Prevention Basics: Overview of Substance Abuse Prevention

1. Prevention Basics:Overview of Substance Abuse Prevention February 23, 2011 Dover, Delaware February 24, 2011 New Castle, Delaware Marcus Bouligny, CAPT Associate Lourdes Vázquez, T/TA Specialist, CAPT Northeast Regional Team

2. Objectives At the end of the workshop participants will be able to: • Define substance abuse prevention • Describe the framework and theories that inform effective substance abuse prevention • Explain the importance of comprehensive, evidence-based prevention planning (the Strategic Prevention Framework [SPF]). • Apply new knowledge to a case study relevant to the content of the workshop

3. Agenda 9:00 - 10:00 Introduction Outcome-based Prevention 10:00 - 10:15 Break 10:15 - 12:00Prevention Research 12:00 - 1:00 Lunch Break 1:00 - 3:00 Planning and Outcome-Based Prevention 3:00 - 4:00 Putting it all Together 4:00 Close

4. What Would You Like to Take Home?

5. Definition of Prevention A proactive process that empowers individuals and systems to foster a climate where: • Alcohol use is acceptable only for adults when risk of adverse consequences are minimal; • Prescriptions, over-the-counter drugs, and other abusable substances are used only for their intended purposes and as intended; and • Illegal drugs and tobacco are not used at all. • (CSAP’s Prevention Primer; SW CAPT Online Glossary , 1994)

6. Definition of Prevention A proactive process of creating conditions and fostering attitudes that promotes the well-being of people. William Lofquist, Discovering the Meaning of Prevention: A Practical Approach to Positive Change, 1983

7. Attitudes About Drugs • In pairs, please discuss the following questions: • What messages about alcohol, tobacco, marijuana and other drugs did you grow up with? • What prevention programs (if any) do you recall participating in within your school and community? • How have these messages and experiences affect and influence your role as a prevention professional?

8. Attitudes About Drugs (cont.) • No matter how knowledgeable or competent we become as prevention professionals, our work is invariably influenced by the attitudes we grew up with. • It is important that we become aware of those attitudes. • It is also important that we explore and challenge those attitudes which may be counterproductive.

9. Drugs Of Abuse—Classifications In pairs, provide an example for each of the following: • Central Nervous System Depressants • Opioids • Central Nervous System Stimulants • Hallucinogens • Cannabinols • Inhalants • Anabolic Steroids

10. Definitions SUPPLY REDUCTION Any method used to reduce the availability of drugs (e.g., confiscation of drug shipments, destruction of crops, criminal penalties for possession and distribution, “sting” operations).

11. Definitions (cont.) DEMAND REDUCTION Any method used to reduce the demand for drugs(e.g., assessment and treatment services, prevention curricula in schools, sobriety support services).

12. Prevention Discipline • Scientific Theory Base • Verified Methods • Accountability for Service Effectiveness • Academic Coursework or Degree • Formal Training or Internship • Code of Ethics • Certification or Licensure

13. Building Blocks of Successful Prevention Programs • The program is facilitated by knowledgeable and competent staff. • The program is based on sound theory and uses practices grounded in research. • The program is systematically planned and assessed. • The program is evaluated.

14. Building Blocks of Successful Prevention Programs (cont.) • The program is sensitive to participants from a variety of backgrounds and cultures. • The program is developmentally appropriate. • The program incorporates the media. • The program uses a code of ethics.

15. Questions and Discussion

16. Prevention Research

17. Why Study Prevention Research? • “Evidence-based” prevention is the standard of accountability in the field. • Prevention theory assists in identifying what contributes to substance abuse and other problem behaviors and how they can be prevented. • The results of our prevention work depend on the quality of the research that guides us.

18. Scope of Prevention

19. Risk And Protective Factors Theory • Similar to public health model of disease prevention: focus on decreasing risk and increasing protection • Risk factors predict substance abuse and other problem behaviors and protective factors can buffer risk factors

20. Risk And Protective Factors Theory • To prevent substance abuse or any other problem behavior, reduce risk factors and increase protective factors throughout an individual’s life David Hawkins and Richard Catalano

21. Risk And Protective Factors Theory Risk and protective factors: • Can be influenced by individual, family, school, and environmental change strategies; • Have a cumulative effect; and • Occur in communities, families, schools, and individuals and are subject to change.

22. Intervening Variables and Contributing Factors • Risk and protective factors have been studied and validated with 12- to 17-year olds (Hawkins and Catalano) • Some programs will refer to risk and protective factors as intervening variables, especially if the program is working with populations that are outside of the 12- to 17-year old range

23. Intervening Variables and Contributing Factors • Another way to understand why consequences occur is to consider contributing factors. • Contributing factors can help communities gain a more specific understanding of the contextual factors that influence a particular problem.

