SPF Assessment Training. SPF 1. Assessment is the first step in the Strategic Prevention Framework (SPF). 2. SPF is SAMHSA’s Center for Substance Abuse

SPFAssessment Training

SPF

1. Assessment is the first step in the Strategic Prevention Framework (SPF).

2. SPF is SAMHSA’s Center for Substance Abuse Prevention’s model for planning.

3. It can be used for both agency and coalition planning.

Training Objectives

1. Describe the process of a community needs assessment.

2. Describe at least 3 methods for collecting and analyzing data.

3. Prioritize a community problem area based on assessment data.

4. Learn about a community based logic model to assist in the community assessment.

5. Explain how cultural competence and sustainability are infused into a needs assessment.

What is Assessment?

An Assessment reviews data from as many sources as can be identified such as regions, states, communities or neighborhoods to determine ATOD problems and geographical places where problems occur most frequently.

What is Assessment?

Assessment not only defines or highlights our problems, but it is a review of resources, gaps, and readiness of your community to acknowledge and address the problem(s).

What is an Assessment?

It is a multi-data review to determine:

What/Where ATOD problems exist

What resources are in place to address them Which gaps inhibit success

What is the level of community readiness to address this issue

Assessment Answers

Who has the problems?

Where are the problems?

When do problems occur?

How do problems occur ?

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Epidemiology (Epi)

“Epidemiology studies the distribution and determinants of health-related events in

populations.”

Epidemiological data describes substance use and its consequences within and across populations.

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Other Epi Functions . . .

Increases understanding of scope and nature of community problems

Facilitates ability to prioritize

Aids selection of effective solutions

Ultimately leads to healthier community

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Process for Conducting an Assessment

Assessment Activities

• Form Epidemiological Workgroup

• Identify area of concern

• Obtain data relevant to concern

• Analyze data

• Prioritize data

• Share data

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Involve Community Partners

Community coalitions

Office of Highway Safety

Department of Education

Department of Human Services

University faculty/staff/researchers

Treatment/Prevention specialists

Health department/health care providers

Private evaluation/consulting organizations

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Who else should be involved?

School personnel Community leaders Parents Youth Police Religious leaders Treatment providers

Social service providers Health care providers Business & labor leaders Community coalition

members Media representatives Concerned citizens

Assessment Activities

• First, develop a tentative project timeline.

• In your timeline consider: due dates, specific activities, assignments.

There are 7 steps in assessing need.We will review each one of the following…

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Steps in Assessing Need

1. Define/Describe the community

2. Identify the community priority problem

3. Assess the level of substance use

4. Identify population(s) at risk

5. Identify intervening variables

6. Identify community resources

7. Assess community readiness

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Community

You will first need to identify your community

It can be a city, school, district, county, neighborhood, special needs or underserved group

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Demographic Profile of Community

• Population size

• Income/poverty

• Age/gender/race/ethnicity

• Urban/Suburban/Rural

• School enrollment

• Educational attainment

• Disability

• Employment status

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Disaggregation is a big word that simply means - Breaking down aggregate (or a COMBINED MIXTURE) of data into specific subgroups;

For example there may be a need to see what the specific trends are with certain age groups or grades .

Disaggregation of the Data

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Demographics Age/Grade Income levels Gender Race/Ethnicity

Geography State/County/City/Village Topography

History/Present/Future Founding groups Power Groups/Echelons Primary Industries

Disaggregation of the Data

Community Profiletells you what your community looks like.

Average Household Income/Size

Average Educational Level

Large population of non-English-speaking residents

Can help determine economic status & possible resources

Can help determine most appropriate reading level & message content for materials

Need to use different communication channels, e.g. foreign language newspapers, radio stations

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“What human issues does my

community care about that are caused by substance

use/abuse?”

SA Priority Problem

Definition:

The social, economic, and health problems associated with the use of alcohol tobacco and illicit drugs.

Any social, economic, or health problem can be defined as a substance use problem if the use ATOD increases the likelihood of the problem occurring.

