# Presentation: 365493

## Introduction and Overview

- The Center for
- Substance Abuse Prevention’s
- (CSAP’s)
- Southeast Center
-  for the Application of
- Prevention Technologies
- (SECAPT)

## Unlocking the Door
to Sustainability:

Keys to Sustaining Effective Prevention and Positive Outcomes in Your Community

***to Sustainability:***
**Keys to Sustaining Effective Prevention and Positive Outcomes**** ****in Your Community**

## Sustainability Defined

- Sustainability is the ***process*** of ensuring an adaptive prevention system and a sustainable innovation that can be integrated into ongoing operations to benefit diverse stakeholders
- Ultimately, sustainability is about maintaining positive outcomes in communities

**Notes:**
Suggested questions to ask participants to process slide content:
What words do we generally use to define sustainability?
What does it mean to be sustainable? 
How does this definition (presented here on the slide) differ from other definitions?
What comes to mind when you hear the definition presented here?

## Moving fromFunding Focused

- Historically, substance abuse prevention has been directed by the funds available, and many times by the funder.

## A focus on funding has led to program continuation because...

- a “power-filled” agency or person liked the program and believed it to be effective, despite evidence to the contrary;
- an outside source prioritized a particular program, regardless of the local needs of the populations an agency served;
- the coalition became a shadow agency and its work transformed to focus on keeping “its” programs in place.

## Prevention strategies should be continued because...

- there are documented reductions in substance abuse behaviors;
- they are more cost effective when compared to treatment and incarceration costs;
- the cost savings and impact on related problems will be clear to funders and community members.

**Notes:**
Suggested question to ask participants to process slide content:
How have you made the cost savings related to Prevention clear to funders or others? 

## Moving fromProgram Orientationto Outcomes Orientation

- Changing substance consumption behaviors at a population level will require a _mix_ of strategies carefully targeted to reduce risks relying primarily on environmental and other population-influencing strategies.

## Building Capacity to Sustain Prevention Outcomes

**Notes:**
Put this slide up but stop to review the changing world of substance abuse prevention, particularly the public health model and the SPF process.
Suggested question to ask participants to bridge the gap between previous content and forthcoming content:
What is the benefit/utility of the Public Health approach? 

## The prevention system must have capacities necessary to: 

- plan strategically for, carry out, and sustain prevention strategies with adequate effectiveness, scope and intensity
- achieve targeted reductions in substance using behaviors and related consequences experienced by the community

## Community agencies, institutions and organizations must work together to:

- strategically leverage and target the system’s existing resources, assets and capacity
- continually expand the community’s ability to effectively respond to changing patterns of substance use consumption and consequences

## Research Points to Three Key Objectives and Ten Related Actions Necessary for Sustainability

**Notes:**
Reference 2004 Journal article published in Journal of Evaluation and Program Planning, entitled Building Capacity and Sustainable Prevention Innovations: A Sustainability Planning Model, by Knowlton Johnson, Carol Hays, Hayden Center and Charlotte Daley. 

## The Three Key Objectives for Sustainability are:

- Organizational Capacity: Assure that the community agencies, organizations and institutions have adequate internal organizational capacity to achieve positive outcomes
- Effectiveness: Assure effectiveness and alignment of the prevention system to produce positive outcomes
- Community Support: Cultivate community support for the prevention system and its positive outcomes

**Notes:**
Look at pages I-10 and I-11 for additional comments.
Sustainability operates at 3 levels and they are related to one another.
Key 1: Agency Level
Key 2: System/Coalition Level
Key 3: Community Level

## 	1.	Structures and Formal Linkages
	2.	Policies and Procedures
	3.	Resources
	4.	Expertise
	5.	Quality and Accountability
	6.	Effectiveness
	7.	Reach and Alignment
	8.	Relationships
	9.	Champions
	10.	Ownership

- 	2.	Policies and Procedures
- 	3.	Resources
- 	4.	Expertise
- 	5.	Quality and Accountability
- 	6.	Effectiveness
- 	7.	Reach and Alignment
- 	8.	Relationships
- 	9.	Champions
- 	10.	Ownership

**The ten related actions are:**

**Notes:**
Here introduce the concept of 3 Keys and 10 related Actions to be unlocked. Actions = Key turning the lock. Each of the 10 Actions listed can be unlocked by one of the 3 Keys.