24. Community Risk Factors • Availability of alcohol/other drugs • Community laws and norms favorable toward drug use • Transitions and mobility • Low neighborhood attachment and community disorganization • Extreme economic deprivation

25. Community Risk Factors

26. Family Risk Factors • Family history of substance abuse • Family management problems • Family conflict • Parental attitudes and involvement in drug use

27. Protective Factors • Individual characteristics • Resilient temperament • Positive social orientation • Bonding • Opportunities • Skills • Recognition • Healthy beliefs and clear standards

28. Case Study in Prevention • Select a facilitator, a timekeeper, and a recorder. • Read the case study assigned to your group. • Determine which risk and protective factors are at work in your case. • Report back to the whole group.

29. Case Study • Is there consensus on the risk factors you identified? • Is there consensus on the protective factors you identified? • How might our values and culture influence which factors we see present?

30. Questions And Discussion

31. Prevention Planning

32. Prevention Planning Planning allows us to create an objective profile of our community, and identify how to focus resources and efforts and implement more effective strategies.

33. SPF: A Model for Strategic Planning The Strategic Prevention Framework (SPF) is a five-step planning process to create a community-based approach to substance abuse prevention that cuts across existing programs and systems.

34. Steps of the SPF Assessment Profile population needs, resources, and readiness to address needs and gaps Capacity Mobilize and/or build capacity to address needs Planning Develop a Comprehensive Strategic Plan Implementation Implement evidence-based prevention programs and activities Evaluation Monitor, evaluate, sustain, and improve or replace those that fail

35. Focus of the SPF • Community development • Strategic planning • Change process at the community level

36. Key Principles of the SPF • Public Health approach • Agent • Host • Environment • Strategic planning process • Data used to inform decisions • Outcomes-based prevention • Population-level changes in consumption and consequences

37. Outcomes-Based Prevention • Effective prevention is grounded in a solid understanding ofalcohol, tobacco, and other drug consumption and consequence patterns. • Documenting the nature and extent of consumption (e.g., underage drinking) and consequences (motor-vehicle crashes) at the start is critical for determining intervening variables and aligning strategies to address them.

38. Mapping the Problem In small group, discuss and post responses on the wall: • One problem your community is facing that is caused by substance use. • What is the substance being used? • What is allowing or causing the use of this substance? • What might be done about this?

39. Substance Abuse and Related Problems Risk and Protective Factors (Intervening Variables or Contributing Factors) Programs, Policies, and Practices Outcomes-Based Prevention ProblemResponse Planning, Monitoring, Evaluation, and Re-planning

40. Activity In teams of five: • Provide a minimum of three examples of how the Strategic Prevention Framework can support community problem solving.

41. Step 1. Assessment • Assessment of substance use and related problems of substance use • Assessment of resources, gaps and readiness Assessment leads to recommendations regarding community priorities

42. Why Do We Need to Do an Assessment? To answer the question, “What is going on in my community?”

43. Why Do We Need to Do an Assessment? (cont.) More specifically, to identify: • Size and type of substance use problem in the community • Existing resources available to address the identified problems related to substance abuse • What is contributing to the substance abuse problem in my community • How “ready” the community is to address the problem

44. Supporting Accountability, Capacity, and Effectiveness Assessment Profile population needs, resources, and readiness to address needs and gaps Capacity Mobilize and/or build capacity to address needs Planning Develop a Comprehensive Strategic Plan Implementation Implement evidence-based prevention programs and activities Evaluation Monitor, evaluate, sustain, and improve or replace those that fail

45. Step 2.Capacity: What is It? Types and levels of resources needed to address identified needs including: • Human Resources • Technical Resources • Management and Evaluation Resources • Financial Resources

46. Capacity: What Does it Involve? • Mobilizing Resources • Engaging Stakeholders • Partnerships With the Community

47. Capacity: What Does it Involve? (cont.) • Building coalitions • Developing readiness • Focus on cultural competency, sustainability, and evaluation

48. SPF, Revisited Assessment Profile population needs, resources, and readiness to address needs and gaps Capacity Mobilize and/or build capacity to address needs Planning Develop a Comprehensive Strategic Plan Implementation Implement evidence-based prevention programs and activities Evaluation Monitor, evaluate, sustain, and improve or replace those that fail

49. Step 3. Develop a Comprehensive Strategic Plan What is a Comprehensive Strategic Plan? A comprehensive, logical and data-driven plan to address the problems identified in Step 1 using the capacity built or mobilized in Step 2.

50. Step 3. Develop a Comprehensive Strategic Plan (cont.) The Plan includes: • Strategic goals • Objectives • Performance targets • A logic model • An action plan (including, tasks, assignments and timeline)