Strategic Prevention Framework Research Articles

Dimensions of community context that affect coalition effectiveness: development of an instrument

ABSTRACT This study investigates the role of multidimensional contextual factors on the perceived effectiveness of community coalitions engaged in the Strategic Prevention Framework (SPF) for addressing substance misuse. We introduced and validated an instrument for assessing a broad range of contextual factors for coalition development and program implementation. This research also scrutinizes how contextual factors impact coalition effectiveness, considering internal capacity indicators as mediators. Data were sourced from 295 and 297 coalition members across 2015 and 2016, respectively, involved in SPF initiatives within a northeastern state in the United States. Our analysis identifies three critical dimensions of contextual factors – collaboration and resources, politics, and demographics and norms – that significantly affect the perceived management and program effectiveness through different mechanisms. The findings underline the importance of prevention coalitions to comprehensively assess community contexts and strategically address contextual challenges to enhance their impact on substance misuse prevention.

White House proposed FY 2025 budget would increase MH BG $35 million, keep SUPTRS BG level

On March 11, the White House released the proposed budget for fiscal year (FY) 2025, which begins Oct. 1, 2024. The proposal includes a 10% set‐aside in the Substance Use Prevention, Treatment, and Recovery Services (SUPTRS) Block Grant, which is funded at just over $2 billion, level with FY 2023, the most recent year for which final numbers are available. The Community Mental Health Services Block Grant would receive $1.043 billion in the proposed budget, a $35 million increase compared to FY 2023. The budget request (the White House asks Congress to fund programs) includes a proposal in which the Substance Abuse and Mental Health Services Administration would use HIV instead of AIDS to calculate the set‐aside in the SUPTRS BG. The State Opioid Response (SOR) grant would receive $1.595 billion, an increase of more than $20 million compared to FY 2023. Among other programs included in the White House request: Strategic Prevention Framework–Partnerships for Success at $135.5 million, level compared to FY 2023; Medication‐Assisted Treatment for Prescription Drug and Opioid Addiction at $111 million, level compared to FY 2023; Drug Courts at $74 million, level compared to FY 2023; Screening, Brief Intervention, and Referral to Treatment grants at $33.8 million, level compared to FY 2023; and Pregnant and Postpartum Women care at $43,931,000, an additional $39 million compared to FY 2023).

Strategic Framework for Safety Risk Prevention and Control for New Energy Application

Strategic Framework for Safety Risk Prevention and Control for New Energy Application

Common Accidents in Paediatric Practice; Current Evidence for a 4-Pronged Strategic Framework for Prevention

Common Accidents in Paediatric Practice; Current Evidence for a 4-Pronged Strategic Framework for Prevention

Common Accidents in Paediatric Practice; Current Evidence for a 4-Pronged Strategic Framework for Prevention

Accidents are inadvertent untoward events that lead to injuries or diseases. In the healthcare setting, both patients and healthcare workers are at risk of being victims. By virtue of children’s evolving developmental maturity, caring for them puts all parties more at risk. Having a comprehensive framework to prevent accidents in paediatric practice is therefore crucial. This paper aims to utilize the primordial, primary, secondary and tertiary levels of prevention to detail the strategies for preventing needle stick injury, exposure to blood-borne infections, post-injection traumatic neuropathy, post injection abscess, Nicolau syndrome, fluid overload, and drug overdose in paediatric healthcare settings. Preventing the selected injuries and disorders involves a multidisciplinary team of paediatricians, paediatric surgeons, orthopaedic surgeons, burns and plastic surgeons, neurosurgeons, toxicologists, pharmacists, microbiologists, infectious disease physicians, anaesthetists, and public health physicians.

Common Accidents in Paediatric Practice; Current Evidence for a 4-Pronged Strategic Framework for Prevention

Common Accidents in Paediatric Practice; Current Evidence for a 4-Pronged Strategic Framework for Prevention

New prevention coordinator for Hawaii

Cheryl Labuguen, a certified prevention specialist with 15 years of experience in the substance use prevention field, is Hawaii's new prevention coordinator. She is currently a prevention program specialist with the Hawaii State Department of Health, Alcohol and Drug Abuse Division, where she oversees contracts that provide substance use prevention services that strengthen the use of the Strategic Prevention Framework, as well as provide leadership and guidance to prevention providers through technical assistance and trainings.