## Assure that community agencies and organizations have adequate internal organizational capacity

_**The first four Key Actions relate to Organizational Capacity**_
- Develop administrative structures and formal linkages that support comprehensive, collaborative evidence based strategies to achieve and sustain targeted reductions in substance using behaviors
- Adopt supportive policies and procedures that allow community agencies, organizations, and institutions to respond as data indicates
- Secure diverse resources (human, technical, physical and financial) that support the prevention system
- Acquire appropriate expertise that enables the system to prioritize, plan for, and carry out evidence based strategies to reduce substance use/abuse and its consequences

- 1

## Key 1Organizational Capacity

- Structure and Formal Linkages
- Policies and Procedures
- Resources
- Expertise

## Administrative Structures and Formal Linkages

- Office located in State and Federal Programs
- Access to Technology Department
- Access to Finance and Accounting
- Access to Purchasing
- Access to Student Services
- Access to Office of Curriculum

## Internal Linkages

- Parent Coordinator
- Steering Committees
- Instructional Council
- Safe and Drug Free Schools
- Counselor group—needs to be formalized

## Adopt Supportive Policies and Procedures

- Orientation manual developed for Prevention Educators

## Policies and Procedures(Under Development)

- Goals/objectives
- Curriculum summary, sequence and fidelity
- Parent and community collaborations
- Student identification and referral
- Accounting and finance
- Organizational chart
- Written agreements
- Staff development
- Sick time/flex time
- Record keeping forms (coalitions, meetings, presentations)
- Media

## Secure Resources

- Funding, staffing, computer/technology, and workspace currently adequate
- Working with county substance abuse coalition and school district to review 2007 Risk and Protective Factor survey data with the goal of increasing community awareness of substance abuse problems
- Prevention Educators are located in Alternative Education building

## Assess Resources

- Vulnerable Resources
- Salaried positions
- Curriculum – if revised
- Printing/copying costs
- Skills and expertise
- Technology

## Acquire Appropriate Expertise

- Administrator and Project Director attended technical training on engaging parents in an urban setting
- Prevention Educators, Project Director, one school nurse attended curriculum training
- Prevention Educators, Project Director, two school nurses attended substance abuse specialist training

## Communicate Effectiveness to Stakeholders

- Communication plan under development

## Assure effectiveness and alignment of the prevention system

_**The next three Key Actions relate to Effectiveness**_
- Assess Implementation Quality to ensure that it is fully documented through careful process evaluation and addresses the fidelity of service delivery and/or any adaptations made
- Assure that the Strategy being implemented is documented as effective for achieving the desired outcomes
- Assess the Reach and Alignment of the strategy to ensure that it aligns culturally and otherwise with the targeted population and is delivered to an adequate number of people in order to achieve the community outcomes desired.

- 2

## Key 2Effectiveness

- Implementation Quality
- Strategy
- Reach and Alignment

## Implementation Quality

- 	Will have school district students read/tape a section in Project Northland to reflect the population
- Technical Assistance (Parent Involvement in Urban Areas, Sustainability)
- Immediately accessed standards and fidelity checklists
- Plan to track implementation through process evaluation as well as planned and unanticipated adaptations to inform outcome evaluation findings (plan to develop form for Prevention Educator to complete after each classroom presentation)
- Example:  MSU Collaboration Project

## Assure Effectiveness of Each Strategy

- Work with evaluator on passive consent, statement to read to students prior to pre and post survey, collection of anecdotal information, and possible use of electronic records for individual counseling
- Incorporate key stakeholder concerns into evaluation design (implement in different classes for each building)
- Plan to work with evaluator to format evaluation report elements so they can be communicated in a variety of formats.

## Assess Reach and Alignment of Effective Strategies

- County Substance Abuse Coalition received “Drug Free Communities” grant during the summer of 2007
- Plan to work side by side in the community to reach objectives of both grants and see a population level change
- Plan to develop a community plan after reviewing risk and protective factor data and completing a “gaps analysis” for target population

## Cultivate community supportfor the prevention system andits outcomes

_**The last three Key Actions relate to Community Support**_
- Develop and Nurture Positive Relationships among all key stakeholders to create a system of awareness and support in which all interested parties share mutual trust and a willingness to work together strategically
- Turn Stakeholders into System Leaders and Champions who advocate for policies and actions both within the system and throughout the community that supports their long-term strategic outcomes
- Encourage Ownership: We tend to value that which is ours and are more likely to sustain that which we value.

- 3

## Key 3Community Support

- Positive Relationships
- System Leaders and Champions
- Ownership

## Develop and Nurture Positive Relationships

- Internal
- Accounting
- Technology
- Parent Advisory
- Principals
- Instructional Councils
- Steering Committees
- School Board
- Safe and Drug Free Schools Committee
- Employee Groups (nurses, counselors, social workers, teachers)

## Develop and Nurture Positive Relationships

- External
- State Department of Education
- County Substance Abuse Coalition
- Media
- Police
- Michigan State University College of Nursing
- Prevention Network
- Churches
- Boys and Girls Club

## Results of Planning for Sustainability

- A community system that can flexibly respond to problems by providing ongoing support for a strategic approach to achieve positive results and sustain them
- A plan and process that builds the community prevention coalition’s capacity as an effective problem-solving group
- A forum for successful integration of the Strategic Prevention Framework into the community prevention system
- Effective use of limited resources to reduce substance use consumption and consequences