JUNE 2019

A Guide to SAMHSA’s

Strategic Prevention

Framework
Acknowledgments

The content of this report was developed by SAMHSA staff. The final report was formated for the Substance 

Abuse and Mental Health Services Administration (SAMHSA) under contract number HHSS283176901 

with SAMHSA, U.S. Department of Health and Human Services (HHS). Claudia Richards served as 

contracting officer representative.

Disclaimer

The views, opinions, and content of this publication are those of the authors and do not necessarily reflect the 

views, opinions, or policies of SAMHSA or HHS. Nothing in this document constitutes a direct or indirect 

endorsement by SAMHSA or HHS of any non-Federal entity’s products, services, or policies, and any 

reference to non-Federal entity’s products, services, or policies should not be construed as such.

Public Domain Notice

All material appearing in this publication is in the public domain and may be reproduced or copied 

without permission from SAMHSA. Citation of the source is appreciated. However, this publication 

may not be reproduced or distributed for a fee without the specific, written authorization of the Office of 

Communications, SAMHSA, HHS.

Electronic Access

This publication may be downloaded from https://www.samhsa.gov/ebp-resource-center.

Recommended Citation

Substance Abuse and Mental Health Services Administration: A Guide to SAMHSA's Strategic Prevention 

Framework. Rockville, MD: Center for Substance Abuse Prevention. Substance Abuse and Mental Health 

Services Administration, 2019.

Originating Office

Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration, 5600 

Fishers Lane, Rockville, MD 20857, HHS Publication 

Nondiscrimination Notice

SAMHSA complies with applicable Federal civil rights laws and does not discriminate on the basis of race, 

color, national origin, age, disability, or sex.

SAMHSA cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, 

color, nacionalidad, edad.
3

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Step 1: Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Step 2: Capacity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Step 3: Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Step 4: Implementation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Step 5: Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

SPF Guiding Principle: Cultural Competence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

SPF Guiding Principle: Sustainability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

APPENDICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Appendix A: Primary Data Collection Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Appendix B: Key Features of Risk and Protective Factors . . . . . . . . . . . . . . . . . . . . . . . . . 36

Appendix C: Levels of Involvement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

Appendix D: The Socio-Ecological Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Appendix E: Making the Most of Your Evaluation Dollars . . . . . . . . . . . . . . . . . . . . . . . . . . 41

Appendix F: Evaluation Design, Reporting, and Lessons Learned . . . . . . . . . . . . . . . . . . . 43

TABLE OF CONTENTS
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 4

Prevention planners are pressed to put in place solutions to urgent 

substance misuse problems facing their communities. But research 

and experience have shown that prevention must begin with an 

understanding of these complex behavioral health problems within their 

complex environmental contexts; only then can communities establish 

and implement effective plans to address substance misuse.

To facilitate this understanding, SAMHSA developed the Strategic 

Prevention Framework (SPF). The five steps and two guiding principles 

of the SPF offer prevention planners a comprehensive approach to 

understanding and addressing the substance misuse and related 

behavioral health problems facing their states and communities.

The SPF includes these five steps:

1 . Assessment: Identify local prevention needs based on data (e .g ., What is the problem?)

2 . Capacity: Build local resources and readiness to address prevention needs (e .g ., What do you

have to work with?)

3 . Planning: Find out what works to address prevention needs and how to do it well (e .g ., What

should you do and how should you do it?)

4 . Implementation: Deliver evidence-based programs and practices as intended (e .g ., How can

you put your plan into action?)

5 . Evaluation: Examine the process and outcomes of programs and practices (e .g ., Is your plan

succeeding?)

The SPF is also guided by two cross-cutting principles that should be integrated into each of the steps 

that comprise it:

 Cultural competence. The ability of an individual or organization to understand and

interact effectively with people who have different values, lifestyles, and traditions based on their 

distinctive heritage and social relationships.

 Sustainability. The process of building an adaptive and effective system that achieves and

maintains desired long-term results.

INTRODUCTION
5

The SPF has several defining characteristics that set it apart from other strategic planning processes.

Most notably, it is: 

 Dynamic and iterative. Assessment is the starting point, but planners will return to this

step again and again as their community’s substance misuse problems and capacities evolve.

Communities may also engage in activities related to multiple steps simultaneously. For example, 

planners may need to find and mobilize additional capacity to support implementation once a 

program or practice is underway. For these reasons, the SPF is a circular rather than a linear 

model.

 Data-driven. The SPF is designed to help planners gather and use data to guide all prevention

decisions—from identifying which substance misuse problems to address in their communities, 

to choosing the most appropriate ways to address these problems, to determining whether 

communities are making progress.

 Reliant on and encourages a team approach. Each step of the SPF requires—and

greatly benefits from—the participation of diverse community partners. The individuals and 

institutions involved in prevention efforts may change as the initiative evolves, but the need for 

prevention partners will remain constant.

This toolkit provides an introduction to the SPF’s well-tested and user-friendly planning approach.

Organized by each of the steps in the framework, the toolkit provides a snapshot of how each of 

the components fit together and build on one another. Used in tandem with its companion resource, 

Selecting Best-Fit Programs and Practices: Guidance for Substance Misuse Prevention Practitioners, the 

toolkit provides an important starting point for engaging in a thoughtful, data-driven process that supports 

best practices, engages critical stakeholders, and draws on evidence. Adherence to the principles in 

the framework increases the likelihood that prevention efforts will produce anticipated outcomes, reduce 

harmful behaviors, and keep communities healthy and safe.
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 6

STEP 1: ASSESSMENT

OVERVIEW

The purpose of this step is to understand local prevention needs based on a careful review of data 

gathered from a variety of sources. These data help planners to identify and prioritize the substance 

misuse problems present in their community; clarify the impact these problems have on community 

members; identify the specific factors that contribute to these problems; assess readiness; and 

determine the resources required to address those factors. Ultimately, a thorough and inclusive 

assessment process helps to ensure that substance misuse prevention efforts are appropriate and 

on target.

To conduct a comprehensive assessment of prevention needs, prevention professionals gather data 

about each of the following:

 The nature of the substance misuse problem in the community and related harmful behaviors

 Risk and protective factors that influence substance misuse problems, particularly those of high

priority in the community

 Community capacity for prevention, including readiness and available resources

Step 1:

Assessment

Step 2:

Capacity

Step 3:

Planning

Step 4:

Implementation

Assess

problems and 

related

behaviors

Prioritize problems

(criteria: magnitude, 

time trend, severity, 

comparison)

Assess risk

and

protective

factors

Engage 

community

stakeholders

Raise 

community

awareness

Develop and 

strengthen a

prevention team

Prioritize risk

and protective 

factors (criteria:

importance, 

changeability)

Select 

interventions

(criteria:

effectiveness,

conceptual fit, 

practical fit)

Develop a 

comprehensive

plan that aligns

with the

logic model

Deliver

programs and

practices

Balance fidelity 

with planned

adaptations

Retain core

components

Establish

implementation

supports and 

monitor

PROBLEMS AND RELATED BEHAVIORS

It is important to assess the nature and extent of both substance misuse problems and related harmful 

behaviors in the community. But what are problems and what are behaviors?

Substance misuse problems are characterized by the behavior patterns that describe how substances 

are misused, for example, binge drinking alcohol. In turn, substance misuse problems may lead to other 

harmful behaviors or adverse outcomes, such as traffic accidents and fatalities from driving under the 

influence of alcohol or other drugs. However, the relationship between substance misuse and other 

associated problems is not one-to-one. An individual’s substance misuse behavior can lead to a wide 

range of problems, often multiple ones—including illnesses, injuries, violence to self and others, and 

crimes. For example, binge drinking among 12- to 17-year-olds can lead to alcohol poisoning, motor 

vehicle crashes, delinquent and violent acts, and other serious problems reported in this age group.

ASSESSING PROBLEMS AND RELATED HARMFUL BEHAVIORS

Prevention planners can use the following questions to guide community assessment of substance 

misuse problems and related harmful behaviors:
7

 What substance misuse problems (e.g., overdoses, alcohol poisoning) and related harmful

behaviors (e.g., prescription drug misuse, underage drinking) are occurring in the community? 

 How often are these substance misuse problems and related harmful behaviors occurring?

Which ones are happening the most?

 Where are these substance misuse problems and related harmful behaviors occurring

(e.g., at home or in vacant lots, in small groups or during big parties)?

 Who is experiencing more of these substance misuse problems and related harmful behaviors

(e.g., males, females, youth, adults, members of certain cultural groups)?

The answers to these questions can help planners identify—and determine how to most effectively 

address—a community’s priority substance misuse problem(s). To obtain these answers, planners 

rely on data. Data is the driving force behind the SPF planning process. Prevention efforts are more 

successful when planners use data to understand the substance misuse problems facing their 

communities.

Community practitioners and planners may begin by collecting existing state and local archival data that 

are readily available. In some instances, states, tribes, and jurisdictions have established epidemiological 

workgroups—collaborative groups of agencies and individuals focused on using data to inform and 

enhance prevention practice at both the state and local levels. These workgroups collect, analyze, 

and disseminate a wide variety of substance use and behavioral health data. These findings are 

often presented in epidemiological profiles—detailed reports that summarize the problems affecting a 

particular community or population. Hospitals, law enforcement agencies, community organizations, and 

state agencies can also be important sources of data.

Once the data are compiled, it is important to examine and discard what is irrelevant or not useful.