Attuning and Queering SAMHSA’s Strategic Prevention Framework

AbstractTo prevent substance use disorder (SUD) and its consequences, the Substance Abuse and Mental Health Services Administration developed the Strategic Prevention Framework (SPF). The SPF is a structured planning model that evaluates community behavioral health needs and facilitates prevention planning to address substance use concerns. Despite the SPF’s stated foundation in cultural competency, the framework lacks appropriate guidelines to address systemic oppression of historically marginalized communities. Thus, the authors propose that an SPF based on a cultural attunement framework can enhance prevention-based social workers’ ability to dismantle systemic barriers that create and perpetuate health disparities surrounding substance use and treatment for SUD. Using an example scenario, authors offer recommendations for social workers seeking to expand the SPF and fully actualize its application.

A National Cost Analysis of Community Interventions to Prevent Underage Drinking and Prescription Drug Misuse

This prospective cost analysis addresses a gap in the prevention literature by providing estimates of the typical real-world costs to implement community interventions focused on preventing underage drinking and prescription drug misuse. The study uses cost data reported by more than 400 community subrecipients participating in a national cross-site evaluation of the Substance Abuse and Mental Health Services Administration's Strategic Prevention Framework Partnerships for Success grant program during 2013-2017. Community subrecipient organizations completed an annual Web-based survey to report their intervention costs. The analysis compares the relative startup and annual ongoing implementation costs of different prevention strategies and services. Partnerships for Success communities implemented a wide variety of interventions. Annual ongoing implementation was typically more costly than intervention startup. Costs were generally similar for population-level interventions, such as information dissemination and environmental strategies, and individual-level interventions, such as prevention education and positive alternative activities. However, population-level interventions reached considerably more people and consequently had much lower costs per person. Personnel contributed the most to intervention costs, followed by intervention supplies and overhead. Startup costs for initial training and costs for incentives, ongoing training, and in-kind contributions (nonlabor) during ongoing implementation were not typically reported. This study informs prevention planning by providing detailed information about the costs of classes of interventions used in communities, outside of research settings.

A Latent Class Analysis of Prevention Approaches Used to Reduce Community-Level Prescription Drug Misuse in Adolescents and Young Adults.

The Substance Abuse and Mental Health Services Administration's Strategic Prevention Framework Partnerships for Success (PFS) program supports community-based organizations (CBOs) across the United States in implementing evidence-based prevention interventions to reduce substance use in adolescents and young adults. Little attention has been paid to how CBOs combine interventions to create comprehensive community-specific prevention approaches, or whether different approaches achieve similar community-level effects on prescription drug misuse (PDM). We used PFS evaluation data to address these gaps. Over 200 CBOs reported their prevention intervention characteristics, including strategy type (e.g., prevention education, environmental strategies) and number of unique interventions. Evaluation staff coded whether each intervention was an evidence-based program, practice, or policy (EBPPP). Latent Class Analysis of seven characteristics (use of each of five strategy types, use of one or more EBPPP, and number of interventions implemented) identified six prevention approach profiles: High Implementation EBPPP, Media Campaigns, Environmental EBPPP, High Implementation Non-EBPPP, Prevention Education, and Other Information Dissemination. All approaches except Media Campaigns and Other Information Dissemination were associated with significant reductions in community-level PDM. These approaches may need to be paired with other, more direct, prevention activities to effectively reduce PDM at the community level. However, similar rates of change in PDM across all 6 prevention approaches suggests only weak evidence favoring use of the other four approaches. Community-based evaluations that account for variability in implemented prevention approaches may provide a more nuanced understanding of community-level effects. Additional work is needed to help CBOs identify the most appropriate approach to use based on their target communities' characteristics and resources.

A Qualitative Community Assessment of Racial/Ethnic Sexual Gender Minority Young Adults: Principles for Strategies to Motivate Action(s) for Realistic Tasks (SMART Thinking) Addressing HIV/AIDS, Viral Hepatitis, Mental Health, and Substance Abuse.

HIV/STI, substance use, and mental health issues disproportionately affect racial/ethnic sexual minority young adults. These health vulnerabilities intensify across the life course, most notably when young adults are independent college students. To identify the perspectives of racial/ethnic sexual gender minorities living on or near an urban university, we implemented an intersectionality-informed SWOT (strengths, weakness, opportunities, and threats) analysis, as a qualitative community assessment situated within in a campus-community setting. The community needs assessment was the first step in the strategic prevention framework (SPF) to co-locate substance abuse, mental health, viral hepatitis, and HIV prevention care services for Latinx and Black/African American sexual gender minority young adults at a minority-serving institution. The SWOT analysis identified principles for selecting, adapting, and implementing an evidence-based intervention. The significance of these principles demonstrates the value of intersectionality in evidence-based interventions to influence health education and behavior among racial/ethnic sexual gender minorities.

