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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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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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Steps in Assessing Need
1. Define/Describe the community
2. Identify the community priority problem
“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 6: Perceived Gap between Capacity/Resources and Need
Criteria 6: Perceived Gap between Capacity/Resources and Need
Criteria 7: Readiness/Political Will/Public Concern
Criteria 7: Readiness/Political Will/Public Concern
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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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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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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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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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
Intervening Variables
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
Intervening Variables
Strategies
Outcome Based Logic Model
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 way in which people drink, smoke
and use drugs is linked to particular substance
related consequences
Outcome Based Logic Model
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
Intervening Variables
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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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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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
Resources
Survey - Zoomerang www.zoomerang.com or
Survey are Monkey www.surveymonkey.com are
examples of survey formats or organizations may
create their own
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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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 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.
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
Intervening Variables
Strategies
Outcome Based Logic Model
Social, economic, and
health problems
associated with the use of alcohol,
tobacco, and illicit drugs.
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 ProblemPriority Problem
SubstanceUse
The way in which people drink, smoke
and use drugs is linked to particular substance
related consequences
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!