Maryland Strategic Prevention Framework (MSPF) Core Essentials Training

1. Maryland Strategic Prevention Framework (MSPF) Core Essentials Training

2. Training Objectives • Understand and communicate the role of the coalition in achieving community-level change • Engage coalition & community members to conduct a problem analysis and develop a logic model • Work with the coalition to plan and implement comprehensive strategies to address local conditions • Build capacity and engage in planning activities • Establish a network of prevention professionals

3. Training Agenda Welcome Introductions Overview: The Big Picture Community Problem Solving Logic Model Interventions MSPF Strategic Planning Wrap-up

4. The “BIG PICTURE” Community-Level Change Evidence-Based Strategies Role of the Coalition

5. Public Health Approach to Prevention Community Coalitions Host Agent Agent Environment Environment

6. Strategies Targeting Individuals Socialize, Instruct, Guide, Counsel Strategies Targeting the Community Environment Support, Enhance Family School Norms Regulations INDIVIDUALS ENTIRE COMMUNITY Faith Community Health Care Providers Resources Systems

7. Underage Drinking Rigorous enforcement of alcohol laws Compliance checks Community mobilization to address underage-drinking tolerance Normative education emphasizing that most adolescents don’t use ATOD Evidence Based Strategies, Programs, Policies & Practices • Alcohol Crashes • Rigorous enforcement of drinking and driving laws • Awareness regarding increased risk of being caught and punished • Enforcement campaigns with sobriety check points • Court watch activities • Community wide media campaigns about increased enforcement efforts • Binge Drinking • Rigorous enforcement of underage drinking party, keg registration and social host laws • Alcohol excise taxes to reduce economic availability • Responsible beverage server training 7

8. Community Coalitions “A coalition is a formal [voluntary] agreement and collaboration between groups or sectors of a community in which each group retains its identity but all agree to work together through a community building process toward a common goal of building a healthier community.” Community Anti-Drug Coalitions of America(CADCA)

9. Role of the Coalition in Achieving Community-level Change Achieve Positive Outcomes Address conditions & settings in the community identified by the data Impact a Defined Community Engage All Sectors of the Community Promote Comprehensive Strategies

10. Workbook Page 44 Difference Between Coalitions and Programs

11. Coalition Sharing • The “BIG PICTURE” • How has the “BIG PICTURE” been shared with your coalition? • What challenges / successes have you had in communicating the “BIG PICTURE” to your coalition? • As a table, identify one “lesson learned” that will help others communicate the “BIG PICTURE”

12. Community Problem Solving Strategic Prevention Framework

13. Best Processes1 for Implementing theStrategic Prevention Framework 1. Analyzing Information About the Problem, Goals and Factors Affecting Them. A. Assessment 2. Establishing Vision and Mission. 12. Documenting Progress and Using Feedback B. Capacity 3. Defining Organizational Structure and Operating Mechanisms 11. Making Outcomes Matter 4. Assuring Technical Assistance E. Evaluation 5. Developing Leadership 10. Sustaining the Work 6. Arranging Resources for Community Mobilization 9. Implementing Effective Interventions C. Planning D. Implementation 7. Developing a framework or model of change 8. Developing and Using Strategic and Action Plans 1Best processes identified through a literature review conducted by Dr. Renee Boothroyd, University of Kansas – used with permission. Workbook Page

14. Priorities • Underage drinking (alcohol misuse) by youth ages 12-20 • Binge drinking by young persons, ages 18-25 • Alcohol-related crashes involving youth ages 16-25

15. Priorities

16. READY SHOOT AIM Problem Analysis

17. But Why? Priority

18. But Why? 1 But Why? 2 Intervening Variables (Root Causes) Priority But Why? 3 But Why? 4

19. Intervening Variables • Retail availability/access to alcohol • Social availability/access to alcohol • Level of enforcement and adjudication of alcohol laws • Social norms (perception of peer behavior) • Low perceived risks of alcohol use - youth • Pricing of alcohol • Promotion of alcohol

