MB: In Pairs Pair up and answer the question… What are the benefits to doing ES?
MB IOM Definition: Mental health promotion includes efforts to enhance individuals ’ ability to achieve developmentally appropriate tasks (developmental competence) and a positive sense of self-esteem, mastery, well-being, and social inclusion and to strengthen their ability to cope with adversity. Will be provided as handout.
SB They focus on changing conditions in the physical, social and cultural environment of an entire community to create a setting that discourages substance abuse. (add to speakers notes)
SB Handout # 3
SB Get into groups of 4, assign each group a conduction Examples of ES that will address these conditions
Refer to Handout # 4: Norms are basic orientations concerning the “rightness or wrongness,” acceptability or unacceptability, and/or deviance of specific behaviors for a specific group of individuals. Availability can be defined in terms of how much time, energy, and money must be expended to obtain a commodity (alcohol, marijuana, cigarettes). The more resources required, the lower the availability. Regulations are formalized laws, rules, and policies that serve to control availability and codify norms and that specify sanctions for violations. West CAPT: Environmental Prevention Strategies: Putting Theory Into Practice ------------------------------------------------------------------------
MB Refer to Handout # 4: Environmental Strategies Points of Intervention Complex system of factors Multiple points of intervention Varied levels of influence Assessment Then comprehensive and synergistic approach
For example, it is wrong for anyone to use illicit drugs; it is okay for adults to drink in moderation. Norms are the basis for a variety of specific attitudes that support or undermine the particular prevention strategies we may wish to implement. For example, a community norm that impaired driving is unacceptable under any circumstances will make it more likely that community members will adopt the attitudes that roadblocks are a good idea and jail time for first offenders is appropriate. West CAPT: Environmental Prevention Strategies: Putting Theory Into Practice
1) University of Virginia, National Social Norms Institute
West CAPT : Environmental Prevention Strategies: Putting Theory Into Practice
Norms, availability, and regulations are overlapping and interrelated. Availability is often controlled through the use of regulations. For example, a city may pass an ordinance (regulation) that bans cigarette vending machines and thus reduces the availability of tobacco to minors. Similarly, norms are often expressed through regulations. For example, society's belief that crack cocaine is more dangerous and destructive than powdered cocaine is expressed in differential mandatory sentences for violations involving these two substances. The norm in some communities that underage drinking is just "youthful highjinks" is expressed in a police policy of benign neglect toward minor-in-possession violations. In practice, almost all prevention strategies will have an impact on norms, availability, and regulations to a greater or lesser degree. Norms, regulations, and availability are interdependent and mutually supportive; they constitute stable systems that are tightly interwoven. This means that a change in any one of these factors will cause changes in the other two (figure 2a). As norms (or availability or regulations) change, they tend to pull the other factors along with them. However, it appears that no one factor can change too much or too quickly. Moderating pressure from the other two factors will tend to attenuate too rapid or too drastic a change in norms, regulations, or availability West CAPT: Environmental Prevention Strategies: Putting Theory Into Practice
Norm: This community does not approve parents hosting underage drinking parties. Policy: Social Host Law Some policies are legislated, which means that it may be necessary to build support to change or strengthen the laws.
Policies: Perhaps the most potent strategies are the laws and regulations designed to control environments around schools and other community areas where young people gather Enforcement: Laws and regulations must be enforced in order to be effective. Education: For environmental strategies such as policy changes, effective enforcement, and community collaborations to be successful, the public must know what measures are available to them and what policies they are expected to follow. Communication: Media and other communications efforts can be used to help change or reinforce community norms concerning tolerance of sales to and use by minors. Collaboration: Collaborative efforts among different community sectors (e.g., public health, education, business, faith, medical, nursing, law enforcement) have been shown to be effective in raising awareness about the issues of substance abuse and violence and in coordinating prevention and treatment services. Overlap of Categories and Causal Factors Keep in mind that categories and causal factors overlap Strategies that address retail access, for example, may include enforcement, communication, and policy. Northeast CAPT (1999), Changing the Larger Environment: Critical Components Klitzner, M. (1998). Integrating environmental change theory into prevention practice. Northeast CAPT Regional Summit: Environmental Strategies to Reduce Youth Substance Abuse. Providence, RI. Dec. 2 - 3, 1998.
Refer to Handout
Refer to Handout
Refer to Handout
Refer to Handout # 5: A Complex System of Influences Guiding questions for brief dialogue: Where do you see: strong evidence of relationship and strong evidence of population level effects? b) strong evidence of relationship and strong effect on intervening variables which have population level effects? c) strong evidence of relationship and moderate evidence of population level effects? 2. What does this graphic tell you about what seems to have stronger population level effects? What calls your attention? 3. How is this information useful in prevention planning?