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As we collect data to analyze what is going on in our communities we should consider:

Rate: Frequency with which an event occurs in a defined population

Burden: Cumulative effect of a broad range of harmful disease consequences on a community (e.g. health, social, and economic costs to the individual and to society)

Severity: The seriousness of a hazard

Trend: A direction demonstrated through observation of data and/or indicators over time

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Indicator Summary

• Data analysis of ATOD consumption and consequences confirms indicators

• Create an organizational framework to look at your data

• Keep your various goals separate…don’t drop data that doesn’t fit ‘all’ needs

• Be transparent and track your data selection decisions (People change, Processes continue)

Prioritization

To arrange events in the order of importance

what defines “importance”?

Severity: County ranking

Burden: Raw number of incidents, economic

and social impact

Trend: Increase or decrease over time?

Prioritization

Preventability/Changeability: Changeable considering funding and time?

Capacity/Resources: What is currently being done?

Readiness: Public opinion and political climate

Prioritization is a subjective process

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Prioritization Process – Phase 1

Analyze/interpret priority problem according to: Dimensions of numbers (size, magnitude) Rates Changes over time Economic costs Social impact Relative severity among geographic &

demographic subpopulations Political will Capacity

Prioritization Activity

Example of a Way to Process data:

1. Create tables for your data and rank each.

2. Add your scores.

3. Identify the top substance abuse related consequence and record it.

Consequence/Problem: Alcohol related crashes Consequence/Problem: Alcohol related chronic death

Consequence/Problem: Suicide death

Comments: Score Comments: Score Comments: Score

Primary Considerations Primary Considerations Primary Considerations

Criteria 1a: Severity (County Ranking within State)

3 Criteria 1a: Severity (County Ranking within State)

Criteria 1a: Severity (County Ranking within State)

Criteria 1b: Severity (Rate per 100,000) 3 Criteria 1b: Severity (Rate per 100,000) Criteria 1b: Severity (Rate per 100,000)

Criteria 2a: Burden (number/size of problem) 3 Criteria 2a: Burden (number/size of problem)

Criteria 2a: Burden (number/size of problem)

Criteria 2b: Burden (economic impact) 3 Criteria 2b: Burden (economic impact) Criteria 2b: Burden (economic impact)

Criteria 2c: Burden (social impact) 3 Criteria 2c: Burden (social impact) Criteria 2c: Burden (social impact)

Criteria 3: Trend characteristics (increasing, decreasing, stable – compared to state trend)

1 Criteria 3: Trend characteristics (increasing, decreasing, stable – compared to state trend)

Criteria 3: Trend characteristics (increasing, decreasing, stable – compared to state trend)

Secondary Considerations Secondary Considerations Secondary Considerations

Criteria 4: Preventability/Changeability 3 Criteria 4: Preventability/Changeability Criteria 4: Preventability/Changeability

Criteria 5: Capacity/Resources 1 Criteria 5: Capacity/Resources Criteria 5: Capacity/Resources

Criteria 6: Perceived Gap between Capacity/Resources and Need



Criteria 7: Readiness/Political Will/Public Concern



Sum of each column Sum of each column Sum of each column

Total Score Total Score Total Score

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Assess the Level of Use by…

• Frequency, quantity

• High risk situations

• High risk populations

*Conversely low risk situations can also be tracked

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Level of Use Questions

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Intervening Variables

Intervening variables are factors identified as:

Strongly related to and influencing the occurrence and magnitude of substance use and related risk behaviors and their consequences

Causing, or coming before, alcohol consumption or experiencing consequences that follow the misuse of alcohol


As we determine how drugs are being consumed we ultimately learn which consequences are occurring and with who as a result of this use.

This combination of knowledge helps us take a population-based approach to effecting change in our communities.

Examples of Intervening Variables Available Resources

Retail Availability

Social Availability

Economic Availability

Promotion

Community/Social Norms

Enforcement of policies and norms

Low Perceived Risks

Individual-level factors

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Format to Analyze Intervening Variables

• Easy RETAIL ACCESS to Alcohol for youth

• Low ENFORCEMENT of alcohol laws

• Easy SOCIAL ACCESS to Alcohol

• Low PERCEIVED RISK of alcohol use

• SOCIAL NORMS accepting or encouraging youth drinking

• PROMOTION of alcohol use (e.g. advertising, movies, music, etc.)

• Low or discount PRICING of alcohol

Public Health Model

Basically the Public Health Model. Who is using or misusing ATOD in our

community (HOST)? What are they consuming (AGENT)? How are they using? In what context is

consumption occurring (ENVIRONMENT)?

