Coalition Capacity Building Webinar Series Webinar …...3 3 Presenters Dave Shavel, MBA - Currently works on behalf of NCI to provide training and technical assistance to increase

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Coalition Capacity Building Webinar SeriesWebinar 3: Planning and Implementing

Comprehensive Strategies

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Discussion Topics▪Purpose- Provide technical assistance to Community Partners funded by IDPH

regarding coalition capacity building skills

▪Anticipated Outcomes- Support Community Partners’ achieving Goal 4: Coalition Development

(Annual Work Plan)

- Improved Community Partners’ coalitions engagement that leads to realizing the National Tobacco Control Program (NTCP) Goal Areas

▪Recap: Webinar 1: Engaging Coalitions and Partnerships

▪Recap: Webinar 2: Conducting a Community Assessment

▪Webinar 3: Planning and Implementing Comprehensive Strategies

July 2017

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Presenters

▪Dave Shavel, MBA- Currently works on behalf of NCI to provide training and technical

assistance to increase the knowledge, capacity and accountability of community anti-drug coalitions throughout the nation

▪Keith A. Vensey, MBA, MPH- As Director, oversees GHEA which identifies gaps in public health

initiatives related to tobacco and cancer; pinpoints, curates and disseminates evidence-based practices and promising strategies; and facilitates operational effectiveness in executing public health interventions.

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Overview

Session 1

Session 2

Session 3

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Developing Comprehensive

Strategies

Community

AssessmentProblem

AnalysisLogic

ModelComprehensive

Strategies

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Conducting a Community Assessment

Elements of A Community Assessment

1. Community Description

2. Community History

3. Needs Assessment

4. Resource Assessment

5. Identify priorities

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Needs Assessment Data

Problem of

tobacco useConsequences

of tobacco use

Root Causes /

(risk factors) of

tobacco use

Local Conditions describe

what the root causes look

like in the community

Disparities provide

information about

differences in outcomes of

among populations

COMMUNITY

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Needs Assessment – Root Causes

Youth

Tobacco

Use

Retail Availability

Social Availability

Community Norms

Parental Attitudes Favorable Toward Use

Laws and Enforcement

Promotion and Price Favorable Youth Attitudes (Low perception of risk)

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Needs Assessment – Data Collection

https://mapping.countertools.org/iowa/

Retail Availability - # of failed compliance checks

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DisparitiesDisparity Example – Geography & Age

Source: https://www.cdc.gov/tobacco/disparities/geographic/index.htm

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Needs Assessment – Data CollectionData Collection Methods

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Needs Assessment – Data Collection“Triangulation” of Data Collection

Availability of Tobacco

Products to Youth

Surveys:- Parent Survey- Youth Survey- Community

Survey

Archival Data:- Compliance Check Results- Reward & Reminder Results- Police reports of providing to

minors

Qualitative Data:- Interviews with clerks, parents, law

enforcement- Focus Groups/listening sessions with

youth- Observation of retail practices

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Resource Assessment▪Community Resources include:

• Protective Factors and Developmental Assets that create a healthy environment and support healthy decision making.

• Existing facilities, programs, organizations, initiatives, coalitions, advocates that support youth and families.

• Prevention infrastructure including the health department, school system, resource centers, data systems, laws and policies, funding streams

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Resource Assessment▪Examples of community-level tobacco resources:

• Smoke or tobacco free laws or ordinances

• Organizations with tobacco free policies

• Organizations with cessation programs for employees or members

• Classroom curricula addressing tobacco prevention

• Kick-butts Day / Great American Smoke-off and other community events

• SADD and other youth groups engaging in tobacco prevention efforts

• Tobacco prevention or cessation advertisements in the community

• Retailer trainings provided

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Community Assessment Report

Elements of a Community Assessment Report include:

• Executive Summary

• Description of Community

• Community History

• Needs Assessment

• Resource Assessment

• Priorities

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Comprehensive Strategies

SAMHSA: Strategic Prevention Framework

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Strategies

Community

AssessmentProblem

AnalysisLogic

ModelComprehensive

Strategies

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Components:

1. Problem Statement

- Based on community

assessment

- Reflects community concerns

Problem

Root Cause (But Why? But Why Here?)

Problem Analysis

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Underage

Tobacco

Use

Problem Statement

Problem Analysis - Example

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Components:

1. Problem

2. Root Causes / Risk Factors

BUT WHY?