It is also important to determine whether any information (e.g., about a particular problem, behavior, 

or population group) is missing and, if so, identify ways to fill data gaps by collecting new data. (See 

Appendix A to learn about data collection methods and their benefits and limitations.)

PRIORITIZING PROBLEMS AND RELATED HARMFUL BEHAVIORS

Data collected through the assessment process may reveal that a community has multiple areas of 

need that are contributing to substance misuse. Planners will want to establish criteria for analyzing 

assessment data in order to determine how to prioritize problem(s). These criteria may include the 

following:

 Magnitude: Describes the prevalence of a specific substance misuse problem or harmful

behavior (e.g., Which problem/behavior is most widespread in your community?)

 Severity: Describes how large an impact a specific substance misuse problem or harmful

behavior has on the people or the community (e.g., Which problem/harmful behavior is 

most serious?)

 Trend: Describes how substance misuse patterns are changing over time within a community

(e.g., Which problem/harmful behavior is getting worse or better?)
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 8

 Changeability: Describes how likely it is that a community will be able to modify the problem

or behavior (e.g., Which problem/harmful behavior are you most likely to influence with your 

prevention efforts?)

When setting priorities, planners should consider all four of these criteria together in order to gain a 

balanced view of the problem, its significance in the community, and the potential for change. Different 

planners or practitioners may weigh each criterion differently, depending on their unique community 

context and perspective. Working through these considerations is important to build support for the 

community prevention efforts that will be directed to the priority substance misuse problem.

ASSESSING RISK AND PROTECTIVE FACTORS

Once a community has identified one or more priority problems, it is important to look at the factors 

associated with those problems. Two types of factors influence the likelihood that an individual will 

develop a substance misuse or related mental health problem:

 Risk factors are associated with a higher likelihood of developing a problem (e.g., low impulse

control, peer substance use).

 Protective factors are associated with a lower likelihood of developing a problem (e.g., academic

achievement, parental bonding, and family cohesion).

Understanding risk and protective factors is essential to prevention.

Problems

and related

behaviors

Risk and

protective

factors

Programs 

and

practices

Prevention planners cannot change a substance misuse problem directly. Instead, they need to work 

through the underlying risk and protective factors that influence the problem. A prevention program or 

practice can only make a difference if it’s a good match for both the problem and its underlying factors.

The following are some key features of risk and protective factors:

 Risk and protective factors exist in multiple contexts (e.g., individual, family, peer, and community).

 Risk and protective factors are correlated and cumulative.

 Individual factors can be associated with multiple problems.

 Risk and protective factors are influential over time.

It is important to recognize that the underlying factors driving a substance misuse problem in one 

community may differ from the factors driving that same problem in a different community. Effective 

prevention focuses on reducing the risk factors and strengthening the protective factors specific to the 

priority problem in your community. (See Appendix B to learn more about risk and protective factors.)
9

ASSESSING CAPACITY FOR PREVENTION 

Assessing a community’s available resources and readiness to address substance misuse is a key part 

of the prevention planning process. Prevention efforts are more likely to succeed when they are informed 

by a complete assessment of a community’s capacity to address the identified substance misuse 

problems. Capacity for prevention includes two main components: resources and readiness.

Resources include anything a community can use to establish and maintain a prevention effort that 

can respond effectively to local problems. Examples include: 

 People (e.g., staff, volunteers)

 Specialized knowledge and skills (e.g., research expertise)

 Community connections (e.g., access to population groups)

 Concrete supplies (e.g., money, equipment, technology)

 Community awareness about local substance misuse problems (e.g., high rates of opioid

overdose) 

 Existing efforts to address those problems (e.g., policies)

A well-planned and focused resource assessment will produce far more valuable information than one 

that casts a wide net. To that end, it’s helpful to focus capacity assessments on resources that are 

related to your priority problem(s). At the same time, keep in mind that useful and accessible resources 

may also exist beyond the boundaries of the community’s substance misuse prevention effort. Many 

organizations, including state and government agencies, law enforcement, health care centers, and 

faith-based organizations are also working to reduce the impact of substance misuse and other harmful 

behavioral health problems.

Readiness describes the motivation and willingness of a community to commit local resources to 

addressing identified substance misuse problems. Factors that affect readiness include: 

 Knowledge of the substance misuse problem

 Existing efforts to address the problem

 Availability of local resources

 Support of local leaders

 Community attitudes toward the problem

Readiness assessments should reflect the preparedness of the community sectors that will be involved 

in addressing the priority problem and/or will be affected by it. To do this, prevention planners must 

engage in a culturally competent assessment process that includes representatives from across 

community sectors. A thorough capacity assessment should include information about:

 The cultural and ethnic makeup of the community

 How problems are perceived among different sectors of the community

 Who has been engaged in previous prevention efforts

 Existing barriers to participation in prevention efforts
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 10

To assess readiness for prevention, it is often helpful to speak, one-on-one, with local decision-makers 

and public opinion leaders. If individuals with access to critical prevention resources are not initially 

supportive of or invested in prevention efforts, then it will be important to find ways early on to increase 

their level of readiness.

Understanding local capacity, including both resources and readiness, helps prevention planners to:

 Make realistic decisions about which substance misuse problem(s) a community is prepared to

address.

 Identify resources a community may need, but doesn’t currently have, for addressing identified

prevention needs.

 Develop a clear plan for building and mobilizing capacity (see SPF Step 2) to address identified

problems.

Assessing community readiness, in particular, helps prevention professionals determine whether there 

is social momentum for addressing the issue(s) they hope to tackle. Community readiness is just as 

important in addressing substance misuse problems as having tangible resources in place.

SHARING ASSESSMENT FINDINGS

The final step in completing a needs and capacity assessment is to communicate key findings to 

prevention stakeholders. There are many ways to share findings, but what is critical is that the chosen 

approach is the right match for the audience. Included below are some key considerations for sharing 

assessment findings.

 Develop a full report. Funders and close prevention partners (e.g., task force members) will want

the whole story. It’s helpful to have all of the details in one place.

 Highlight key findings. For stakeholders who may be interested only in assessment highlights,

develop brief handouts or short slide presentations.

 One size does not fit all. Be prepared to tailor assessment materials by featuring those data that

are most meaningful to each audience. This is particularly important when presenting assessment 

findings to key stakeholders (e.g., local decision-makers, public opinion leaders, and potential 

partners). If these individuals have specific questions or reservations, be sure to address them.

 Solicit input from the community. Find ways for community members and groups to provide

feedback on the assessment results. Their comments can help to confirm that prevention plans 

are on track and/or shed light on findings that may have been confusing or surprising.
11 A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK

STEP 2: CAPACITY

OVERVIEW

In this step, local resources are built and mobilized and the community’s readiness to address priority 

substance misuse problems is determined. In Step 1, planners took stock of what was available in their 

communities. In Step 2, they ensure the readiness of the community to buy in to the prevention effort and 

take stock of the resources needed to tackle the problem and produce a positive change.

A community needs both human and structural resources to establish and maintain a prevention system 

that can respond effectively to local problems. It also needs people who have the motivation and 

willingness—that is, the readiness—to commit local resources to addressing these problems.

The following are three strategies for building local capacity for prevention:

1. Engage diverse community stakeholders

2. Develop and strengthen a prevention team

3. Raise community awareness about the issue

By building and mobilizing local capacity for prevention, planners create the foundation communities will 

need to begin developing prevention efforts that will be effective and enduring.

Step 1:

Assessment

Step 2:

Capacity

Step 3:

Planning

Step 4:

Implementation

Step 5:

Evaluation

Assess

problems and

related

behaviors

Prioritize problems

(criteria: magnitude, 

time trend, severity, 

comparison)

Assess risk

and

protective

factors

Engage 

community 

stakeholders

Raise 

community 

awareness

Develop and 

strengthen a 

prevention team

Prioritize risk

and protective 

factors (criteria:

importance, 

changeability)

Select 

interventions

(criteria:

effectiveness,

conceptual fit, 

practical fit)

Develop a 

comprehensive

plan that aligns

with the

logic model

Deliver

programs and

practices

Balance fidelity 

with planned

adaptations

Retain core

components

Establish

implementation

supports and 

monitor

Conduct

process

evaluation

Conduct

outcome

evaluation

Recommend

improvements

and make 

mid-course 

corrections

Share and

report

evaluation

results

ENGAGING DIVERSE STAKEHOLDERS

Substance misuse is a complex behavioral health problem, and to address it requires the energy, 

expertise, and experience of multiple players, working together across disciplines. Prevention planners 

need diverse partners—from neighborhood residents to service providers to community leaders—

to share information and resources, raise awareness about critical substance misuse problems, 

build support for prevention, and ensure that prevention activities reach multiple populations with 

multiple strategies in multiple settings. By involving community members in all aspects of prevention 

planning, implementation, and evaluation, planners demonstrate respect for the people they serve 

and are more likely to develop prevention services that meet genuine needs, build on strengths, and 

produce positive outcomes.
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 12

Following are community sectors that planners may want to involve in prevention efforts:

 Treatment providers  Local businesses

 Law enforcement  University and research institutions

 Health care providers  Neighborhood and cultural associations

 Local government  Faith communities

 Youth-serving agencies and institutions

It is important to build relationships with stakeholders who support prevention efforts as well as with 

those who do not. It is also important to recognize that potential community partners will have varying 

levels of interest and/or availability to get involved. One person may be willing to help out with a specific 

task, while another may be willing to assume a leadership role. Keep in mind that as people come 

to understand the importance of prevention efforts, they are likely to become more engaged. (See 

Appendix C to learn more about levels of involvement.)

