first number indicates the ranking for youth and the second number
indicates the ranking for adults (+18). **Substances are ranked based on trends. The first number indicates the ranking for youth and the second
number indicates the ranking for adults (18+). With the exception of youth marijuana use, there has not been any discernible increasing or
decreasing trends in these five substances. Youth marijuana use, therefore, was given the highest ranking.
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Why does this matter?
Predictions??
Why does this matter?
Our youth use too much alcohol.
And our prevention efforts need to reduce that consumption.
Replace with image of your local data here…
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Why does this matter?
Youth in this community are using marijuana
more than others in the state.
During the past 30 days, on how many days did you use marijuana or
hashish? (results of any use)
Replace with image of your local data here…
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Wows and Wonders
What's My role Here?
• Why do we care?
• Why should I be here?
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You are an Architect
• In this process we use resources (YOU) to
address these issues in your community with
solutions you design.
• Don’t worry there is a simple process for us to
do this!
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Introduction to Prevention Redesign
Initiative (CPWI)
• Purpose
• CPWI - Strategic Prevention Framework
• Community selection
• Training approach and research support
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Evaluation
Implementation
Planning
Assessment
Getting Started
Adapted from SAMHSA Strategic Prevention Framework
CPWI Framework based on…
• The Strategic Prevention Framework (SPF)
was developed by the federal SAMHSA based
on a proven effective prevention planning
system ‘Communities That Care’® (CTC) .
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Key Strengths
• Promotes healthy youth development by engaging all
areas of the community.
• This planning process is community.
• Guides communities to select community actions,
policies and programs with demonstrated effects.
• Specifies outcome objectives to ensure
accountability for resources used.
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CPWI Purpose
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The DSHS Division of Behavioral Health and Recovery (DBHR) is
committed to its partnerships.
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DBHR is committed to provide effective prevention services.
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CPWI will
DBHR anticipate CPWI will help leverage resources and focus and
concentrate its efforts.
– have a deeper impact,
– better measure those impacts, and
– build support for additional investments in prevention.
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CPWI Objectives
Selected communities will:
• Designate a community coordinator.
• Use evidence-based capacity building.
• Implement proven environmental strategies and targeted direct services,
programs and policies through a prevention coalition.
• Partner with school-based prevention/intervention specialists.
• Evaluate chosen programs, policies and community-level change, and
participate in statewide evaluation.
• Receive technical assistance from DBHR.
• Support state efforts to reduce youth access to alcohol, drugs and
tobacco.
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Community Selection Process
“High need and some readiness for change”
…this community was chosen because…
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Community Selection Process
• ADD Local Rationale HERE
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Highline Coalition Brief History
• Add Local History HERE
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Moving Forward
• ADD Local Timeline here.
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Building a Plan for our Community
1.
2.
3.
4.
5.
6.
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Getting Started
Capacity Building
Assessment
Planning
Implementation
Reporting and Evaluation
The 'elevator speech'…
We will be able to say…
By Addressing Intervening Variables and Risk/Protective Factors, in
Community Domain
Family Domain
School Domain
Peer/Individual
Domain
With Strategies and Programs, such as
Community
Mobilization
Enforcement of
alcohol laws
Parenting
Classes
Early Childhood
Education
Peer Education
We can affect community and family outcomes, which lead to
Reduction of Youth Substance abuse and other related problem behaviors
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Benefits of Community Action Plan
Key Elements:
• Broad community involvement & ownership
• Data-driven assessment of risk,
protection, behavior and resources
• Mutually agreed-upon focus and priorities
• Research-based programs, policies and
practices, building on existing resources
• Outcome-based plan and evaluation strategy
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Process and Timeline
Process
6 – 9 months
• Assess
needs,
resources,
readiness
and gaps
1 Year
• Implement
evidencebased
prevention
strategies
• Develop
community
strategic
prevention
plan
Evaluate Measurable Outcomes
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2-4 Years
• Changes in
targeted
intervening
variables
5-10 Years
• Increase in
positive
youth
development
• Decreases in
problem
behaviors
10-15 years
• Vision
Cultural Competency
“Cultural competency is not the tenth thing on
the list in getting things done; it’s the way we
manage the other nine.”