Need and Capacity of a Toolkit for Occupational Health Nurses to Promote a New or Enhanced Drug-Free Workplace Program

Background: A drug-free workplace program (DFWP) has been shown to be effective in reducing workers' drug misuse. The purpose of this project was to determine the need and capacity for a new or enhanced DFWP in a large health system. If determined to be needed, the next step would be to develop, implement, and evaluate a toolkit to assist occupational health nurses to promote a new or enhanced DFWP. Methods: A strategic prevention framework was used to assess the need and capacity for a toolkit to prepare occupational health nurses to promote a new or enhanced DFWP. The project was conducted in the occupational health services department at a large health system in the Midwest U.S. occupational health nurses and employee assistance counselors in the hospital system completed a survey assessing the need and capacity for a new or enhanced DFWP. Findings: A gap was identified in the perceived effectiveness of training about DFWP and current DFWP components. The findings reflect the need and capacity for a DFWP toolkit. Optimally, a DFWP toolkit would include evidence-based drug and alcohol screening tools. We found that a toolkit for occupational health nurses to promote a new or enhanced DFWP in the project site was warranted. Conclusion/Application to practice: A DFWP can be an effective method of promoting workplace health and safety. Occupational health nurses can contact state and national representatives to encourage monitoring of drug-related work injuries to provide evidence to influence health policies to support effective DFWPs.

Primary drug prevention — stopping use before it starts — under budget threat

The White House budget request for fiscal year 2021 for the Substance Abuse and Mental Health Services Administration (SAMHSA) proposes to zero out a major prevention program — the Strategic Prevention Framework State Incentive Grant — Partnerships for Success program. This is a cut of $109 million. It recommends using the prevention set‐aside (20%) from the Substance Abuse Prevention and Treatment block grant instead. But it doesn't give any more money to the block grant.

White House budget request decimates substance use prevention

The White House budget request for fiscal year 2021 for the Substance Abuse and Mental Health Services Administration (SAMHSA) proposes to zero out a major prevention program — the Strategic Prevention Framework State Incentive Grant — Partnerships for Success program. This is a cut of $109 million. It recommends using the prevention set‐aside (20%) from the Substance Abuse Prevention and Treatment (SAPT) block grant instead. But it doesn't give any more money to the block grant.

Creating Spaces for Young People to Collaborate to Create Community Change: Ohio's Youth-Led Initiative.

Scholars and researchers are increasingly calling attention to the need for community-based coalitions to become more inclusive of local residents and engage those most directly affected by the issues. One population, however, often remains the recipient of services as opposed to partners or leaders in community change initiatives: youth. Over the past several years in Ohio, adults convening and facilitating youth-led programs have been transforming their work by utilizing the Youth Empowerment Conceptual Framework and the Substance Abuse and Mental Health Services Administration's Strategic Prevention Framework to empower young people and ensure their equitable participation in community change efforts. This article provides an overview of Ohio's statewide youth-led initiative, highlighting how adult allies engaged young people in a data-driven strategic planning process and intentionally selected and implemented strategies designed to affect the health of their local communities. This initiative provides key insights into the Collaborating for Equity and Justice Principles 4, 5, and 6.

The strategic prevention framework in community-based coalitions: Internal processes and associated changes in policies affecting adolescent substance abuse

Substance abuse is a leading contributor to the major causes of morbidity and mortality among adolescents. Traditionally, preventive interventions in the area of substance abuse have focused on the individual level of analysis, with the goal of changing knowledge, attitudes, and motivations. Recently, however, prevention efforts have increasingly adopted models of intervention that target change across an entire population or community. These innovative models target the conditions of a community, with the intention of reducing access or opportunities for substance abuse while enhancing opportunities for healthy lifestyle choices. The U.S. Substance Abuse and Mental Health Services Administration developed the Strategic Prevention Framework (SPF) as a structured guide for the process of community change. This paper describes implementation of the SPF by community-based coalitions in New Jersey and presents results of a study on their internal processes and the associated changes in policies and practices of institutions and communities that affect adolescent substance abuse.