The following list includes some of the ways to approach people and organizations in the community with 

information about, and invitations to participate in, prevention efforts:

 Call known contacts, particularly those with overlapping interests

 Attend and speak up at community meetings and events

 Ask partners to contact their partners

 Keep potential partners well informed about prevention activities and progress made

 Meet with key players, including public opinion leaders and local decision-makers

 Anticipate and overcome roadblocks (e.g., address the concerns of those who might oppose or

hinder prevention efforts)

Included below are different ways to encourage stakeholders who are already engaged to get more

involved in prevention efforts:

 Meet face-to-face to discuss overlapping goals and agendas

 Extend an invitation to attend a prevention team or task force meeting

 Once prevention planning is underway, make more specific requests for involvement

 Extend invitations to attend future prevention events and activities

 Maintain relationships by keeping stakeholders informed of prevention activities and progress

made

DEVELOPING AND STRENGTHENING A PREVENTION TEAM

A strong prevention team is often the guiding force behind effective prevention efforts. The prevention 

team, or task force, should include representatives from those community sectors that are most vital 

to the success of the prevention initiative. In other words, the prevention team will be a subset of 

the stakeholders identified above. Here are some considerations for building and/or strengthening a 

prevention team:

 Be deliberate. Establishing a representative prevention team requires deliberate and strategic

planning. When inviting new members, be clear about the purpose of the collaboration, determine 

how goals will be attained, and establish clear roles and responsibilities for all involved.
13

 Build prevention knowledge. A truly representative prevention team means that members will

bring diverse insights and experiences to the table, as well as varied knowledge and perspectives 

on the priority problem being addressed. Use a variety of strategies—including guest speakers 

and group trainings—to increase the team’s understanding of the problem and effective prevention 

strategies.

 Monitor and improve group structure and processes, as needed. Even the most wellinformed group won’t be productive unless it functions well. To help the team work together 

effectively, discuss how you will share leadership, make decisions, divide tasks, resolve conflicts, 

and communicate with one another as well as with the broader community.

RAISING COMMUNITY AWARENESS

By raising public awareness about a community’s priority substance misuse problem(s), prevention 

planners can help garner valuable resources and increase local readiness for prevention. The following 

are some strategies for raising community awareness:

 Meet one-on-one with public opinion leaders

 Ask task force members to share information in their own sectors

 Submit articles to local newspapers, church bulletins, neighborhood newsletters, etc.

 Share information on relevant websites and social media outlets

 Host community events to share information about and discuss the problem

 Convene focus groups to get input on prevention plans

It is always helpful to think “outside the box” when looking for new ways to raise community awareness.

For example, the local high school may have a media club that can help to create a video about the 

community’s priority problem and/or prevention efforts. Also, think about “ripple” potential—that is, 

which individuals and community groups might help to spread the word and get others involved in 

prevention efforts.

Finally, when building capacity, don’t forget about the data. Data collected during the assessment 

process can help to increase general awareness about critical prevention problems and engage key 

stakeholders. Data can also be used to mobilize resources to support prevention efforts.
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 14

STEP 3: PLANNING

OVERVIEW

Strategic planning increases the effectiveness of prevention efforts by ensuring that prevention planners 

select and implement the most appropriate programs and strategies for their communities. In an effective 

planning process, communities involve diverse stakeholders, replace guesswork and hunches with datadriven decisions, and create comprehensive, evidence-based prevention plans to address their priority 

substance misuse problems.

To develop a solid prevention plan, planners need to:

 Prioritize the risk and protective factors associated with the substance misuse problems that have

been identified (See Step 1: Assessment)

 Select appropriate programs and practices to address each priority factor

 Combine programs and practices to ensure a comprehensive approach

 Build and share a logic model with stakeholders

The flowchart included previously in Step 1: Assessment to illustrate the information communities must 

gather in order to determine their prevention needs can also guide the development of an effective 

prevention plan.

Problems

and related

behaviors

Risk and

protective

factors

Programs 

and

practices

Step 1:

Assessment

Step 2:

Capacity

Step 3:

Planning

Step 4:

Implementation

Step 5:

Evaluation

Assess

problems and

related

behaviors

Prioritize problems

(criteria: magnitude, 

time trend, severity, 

comparison)

Assess risk

and

protective

factors

Engage 

community

stakeholders

Raise 

community

awareness

Develop and 

strengthen a

prevention team

Prioritize risk

and protective 

factors (criteria: 

importance, 

changeability)

Select 

interventions 

(criteria: 

effectiveness, 

conceptual fit, 

practical fit)

Develop a 

comprehensive 

plan that aligns 

with the

logic model

Deliver

programs and

practices

Balance fidelity 

with planned

adaptations

Retain core

components

Establish

implementation

supports and 

monitor

Conduct

process

evaluation

Conduct

outcome

evaluation

Recommend

improvements

and make 

mid-course 

corrections

Share and

report

evaluation

results

As noted earlier, communities can’t change substance misuse problems directly. These are changed 

indirectly by addressing the risk and protective factors that are associated with the problem. Evidencebased programs and practices can only make a difference if they’re a good match for both the substance 

misuse problem and the underlying risk and/or protective factors that drive changes in that problem.
15

PRIORITIZING RISK AND PROTECTIVE FACTORS

Every substance misuse problem in every community is associated with multiple risk and protective 

factors. No community can address all of these factors—at least not all at once. So, the first step in 

developing a prevention plan is to figure out which risk and protective factors are the “key drivers” of a 

community’s priority problems. To prioritize factors, it is helpful to consider a factor’s importance and 

changeability.

Importance describes how a specific risk or protective factor affects a problem. To determine a 

factor’s importance, ask the following:

 How much does this factor contribute to our priority problem?

 Is this factor relevant, given the developmental stage of our focus population?

 Is this factor associated with other harmful behavioral health problems?

Changeability describes a community’s capacity to influence a specific risk or protective factor. To 

determine a factor’s changeability, ask the following:

 Do we have the resources and readiness to address this factor?

 Does a suitable program or practice exist to address this factor?

 Can we produce outcomes within a reasonable timeframe?

When developing a prevention plan, it is best to prioritize risk and protective factors that are high for both 

importance and changeability. 

Risk and

protective

factors

IMPORTANCE

Low importance and

low changeability

High importance and

low changeability

High importance and

high changeability

Low importance and

high changeability

CHANGEABILITY

If no factors are high for both, the next best option is to prioritize factors with high importance and 

low changeability. Since factors with high importance contribute significantly to priority substance 

misuse problems, addressing these factors is more likely to make a difference. Also, it may be easier 

to increase the changeability of a factor (e.g., by building capacity) than it is to increase its importance.

In some cases, however, a community may choose to address a factor with low importance and high 

changeability. Doing this can give the community a quick “win,” help raise awareness and support for 

prevention, as well as increase the community’s capacity to address more important factors in the future.
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 16

SELECTING APPROPRIATE PROGRAMS AND PRACTICES

Sometimes people want to select prevention programs or practices that are popular, those that worked 

well in a different community, or those with which they are familiar. These are not necessarily the best 

selection criteria. What is more important is that the program or practice can effectively address the 

priority substance misuse problem and associated risk and protective factors, and that it is a good fit for 

the specific community.

The following are three important criteria for selecting appropriate prevention programs and practices:

 Evidence-based foundation. Whenever possible, prevention planners should select programs

or practices that are evidence-based (i.e., that have documented evidence of effectiveness). The best 

places to find evidence-based programs are federal registries, peer-reviewed journals, systematic 

reviews, and individual evaluation reports. Planners may also look to federal reports, such as Facing 

Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health, 2016; many 

include extensive program listings and descriptions. Since states have different guidelines for what 

constitutes credible evidence of effectiveness, it can also be helpful to talk to prevention experts, 

including state-level evidence-based workgroups.

 Conceptual fit. A program or practice has a good conceptual fit if it directly addresses one or more

of the priority factors driving a specific substance misuse problem and has been shown to produce 

positive outcomes for members of the focus population. To determine a conceptual fit, ask, “Will this 

program or practice have an impact on at least one of the community’s priority risk and protective 

factors?”

 Practical fit. A program or practice has a good practical fit if it is culturally relevant for the focus

population, the community has the will and capacity to support it, and it enhances or reinforces 

existing prevention activities. To determine a practical fit, ask, “Is this program or practice appropriate 

for our community?”

Evidence-based programs or practices with both conceptual fit and practical fit will have the highest 

likelihood of producing positive prevention outcomes. (To learn more about each of these criteria, see 

SAMHSA’s companion tool Selecting Best-Fit Programs and Practices: Guidance for Substance Misuse 

Prevention Practitioners.)
17

ENSURING A COMPREHENSIVE APPROACH

In a comprehensive approach to prevention, programs and practices combine to reach people with 

different levels of risk. They target multiple social contexts and ensure cultural relevance. Each of these 

is described below.

 Levels of risk. To stop the progression of

substance misuse, effective prevention efforts include 

those programs and practices that are directed toward 

individuals or groups who are not yet engaging in 

risky behaviors (e.g., alcohol awareness programs 

for all 10th grade students). These efforts also 

include interventions for individuals or groups who 

have a higher likelihood of engaging in these risky 

behaviors or who have already begun doing so (e.g.,

programs for children whose parents have substance 

use disorders, or post-overdose interventions for 

individuals who have survived an opioid overdose).

