Maryland Strategic Prevention Framework

(MSPF)Core Essentials Training

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• 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

Training Objectives

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Training AgendaI. Welcome

II. Introductions

III. Overview: The Big Picture

IV. Community Problem Solving

V. Logic Model

VI. Interventions

VII. MSPF Strategic Planning

VIII.Wrap-up3

The “BIG PICTURE”

Community-Level Change

Evidence-Based Strategies

Role of the Coalition

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Public Health Approach to Prevention

Host Agent Agent

EnvironmentEnvironment

Community Coalitions

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Strategies Targeting Individuals

Socialize, Instruct, Guide, Counsel

Family School

Health Care

Providers

INDIVIDUALS

Faith Community

Strategies Targeting the Community

EnvironmentSupport, Enhance

Resources

RegulationsNorms

Systems

ENTIRE COMMUNITY

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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

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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

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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)

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Impact a Defined Community

Engage All Sectors of the Community

Address conditions & settings in the

community identified by the data

Promote Comprehensive

Strategies

Achieve Positive Outcomes

Role of the Coalition in Achieving Community-level

Change

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Difference Between Coalitions and ProgramsCoalitions Programs

ScaleCoalitions measure success by examining community-level indicators. This applies to all coalition outcomes (short & long- term).

Programs measure change in individuals who have been directly affected by the intervention(s).

Addresses multiple causesCoalitions seek to ensure that all causes of identified problems are addressed

Programs are more focused on single strategies, e.g., parenting classes or peer mentoring.

ActorsCoalition activities are diffused and taken by all members with staff playing a coordinating or supporting role.

Program staff lead the process and are responsible for implementing interventions.

Workbook Page 44

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Coalition Sharing

The “BIG PICTURE”1. How has the “BIG PICTURE” been shared

with your coalition?

2. What challenges / successes have you had in communicating the “BIG PICTURE” to your coalition?

3. As a table, identify one “lesson learned” that will help others communicate the “BIG PICTURE”

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Strategic Prevention Framework

Community Problem Solving

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Best Processes1 for Implementing the Strategic Prevention Framework

8. Developing and Using Strategic

and Action Plans

6. Arranging Resources forCommunity Mobilization

5. Developing Leadership

4. Assuring Technical Assistance

12. Documenting Progress andUsing Feedback

11. Making Outcomes Matter

10. Sustaining the Work

A. Assessment

B. Capacity

D. Implementation C. Planning

E. Evaluation

7. Developing a framework or model of change

1Best processes identified through a literature review conducted by Dr. Renee Boothroyd, University of Kansas – used with permission.

9. Implementing Effective Interventions

3. Defining Organizational Structure

and Operating Mechanisms

1. Analyzing Information About the Problem, Goals and

Factors Affecting Them.

2. Establishing Vision and Mission.

Workbook Page

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• 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

Priorities

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Priorities

CountyUnderage Drinking

Binge Drinking

Alcohol Related Crashes

Baltimore City      

Frederick County  

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READY

SHOOT

AIM

Problem

Analysis

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But Why?

Priority

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Priority

But Why?1

But Why?2

But Why?3

But Why?4

Intervening Variables

(Root Causes)

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• 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

Intervening Variables

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But Why?

Priority

But Why Here?

Intervening VariablesContributing

Factors (Local

Conditions)

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Problem Analysis

Criteria for good “But, why here?” Contributing Factors (Local Conditions)

1. Specific (not another risk factor)2. Identifiable3. Actionable

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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

Logic Model

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PriorityBut Why? But Why Here?

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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

Logic Model

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Priority But Why? But Why Here?

Underage Drinking

Promotion(Marketing)

Store windows on Main Street are covered with

alcohol ads.

Alcohol industry sponsors main three community events.

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Two Ways to Critique Your Logic Model1. Line Logic

• Is there a credible connection between each element? (science, community experience, logic?)

2. Completeness Check• Are all the pieces present?• Are there any missing intervening

variables or important contributing factors?