-Dr. Robert Hayles
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Cultural Competency
Understanding culture is a process
• Cultural Knowledge – knowledge of some cultural characteristics,
history, values, beliefs and behaviors of a different group.
• Cultural Awareness – Openness to the idea of changing cultural
attitudes.
• Cultural Sensitivity – knowledge of cultural differences without
assigning values to the differences.
• Cultural competence – Ability to bring together different
behaviors, attitudes and policies and work effectively in crosscultural settings to produce better results.
-CADCA’s National Coalition Institute Cultural Competence Primer.
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Cultural Competency and Community
Engagement
• Communities determine their own needs.
• Community members are full partners in
decision making.
• Communities should economically benefit
from collaboration.
• Community engagement should result in the
reciprocal transfer of knowledge and skills
among all collaborators and partners.
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Sustainability
• What is sustainability?
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Sustainability
Question 1: What are you sustaining?
• Efforts – Strategies and Activities
• Structure to support the efforts (internal and
external)
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Sustainability
•
•
•
•
•
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Question 2: What do you need to sustain it?
Policies
Resources
People
Funding
Outcomes
Sustainability
Question 3: How will you get it?
• Clear direction
• People
• Data
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Lunch Discussion
• What do you think sustainability means to
you?
• How can you contribute to the sustainability
of this effort?
• What do you need from this effort to be able
to support it?
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Overview: Prevention Framework
Goal:
Provide an overview of the research framework
that supports prevention efforts and CPWI Strategic
Planning Framework process.
Objectives:
• Describe the research foundation of the CPWI
process.
• Explain how the prevention-science research
base helps build positive futures for youth and
prevent problem behaviors.
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“Begin with the end in mind.”
-Stephen Covey
• Childhood is not the end we need to focus on.
• Positive, healthy adulthood is the end we
must keep in mind.
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Spectrum of Prevention
http://www.preventioninstitute.org/component/jlibrary/article/id-105/127.html
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Prevention Framework
• The Public Health Approach.
• Intervening Variables, Risk and Protective
Factors and The Social Development Strategy.
• Contributing Factors and selection of
Evidence-based prevention strategies.
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The Public Health Approach
• Research-based predictors of health problems
• Modifies predictors to prevent behavior
problems
• Can affect the entire social environment
• Works through collaboration
• Can create long-lasting results
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The Public Health Approach
Problem…
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…Response
Health Promotion Framework
Consequence
Death
from heart
disease
Problem…
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Health
Indicator
Heart
Disease
Intervening
Variable
Strategies
High blood
pressure
Blood pressure
meds, diet, stress
reduction, etc.
Genetics
Knowing family
history
Sedentary
Lifestyle
Exercise. Increase
physical activity
High fat diet
Lower the fat in
your diet
Tobacco use
Reduce, curtail,
quit
…Response
Must include all below.
Can add additional
consequences.
Must include all
below. Can add
additional problems.
Must include a least
one from each box
below. Can add
additional factors.
Must include a least
one for each box
below. Can add
additional factors.
Must include a least
one for each box
below. Can add
additional activities.
Must include at least
one for each box
below. Can add
additional indicators.
Prevention Framework
• The Public Health Approach.
• Intervening Variables, Risk and Protective
Factors and The Social Development Strategy.
• Contributing Factors and selection of
Evidence-based prevention strategies.
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Intervening Variables
• Intervening Variables: Characteristics that are strongly
predictive of underage drinking and substance abuse. They are
characteristics of the community that are likely to influence
youth alcohol use.
• Examples:
–
–
–
–
–
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Alcohol Availability (Ease of access; usual sources; retailers)
Promotion of alcohol
Alcohol laws (enforcement; penalties)
Community norms (acceptability among peer and community)
Risk and protective factors
Risk Factors
• Predictors of Problem Behaviors and Positive Youth
Outcomes
• Risk Factors exist in four domains: Community,
Family, School, and Peer/Individual.