Handout # 6
MB / SB They will stay in case study groups Come up with an ES to address at least three of the conditions Then answer the the questions for the three conditions
Look back at the case study: 1. List three ways the case study community would benefit form a strong coalition
MB Come up with an ES that would benefit our case study community
MB - Build on our ES in the case study, and answer the following questions
Back to this at the end
IOM Definition: Mental health promotion includes efforts to enhance individuals ’ ability to achieve developmentally appropriate tasks (developmental competence) and a positive sense of self-esteem, mastery, well-being, and social inclusion and to strengthen their ability to cope with adversity. Will be provided as handout.
Provided as Handout
Environmental strategies workshop bouligny
+Applying EnvironmentalApplying EnvironmentalStrategies to Affect SustainableStrategies to Affect SustainableCommunity ChangeCommunity ChangeApril 30 – May 3, 2013Macon, GAShayla Bennett, MPACITF Coach
+Today’s TrainingShare with a peer…Two things you already know about environmentalstrategies.One thing you would like to know more aboutenvironmental strategies.Today’s expectations
+Today’s Learning ObjectivesAt the end of this workshop, participants will be able to:•Discuss the role environmental strategies (ES) play in substanceabuse prevention•List at least two ES and the risk factors each address•Discuss the best practices for proper selection and implementationof ES•List the 5 critical conditions that need to changefor environmental change to occur•Discuss the role that needs assessment data plays in directing theselection of the most effective•Become familiar with the underage drinking causal model from thePacific Institute of Research and Evaluation that demonstrates aresearched approach to using comprehensive selection of strategies
+Today’s Agenda• Introduction and workshop objectives• Why are environmental approaches toprevention effective?• Identifying and selecting environmentalStrategies: the role data plays.• Moving the process forward• Closing and Evaluation
+5Why An EnvironmentalApproach to Prevention?Setting the Foundation
+The Institute of Medicine (IOM) ContinuumSource: Committee on Prevention of Mental Disorders and Substance Abuse Among Children, Youth, andYoung Adults, 2009PromotionPromotionUniversalUniversalSelectiveSelectiveIndicatedIndicatedCaseCaseIdentificationIdentificationStandardTreatmentStandardTreatmentforKnownforKnownDisordersDisordersCompliance…Compliance…..After Care….After Care….
+Center for Substance Abuse Prevention’sSix Core Strategies
+Logic Model Prevention requires a shift from “select an intervention” to a“prevention by design” approach focused on population-levelchangeSELECT SOURCES: SAMHSA/CSAP, SPF Grants, 2004 - ; Green & Kreuter, 1999
+10The SPF ProcessAssessmentProfile population needs, resources, andreadiness to address needs and gapsCapacityMobilize and/or build capacity to addressneedsPlanningDevelop a Comprehensive Strategic PlanImplementationImplement evidence-based preventionprograms and activitiesEvaluationMonitor, evaluate, sustain, and improve orreplace those that fail
+Environmental StrategiesPrevention efforts aimed at changing or influencing:• Community conditions,• Norms and standards,• Institutions,• Structures,• Systems, and• Policies that contribute to substance use andconsequences.
+Environmental Strategies (cont’d.)• Environmental strategies involve longer-term, potentiallypermanent changes that have a broader reach (e.g.,policies and laws that affect all members of society).
+Environmental StrategiesAll Around UsEnvironmentalStrategies Do NotHave To Be ComplexEffect is on apopulation
+What Are Some of Your Favorites?Activity: What Are Some of Your Favorites?1. Get into groups of three2. In your small group, choose your group’s two favorite environmentalstrategies. (They do not have to be substance abuse prevention -related strategies)3. Be prepared to talk about:Why you consider each one of them as an environmental strategy.Why do you believe each one of them have been effective.
+• Personality• Skills• Values• Knowledge• Attitudes• FeelingsAttributesAttributesWhat Are We Looking to Change?
+What Are We Looking to Change?ConditionsConditionsNormsNormsCultural practicesCultural practicesOpportunitiesPricesPrices Laws andLaws andPoliciesPolicies
+Environmental Strategies: PotentialEffect• Changing economic conditions• How much things cost; how available thingsare• Changing social conditions• What people think; how people live• Changing media conditions• What people read, watch, hear, and see• Changing political conditions• Who has power; who has influence
+Strategies Targeting the SharedEnvironmentSource: New Mexico SPF SIG, Environmental Approaches to Substance Abuse Prevention. ACompendium of Model Programs and Best Practices for Use in Designing Prevention Programs inCommunitiesALLALLYOUTHYOUTH
+ Environmental Strategies Points ofIntervention A complex system of factors produces substanceuse and related problems.SELECT SOURCES: Birckmayer et al., 2004; IOM, 2004
+Norms• Basic orientations concerning the “rightness orwrongness,” acceptability or unacceptability, and/ordeviance of specific behaviors for a specific group ofindividuals.