Logic Model

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Seven behavior change strategies:

1.Provide Information

2.Build Skills

3.Provide Support

4.Enhance Access / Reduce Barriers

5.Change Incentives / Disincentives

6.Change the Physical Design of the Environment

7.Change Policies or Regulations

Developing Interventions

Workbook Page 43

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Store windows on Main Street

are covered with alcohol ads

Alcohol industry sponsors three

community events

Intervention/Action

Leaflets

Training

L. E. Partnership

Recognition

Alternative Ads

Sign Removal

City Ordinance

Promotion

Underage Drinking

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1. Provide Information: Presentations, workshops, brochures, billboards, social norms campaigns, town hall meetings, Web-based communications, etc.

2. 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

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4. Changing Access/BarriersAccess:

- 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

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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

5. Changing Consequences (Incentives/ Disincentives)

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6. Physical Design

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

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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

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ExampleContributing Factor: Emphasis and availability of

alcohol at the local festivals/fairs.1. Provide Information—Educate event organizers

about the issue

2. Build Skills—Train event staff to check and monitor IDs - free

3. Provide Support—Identify non-alcohol sponsors for events

4. Access / Barriers—Establish ID bracelet system for access

5. Incentives / Disincentives—Paid advertising for events

6. Physical Design—Roped-off beer garden away from center

7. Policies or Regulations—Change alcohol serving policy at public events

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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

Evidence Based Strategies, Programs, Policies & Practices

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Evidence Based Strategies, Programs, Policies & Practices

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Goodness of FitWill the Strategy change the Contributing Factor?

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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.

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Strategic Planning

Community Assessment

Logic

ModelComprehensive

Strategies

Community-level Outcomes

Goal

Reduce substance

abuse among youth

Short-Term Objectives

Decrease retail outlets selling alcohol to minors as measured by compliance check results

by 25% by 2011.

Intermediate Objectives

Increase “youth perception of harm from alcohol use” by 25% as measured by the

ABC Youth survey by 2011.

Long-term Objectives

Decrease underage drinking in ABC County by 5% as measured by the ABC Youth survey by

2014.

Evaluation44

Contributing Factor

“But, why here?”

Information

Build Skills

Provide Support

Reward / Consequence

Access / Barriers

Policy Change

Physical ChangeIntervening Variable

“But why?”

Priority

Intervention/Action

- Data 1 & Source

- Data 2 & Source

Information

Build Skills

Provide Support

Reward / Consequence

Access / Barriers

Policy Change

Physical Change

Intervention/Action

Information

Build Skills

Provide Support

Reward / Consequence

Access / Barriers

Policy Change

Physical Change

Intervention/Action

- Data 1 & Source

- Data 2 & Source

- Data 1 & Source

- Data 2 & Source

- Data 1 & Source

- Data 2 & Source

- Data 1 & Source

- Data 2 & Source

- Data 1 & Source

- Data 2 & Source

Long-Term Objectives(3-10 years)

Intermediate Objectives(1-4 years)

Short-Term Objectives(6-24 months)

Strategic Planning

Intervening Variable

“But why?”

Contributing Factor

“But, why here?”

Contributing Factor

“But, why here?”

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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”

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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”

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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 checksTarget 2013: 100% of retailers passed compliance checks

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Coalition ObjectivesPriority: Underage Drinking

Long-term Objective:

Measure: 30-day use of alcohol reported by 10th graders on ABC Youth Survey

Baseline 2010: 36% Target 2016: _____%

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Coalition ObjectivesIntervening 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: _____%

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Coalition ObjectivesContributing 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 51

How Behavior Change Happens

IF…We increase awareness about risks

associated with social hosting

THEN…Parents will

become concerned

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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

alcoholTHEN…

Youth won’t binge drink as

much

Your logic model should be informed by series of “if-then” relationships that indicate your program’s theory of how change will occur.

Building Coalition Capacity (Form)

Building coalition capacity includes addressing:

• Coalition Membership• Coalition

Organization/ Structure

• Leadership • Cultural Competence 56

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1. Assess your coalition’s capacity

2. Develop a data driven logic model

3. Write SMART objectives

4. Select strategies that best fit your contributing factors

Wrap-up

ResourcesCADCA – Community Anti-Drug Coalitions of

America: www.cadca.org

MSPF Website:http://adaa.dhmh.maryland.gov/mspf/SitePages/Home.aspx

MSPF Help & Technical Assistance – Contact:Nicole Sealfon Adam Tatensealfon@rx.umaryland.edu

atate@rx.umaryland.edu 410.706.0178 410.706.7614

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