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I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Headquarters U.S. Air Force
1
CoRC 101
Dr. Milton H. Cambridge
Demand Reduction Prevention and Outreach
Coordinator
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Overview
Review CoRC Foundational Principles Comprehensive Community Approach Leadership Driven ! CAIB/IDS 4 Tiered Approach Universal/Primary Prevention Selected/Secondary Prevention Targeted/Tertiary Prevention CoRC Metrics CoRC CONOPS and Toolkits: www.afcrossroads.com
7 Steps of Prevention Planning Process CoRC Logic Model
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Overview
“Best Practices/Lessons Learned”
Ideas for Improving CoRC Implementation
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Community Approach toPopulation Health Services
0%
100% Excellent
Poor
Prevention and Education
Leadership Supports Health Behavior Change
Installation Policies Enhance Health
Primary Care
Early Intervention
Specialty Care
Treatment of Disease
Helping Agency Support (IDS)
HEALTHHEALTHPOPULATIONPOPULATION
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Community PreventionModel for Population Health
CommunityAirmen/Families
Military TreatmentFacility
Wing LeadershipInstallation Support
IDS
Academia Public Affairs
Unit CCs/First SgtSquadrons
Assuring the ConditionsFor Population Health
The Future of the Public’s Health in the 21st Century, November 2002
I n t e g r i t y - S e r v i c e - E x c e l l e n c e
CoRC Conceptualization
Culture/NormsEnvironment
Families
Primary CareLife Skills
ADAPT/DDR
Wing LeadershipInstallation Support
CAIB/IDS
ResearchEducation
Media
PolicyDeterrence
Prevention
Early InterventionReducing Substance Misuse: Not Just a Medical Issue
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CoRC:AF Functional Community Players
Public Affairs
Legal
SecurityForces
Medical Treatment
FacilityChaplains
Mission
Support/
Services
Senior LeadershipCC/1st Sergeants
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2. 2. INDIVIDUAL LEVEL
3.BASE COMMUNITY
4. LOCAL COMMUNITY1. LEADERSHIP
INTEGRATED4-PRONGED COMMUNITYAPPROACH
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CoRC Basics1. Leadership Driven Program: Message and support from top down
2. Individual Level Opportunities for Change Assessment/Screening of risk in all personnel Education/awareness Brief Interventions and treatment when needed Responsibility and commitment
3. Base Community Opportunities for Change Develop range of alternate activities Consistent and equitable detection/enforcement Media campaign promoting responsibility Monitor AF metrics/consider base specific metrics
4. Local Community Opportunities for Change Assess threat and availability of drugs and alcohol Develop coalition with community agencies
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Surgeon General’s Toolkit:Bucket 1
Universal/Primary Prevention
Population outreach: Screening population/surveillance
Take “temperature” of risk on base Education and feedback at teachable moments
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Selected/Secondary Prevention
Targeted, individualized, non-anonymous alcohol and drug screening at Primary Care and Flight Medicine
PHA: Everyone screened annually, feedback provided, and referred as needed
Routine Care: Options for screening, brief intervention and referral as part of routine care
Surgeon General’s Toolkit:Bucket 2
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Targeted/Tertiary Prevention
Screening, Assessment & Brief Intervention Designed for behavioral health outside of ADAPT
Family Advocacy and Life Skills Support Centers
Tools to identify and treat “sub-clinical” alcohol misuse
Improved identification of substance use disorders
Options for screening at each new intake
Improved decision treeWhen to refer to ADAPT and when to
incorporate into existing treatment plan
Surgeon General’s Toolkit:Bucket 3
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Subject Matter Consultation Guidance for ADAPT and DDR PMs about their role as
CC consultants for CoRC implementation Booklet with core consultant competencies References and Resources Resources and opportunities for training
Surgeon General’s Toolkit:Bucket 4
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The 7 Steps of Program Planning
Assess the Readiness of the Community
Assess the Levels of Risks and Protective Factors
Translate the Risk and Protective Factors into Priorities
Examine the Resources in the Community
Select a Target Population
Apply “Best Practices and “Guiding Principles”
Evaluate the Program
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AF Readiness Level
Substance Misuse: A Clear and Present Danger
Alcohol Misuse is involved in 33% of Suicides 57% of Sexual Assaults 28.5% of Domestic Violence Incidents 44% of PMV Accidents
33% of AD (17-24) commit 81% of ARIs
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AF Readiness Level
AD AF FY 04 – 0.45% Drug Positive Rate
Equals – 1,572 AD Airmen Drug Positive
Discharge over 1500 Airmen because Drug Positives
Costs – 36 – 79K to produce each trained Airmen
Cost to the AF – Over 93 Million Dollars per Year
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AF Readiness Level
CSAF- Must Reduce ARIs and Drug Positives via The Culture of Responsible Choices (CoRC)- July 2005
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Risk Factors AF- Wide
Age (17-24) *
Male*
Availability of Alcohol and Drugs*
Underage Drinking/Binge Drinking*
Single Status
High OPS TEMPO/Deployments
Stress
Sensation-Seeking
High Priority Risk Factors*
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Protective Factors AF- Wide
AF is a Family*
Excellent Health Care System*
Healthy Alternatives*
Fitness Activities First Term Airmen Centers
Network of Helping Professionals*
Opportunities for Education and Training*
High Priority Protective Factors*
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Protective Factors AF- Wide
“Wingman’s Culture”*
“Culture of Airmen”*
Suicide Intervention Program*
Enforcement of Underage Drinking Laws*
AF Zero Tolerance Policy*
Strong Leadership*
Implementation of CoRC* www.afcrossroads.com
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Examine Resources
Leadership
ADAPT/DR
Base Prevention Coalitions i.e. CAIB, IDS, Cross-Functional Oversight, CoRC Steering Committee under the IDS
Primary Care, Security Forces, OSI, Chaplains, Public Affairs, Health Educators, Family Advocacy, Outreach Managers and Other Helping Professionals
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Examine Resources
Off Base Coalitions- Community Anti Drug Coalitions of America (CADCA)
www.CADCA.org Department of Justice Enforcing Underage Drinking Laws
(EUDL) Grants
Community Prevention Agencies
Churches, Schools, etc.