+24Source: National Social Norms Institute, University of VirginiaSocial Norms
+Availability Can be defined in terms of how much time, energy,and money must be expended to obtain a product(alcohol, marijuana, cigarettes). The more resourcesrequired, the lower the availability.
+Regulations• Formalized laws, rules, and policies that serve tocontrol availability and codify norms and that specifysanctions for violations.• May be instituted by governments, public agencies(e.g., police departments, school systems), orprivate organizations (include in talking points)
+PoliciesPolicies codify norms and practices, thereby providing theauthority to make sure norms and practices are followed.•Public•Local•Institutional
+Categories of EnvironmentalStrategies(Klitzner, 1998)
+IVs and CFsNot CheckingIDs at retaillocationsCFEnvironmentalStrategyRetail EnforcementEnvironmentalStrategyMedia CampaignEnvironmentalStrategyIncrease PenaltiesLow perceivedRisk ofPenaltyCF
A Complex System InfluencesUnderage DrinkingRetail Availabilityof Alcohol toYouthVisibleEnforcementUnderageDrinking LawsAlcohol-RelatedProblemsUnderageDrinkingSocialAvailability ofAlcohol toYouthDrinking BeliefsFamily, School,and PeerInfluenceDrinking ContextPriceCommunityNormsAboutYouthDrinkingUnderage Drinking Causal ModelAlcohol PromotionSource: Pacific Institute for Research and Evaluation, Calverton, Maryland
+ActivityRefer to Handout Appendix C: Examples of EnvironmentalStrategies
+ActivityCase StudyReview Handout # 7: Case Study
+Where Do WeStart?Our first question... what is our data telling us?Look at your community data…What is the data saying about:•The substance abuseproblem(s),• Related consequences?•What is causing theseproblems?
+Moving the ProcessForwardCoalitions link and CPAWPrimary Vehicles forImplementing EnvironmentalStrategies
+Why Coalitions /CPAW• Community-based problems require community-basedsolutions• One agency/organization is not responsible for theproblem or the solution• There is strength in numbers• Collaboration is effective at promoting long-term change• Mutual commitment, benefit, risks
+What Makes Coalitions /CPAW Strong• Clear understanding of the community/settingin which they work• Representative membership and staff(including diverse partners)• Professional development/capacity buildingopportunities• Defined organizational structure• Strategic planning (including evaluation)
+What Makes Coalitions /CPAW Strong• Strong, sustained leadership• Multiple strategies across multiplesectors• Diversified funding• Access to community leaders(advocacy)• Up-to-date technology
+Key Principle Prevention requires a shift from “select an intervention” to a “preventionby design” approach focused on population-level changeSELECT SOURCES: SAMHSA/CSAP, SPF Grants, 2004 - ; Green & Kreuter, 1999
+Describe the Program Identify what activities you will do based on the needsidentified from the data Clearly outline what the activities will accomplishimmediately Clearly outline the impact the activities will have in thelonger term
+ The Process Tracking the steps involved in preparation andimplementation (e.g. Number of Responsible BeverageServer/Retailer Trainings provided) Extent Assessment of reach or penetration into the community (e.g.percent of restaurants completing merchant education,percent or alcohol outlets that display “We card” signs etc.) Success Was the strategy effective? Did it achieve the purpose forwhich it was intended? (e.g. merchant educationimplemented communitywide, what percent of restaurantspass compliance checks within a specified time period)Evaluation of Environmental Strategies
+Focus Evaluation Design Guiding Question: How will this Evaluation balance thefidelity of implementation with the adaptations made tomake the program fit the community needs?
Focus Evaluation DesignGOALSINTERVENINGVARIABLESFOCUSPOPULATIONSTRATEGIES“IF-THEN”STATEMENTSSHORT-TERMOUTCOMESLONG-TERMOUTCOMESA. Toaddressthissubstanceabuse orrelatedproblem:B. Byaddressingtheseinterveningvariables(e.g. riskand/orprotectivefactor):C. For thesepeople:D. We will dothe followingprogramactivities/strategies (what,where, andhow much):E. We expectthat this activitywill lead tochanges intheserisk/protectivefactors, whichin turn will leadto our programgoal:F. We willknow thesechanges haveoccurred if:G. We willknow we arereaching ourgoals if:1. Logic Model:FILL THISOUT2. Evaluation Questions:We willfocus onEvaluationQuestionsnow
+Focus Evaluation Design The community should have the Logic Model from Module 4(Planning and Implementation) Now, you will design the questions to ask to determine theeffectiveness of strategies implemented
+The Institute of Medicine (IOM)ContinuumSource: Committee on Prevention of Mental Disorders and Substance Abuse Among Children, Youth, andYoung Adults, 2009PromotionPromotionUniversalUniversalSelectiveSelectiveIndicatedIndicatedCaseCaseIdentificationIdentificationStandardTreatmentStandardTreatmentforKnownforKnownDisordersDisordersCompliance…Compliance…..After Care….After Care….