 Multiple social contexts. The socio-ecological model shows how risk and protective factors

operate across all social contexts, including individuals, friends and family, schools and other 

community settings as well as the broader societal context of laws and norms. A comprehensive 

prevention plan includes multiple programs and practices, operating in multiple settings and across 

multiple domains. (See Appendix D: The Socio-Ecological Model to learn more about this topic.)

 Cultural relevance. Programs and practices must be responsive to, and appropriate for, the

different cultural groups that comprise a focus population. Throughout the SPF process, planners 

must take steps to ensure the cultural relevance of prevention efforts. For example:

 During Step 1: Assessment. Map the cultural landscape to identify different population

groups in the community as well as key leaders within each group. Analyze assessment data 

by group.

 During Step 2: Capacity. Share and discuss assessment findings throughout the community.

Invite interested community members and groups to participate in prevention planning. Make 

sure the planning team includes individuals with strong ties to groups at high risk.

 During Step 3: Planning. Recruit focus population members to help identify appropriate

programs and practices. Convene focus groups with diverse community members to obtain 

valuable feedback on potential interventions.

BUILDING AND SHARING A LOGIC MODEL

A logic model is a graphic planning tool, much like a roadmap, that can help prevention planners 

communicate where prevention efforts are headed and how goals will be reached. Logic models can 

help planners:

 Explain why a program or practice will succeed. By clearly laying out the tasks of

development, implementation, and evaluation, a logic model can help planners clearly explain 

what will happen and why.

SOCIETY

COMMUNITY

RELATIONSHIP

INDIVIDUAL
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 18

 Identify the logical connections between the problem to be addressed, the associated

underlying factors, and the prevention programs and practices that will effect change.

Logic models help to expose gaps in reasoning or “disconnects” between the community’s 

problem and the actions that have been planned to address it. A logic model helps planners 

identify places where assumptions might be off track or may be unsupported by research or past 

experience. The sooner mistakes are discovered, the easier they are to correct.

 Make evaluation and reporting easier. Developing a logic model before implementing a

program or practice makes evaluation easier since it shows clear, explicit, and measurable 

intended outcomes. When a prevention initiative is laid out fully and clearly in a logic model, 

it is much easier to identify appropriate evaluation questions and gather the data needed to 

answer them.

Though logic models can vary in their design, most include the following four critical components.

Problems

and related

behaviors

Risk and

protective

factors

Programs 

and

practices

Outcomes

Outcomes are the changes communities want their prevention programs and practices to produce.

Prevention outcomes can be either short-term or long-term.

 Short-term outcomes. Short-term outcomes are the most immediate effects of a program

or practice. Short-term outcomes are closely related to how well a program or practice is 

implemented. These include changes in knowledge, attitudes, beliefs, and skills, and are usually 

connected to changes in priority risk and protective factors.

 Long-term outcomes. Long-term outcomes are the effects of a program or practice after

it has been in place for an extended, clearly defined, period of time—usually months or years.

Short-term outcomes reflect changes primarily in risk/protective factors. Long-term outcomes 

build on these short-term effects to produce changes in substance misuse behavior.

After completing a logic model for prevention, it is important to share it with these two important groups:

 Prevention partners. These include the individuals, groups, and institutions who participated

in the needs assessment; were brought onboard during the capacity-building process; and will 

play a key role in selecting prevention programs and strategies. Make sure the logic model clearly 

communicates what the prevention plan hopes to accomplish and what the role of partners will be 

in helping everyone to get there.
19

 Other prevention stakeholders. These include funders as well as community members

and groups who may not yet be actively involved in prevention efforts. A logic model can help 

planners build support for prevention overall, as well as to mobilize the specific capacities needed 

to implement specific programs and practices. Also, the more people who understand the problem 

and are onboard with the prevention plan, the more likely it is that selected programs and practices 

will be sustained over time.
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 20

STEP 4: IMPLEMENTATION

OVERVIEW

In this step, a community’s prevention plan is put into action by delivering evidence-based programs and 

practices as intended. To accomplish this task, planners will need to balance fidelity and adaptation, and 

establish critical implementation supports. Each of these tasks is addressed in detail below.

Capacity

Step 3:

Planning

Step 4:

Implementation

Step 5:

Evaluation

Engage 

community

stakeholders

Raise 

community

awareness

Develop and 

strengthen a

prevention team

Prioritize risk

and protective 

factors (criteria:

importance, 

changeability)

Select 

interventions

(criteria:

effectiveness,

conceptual fit, 

practical fit)

Develop a 

comprehensive

plan that aligns

with the

logic model

Deliver 

programs and 

practices

Balance fidelity 

with planned 

adaptations

Retain core

components

Establish 

implementation 

supports and 

monitor 

Conduct

process

evaluation

Conduct

outcome

evaluation

Recommend

improvements

and make 

mid-course 

corrections

Share and

report

evaluation

results

BALANCE FIDELITY AND ADAPTATION

In preparing to implement selected programs and practices, it is important to consider fidelity and 

adaptation.

 Fidelity: The degree to which a program or practice is implemented as intended.

 Adaptation: Describes how much, and in which ways, a program or practice is changed to meet

local circumstances.

Evidence-based programs and practices are defined as such because they consistently achieve 

positive outcomes. The greater the fidelity to the original program design, the more likely the program 

will be to reproduce positive results. While customizing a program to better reflect the attitudes, beliefs, 

experiences, and values of a focus population can increase its cultural relevance, it is important to keep 

in mind that such adaptations may compromise program effectiveness.

Remaining faithful to the original design of an evidence-based program or practice, while addressing 

the unique needs and characteristics of the target audience, requires balancing fidelity and adaptation.

When we change a program, we risk compromising outcomes. However, implementing a program that 

requires some adaptation may be more efficient and cost-effective than designing a program from 

scratch.

Consider these guidelines when balancing fidelity and adaptation:

 Retain core components. Evidence-based programs are more likely to be effective when their

core components are maintained. Core components are those parts of a program or practice that 

are responsible for producing positive outcomes, and thus most essential and indispensable. Core 

components are like the key ingredients in a cookie recipe. We might be able to take out the 

chocolate chips, but if we take out the flour—a core component—the recipe won’t work. However, 

understanding and adhering to the principles underlying each core component may allow for 

flexibility (see Adapt with care on next page).
21

 Build capacity before changing the program. Rather than change a program to fit local

conditions, consider ways to develop resources or to build local readiness so that it can be 

delivered as it was originally designed.

 Add rather than subtract. Doing so decreases the likelihood of important program elements (i.e.,

those that are critical to program effectiveness) getting lost.

 Adapt with care. Even when programs and practices are selected with great care, there may

be ways to improve their appropriateness for a unique focus population. Cultural adaptation, 

for example, refers to modifications that are tailored to the beliefs and practices of a particular 

group and enhance the cultural relevance of an intervention. To make a program or practice more 

culturally appropriate, consider the language, values, attitudes, beliefs, and experiences of focus 

population members.

 If adapting, get help. Knowledge experts, such as program developers, can provide information

on how a program has been adapted in the past, how well these adaptations have worked, and 

what core components should be retained to maintain effectiveness. Members of the focus 

population can also suggest ways to enhance program materials or messaging to better reflect 

their concerns and experiences.

Keep in mind that adaptations can be planned in order to improve a program (e.g., the case with cultural 

adaptation) or unplanned. It’s important to be aware of the potential for unplanned changes that may 

occur during implementation (e.g., missed sessions when schools close unexpectedly due to bad 

weather) and to address any changes that might compromise program effectiveness (e.g., schedule 

makeup sessions so students don’t miss out on core program content).

ESTABLISH IMPLEMENTATION SUPPORTS

Many factors combine to influence implementation and support the success of prevention efforts. These 

include the following: 

 Favorable prevention history. An individual (or organization) who has had positive experiences

implementing prevention programs or practices in the past is likely to be more willing and able 

to support the implementation of a new intervention. If an individual (or organization) has had a 

negative experience implementing a program or practice—or doesn’t fully understand its potential 

—make sure to address their concerns early in the implementation process.

 Leadership and administrative support. Prevention programs and practices assume many

forms and are implemented in many different settings. However, in order to be effective, all of them 

require leadership and support from key stakeholders.

 Provider selection. When selecting the best candidate to deliver a prevention program, consider

professional qualifications and experiences, practical skills, as well as fit with the focus population.

Ask, “Who is prepared to implement the program effectively? With whom will program participants 

feel comfortable?” Certain provider characteristics that extend beyond academic qualifications 

and experience factors are difficult to teach in training sessions, so must become part of the 

selection criteria.
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 22

 Provider training and support. Pre- and in-service trainings can help providers who are

responsible for implementing a program to understand how and why it works, practice new skills, 

and receive constructive feedback. Since most skills are learned on the job, it is also very helpful 

to connect these providers with a coach who can provide ongoing support. The implementation of 

evidence-based programs and practices requires behavior change at the provider, supervisory, 

and administrative support levels. Training and coaching are the principal ways in which behavior 

change is brought about for selected staff in the beginning stages and throughout the process of 

implementing evidence-based programs and practices.

