"Experiences in Effective Prevention: Past, Present & Future" 3 of 4

Richard Lucey, Jr. Author

07/16/2018 Added

137 Plays

Description

This interactive session highlights current drug use rates among college students; seven elements of effective drug abuse prevention on college campuses; discussion around a strategic planning process; recommended strategies; and resources that are available to assist in prevention efforts. The session’s content is based around the speaker’s experiences and observations around drug abuse prevention among college students in New York State and with three federal agencies during the past 26 years.

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[00:00:05.390]This afternoon and I'm gonna talk a little bit,
[00:00:08.430]drill down a little bit deeper
[00:00:09.580]into the strategic planning process.
[00:00:12.430]A couple of things will loop back to what I talked about
[00:00:15.730]this morning because they do relate to the seven elements
[00:00:19.300]of an effective campus prevention program.
[00:00:21.890]And then I'll wrap up talking a little bit about
[00:00:23.920]why DEA even in this space of working
[00:00:27.480]primarily with colleges and universities
[00:00:30.530]and some of the resources that we have?
[00:00:32.890]And then we'll be able to wrap it up and
[00:00:34.610]have you out of here by 2:30, which would be a great thing.
[00:00:37.550]So,
[00:00:39.660]a strategic approach to prevent drug abuse.
[00:00:43.310]I said this morning that prevention is not random,
[00:00:47.250]that it is, it needs to be intentional,
[00:00:49.340]it needs to be with purpose and it needs to be strategic.
[00:00:53.700]I basically grew up on in the prevention science
[00:00:57.390]and then in my eight years working at SAMHSA
[00:01:01.720]really worked with and talked about it with
[00:01:06.180]campuses and communities.
[00:01:07.270]It was the Strategic Prevention Framework
[00:01:09.430]otherwise known at the SPF.
[00:01:12.237]And it really does serve as a nice guideline,
[00:01:15.240]guidebook, planning process, whatever you wanna call it,
[00:01:18.800]because deciding what to do and how to do it and
[00:01:22.710]how well something works,
[00:01:24.060]it really does require good data, care and logic.
[00:01:28.490]And so, the Strategic Prevention Framework is
[00:01:32.440]just one such approach.
[00:01:34.740]It's not the only one, of course, but it is one of the more
[00:01:38.330]predominantly known strategic approaches.
[00:01:41.630]Many of the states, well, in fact all of the states that
[00:01:45.080]get money through the Block Grant and then through
[00:01:47.960]some of the discretionary, competitive awards
[00:01:52.130]like the Partnerships for Success Grants,
[00:01:54.160]which I know that Nebraska has,
[00:01:56.370]whether it's one of the early Partnership for Success Grants
[00:02:00.100]or one of the newer ones
[00:02:01.490]which deals with specifically opioids,
[00:02:05.100]need to follow the SPF.
[00:02:06.410]I mean, that's what the whole issue
[00:02:09.810]is based upon and so the states are really familiar with
[00:02:13.090]this five step process to help support their
[00:02:17.310]drug abuse prevention activities.
[00:02:19.480]And so it really comes down to five steps,
[00:02:21.900]which is conducting a needs assessment, building capacity,
[00:02:25.970]identifying and implementing a prevention program
[00:02:30.070]and then evaluating it.
[00:02:31.460]So identify and implement and evaluate,
[00:02:33.070]those are the final three.
[00:02:33.960]We're gonna just dive in to each of those a little bit more,
[00:02:37.400]talking about some of the struggles
[00:02:38.590]I know that people have with them,
[00:02:39.780]some of the struggles I have with them
[00:02:41.720]and trying to talk about them and some of the experiences
[00:02:44.133]that I know campuses have had with each of these five steps.
[00:02:51.630]So,
[00:02:53.500]the first thing I talk about when I'm
[00:02:55.600]mentioning the SPF and why it's a good process
[00:02:59.620]and why to use is that it's data-driven.
[00:03:03.130]I mentioned this a few times this morning, that
[00:03:06.778]the work that we do in prevention should be guided by data.
[00:03:12.380]How do we know what we want to focus on
[00:03:14.330]unless we've done a survey?
[00:03:16.520]You really can't just rely on anecdotal data
[00:03:20.090]or hearsay,
[00:03:22.060]you really do need to
[00:03:24.010]focus on good numbers,
[00:03:26.790]so you realize what you have to focus on.