Exploration of epidemiologic profile and strategic prevention framework for surgical site infection rates in a tertiary care hospital of Bhopal city

Background: Post-operative surgical site infections are deadlock for any successful surgery. This exigency triggers draining of extra resources for management of the quagmire. Methods: This prospective direct surveillance study based on incidence design was undertaken to gauge and estimate the nature of propensity of various surgical site infections in a tertiary care hospital over a period of twelve months. Results: Calculated cumulative SSI rate for the year 2016 was found to be 4.32%. Conclusions: It was concluded that a multidisciplinary approach integrating periodic training sessions on infection control, checklists based routine surveillance & following some benchmark etc. are the linchpin in controlling hospital acquired infections including surgical site infection rates in any clinical setting.

Long-Term Sustainability of Evidence-Based Prevention Interventions and Community Coalitions Survival: a Five and One-Half Year Follow-up Study.

This study examines (1) coalition survival, (2) prevalence of evidence-based prevention interventions (EBPIs) to reduce substance abuse implemented as part of the Tennessee Strategic Prevention Framework (SPF) State Incentive Grant (SIG), (3) EBPI sustainability, and (4) factors that predict EBPI sustainability. Secondary data were collected on 27 SPF SIG-funded coalitions and 88 EBPI and non-EBPI implementations. Primary data were collected by a telephone interview/web survey five and one-half years after the SPF SIG ended. Results from secondary data show that 25 of the 27 coalitions survived beyond the SPF SIG for one to five and one-half years; 19 coalitions (70%) were still active five and one-half years later. Further, 88 EBPIs and non-EBPIs were implemented by 27 county SPF SIG coalitions. Twenty-one (21) of 27 coalitions (78%) implemented one to three EBPIs, totaling 37 EBPI implementations. Based on primary survey data on 29 of the 37 EBPI implementations, 28 EBPIs (97%) were sustained between two and five and one-half years while 22 EBPI implementations (76%) were sustained for five and one-half years. When controlling for variability among coalitions (nesting of EBPIs in coalitions), increases in data resources (availability of five types of prevention data) was a strong predictor of length of EBPI sustainability. Positive change in extramural funding resources and level of expertise during SPF SIG implementation, as well as level of coalition formalization at the end of the SPF SIG predicted EBPI sustainability length. One intervention attribute (trialability) also predicted length of sustainability. Implications are discussed.

Improving Community Readiness for Change through Coalition Capacity Building: Evidence from a Multi-Site Intervention.

Often, community coalitions are facilitators of community-level changes when addressing underage drinking. Although studies have shown that enhancing coalition capacity is related to improved internal functioning, the relationship between enhanced capacity and community readiness for change is not well established. The present study used a pretest-posttest design to examine whether enhancing coalition capacity through training and technical assistance was associated with improved community readiness and coalition-facilitated community-level changes. Seven Kansas communities engaged in an intensive capacity building intervention through implementation of the Strategic Prevention Framework. The results indicated strong correlations between increased coalition capacity, changes in community readiness stages, and the number of community changes facilitated. The results suggest that strengthening coalition capacity through training and technical assistance may improve community readiness for change and enable the implementation of community-wide program and environmental changes.

Assessing Community Coalition Capacity and its Association with Underage Drinking Prevention Effectiveness in the Context of the SPF SIG.

Community coalitions are a prominent organizational structure through which community-based substance abuse prevention efforts are implemented. There is little empirical evidence, however, regarding the association between coalition attributes and success in achieving community-level reductions in substance abuse behaviors. In this study, we assessed the relationship between coalition capacity, based on coalition coordinator responses to 16 survey items, and reductions in underage drinking prevalence rates. The coalitions were funded through the federally sponsored Strategic Prevention Framework State Incentive Grant (SPF SIG). We first examined whether coalition capacity increased over the life of the projects. Mean capacity scores increased for all 16 capacity items examined (N = 318 coalitions), the majority of which were statistically significant. Analysis of the associations between capacity and reductions in underage drinking was limited to coalitions that targeted underage drinking and provided usable outcome measures based on student survey data for either past 30-day alcohol use (N = 129) or binge drinking (N = 100). Bivariate associations between the capacity items and prevalence reductions for each outcome were consistently positive, although many were not statistically significant. Composite measures of correlated items were then created to represent six different capacity constructs, and included in multivariate models to predict reductions in the targeted outcomes. Constructs that significantly predicted reductions in one or both outcome measures included internal organization and structure, community connections and outreach, and funding from multiple sources. The findings provide support for the expectation that high functioning community coalitions can be effective agents for producing desirable community-level changes in targeted substance abuse behaviors.