- Based on community

assessment

- Supported by prevention

science


Problem Analysis

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Retail Availability

Social Availability

Community Norms

Parental Attitudes Favorable Toward Use

Laws and Enforcement

Promotion and Price

Root Causes - Risk Factors

Favorable Youth Attitudes (Low perception of risk)



Youth

Tobacco

Use

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Underage

Tobacco

Use

Retail

Availability



Social

Availability

Favorable

Attitudes

Laws and

Enforcement

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Root Cause Root Cause

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Components:

1. Problem

2. Root Causes / Risk Factors

3. Local Conditions

BUT WHY HERE?

- Specific

- Identifiable

- Actionable


Problem Analysis

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Underage

Tobacco

Use

Retail

Availability

Social

Availability

Favorable

Attitudes

Laws and

Enforcement

Friends At

School

Parents At

Home

Strangers at

the Mall

Parents

smoke w/Child

Staff Smoke

Outside School

Coaches chew

at games

Police Don’t

Enforce at mall

School allows

behind Gym

Adults smoke

at games

Stores don’t

check ID

Youth have fake

ID’s

Glass shops

sell vapes

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Local Conditions

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Create a Logic Model

Community

AssessmentProblem

AnalysisLogic

ModelComprehensive

Strategies

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Problem /Goal

Statement

But Why?

(Root Cause)

But Why Here?

(Local Condition)

Logic Model

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Logic Model

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Problem Analysis

Moving from Problem Analysis to

a Logic Model


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1. Based on local data

2. Local conditions are specific, identifiable

and actionable

3. Prioritize based on “Importance” and

“Changeable”

4. The logic model will be consistent with

community experience and expectations

Moving from Problem Analysis to

a Logic Model


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Coaches Chew at

High School

Football Games

Favorable

Attitudes

Underage

Tobacco Use

Parents smoke

tobacco with their

children

Liquor stores not

Carding Under 21

Youth share their

tobacco at school

Availability

Of Tobacco

Problem

Statement

But Why?

(Root Cause) But Why Here?

(Local Conditions)

Local

Conditions

- Specific

- Identifiable

- Actionable

Logic Model

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- School Reports

- Youth Focus Groups

- Perceived Availability

- Police Reports-

- Survey

- Interviews

- Compliance Check

- Youth Survey

- School Discipline

- Youth Survey

Adding Data to the Logic Model

- Perception of Risk

- Parental Disapproval

- 30-day use

- Age of Onset

Considerations:

• 2 pieces of data for each element

• Include quantitative and qualitative data

• Must be able to collect the same data multiple times

Coaches Chew at

High School

Football Games

Favorable

Attitudes

Underage

Tobacco Use

Parents smoke

tobacco with their

children

Liquor stores not

Carding Under 21

Youth share their

tobacco at school

Availability

Of Tobacco

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Sample Coalition Logic Model

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Activity - Practice

Review your logic model:

1. Does it meet the criteria?

• Data from multiple sources

• Specific, identifiable and actionable

local conditions

2. How can it be improved?


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Activity – Practice

Observations

1. Problem Statement Data: “peers and parents find it

wrong” is not a measure of tobacco use – it is a

measure of favorable attitudes.

2. Local conditions: If possible provide more detail on

when, where, how often the local conditions occur.

3. Data: Good use of multiple data sources. Try to use

2 pieces of data for each element.


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Develop Comprehensive Strategies

Community

AssessmentProblem

AnalysisLogic

ModelComprehensive

Strategies

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- School Reports


- Survey

- Interviews

- Compliance Check

- Youth Survey

- School Discipline

- Youth Survey



- 30-day use

- Age of Onset

Coaches Chew at

High School

Football Games

Favorable

Attitudes

Underage

Tobacco Use

Parents smoke

tobacco with their

children

Liquor stores not

Carding Under 21

Youth share their

tobacco at school

Availability

Of Tobacco


- Police Reports-

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Strategies Targeting Individualized Environments

Family School

Health

Care

Providers

INDIVIDUAL

YOUTH

Faith

Community

Strategies Targeting the Shared

“Community” Environment

Availability

RegulationsNorms

ALL

YOUTH


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Environmental Strategies: Definition

Prevention efforts aimed at changing or influencing community conditions, standards, institutions, structures, systems and policies that shape behaviors