Public Health Model

Two Types of Data

QUANTITATIVE DATA Defined as variables that you can count Should be able to verify independently Critical in identifying substance-related consequences &

issues

QUALITATIVE DATA Defined as people’s attitudes, opinions, or beliefs Cannot be verified independently Can be collected from interviews, town hall meetings,

focus groups, or survey questions

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Risk & Protective Factors

Analyzing risk and protective factors will help you gain insight into the context of use.

Risk factors Increase the potential for substance use

Protective factors Reduce the potential for substance use

Four classic domains: Community, Family, School, Individual/Peers

Outcome Based Logic Model

Remember: The logic model makes logical, evidence-based

connections between Priority Problem, Substance Use, Intervening Variables, and Strategies.

It is crucial that all elements of the logic model tie back to the consequence.

Priority Problem Substance Use


Strategies


Social, economic, and

health problems

associated with the use of alcohol,

tobacco, and illicit drugs.

Links factors that influence substance

use patterns to substance related

consequences

Evidence-Based Programs,

practices or policies that

address factors strongly related

to and influencing the occurrence and magnitude of substance use

and related risk behaviors and

their consequences

InterveningVariables

Strategies(Examples)

Priority Problem

SubstanceUse

SubstanceUse

The way in which people drink, smoke

and use drugs is linked to particular substance

related consequences





The identification of Intervening Variables is the beginning of the work that will need to be conducted in this column of the logic model.

Each Intervening Variables is made up of contributing factors.

Contributing Factors: The specific issues in a community that comprise an Intervening Variable. They are identified through focus groups, surveys, observation, and other data gathering processes and are the key link to the identification of programs policies and practices prevention programs will address.

ATOD Data Sources

Archival

Survey

Interviews

Focus Groups

Direct observations

Hearings

Archival Data Service Agencies: DHS, CO Health,

Medical Records: Hospital, EMT, Examiner

Law Enforcement: Crime Report

Schools: Truancy, Discipline Reports

Treatment Data

AIDS/HIV

SURVEY DATA

Annual student surveys

Arrestee interviews

National household surveys

Census data

Local survey tools covering variety of health issues (incl. ATODs)

INTERVIEWS

Key informant interviews

One-on-ones in neighborhoods

Agencies or coalition members can be trained on interview and survey development skills

Focus Group

A defined topic is discussed in an interactive setting to gather data on the opinions and attitudes of a specific group of people.

Typically, focus groups are comprised of 7 to 10 people who meet the demographic requirements of the target population.

A facilitator guides the discussion using open-ended questions to elicit information pertinent to the topic, allowing group participants to speak freely with each other while also maintaining the focus of the research.

Source: Spotlight on focus groups, Fok-Han Leung & Ratnapalan Savithiri

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DIRECT OBSERVATIONS

Street observation - Records events as they actually occur (i.e. drug dealing)

Tip lines or forms created to capture specific information

Volunteer or youth retail alcohol and tobacco sales observations/checks

Information can serve as basis for law or code enforcement

HEARINGS

Gather information in fact-gathering

sessions on a specific policy under

consideration or in less formal

settings.

DATA MAPPING

Technique to pull the data together in one place

Describes types of data applicable to various problems, but can be organized to show inter-relation to the problem or project at hand

Useful for strategic program planning and evaluation

GIS MAPPING

Geographic Information System (GIS) links data to locales to increase understanding of community ATOD usage

Map can show concentration of ATOD incidents, proximity of police calls and arrests, location of ARTCDs, and etc.

ASIPS adds GIS identifiers to police calls to map specific locations and ATOD-related crimes

Intervening Variable Prioritization

After you have completed an assessment and prioritization of substance abuse related community priority problems you will also complete a prioritization process for Intervening Variables.

Determine priority intervening variables, related to the community’s priority, based on epidemiological and other data

Substance Abuse Related Consequence

Substance Use


Strategies

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Clarifying Questions

Which intervening variables have the greatest impact?

Where do we have the capacity and readiness to intervene to reduce burden related to the state/community priority?

Which intervening variables are most amenable to change?

Which intervening variables have the greatest potential for “small wins?”

Who should findings be presented to?