 A clear action plan. When developed in collaboration with all key partners, these plans can

help to ensure that everyone involved in implementation is on the same page and no key tasks 

fall through the cracks. A clear action plan includes all implementation tasks, deadlines, and 

person(s) responsible.

 Implementation monitoring. By closely monitoring and evaluating the delivery of a program

or practice, planners can make sure that it is being implemented as intended and can thereby 

improve it as needed. By assessing program outcomes, planners can determine whether a 

program or practice is working as intended and is worthy of sustaining over time. Assessments 

of provider performance and measures of fidelity also provide useful feedback to managers and 

implementers regarding the progress of implementation efforts and the usefulness of training and 

coaching. (See Step 5: Evaluation to learn more about this topic.)

These implementation supports are interactive and can compensate for one another, so that a weakness 

in one can be overcome by strengths in others. Organizations are dynamic and there is an ebb and flow 

to the relative contribution of each support to the overall outcomes. Implementation monitoring can help 

to reveal where supports may need to be adjusted to improve effectiveness or efficiency.
23

STEP 5: EVALUATION

OVERVIEW

In the SPF, evaluation is about enhancing prevention practice. It is the systematic collection and analysis 

of information about prevention activities to reduce uncertainty, improve effectiveness, and facilitate 

decision-making.

The evaluation step helps communities to:

 Systematically document and describe prevention activities.

 Meet the diverse information needs of prevention stakeholders, including funders.

 Continuously improve prevention programs and practices.

 Demonstrate the impact of a prevention program or practice on substance misuse and related

behavioral health problems.

 Identify which elements of a comprehensive prevention plan are working well.

 Build credibility and support for effective prevention programming in the community.

 Advance the field of prevention by increasing the knowledge base about what works and what

does not.

Step 2:

Capacity

Step 3:

Planning

Step 4:

Implementation

Step 5:

Evaluation

Engage 

community

stakeholders

Raise 

community

awareness

Develop and 

strengthen a

prevention team

Prioritize risk

and protective 

factors (criteria:

importance, 

changeability)

Select 

interventions

(criteria:

effectiveness,

conceptual fit, 

practical fit)

Develop a 

comprehensive

plan that aligns

with the

logic model

Deliver

programs and

practices

Balance fidelity 

with planned

adaptations

Retain core

components

Establish

implementation

supports and 

monitor

Conduct

process

evaluation

Conduct

outcome 

evaluation

Recommend 

improvements

and make 

mid-course 

corrections

Share and 

report

evaluation 

results

EVALUATION AND THE SPF

In the SPF, evaluation involves examining both the process and outcomes of prevention programs and 

practices. This means asking questions at three levels:

1. Since a comprehensive prevention plan includes multiple programs and practices, examine 

separately how each was delivered and the degree to which it produced positive outcomes.

2. Determine how well these different programs and practices work together as part of the 

community’s comprehensive plan to address priority substance misuse problems.

3. Evaluate the implementation of the SPF process itself (e.g., “Were all step-specific tasks 

completed? Were cultural competence and sustainability principles and activities integrated along 

the way?”) 

Stakeholder involvement is as crucial a part of the evaluation step as it is of other SPF steps. An 

evaluation stakeholder is anyone who cares about, or has something to gain or lose from, a program 

or practice and its evaluation findings. This includes members of those populations that the prevention 

program or practice is intended to reach. The importance and benefits of involving diverse stakeholders 
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 24

in the evaluation process cannot be overstated. By involving diverse stakeholders, prevention 

planners can:

 Demonstrate respect for the many individuals and groups connected to prevention efforts.

 Obtain the help and support needed to conduct a thorough evaluation.

 Enhance understanding of the evaluation process among those involved in data collection and

analysis.

 Ensure the cultural relevance and appropriateness of the evaluation design, tools, and findings.

 Increase the credibility of prevention programming as well as the evaluation process and findings.

 Increase the likelihood that evaluation findings will be disseminated and used.

 Garner support for any efforts to expand and/or sustain programs and practices that have been

shown to be effective.

UNDERSTANDING THE DIFFERENCE BETWEEN PROCESS AND 

OUTCOME EVALUATION

In the SPF, prevention planners consider two types of evaluation: process and outcome.

Process evaluation answers the question, “Did we do what we said we would do?” Prevention 

planners use process evaluation extensively to assess the quality of implementation, keep 

implementation on track, and inform adjustments that can strengthen the effectiveness of their prevention 

efforts. Process data help prevention planners determine the following:

 Were programs and practices implemented as planned?

 What adaptations were made?

 Were the resources sufficient?

 What obstacles were encountered?

 Who participated and for how long?

Outcome evaluation measures the direct effects of a program or practice following implementation, 

That is, it determines whether the program or practice made a difference and, if so, what changed. An 

outcome evaluation might document changes in a population group’s knowledge, attitudes, skills, or 

behavior in both the short- and long-term. Specifically, outcome data can help planners determine:

 What changes occurred.

 How resulting changes compare to what the program or practice was expected to achieve.

 How resulting changes compare with those of individuals not exposed to the program or practice.

Both process and outcome data are important. Outcome evaluation looks at results, but results don’t 

tell the whole story. An evaluation that focuses only on outcomes is sometimes called a “black box” 

evaluation because it does not take process into consideration. Case in point, examining how a program 

or practice was implemented, the number of clients served, dropout rates, and how clients experienced 

the intervention can shed light on disappointing outcome evaluation results. Similarly, examining these 

same factors can also explain positive evaluation results. (One can’t take credit for positive results if one 

can’t show what caused them.) An outcome evaluation alone, without a process evaluation component, 

won’t provide information about why a program did or did not work. (To learn about some cost-effective 

ways to conduct both process and outcome evaluations, see Appendix E: Making the Most of Your 

Evaluation Dollars.)
25

ADHERING TO EVALUATION PRINCIPLES

Successful evaluations adhere to the principles of utility, feasibility, propriety, and accuracy.

 Utility is about making sure that the evaluation meets the needs of prevention stakeholders,

including funders. To increase the utility of the evaluation, prevention planners may:

• Identify the evaluation needs of all key stakeholders

• Document findings so that they are easily understood

• Share findings with stakeholders in a timely manner

 Feasibility is about making sure that the evaluation is realistic and doable. To ensure the

feasibility of the evaluation, prevention professionals may:

• Establish data collection procedures that are practical and minimize disruption

• Anticipate and address potential obstacles (e.g., opposition from special interest groups)

• Consider efficiency and cost-effectiveness

 Propriety is about making sure that the evaluation is conducted in accordance with legal and

ethical guidelines and is consistent with each community’s cultural context. To support the 

propriety of the evaluation, prevention professionals may:

• Respect the rights and protect the well-being of all involved

• Examine the program or practice in a thorough and impartial manner

• Define how findings will be disclosed and who can access them

 Accuracy is about making sure that the evaluation is conducted in a precise and dependable

manner. To increase the accuracy of evaluation findings, prevention professionals may:

• Clearly describe the program or practice as well as the evaluation procedures

• Gather and use information that is both valid and reliable

• Systematically and appropriately analyze all information

• Justify and fairly report all conclusions

(See Appendix F: Evaluation Design, Reporting, and Lessons Learned for more information on 

this topic.)
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 26

SPF GUIDING PRINCIPLE:

CULTURAL COMPETENCE 

Behavioral health disparities pose a significant threat to the most vulnerable populations in our society.

Whether manifesting themselves as elevated rates of substance misuse among American Indian/Alaska 

Natives, high rates of suicide among LGBTQ youth, or reduced access to prevention services among 

people living in rural areas, these disparities threaten the health and wellness of these populations and of 

our society as a whole. 

To overcome systemic barriers that may contribute to disparities, planners must be culturally competent.

They must recognize and value cultural differences—such as those in the health beliefs, practices, 

and linguistic needs of diverse populations. They must develop and deliver prevention programs and 

practices in ways that ensure members of diverse cultural groups benefit from their efforts.

SAMHSA has identified the following cultural competence principles for prevention planners:

 Include the target population in all aspects of prevention planning

 Use a population-based definition of community (i.e., let the community define itself)

 Stress the importance of relevant, culturally appropriate prevention approaches

 Employ culturally competent evaluators

 Promote cultural competence among program staff, reflecting the communities they serve

Cultural competence is one of the SPF’s two guiding, cross-cutting principles and, as such, should 

be integrated into each step of the framework’s implementation. By considering culture at each step, 

planners can help to ensure that members of diverse population groups can actively participate in, feel 

comfortable with, and benefit from prevention practices.

Included in the following table are some opportunities to integrate cultural competence throughout the

SPF process.
27

SPF Step Opportunities to Integrate Cultural Competence

Assessment

 Take steps to identify those sub-populations who are vulnerable to

behavioral health disparities and the disparities that they experience.

 Identify data gaps and take efforts to fill them.

 Develop plans to share and solicit input about assessment findings with

members of these sub-populations, and describe these findings using 

terms and phrases that are devoid of jargon.

Capacity

 Build the knowledge, resources, and readiness of prevention practitioners

and community members to address disparities, as well as to provide 

culturally and linguistically appropriate services.

 Make sure that practitioners understand the role of cultural competence

in their work, overall, and the unique needs of those sub-populations 

experiencing disparities.

 Develop new partnerships that will help engage members of these groups

in prevention planning efforts.

Planning

 Make community representation in the planning process a priority.

 Involve members of the focus population as active participants and

decision-makers.

 Identify and prioritize factors associated with disparities.