• For example: Risk Factors are predictive of higher
levels of adolescent substance abuse, delinquency,
teen pregnancy, school drop-out and violence.
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Risk Factors
Community Risk Factors
Availability of Drugs
Availability of Firearms
Community Laws and Norms Favorable Toward Drug Use, Firearms, and
Crime
Media Portrayals of Violence
Transitions and Mobility
Low Neighborhood Attachment and Community Disorganization
Extreme Economic Deprivation
SA
D
TP
SDO
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D&A
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Family Risk Factors
Family History of the Problem Behavior
Family Management Problems
Family Conflict
Favorable Parental Attitudes and Involvement in the Problem Behavior
School Factors
Academic Failure Beginning in Late Elementary School
Lack of Commitment to School
Peer/Individual Factors
Early and Persistent Antisocial Behavior
Rebelliousness
Friends Who Engage in the Problem Behavior
Favorable Attitudes Toward the Problem Behavior
Early Initiation of the Problem Behavior
Constitutional Factors
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Risk and Protective Factors
Research has shown:
• Common risk and protective factors predict
diverse behavior problems.
• Risk and protective factors work
similarly across racial lines.
• Both risk and protective factors
should be used in prevention efforts.
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Risk
Factors
Protective
Factors
Community Norms
and Laws
Bonding and
Attachment
Availability of Drugs
Resistance and Social
Skills
Academic Failure
Sense of
purpose/future
orientation
Adapted from Dr. Michael Compton, Ph.D., (editor of Clinical Manual of Prevention in Mental Health), and Dr. Ruth Shim, Ph.D., Morehouse University School of
Medicine
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Risk
Factors
Protective
Factors
Adapted from Dr. Michael Compton, Ph.D., (editor of Clinical Manual of Prevention in Mental Health), and Dr. Ruth Shim, Ph.D., Morehouse University School of Medicine
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At risk for underage
drinking, school drop-out,
teenage pregnancy, and
depression…
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Risk and Protective Factors
Risks
Community Laws & Norms
Favorable toward use
Underage
Drinking
Availability of Drugs
Academic Failure in Early
Elementary
Bonding and Attachment
Bonding and Attachment
Protection
Problems
School
Drop-Out
Teenage
Pregnancy
Resistance and Social Skills
Resistance and Social Skills
Sense of purpose/future
Sense of purpose/future
orientation
orientation
Depression
Adapted from Dr. Michael Compton, Ph.D., (editor of Clinical Manual of Prevention in Mental Health), and Dr. Ruth Shim, Ph.D., Morehouse University School of Medicine
Risk and Protective Factors
Risks
Community Laws & Norms
Favorable toward use
Underage
Drinking
Availability of Drugs
Academic Failure in Early
Elementary
Bonding and Attachment
Bonding and Attachment
Protection
Problems
School
Drop-Out
Teenage
Pregnancy
Resistance and Social Skills
Resistance and Social Skills
Sense of purpose/future
Sense of purpose/future
orientation
orientation
Depression
Adapted from Dr. Michael Compton, Ph.D., (editor of Clinical Manual of Prevention in Mental Health), and Dr. Ruth Shim, Ph.D., Morehouse University School of Medicine
Prevention Framework
• The Public Health Approach.
• Intervening Variables, Risk and Protective
Factors and The Social Development Strategy.
• Contributing Factors and selection of
Evidence-based prevention strategies.
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Contributing Factors
• Contributing Factors are related specifically to
intervening variables and are intended to
supply a more community-specific explanation
of the problem identified via each prioritized
intervening variable.
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Contributing Factors: Why Here?
Lack of
Adult/parents’
support for
enforcement
Adult/parents’
belief that
underage
drinking is a “rite
of passage”
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Lack of Justice
system’s vigorous
prosecution of
underage
drinking violators
Lack of
Enforcement
of Underage
Drinking
Laws
Lack of Facilities
to hold juveniles
under the
influence
Look at the Data Book
Add screen-shot image of your local data book here.