Coordination Agency

Advisory Committee

Workgroups Collaboratives, Coalitions, Community Leaders Media

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Resources

Join Together’s “How do we know we are making a difference? A Community Substance Abuse Indicators Handbook” http://www.indicatorshandbook.org/about.html

You may access a supporting companion site at: http://www.indicatorshandbook.org/howtouse.html

SAMHSA’s Strategic Prevention Framework http://www.kitsco.com/casupport/WebHelp_Prevention101/SAMHSA_s_Strategic_Prevention_Framework_SPF.htm

http://www.indicatorshandbook.org/about.html

http://www.indicatorshandbook.org/howtouse.html

Resources

Survey - Zoomerang www.zoomerang.com or

Survey are Monkey www.surveymonkey.com are

examples of survey formats or organizations may

create their own

http://www.surveymonkey.com/

Tips

• Host short, succinct and non threatening forum

• Review current partnerships and their value

• Clearly state goals (periodically re-state)

• Provide networking opportunities

• Allow participants to report “new discoveries”

• Capture information before participants disband

• Share an outcome report

• This should be an ongoing process

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Community Readiness

The capacity of a community to implement programs, policies and other changes that are designed to reduce the likelihood of substance use.

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Community Readiness

How Readiness Determined?

1. Identify the issue2. Define the community3. Conduct key respondent interviews4. Score interviews to determine level of

readiness5. Develop strategies based on level of readiness and conduct workshops or trainings

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Community Readiness

Variety of community readiness instruments address common stages of readiness

There are nine stages of readiness

Various strategies on how to elevate a community to a higher stage of readiness

Community Readiness Stages

1. No awareness 2. Denial/resistance 3. Vague awareness 4. Preplanning 5. Preparation 6. Initiation 7. Stabilization 8. Confirmation/Expansion 9. High Level of Community Ownership

Logic Model

All of the information you gathered in this Assessment Phase of SPF can be put into an easy to follow graph called a “Logic Model”.

What is a Logic Model?

A simplified picture of a program, initiative, or intervention that is a response to a given situation.

Shows the logical relationships among the resources that are invested, the activities that take place, and the benefits or changes that result.

Core of program planning, evaluation, program management and communications.

Logic models can be used at outcome and strategy levels.


Remember: The logic model makes logical, evidence-based

connections between Priority Problem, Substance Use, Intervening Variables, and Strategies.

It is crucial that all elements of the logic model tie back to the consequence.

Priority Problem Substance Use


Strategies



health problems




health problems



Links factors that influence substance

use patterns to substance related

consequences

Evidence-Based Programs,

practices or policies that

address factors strongly related

to and influencing the occurrence and magnitude of substance use

and related risk behaviors and

their consequences

InterveningVariables

Strategies(Examples)

Priority ProblemPriority Problem

SubstanceUse




Other Considerations

Cultural considerations and sustainability should be considered throughout the SPF process.

Cultural Considerations

Ethnicity Race Language Income Income or Class Historical Issues Generational Issues Unique Risk Factors Unique Protective Factors

Cultural Awareness

Communities may self-identify cultural issues or may need benefit of demographic profile.

The above statement might be true because of:DenialEquate culture with race HostilityIndifferenceInnocent lack of awareness

Infusing Cultural Competency Identify cultural issues related to indicators Document evidence of cultural causes that

correlate to consequential problems (e.g. underage age drinking, DWI).

What are cultural norms/beliefs/practices that contribute to or deter use?

How does culture view health, illness and addiction in context of substance use or prescription drugs?

Sustainability

How frequently will data be available?

What in timeline for collection/analysis?

Who should be assigned to collect/report?

How can partners share data?

What resources should be consulted?

What gaps or priorities should be next?

Next Step

The next SPF online training will focus on

Capacity, the second step in the SPF process.

QuestionsIf you have any questions or desire technical assistance on this topic please contact:

MDCH Bureau of Substance Abuse & Addiction SvcsLarry Scott, Prevention Section Manager

320 S. Walnut StreetLansing, MI [email protected]

Thank you for participating in this training module!

Documents

SPF Assessment Training. SPF 1. Assessment is the first step in the Strategic Prevention Framework (SPF). 2. SPF is SAMHSA’s Center for Substance Abuse