 Develop logic models that include a reduction in health disparities as a

long-term outcome.

 Incorporate effective prevention programs and practices that have

been developed for and evaluated with an audience similar to the focus 

population.

 If and when misunderstandings arise, be persistent in keeping

communication lines open.

Implementation

 Implement prevention programs that target populations experiencing

behavioral health disparities.

 Involve members of these groups in the design and delivery of those

programs.

 Understand that people may choose to participate in different ways and

that they may also have different learning styles.

 Adapt and/or tailor evidence-based practices to be more culturally

relevant. For example, create an in-person version of a training that was 

originally designed to be delivered virtually so that it is accessible to 

audiences with limited online access.
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 28

Evaluation

 Conduct process and outcome evaluations to demonstrate whether

selected programs and practices are having the intended impact on 

identified disparities.

 Track all adaptations.

 Allocate the evaluation resources needed to learn whether the

interventions you selected are having the intended impact on the 

behavioral health disparities you are hoping to reduce.

 Conduct follow-up interviews with program participants to better

understand program evaluation findings.

Sustainability 

(Guiding 

Principle)

 Engage partners who represent and work with sub-populations

experiencing behavioral health disparities in your sustainability planning 

efforts.

 Sustain processes that have successfully engaged members of these

populations.

 Sustain programs that produce positive outcomes for these populations.
29

SPF GUIDING PRINCIPLE:

SUSTAINABILITY 

In prevention, sustainability is the capacity of a community to produce and maintain positive prevention 

outcomes over time. To maintain positive outcomes, communities will want to sustain an effective 

strategic planning process as well as those programs and practices that produced positive prevention 

results. Accomplishing these dual tasks requires the participation, resolve, and dedication of diverse 

community members and a lot of careful planning.

SUSTAINING AN EFFECTIVE STRATEGIC PLANNING PROCESS

There are a number of reasons why it is important to sustain an effective strategic planning process.

These are some things to keep in mind: 

 Prevention takes time. While communities are likely to achieve some short-term outcomes

initially, it can take many years to produce long-term results. When practitioners help the SPF 

process live on over time, communities are much more likely to make a significant and lasting 

impact on their substance misuse problems.

 Substance misuse problems and priorities change. Prevention needs and capacity are always

evolving with new substance misuse issues arising that no one can anticipate right now. With a 

well-established strategic planning process like the SPF already in place, communities will be able 

to recognize—and respond effectively to—these important changes over time.

 Successful implementation of the SPF depends on collaboration. The SPF is widely

recognized by many public health funders and practitioners. Adherence to a common planning 

process can help planners establish a shared language across health issues and build the 

interdisciplinary partnerships needed to make a real difference.

SUSTAINING PROGRAMS AND PRACTICES THAT WORK

A primary goal of an effective strategic planning process like the SPF is to identify the right combination 

of programs and practices to address local prevention priorities. Many factors contribute to effectiveness 

in prevention. In general, programs and practices must operate in a variety of community settings 

and influence local risk and protective factors at both the individual and environmental levels. Thus, a 

comprehensive prevention plan might include:

 A school-based youth skills promotion program

 Parent education to support children’s healthy development

 Organizational/community rules and regulations that support healthy behavior

 Enforcement of rules and regulations that support healthy behavior

Some programs and practices included in a comprehensive prevention plan are likely to work better than 

others (e.g., they produce positive outcomes and/or receive community support). To maintain positive 

outcomes over time, it’s important to identify and sustain those prevention programs and practices that 

work well for a community.
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 30

SPF Step How the SPF Contributes to Sustainability

Assessment

 During assessment, practitioners begin making decisions based on

a clear understanding of local prevention needs. They also begin 

building relationships with data keepers and stakeholders who can play 

important roles in supporting and sustaining local prevention efforts 

over time.

Capacity

 Intentional capacity building at all levels helps to ensure that successful

programs are sustained within a larger community context, and 

therefore less vulnerable to local budgetary and political fluctuations.

 Effective capacity building increases an organization’s or community’s

ability to respond to changing issues with innovative solutions.

 Building capacity also involves promoting public awareness and support

for evidence-based prevention, and engaging partners and cultivating 

champions who will be vital to the success—and sustainability—of local 

prevention efforts. 

Planning

 When developing a comprehensive approach to preventing substance

misuse, communities should consider the degree to which prevention 

interventions fit with local needs, capacity, and culture: the better the fit, 

the more likely interventions are to be both successful and sustainable.

Implementation

 By working closely with community partners to deliver evidence-based

programs and practices as intended, closely monitoring and improving 

their delivery, and celebrating “small wins” along the way, planners help 

to ensure their effectiveness and begin to weave prevention into the 

fabric of the community.

Evaluation

 Through process and outcome evaluation, communities can make

important mid-course corrections to prevention efforts, identify which 

practices are worth expanding and/or sustaining, and examine ongoing 

plans for—and progress toward—sustaining those practices that work.

 By sharing evaluation findings, planners can also help build the support

needed to expand and sustain effective interventions.

Cultural 

Competence 

(Guiding 

Principle)

 To ensure that prevention practices produce positive outcomes for

members of diverse population groups, communities must engage 

in an inclusive and culturally appropriate approach to identifying and 

addressing their substance misuse problems.

 Culturally competent prevention is the only type of prevention worth

doing—and sustaining.
DRAFT

Step 1:

Assessment

Step 2:

Capacity

Step 3:

Planning

Step 4:

Implementation

Step 5:

Evaluation

Assess

problems and 

related

behaviors

Prioritize problems

(criteria: magnitude, 

time trend, severity, 

comparison)

Assess risk

and

protective

factors

Engage 

community 

stakeholders

Raise 

community 

awareness

Develop and 

strengthen a 

prevention team

Prioritize risk

and protective 

factors (criteria: 

importance, 

changeability)

Select 

interventions 

(criteria: 

effectiveness, 

conceptual fit, 

practical fit)

Develop a 

comprehensive 

plan that aligns 

with the

logic model

Deliver 

programs and 

practices

Balance fidelity 

with planned 

adaptations

Retain core

components

Establish 

implementation 

supports and 

monitor 

Conduct

process

evaluation

Conduct

outcome 

evaluation

Recommend 

improvements

and make 

mid-course 

corrections

Share and 

report

evaluation 

results

31 A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK (SPF)

PUTTING IT ALL TOGETHER:

THE SPF AT-A-GLANCE
APPENDICES
33

APPENDIX A:

 PRIMARY DATA COLLECTION METHODS

Data is essential to understanding the prevention problems that may exist in our communities. It also 

helps us to determine which, if any, groups are experiencing poorer behavioral health outcomes, and to 

quantify the extent of these disparities. The more we learn about these populations, the more we can 

help identify those characteristics and situations that place members at higher risk for substance misuse, 

as well as those factors that might mitigate those risks.

Practitioners frequently engage in primary data collection efforts to better understand the needs of atrisk populations not captured in standardized surveys or surveillance systems. In the following pages, 

we provide a quick overview of three common data collection methods: interviews, focus groups, and 

surveys. When selecting a method, or combination of methods, think carefully about which to employ 

and understand that a one-size-fits-all approach to data collection is unlikely to reveal the critical needs 

of those populations most often underserved.

It is also important to involve members of these groups, from the start, in the data collection process, in 

making decisions about methodology, developing tools and questions, and in interpreting findings. The 

greater the involvement of community members, the greater the likelihood that data collection strategies 

and survey questions will reflect the culture and attitudes of the populations experiencing disparities.

INTERVIEWS

Interviews are structured conversations with specific individuals who have experience, knowledge, or 

understanding about a topic or issue about which you want to learn more. Relatively easy to prepare for 

and conduct, interviews offer practitioners the chance to find out how community members are thinking 

about an issue or situation. Interviews can be conducted in-person or by phone. The structure of the 

conversation is also somewhat flexible. Questions and topics can be added or omitted as needed.

Key informant interviews are conducted with select people who are in key positions and have specific 

areas of knowledge and experience. These can be useful for exploring specific problems and/or 

assessing a community’s readiness to address those problems.

One-on-one community interviews, typically conducted by coalition members, tend to be less formal and 

offer excellent opportunities to build relationships, raise awareness, and inform community members 

about pressing problems and prevention efforts.
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 34

INTERVIEW PROS INTERVIEW CONS

9 Low cost, assuming relatively few are 

conducted

9 Respondents define what is important

9 Have relatively short turnaround time

9 Make it possible to explore issues in depth

9 Offer opportunity to clarify responses 

through probes

9 Can be source of leads to other data 

sources and key informants

9 Have generally lower refusal rates

9 Offer opportunity to build partnerships

3 Can be time consuming to schedule

3 Require skilled and/or trained interviewers

3 Have limited generalizability 

3 Produce limited quantitative data

3 Have potential for interviewer bias

3 May not be good for sensitive information 

unless rapport is established

3 May make it more difficult to summarize 

and analyze findings

FOCUS GROUPS

A focus group is a systematic way of collecting qualitative or descriptive data through small-group 

discussion. Focus group participants are chosen to represent a larger group of people from whom you 

want information. Through focus groups, practitioners can explore prevention related topics in depth and 

participants can share their unique perspectives.

Specifically, in focus groups prevention practitioners can ask participants questions that may be difficult 

for them to answer in writing and help them clarify their responses by asking follow-up questions. Focus 

groups create an opportunity for rich dialogue as participants build on one another’s responses. They 

also generate narrative information that is compelling and easy to understand.