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Examine Resources
Center for Substance Abuse Prevention (CSAP)
Model Programs Online Prevention Training Centers For The Advancement of Prevention Technologies
(CAPTs) Strategic Prevention Framework (SPF) National Survey on Drug Use and Health (NSDUH)
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Examine Resources
NIAAA 2002 – “A Call to Action” Changing the Culture of Drinking on College Campuses”
National Academy of Sciences, Institute of Medicine (IOM) – “Reducing Underage Drinking: A Collective Responsibility”
Research Triangle Institute (RTI) – “Survey of Health-Related Behaviors Among Military Personnel” (1980 – 2005)
IC & RC
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Examine Resources
Other ADAPT and DR Folks
Networking
AF Best “Practices and Lessons Learned”
ADADT/DR World-wide Conferences
CoRC Tactical Communication Plan – Dec 2006
CoRC Steering Committee
CAIB/IDS
CoRC CONOPS and Toolkits www.afcrossroads.com
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Examine Resources
All 72 SG toolkit documents found at: www.afcrossroads.com
Bucket 1: Resources for universal/primary prevention through population-level outreach and screening
Bucket 2: Resources for selected/secondary prevention through targeted, individualized, non-anonymous alcohol and drug screening at Primary Care/Flight Medicine during PHA and routine care
Bucket 3: Resources for Behavioral Health targeted prevention through assessment for alcohol related problems (misuse, abuse, and dependence) and drug use at all Life Skill's intakes
Bucket 4: Resources for ADAPT/DDR staff to use in their role as the Commanders' substance use subject matter experts
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CoRC Target Populations
Primary – 17-24 AD
Secondary - > 24 AD
Tertiary – Civilians, Retirees, and Family Members
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Best Practices
CoRC is based on the adaptation of the Best Practice and nationally acclaimed F.E. Warren’s “0-0-1-3” Responsible Drinking Program
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Guiding Principles
2005 CORONA Tasker
Community Prevention Model to Population Health
CoRC 4 Tiers
CSAP 6 Prevention Strategies
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Guiding Principles
Prevention Research
NIAAA 2002- “A Call to Action: Changing the Culture of Drinking on College Campuses
IOM 2003 – “Reducing Underage Drinking: A Collective Responsibility”
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Evaluation
CoRC Metrics
25% reduction in ARMs from Baseline Year
25% reduction in Drug Positives from Baseline Year
Other Measures
Process, Outcome and Impact Program Evaluation
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CoRC Logic Model
What are the Risk and Protective Factors to be addressed ? (The Goals)
Reduce ARMs by 25%
Reduce Drug Positive by 25%
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CoRC Logic Model
What services and activities will be provided ?
6 CSAP Prevention Strategies: Dissemination of Information, Prevention Education,
Alternative Activities, Community-based Processes, Environmental Approaches, and Problem Recognition and Referral
Urinalysis – “Smart Testing”
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CoRC Logic Model
Who will participate in or be influenced by the program ?
AD 17-24
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CoRC Logic Model
How will the activities lead to expected outcomes ?
If CoRC is implemented AF-wide according to the CONOPs than AD 17-24 will be more informed
With Strong Command support and if all 6 CSAP Prevention Strategies and “Smart Testing” are implemented than we will achieve the CoRC goals AF-wide
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CoRC Logic Model
What immediate changes are expected for AD ? (The short-term outcomes)
A 25 % reduction in ARMs and UA+s
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CoRC Logic Model
What changes will CoRC ultimately like to create? ( The long-term impacts)
A change in the AF Culture
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Summary: 7 steps for a Prevention Planning Process
Assess the Readiness of the Community
Assess the Levels of Risks and Protective Factors
Translate the Risk and Protective Factors into Priorities
Examine the Resources in the Community
Select a Target Population
Apply “Best Practices and “Guiding Principles”
Evaluate the Program
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CoRC
Best Practices: Kadena Air Base, PACAF
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Best Practices
Davis Monthan AFB - EUDL Project, Leadership Tier
Barksdale AFB - Individual Tier
Little Rock AFB - Base Community Tier
Malstrom AFB - EUDL Project, Local Community Tier
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Other Best Practices/Lessons Learned
A monthly listing of those turning 21 are sent to First Sergeants from Alpha roster- ACC
Placing 0-0-1-3 stickers on menus and doors of local establishments –ACC
Attending Underage Drinking Task Force and University Task Force Meeting to share ideas and gain synergy – ACC
Responsible Choices through Education, Support and Accountability – USAFE
Integrating CoRC into the Air Commando Culture - AFSOC
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Ideas for Improving CoRC Implementation
Strong Leadership Commitment !!! Implement under CAIB/IDS Appoint Base-level CoRC POC Do a local Needs Assessment Comprehensive Community Approach
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Ideas for Improving CoRC Implementation
Add a Best Practices/Lessons Learned section to CoRC Website
Use CoRC CONOPS to train Periodically Update Toolkits on CoRC Website Increase the pool of Resources at the CoRC Website
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Questions ?
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