20. But Why Here? But Why? Intervening Variables Priority Contributing Factors (Local Conditions)

21. Problem Analysis • Criteria for good “But, why here?” • Contributing Factors (Local Conditions) • Specific (not another risk factor) • Identifiable • Actionable

22. Logic Model 1. Clearly stating the priority (Problem statement). 2. Identifying the Intervening Variables 3. Identifying why these intervening variables exist in your community (i.e. Contributing Factors) 2.6

23. Priority But Why? But Why Here?

24. Logic Model • When should Intervening Variables & Contributing Factors make it to your logic model? • Should be driven by: • Data from your community • Current events or political opportunities for change • Community expectations or demands

25. Store windows on Main Street are covered with alcohol ads. Promotion (Marketing) Alcohol industry sponsors main three community events. Underage Drinking Priority But Why? But Why Here?

26. Logic Model Two Ways to Critique Your Logic Model • Line Logic • Is there a credible connection between each element? (science, community experience, logic?) • Completeness Check • Are all the pieces present? • Are there any missing intervening variables or important contributing factors?

27. Workbook Page 43 Developing Interventions • Seven behavior change strategies: • Provide Information • Build Skills • Provide Support • Enhance Access / Reduce Barriers • Change Incentives / Disincentives • Change the Physical Design of the Environment • Change Policies or Regulations

28. Intervention/Action Leaflets Training L. E. Partnership Recognition Alternative Ads Sign Removal City Ordinance Store windows on Main Street are covered with alcohol ads Promotion Alcohol industry sponsors three community events Underage Drinking

29. Provide Information:Presentations, workshops, brochures, billboards, social norms campaigns, town hall meetings, Web-based communications, etc. Enhance Skills:Workshops/seminars designed to teach skills needed to achieve population-level outcomes. 3. Providing Support:Assisting others to conduct training, obtaining funding for equipment, training, reach specific target audiences. Seven Strategies for Community Change

30. 4. Changing Access/Barriers Access: - Provide instructions/training in multiple languages - Give scholarships to training programs - Provide training at vendor locations Barriers: - Enhance law enforcement operations for dealing with MIP - Remove tobacco machines from public venues - Place pseudoephedrine behind the counter

31. Incentives: Provide awards to businesses/organizations who pass Compliance Checks Public Recognition (as part of a overall effort) Disincentives: Increase Citations/Fines Increase Excise Taxes Use/Lose Laws • Changing Consequences (Incentives/ Disincentives)

32. Physical Design - Lighting in parks - Signage - Alcohol Outlet Density/Proximity - Advertising (Restrictions) - Product Placement - Packaging

33. 7. Modify/Change Laws, Policies, Procedures, By-Laws Laws:Social Host Liability, Keg Registration Policies:24/7 Zero Tolerance policy in a school district, Drug Free Workplace Policies, Mandatory Merchant Education with License Re-Application Procedures:MIP Arrest Processing by Law Enforcement, By-Laws:Civic organization use of alcohol, collaboration & networking CADCA Environmental Strategies Guide: Page 8

35. Example • Contributing Factor: Emphasis and availability of alcohol at the local festivals/fairs. • Provide Information—Educate event organizers about the issue • Build Skills—Train event staff to check and monitor IDs - free • Provide Support—Identify non-alcohol sponsors for events • Access / Barriers—Establish ID bracelet system for access • Incentives / Disincentives—Paid advertising for events • Physical Design—Roped-off beer garden away from center • Policies or Regulations—Change alcohol serving policy at public events

36. Evidence Based Strategies, Programs, Policies & Practices • Environmental Strategies can: • Reach entire populations • Impact the overall environment • Create lasting change in community norms and systems • Produce “quick wins” • Instill commitment toward long-term impact

37. Evidence Based Strategies, Programs, Policies & Practices

38. Goodness of Fit Will the Strategy change the Contributing Factor?

39. Coalitions must think comprehensively even if they cannot act comprehensively. Grantors do not fund the greatest need, they fund an opportunity to make a difference.