FOCUS GROUP PROS FOCUS GROUP CONS

9 Relatively low cost

9 Have relatively short turnaround time

9 Participants define what is important

9 Offer some opportunity to explore issues 

in depth

9 Offer opportunity to clarify responses 

through probes

3 Can be time consuming to assemble 

groups

3 Produce limited quantitative data

3 Require trained facilitators

3 Offer less control over the process as 

compared to key informant interviews

3 Make it difficult to collect sensitive 

information

3 Have limited generalizability

3 May make it more difficult to summarize 

and analyze findings
35

SURVEYS

Surveys provide standardized data that is relatively easy to manage and can be compared to other 

surveys that use the same questions. They are beneficial in situations where you want to collect 

information across a large geographic area, hear from as many people as possible, and explore sensitive 

topics.

Survey modes of administration can include phone, paper (mailed), and online surveys. Phone and 

mailed surveys can be expensive and time consuming to implement. On the other hand, respondents 

may be more likely to respond honestly to questions presented in an anonymous, written survey than to 

those posed during a one-on-one interview. Online surveys are less expensive to administer but tend to 

yield lower response rates.

SURVEY PROS SURVEY CONS

9 Can be highly accurate

9 Can be highly reliable and valid

9 Allow for comparison with other/larger 

populations when items come from 

existing instruments

9 Generate quantitative data

9 Make it easy to summarize and analyze 

findings

9 Make it possible to add more sensitive 

questions

3 Relatively high cost

3 Take time to design, implement, clean, and 

analyze

3 Accuracy depends on who is surveyed 

and the size of the sample

3 Accuracy is limited to willing and reachable 

respondents

3 May have low response rates

3 Offer little opportunity to explore issues in 

depth

3 Questions cannot be clarified

3 Offer no opportunity to build rapport with 

respondents
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 36

APPENDIX B: KEY FEATURES OF RISK 

AND PROTECTIVE FACTORS

When identifying, assessing, and prioritizing the risk and protective factors present in their communities 

prevention planners should consider that:

 Risk and protective factors exist in multiple contexts.

 Risk and protective factors are correlated and cumulative.

 Risk and protective factors are influential over time.

 Not all people or populations are at the same risk.

These are described in greater detail below.

RISK AND PROTECTIVE FACTORS EXIST IN MULTIPLE CONTEXTS

All people have biological and psychological characteristics that make them vulnerable to or resilient 

in the face of potential behavioral health issues. Because people have relationships within their 

communities and the larger society, each person’s biological and psychological characteristics exist in 

multiple contexts. A variety of risk and protective factors operate within each of these contexts. These 

factors also influence one another. Targeting only one context when addressing a person’s risk or 

protective factors is unlikely to be successful because people don’t exist in isolation.

RISK AND PROTECTIVE FACTORS ARE CORRELATED AND CUMULATIVE

Risk factors tend to be positively correlated to one another and negatively correlated to protective 

factors. In other words, people with some risk factors have a greater chance of experiencing even more

risk factors and are less likely to have protective factors. Risk and protective factors also tend to have a 

cumulative effect on the development of behavioral health problems, including substance misuse. Young 

people with multiple risk factors have a greater likelihood of experiencing substance misuse problems or 

engaging in other related harmful behaviors. On the other hand, young people with multiple protective 

factors are at a reduced risk. These correlations underscore the importance of early intervention and 

programs and practices that target multiple, rather than single, factors.

INDIVIDUAL FACTORS CAN BE ASSOCIATED WITH MULTIPLE OUTCOMES

Although preventive programs and practices are often designed to produce a single outcome, both risk 

and protective factors can be associated with multiple outcomes. For example, negative life events are 

associated with substance misuse as well as with anxiety, depression, and other harmful behavioral 

health problems. Prevention efforts targeting a set of risk or protective factors have the potential to 

produce positive effects in multiple areas.

RISK AND PROTECTIVE FACTORS ARE INFLUENTIAL OVER TIME

Risk and protective factors can have influence throughout a person’s entire lifespan. For example, 

risk factors such as poverty and family dysfunction can contribute to the development of mental and/

or substance use disorders later in life. Risk and protective factors within one particular context—such 

as the family—may also influence or be influenced by factors in another context. Effective parenting 
37

has been shown to mediate the effects of multiple risk factors—including poverty, divorce, parental 

bereavement, and parental mental illness. The more planners understand how risk and protective factors 

interact, the better prepared they will be to develop appropriate programs and practices.

NOT ALL PEOPLE OR POPULATIONS ARE AT THE SAME LEVEL OF RISK 

Prevention programs and practices are most effective when they are matched to their target population’s 

level of risk. Prevention programs and practices fall into three broad categories.

 Universal programs and practices take the broadest approach and are designed to reach entire

groups or populations. Universal prevention programs and practices might target schools, whole 

communities, or workplaces.

 Selective programs and practices target individuals or groups who experience greater risk

factors (and perhaps fewer protective factors) that put them at higher levels of risk for substance 

misuse than the broader population.

 Indicated programs and practices target individuals who show early signs of substance misuse

but have not yet been diagnosed with a substance use disorder. These types of interventions 

include referrals to support services for young adults who violate drug policies. They also include 

screening and consultation for the families of older adults who are admitted to hospitals with 

potential alcohol-related injuries.
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 38

APPENDIX C:

LEVELS OF INVOLVEMENT

Potential community partners will have varying levels of interest and/or availability to participate in 

prevention efforts. Some may be willing to help out with specific tasks, while others may be willing to take 

on leadership roles. Some participation options for prevention stakeholders are included below.

PARTICIPATION OPTIONS 

 No involvement. Stakeholders engage in separate activities, strategies, and policies. (For

example, “You do your thing, we’ll do ours.”)

 Networking. Stakeholders share what they are doing during interagency meetings. They talk

about community issues in which they all have a stake or communicate about existing programs, 

activities, or services. (For example, “Let’s talk and share information.”)

 Cooperation. Stakeholders publicize one another’s programs in agency newsletters, write

letters in support of one another’s grant applications, co-sponsor trainings or professional 

development activities, and/or exchange such resources as technology expertise or meeting 

space. (For example, “I’ll support your program, and you’ll support mine.”)

 Coordination. Stakeholders serve together on event planning committees and community

boards or implement programs and services together. (For example, “Let’s partner on an event.”)

 Collaboration. Stakeholders create formal agreements (e.g., memoranda of understanding

or contracts). They develop common data collection systems; partner on joint fundraising 

efforts; pool fiscal or human resources; and create common workforce training systems.

(For example, “Let’s work together on a comprehensive plan to address the issue. After all, 

our missions overlap.”)
39

APPENDIX D: 

THE SOCIO-ECOLOGICAL MODEL

OVERVIEW

The socio-ecological model is a multi-level framework that allows us to consider the different contexts in 

which risk and protective factors exist. The model also allows us to examine how contexts interact with 

one another and to choose prevention strategies that operate at multiple levels in order to achieve the 

greatest impact.

ABOUT THE MODEL

The theory behind the socio-ecological model is that an individual does 

not exist in a vacuum and that her/his behavior both influences and is 

influenced by the surrounding environment, which consists of various 

levels. Each level operates within and is influenced by the next level.

1

 This 

reciprocal relationship and dynamic interaction helps us to understand 

human development and behavior because different risk and protective 

factors operate within each level.

2

 The four levels3 are:

 INDIVIDUAL. Includes factors specific to the individual, such as age, education, income,

health, and psychosocial problems, which may correspond with substance use. For example, 

undergraduate students who exhibit poor self-regulation, impaired control, and impulsiveness are 

more likely to binge drink.

4

 RELATIONSHIP. Includes an individual’s closest social circle—family members, peers,

teachers, and other close relationships—that contribute to their range of experience and may 

influence their behavior. For example, youth who affiliate with deviant peers are more likely to use 

marijuana.

5

 COMMUNITY. Includes the settings in which social relationships occur, such as schools,

workplaces, and neighborhoods. For example, living in neighborhoods with chronically high rates 

of disorganization, crime, and unemployment is associated with higher risk for substance abuse.

6

 SOCIETY. Includes broad societal factors, such as social and cultural norms. Other significant

factors operating at this level include the health, economic, educational, and social policies that 

contribute to economic and/or social inequalities between populations.

1

 Bronfenbrenner, U. (1977). Toward an experimental ecology of human development. American Psychologist, 32(7), 513-531.

2

 Blum, R. W., McNeely, C., & Nonnemaker, J. (2002). Vulnerability, risk, and protection. Journal of Adolescent Health, 31(1 Suppl), 28-

3

 Terminology adapted from Bronfenbrenner (1977).

4

 Neal, D., & Carey, K. (2007). Association between alcohol intoxication and alcohol related problems: An event analysis. Psychology of 

Addictive Behaviors, 21(2), 194-204.

5

 Hampson, S.E., Andrews, J.A., & Barckley, M. (2008). Childhood predictors of adolescent marijuana use: Early sensation-seeking, deviant 

peer affiliation, and social images. Addictive Behaviors, 33(9) 1140-1147.

6

 Institute of Medicine, O’Connell, M. E., Boat, T. F., Warner, K. E., & National Research Council. (2009). Preventing mental, emotional, and 

behavioral disorders among young people: Progress and possibilities. Washington, DC: National Academies Press.