[00:03:29.440]The data also plays a role in evaluation, obviously,
[00:03:32.840]because it helps people know whether they're going in the
[00:03:37.840]right direction with their efforts.
[00:03:39.460]So data driven is one of the first five reasons why it's,
[00:03:43.170]you know, why to use it.
[00:03:44.070]It's a dynamic process.
[00:03:46.050]The SPF is five steps but it is a circular process,
[00:03:49.740]it is not linear.
[00:03:51.400]It starts with a needs assessment
[00:03:53.000]and it works its way around to evaluation,
[00:03:55.170]and then when you get back to evaluation,
[00:03:57.290]it's that now what, right?
[00:03:59.420]I mentioned those what, so what, now what?
[00:04:02.490]And you're going through the whole thing again.
[00:04:04.630]So it's not five steps ad finite.
[00:04:07.210]Remember what I said about prevention.
[00:04:08.900]Prevention itself, as a philosophy, as a practice,
[00:04:12.240]is not finite.
[00:04:13.610]Programming can be finite,
[00:04:16.230]but prevention is not.
[00:04:17.210]So it's a dynamic process.
[00:04:20.520]It's focused on population level change.
[00:04:22.990]So this is what's always been an interesting dynamic,
[00:04:25.370]working on college campuses and actually some of the tension
[00:04:29.600]between the prevention field and the treatment field,
[00:04:33.190]if you will.
[00:04:34.160]And, you know, the treatment field,
[00:04:36.040]nothing against the treatment field,
[00:04:37.260]but they have predominantly gotten more of the resources
[00:04:39.810]than prevention ever has, right?
[00:04:41.800]Well,
[00:04:43.270]you think about often sometimes,
[00:04:45.700]and I know a couple of the gentlemen talked about
[00:04:47.610]being in a counseling center and in a health center,
[00:04:49.920]you know, it's unfortunate, I've known of college campuses
[00:04:52.340]where the health center and the counseling center
[00:04:54.010]are like this.
[00:04:55.700]You know, they're working kind of at odds with each other.
[00:04:58.760]The health center, oftentimes, is looking at this
[00:05:01.180]population level change, or the more environmental change,
[00:05:04.010]whereas counselors are more what?
[00:05:06.850]One on one.
[00:05:08.700]Right?
[00:05:09.533]They have a case load, client load, and they're working
[00:05:12.370]one on one with students and so they are more involved
[00:05:15.960]and focused on
[00:05:17.720]individual change, as opposed to population level change,
[00:05:21.840]which, you know, for campuses may be,
[00:05:25.190]we might be looking at changing the sports culture.
[00:05:28.300]And if you drill that down even further, we may be looking
[00:05:30.450]to try to change the culture of one team.
[00:05:33.490]So, for example, the NCAA, I can tell you,
[00:05:35.490]just came out with their quadrennial survey that they do
[00:05:38.920]every four years, looking at the drug use rates of
[00:05:42.640]student athletes, at D1 through D3 schools.
[00:05:48.240]What do you think, you probably could guess,
[00:05:50.000]if you've read the study you know that
[00:05:51.830]they've broken it down by divisions and by gender
[00:05:54.020]and by sports.
[00:05:56.030]What is one of the sports that across the board,
[00:05:58.830]all of the substances is off the charts?
[00:06:02.570]What's that?
[00:06:04.800]No.
[00:06:05.992](laughing)
[00:06:06.825]He said, surprisingly, female swimming.
[00:06:08.230]No.
[00:06:10.600]It's predominantly male.
[00:06:12.140]It's not that it's not both, but it's predominantly male.
[00:06:15.930]No.
[00:06:17.600]Lacrosse.
[00:06:19.090]Lacrosse, off the charts.
[00:06:21.030]Lacrosse is off the charts.
[00:06:23.130]And this was actually
[00:06:24.830]an interest of some folks in DEA because they are,
[00:06:28.450]you know, outside of the office, their kids play lacrosse,
[00:06:30.980]they actually coach lacrosse, they're involved in this.
[00:06:33.810]And so when they knew my interest and kind of why
[00:06:37.820]I was brought into DEA and the connections that I had
[00:06:40.560]with the NCAA and such, we were able to get some of the data
[00:06:43.790]ahead of time and share it with them and they were just
[00:06:45.830]amazed at how much
[00:06:47.990]it's, like, way out there.
[00:06:49.340]So even within athletics, we could be trying to change the
[00:06:52.650]culture of a sport, as opposed to all of athletics.
[00:06:55.530]Within fraternities and sororities, the same thing.
[00:06:57.400]We could be trying to change the culture of a chapter,
[00:07:00.260]right, as opposed to the whole Greek system.