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Sources of Data We Use in Assessing
Communities
Healthy Youth
Survey
Social
Indicator data
& Community
Survey
Local data
Data Assessment
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Reviewing Community Data
XYZ Community
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XYZ Community
Selecting and Implementing Strategies and
Programs
• Using information from the data and
resources assessment the Coalition will move
to selecting the best fit strategies.
• Resources for selecting:
– Evidence-based practices list (DBHR)
– CTC manuals
– NREPP
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Evidence-based Prevention Strategies
• Programs, policies or practices that have
demonstrated effectiveness in:
• Reducing specific risk factors
and enhancing protective factors
• Enhancing positive behaviors
and reducing negative behaviors
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Module 3:
Building an Effective Coalition
• Goal: Understanding keys to effective
community coalition and roles of members
and key leaders
• Objectives:
– Define a coalition and roles.
– Identify ways to involve community members,
youth, key political, social, and cultural leaders
from the community to recruit for involvement
and support of the CPWI effort.
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What is a Coalition?
A formal
arrangement for
cooperation and
collaboration
New members are invited
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Sectors
Members
represent and
function on
behalf of
Members act within their
own sphere of influence
Sample Local Organization
Fiscal Agent
Community
Coalition
Coordinator
Leadership
Committee
Workgroups
formed early in
the process
Assessment
Work Group
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Resources
Assessment
Work Group
Workgroups
formed later in
the process
Youth
Involvement
Community
outreach and
public relations
Funding and
sustainability
Coalition
maintenance
Roles and Responsibilities
Guide p. 6
P-I
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Next Steps
Goal: Review the next steps in the planning
process.
Objectives:
• Confirm and assign tasks.
• Develop and agree on a work plan and
timeline.
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Coalition Logic Model
Long-Term
Outcome:
Consequences
(10-15 years)
What is the problem?
Intervening
Variables
Behavioral
Health
Problems
(Risk/Protective
Factors)
(Consumption)
(5-10 years)
Outcomes
Why?
(2-5 years)
Why here?
…with these common
factors…
These problems…
School performance
(% of courses passed)
(HYS Academic)
Youth Delinquency
(either HYS Perception
of Risk, or Alcohol
related arrests of 1017 year olds,
depending on
coalition’s strategy)
These types of
problems…
Any Underage
Drinking
Alcohol Availability:
(10th grade 30-day use)
Retail or Social Access
(10th grade)
(6 months – 2 years)
But why here?
…specifically in our
community…
[Add Yours Here]
Evaluation Plan
Action
What are we doing
about it?
So what? How will
we know?
…can be addressed
thru these strategies…
…and we will use
these tools to measure
our impact…
Community
engagement/Coalition
development:
[Coalition Name]
[Add Yours Here]
Community
engagement/Coalition
development:
Public Awareness:
Enforcement; Penalties;
Regulations
[Add Yours Here]
Public Awareness:
[Add Yours Here]
Environmental
Strategies:
Alcohol Laws:
Low Commitment to
School
[Add Yours Here]
[Add Yours Here]
Favorable Attitudes
Friends Who Use
Perception of Harm
[Based on individual
assessment]
[Add Yours Here]
State Assessment
Strategies &
Local
Implementation
Annual Coalition Survey
Sustainability
Documentation
Promotion of Alcohol
Underage
Problem and Heavy
Drinking
[Add Yours Here]
Mental Health
(HYS depression)
Community
Disorganization/
Community
Connectedness
Local Conditions
and
Contributing
Factors
[Add Yours Here]
School-based
Prevention/
Intervention Services:
Student Assistance
Program
Risk & Protective
Factors:
Direct Services:
[Add Yours Here]
[Add Yours Here]
Process measures
Community Survey
Environmental
Strategies:
Process measures
Community Survey; HYS
Prevention/
Intervention Services:
pre/post
Direct Services:
Assigned Program
pre/post and process
measures; HYS
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Local Assessment
Plan/Implementation
Reporting/Eval
Strategic Plan Suggested Timeline
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Next Steps
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Accomplishments to date
•
ADD COALITION’S ACCOMPLISHMENTS HERE
Wrap up
Thank you
• Next steps
Next coalition meeting
• Date:
• Time:
• Location:
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