INDIVIDUAL

RELATIONSHIP

COMMUNITY

SOCIETAL
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 40

APPLYING THE MODEL TO PREVENTION 

The socio-ecological model highlights the importance of working across levels to address the 

constellation of factors that influence both individuals and populations.

7 For example, a strong school 

policy forbidding alcohol use on school grounds will likely have little impact on underage drinking in a 

community where parents accept underage drinking as a rite of passage or where alcohol vendors are 

willing to sell to young adults.

A more effective and comprehensive prevention approach—with the potential to impact multiple 

contexts—might include changes to the school policy plus education for parents on the dangers of 

underage drinking, or a city ordinance that requires alcohol sellers to participate in responsible server 

training. The table below, organized by the levels of the socio-ecological model, offers examples of 

relevant risk and protective factors and related prevention strategies.

Level Risk Factor Protective Factor Strategy Example

Individual Genetic predisposition to 

substance misuse

Prenatal exposure to 

alcohol

Poor impulse control

Positive self-image 

Self-regulation and 

control

Social competence

One-on-one psychoeducation therapy 

Social and decisionmaking skills training

Relationship Parental permissiveness

Peer acceptance of 

heavy drinking

Positive parental 

involvement

Peer disapproval of 

substance use

Low peer substance 

use 

Parental training 

on communicating 

disapproval of use

Peer refusal skills training

Community Poor neighborhood 

safety

Law enforcement 

permissive of underage 

substance use

Availability of 

afterschool activities

Low perceptions of 

alcohol use among 

the general student 

population

Social marketing 

campaign to promote 

positive social norms

Societal Laws favorable to 

substance use

Historical trauma

Limited availability

of substances

Increase price or tax of 

alcohol

Raise minimum legal 

drinking age

7

 Blum, et al. (2002).
41

APPENDIX E: MAKING THE MOST OF 

YOUR EVALUATION DOLLARS

OVERVIEW

There are no two ways about it: well-designed evaluations cost money. Just how much money depends 

on the experience and education of your evaluator, the type of evaluation required, and the geographic 

location of your program or practice. But there are ways to save money without compromising the validity 

of your findings.

WORKING WITH AN EVALUATOR:

 Look for a qualified yet inexpensive evaluator. Create a practitioner-researcher partnership.

Faculty at colleges and universities are a good source. They might consider making the evaluation 

a project for one of their classes. They may also have access to students who can act as paid 

research assistants, but who earn less than other evaluation staff. Make sure, however, that the 

faculty member will be closely supervising any students who participate in the study.

 Look for an evaluator who may be able to get independent funding to conduct the evaluation

through a separate grant or contract. This is rare but not unheard of. The chief drawback is that 

you may have to wait, sometimes several months, to see if this can be done before proceeding 

with the study.

 Explore other incentives. For example, look for an evaluator who is interested in branching out

and trying new things. Sometimes an evaluator will work for less in order to have an opportunity to 

do research on a new topic.

 Look for an evaluator who has experience evaluating programs like yours. Again, this will

save money because the evaluator is already familiar with instruments, design issues, and other 

aspects of the study.

 Use a collaborative model. Having program staff assume some evaluation tasks (like survey

monitoring or data entry) reduces costs. If your organization has the capacity, also consider using 

an in-house evaluator.

 Ask the evaluator to price components of the evaluation. This will make it easier for you to

drop particular elements or make informed decisions about how to spread around the work.

 Estimate costs before specifying an amount in your funding proposal. If you pick a number

at random—say, $30,000—you are going to get proposals for studies that cost close to that 

amount. There may be a chance that you could get the study done for substantially less. Your 

future funder may be willing to help you estimate appropriate costs. Ask them to look at what they 

want from the evaluation and provide a ballpark estimate of what it should cost. You can also hire 

an evaluator just to do a cost estimate.
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 42

SPENDING LESS ON DATA COLLECTION:

 Start small. Narrowing the scope of your evaluation will save costs without compromising

outcomes. One way to do this is by limiting your evaluation to specific target audiences. For 

example, if your program aims to affect both students and parents, you might study its impact 

on only one group, then study the other group when you have more resources. Another way to 

save money is by focusing on intermediate outcomes, since long-term outcomes are usually 

more difficult to assess. If you are involved in a drug education program, for example, start out 

by focusing on whether program participants learn new information about drugs. Then, if you get 

positive results, you can look at long-term outcomes when more funds become available.

 Use existing data. Data specialists often have concerns about the quality of even the most

reputable national data sources. Yet many of these data are better than what a community can 

collect on its own without a significant expenditure of time, money, and expertise. Most national 

data systems analyze their data and publish data reports (often available for no cost online).

Others will supply raw data to users, do custom data runs, and/or make their data available in 

formats (or on the Web) that allow people to generate reports tailored to their specifications.

 Pilot test. Save money in the long run with pilot testing—the process of trying out your data

collection instruments and procedures with a small target audience. This can reveal critical flaws 

like ambiguous questions or interviews that take too much time. Data collection efforts (especially 

those involving large numbers of people) should always be pilot tested before implementation.

 Implement with care. When collecting data, consistency is key. Communicate the importance of

consistency to everyone involved in your effort to ensure your results are reliable. If your results 

are not, you may need to start the evaluation process all over again.

 Select data collection methods wisely. Consider the advantages and disadvantages of focus

groups, surveys, and interviews. Qualitative methods tend to be less expensive than administering 

a survey (depending on the population you are surveying) and can produce useful information.

Keep in mind that investing in evaluation can actually save you time and money over the long haul.

With the information you learn from a worthwhile evaluation, you can focus your resources on the 

most critical problems facing your community and the most effective countermeasures. However, 

you are much more likely to collect this information if you partner with a knowledgeable evaluator 

who understands your program and with whom you can work comfortably.
43

APPENDIX F: EVALUATION DESIGN, 

REPORTING, AND LESSONS LEARNED

OVERVIEW

Evaluation results are used to improve programs and practices, sustain positive outcomes, and improve 

the community’s overall plan for addressing substance misuse and promoting wellness. But they can be 

used for other reasons as well, such as to help obtain funding and to build community awareness and 

support for prevention. Therefore, evaluation results need to get into the hands of the people who can 

use them. Keep in mind that organizations don’t use evaluation results, people do. The Department of 

Health, for example, isn’t going to use the results of an evaluation, but “Cathy Smith” in the Department 

of Health may. So, unless you get the results of the program evaluation into her hands and explain how 

she can use them, they will sit on a shelf somewhere in the Department of Health.

Follow these general guidelines for reporting your results: 

 Brief stakeholders throughout the process. Try to avoid surprising your stakeholders with the

results of your evaluation. Brief them along the way, rather than waiting until the end of the project.

Present a draft form of your report before it goes public.

 Create a dissemination plan. Identify the various audiences who need to see the results

(including the population that is the focus of the program or practice). Also, identify what 

information would be most useful to these audiences and how to get it into their hands.

 Select vehicle for reporting results. Make sure you use the most appropriate vehicle

(e.g., public presentation, social media post/campaign, flyers, reports) for each of the audiences 

you identified.

 Help stakeholders understand the data. Take time to review the findings with your

stakeholders, discussing the ramifications of what you found. Don’t shy away from negative or 

unexpected results. Instead, use these as an opportunity to inform future efforts.

SELECTING AN APPROPRIATE EVALUATION DESIGN

The first step in any project is to develop a plan for getting the work done. The plan for an evaluation 

project is called the “design.” All too often, prevention planners launch into their evaluation without 

coming up with a plan. They start thinking about how to collect data before determining what to collect.

This is usually followed by the statement, “Let’s do a survey.” But before choosing methods, planners 

need to take a step back, consider the four principles outlined above, and do the following: 

 Clarify purpose. For example, is the purpose of the evaluation to find out if the program or

practice reached the focus population or to determine how well it worked to bring about change? 

Purpose should be dictated by stakeholder needs, including funding requirements, and guide all 

decisions that follow.

 Develop questions. Questions should be closely tied to purpose. Some questions will provide

insight into implementation and others will produce information related to outcomes. When 
A GUIDE TO SAMHSA’S STRATEGIC PREVENTION FRAMEWORK 44

developing questions, make sure to avoid those you can’t afford to answer. Available resources 

(i.e., time, money, people) can influence an evaluation plan more than any other single factor. (See 

Appendix E: Making the Most of Your Evaluation Dollars for more information on this topic.)

 Select the right design. There are different ways to design, or structure, an evaluation. Some

questions are best answered by gathering data from program participants and practitioners 

throughout the implementation. Other questions are best answered by gathering data before and 

after the program, and/or by gathering data from non-participants as well as participants. This last 

approach allows for helpful comparisons and a better understanding of an intervention’s effects.

 Choose appropriate methods. There are many different ways to gather evaluation data. Which

methods you select will depend on what you want to learn, on your budget and timeline, and on 

what’s most appropriate for your focus population.

• Qualitative methods (e.g., key informant interviews, focus groups) produce data that are

usually expressed in words. They let planners explore an issue or population in depth by

having such questions as “Why or why not?” and “What does that mean?” answered.

• Quantitative methods (e.g., surveys, checklists) produce data that are usually expressed

in numbers. They allow planners to draw general conclusions about an issue or population

based on answers to such questions as “How much? How many?” and “How often?”
SAMHSA 

Substance Abuse and Mental Health 

Services Administration