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Environmental Prevention Strategies

- Outlet Density Reduction

- Clean air laws / Smoking Bans

- Advertising Ordinance/Laws

- Smoke-free Parks & Public Spaces

- Restriction on Tobacco Outlet locations

- Restrictions on paraphernalia

- Increase the prices (taxes)

Developing Comprehensive Strategies

- Enhanced Enforcement of Laws

- Smoke Free Workplaces

- Cessations Campaigns

- Compliance Checks (Synar)

- Anti-Smoking Media Campaign

- Required Retailer Education

- School Policies

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Sources of Evidence-Based Environmental StrategiesDevelop Comprehensive Strategies

July 2017

NIH: Evidence-based Programs and Practiceshttps://prevention.nih.gov/resources-for-researchers/dissemination-and-implementation-resources/evidence-based-programs-practices#topic-8

https://prevention.nih.gov/resources-for-researchers/dissemination-and-implementation-resources/evidence-based-programs-practices#topic-8

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Info for school staffTraining for coachesCessation resourcesOn-campus servicesRecognize coachesPost signs on the fieldEnforce School Policy


Seven Strategies for Behavior Change

- School Reports


- Survey

- Interviews

- Compliance Check

- Youth Survey

- School Discipline

- Youth Survey



- 30-day use

- Age of Onset

Coaches Chew at

High School

Football Games

Favorable

Attitudes

Underage

Tobacco Use

Parents smoke

tobacco with their

children

Liquor stores not

Carding Under 21

Youth share their

tobacco at school

Availability

Of Tobacco


- Police Reports-

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1. Provide information

2. Build skills

3. Provide support

4. Change access / barriers

5. Change consequences

6. Alter the physical design of the environment

7. Change policies, rules, practices, procedures



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Local Condition: Retail stores are selling tobacco products sold to youth despite age restrictions.1. Provide Information—Post signs: “We don’t sell to minors…”

2. Build Skills—Train merchants to check ID’s

3. Provide Support—Technical assistance to merchants

4. Access/Barriers—Translate merchant education materials

5. Incentives/Disincentives—Increase fines/Recognize sellers

6. Physical Design—Place tobacco products behind the counter

7. Policies or Regulations— Increase compliance checks/fines


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Prevent Tobacco Use: A CADCA Toolkit

http://www.preventtobaccouse.org/

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When developing comprehensive strategies:

• Consider all 7 behavior change strategies

• Plan for multiple, complimentary strategies

• Identify multiple “target audiences” for each strategy

• Plan to implement the strategies over time

• Focus on changing the local condition

Develop Comprehensive StrategiesSeven Strategies for Behavior Change

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Policy Development Steps

1.

2.

3.

4.

5.

6.

7.

8.

9.

10

Develop Comprehensive StrategiesPolicy Development

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▪ Home

▪ Neighborhood

▪ Institutional

Levels of Policy

▪ City

▪ State

▪ National

Both: “P” and “p”

Policy Development


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1. Clearly state the problem (local conditions)

2. Engage enforcement

3. Gather and analyze data to make your case

4. Research model legislation/policies

5. Draft policy language

6. Use media to educate

7. Mobilize support and provide community education

8. Get the policy adopted

9. Ensure enforcement of the policy

10. Evaluate effects of policy change



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Create an Issue Brief



http://www.texansstandingtall.org/pdfs/Comprehensive%20Smoke%20Free%20Brief.pdf

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Strategies

Community

AssessmentProblem

AnalysisLogic

ModelComprehensive

Strategies

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Next Steps

Taking it home:

• What concepts are relevant to your organization?

• How should you approach the organization?

• When should you do it?

• Who should be involved?

• What additional training, T/A and information is needed?

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CADCA Resources

CADCA – Community Anti-Drug Coalitions of America

-www.cadca.org

CADCA Help and Technical Assistance – Contact:

-(800)-54CADCA Ext 240

[email protected]

CADCA – Geographic Health and Equity Alliance

-http://www.nohealthdisparities.org/

July 2017

http://www.cadca.org/

mailto:[email protected]

http://www.nohealthdisparities.org/

Documents

Coalition Capacity Building Webinar Series Webinar …...3 3 Presenters Dave Shavel, MBA - Currently works on behalf of NCI to provide training and technical assistance to increase