40. Long-term Objectives Decrease underage drinking in ABC County by 5% as measured by the ABC Youth survey by 2014. Intermediate Objectives Increase “youth perception of harm from alcohol use” by 25% as measured by the ABC Youth survey by 2011. Short-Term Objectives Decrease retail outlets selling alcohol to minors as measured by compliance check results by 25% by 2011. Strategic Planning Reduce substance abuse among youth Community Assessment Logic Model Community-level Outcomes Goal Comprehensive Strategies Evaluation

41. Strategic Planning Intermediate Objectives (1-4 years) Short-Term Objectives (6-24 months) Intervention/Action Information Build Skills Provide Support Reward / Consequence Access / Barriers Policy Change Physical Change Contributing Factor “But, why here?” Long-Term Objectives (3-10 years) - Data 1 & Source - Data 2 & Source Intervening Variable “But why?” Intervention/Action Information Build Skills Provide Support Reward / Consequence Access / Barriers Policy Change Physical Change Contributing Factor “But, why here?” - Data 1 & Source - Data 2 & Source Priority - Data 1 & Source - Data 2 & Source - Data 1 & Source - Data 2 & Source Intervention/Action Intervening Variable “But why?” Information Build Skills Provide Support Reward / Consequence Access / Barriers Policy Change Physical Change Contributing Factor “But, why here?” - Data 1 & Source - Data 2 & Source - Data 1 & Source - Data 2 & Source

42. Coalition Objectives • What will be changed? • By when? • By how much? • Baseline? • How will it be measured? • Example: Long-term Objective (Priority) • Decrease underage drinking by 10% as measured by the ABC Youth survey (reported 30-day use) by 2013. • Baseline 2011: 34% of 8-12 graders report “use of alcohol within the last 30 days of the survey” • Target 2017:30% of 8-12 graders report “use of alcohol within the last 30 days of the survey”

43. Coalition Objectives • What will be changed? • By when? • By how much? • Baseline? • How will it be measured? • Example: Intermediate Objective (Intervening Variable) • Decrease perceived availability of alcohol by 25% as measured by the ABC Youth survey by 2014. • Baseline 2011: 50% of 8-12 graders report “alcohol is easy or very easy to get” • Target 2014:37.5% of 8-12 graders report “alcohol is easy or very easy to get”

44. Coalition Objectives • What will be changed? • By when? • By how much? • Baseline? • How will it be measured? • Example: Short-term Objective (Contributing Factor) • Decrease in retailers selling alcohol to minors as measured by the retailer compliance checks by 2014. • Baseline 2011:55% of retailers passed compliance checks • Target 2013: 100% of retailers passed compliance checks

45. Coalition Objectives Priority: Underage Drinking Long-term Objective: Measure: 30-day use of alcohol reported by 10th graders on ABC Youth Survey Baseline 2010: 36% Target 2016: _____%

46. Coalition Objectives Intervening Variable: Availability of Alcohol Intermediate-term Objective: Measure: Perceived availability of alcohol “reported as very easy to get” by 10th graders on the ABC Youth Survey Baseline 2010: 52% Target 2013: _____%

47. Coalition Objectives Contributing Factor: Retailers selling alcohol to minors Short-term Objective: Measure: Failed compliance checks by retailers reported by Alcohol Beverage Control. Baseline 2010: 35% of retailers failed their compliance checks Target 2012: _____% of retailers failed their compliance checks

48. How Behavior Change Happens Your logic model should be informed by series of “if-then” relationships that indicate your program’s theory of how change will occur. • IF… • We increase awareness about risks associated with social hosting • THEN… • Parents will become concerned • IF… • Parents become concerned • THEN… • They won’t host parties for their kids • IF… • Parents don’t host • THEN… • Youth will have reduced social access to alcohol • IF… • There is reduced youth social access to alcohol • THEN… • Youth won’t binge drink as much

49. Building Coalition Capacity (Form) • Building coalition capacity includes addressing: • Coalition Membership • Coalition Organization/ Structure • Leadership • Cultural Competence