[00:07:02.220]So that's also a benefit of using the
[00:07:04.210]Strategic Prevention Framework, 'cause it moves beyond
[00:07:06.700]just individual outcomes and it looks at
[00:07:08.700]population level change.
[00:07:11.990]Traditionally within prevention, just as treatment
[00:07:14.980]has typically gotten more resources than prevention,
[00:07:17.750]if you look at the prevention field,
[00:07:19.760]K12 has typically gotten more resources than college.
[00:07:24.240]Okay, there's more K12 schools than there are colleges,
[00:07:27.440]but I'm not saying they should be 50-50,
[00:07:29.700]but they are predominantly disparate, if you will.
[00:07:34.600]Most of our prevention efforts have typically focused on
[00:07:38.510]the K12 population, the 12 to 17 year olds,
[00:07:42.150]mainly because that's where we see early onset of first use,
[00:07:45.610]it's where a lot of the norms are established,
[00:07:47.910]in high school and such.
[00:07:49.730]However, the nice thing about the
[00:07:51.130]Strategic Prevention Framework is that
[00:07:53.060]it can be used with other populations,
[00:07:55.520]especially colleges and universities.
[00:07:57.720]If you're looking at older adults,
[00:07:59.510]and the older adult population, looking at maybe mixing
[00:08:02.340]alcohol and prescription drugs, which is a significant issue
[00:08:05.700]among older adult population and such.
[00:08:09.050]And then lastly, the SPF does rely on a team approach.
[00:08:12.920]I talked about it earlier, again, this loops back to
[00:08:15.390]building coalitions and such, that
[00:08:19.360]every step of the SPF, whether it's conducting a
[00:08:22.510]needs assessment or capacity building
[00:08:25.960]and the other three, it does require a team approach.
[00:08:29.480]And so that's why
[00:08:31.730]the SPF is a benefit
[00:08:34.180]to folks there.
[00:08:35.013]So we're gonna talk about each of the steps here.
[00:08:37.300]So, step one is needs assessment, what to assess.
[00:08:40.434]And I always say to folks how do you know what you're
[00:08:43.790]going to work on if you haven't taken the picture,
[00:08:47.700]if you will, of your campus or of a student group,
[00:08:50.580]of the student body of your community to know
[00:08:53.890]what is the nature and extent of their substance use,
[00:08:56.540]problems and their behaviors?
[00:08:58.460]You can't just base it on hearsay or maybe a visual scan.
[00:09:03.014]You know, they're always out drinking on
[00:09:04.760]Fridays and Saturday nights.
[00:09:06.560]How do you know?
[00:09:07.950]Well, I hear the police reports and I live kind of
[00:09:10.570]in the neighborhood and I just know that
[00:09:12.000]all the students are down there.
[00:09:13.470]All the students?
[00:09:14.303]Really?
[00:09:15.550]So doing the survey really does give you that
[00:09:19.260]concrete picture of what you should be focusing on.
[00:09:22.510]But it's not just the nature and the extent of the problems.
[00:09:25.540]There are many other things that you can assess.
[00:09:27.240]You can also be looking at assessing the risk
[00:09:29.050]and the protective factors,
[00:09:30.530]those risk factors that contribute to drug use,
[00:09:33.170]the protective factors that help protect
[00:09:36.490]or bolster their healthy behaviors.
[00:09:40.410]And then, also, you can be assessing the community,
[00:09:43.510]and I'll use that word broadly,
[00:09:45.190]whether it's the campus community
[00:09:46.390]or the community at large to look at what resources exist.
[00:09:49.730]What's their readiness to change?
[00:09:51.860]The former Higher Ed Center,
[00:09:53.630]and I say it that way just because we do have one that
[00:09:55.770]exists at the Ohio State University, but
[00:09:58.100]the one that we had funded at the
[00:09:59.390]Department of Education talked a lot about readiness,
[00:10:03.020]you know, how ready is a campus to change?
[00:10:07.070]How ready is the community to move forward?
[00:10:10.120]So all of these things are things that can be assessed
[00:10:14.360]as part of this first step.
[00:10:19.770]And step two is building capacity,
[00:10:22.130]and this is the one that I tend to struggle with.
[00:10:24.310]And I'm very upfront with people about it.
[00:10:27.920]So when you think about building capacities,
[00:10:30.370]what is it that you need
[00:10:32.530]to address the problem that you've identified
[00:10:35.320]through the needs assessment?
[00:10:37.010]Who are the people that are gonna help you?
[00:10:39.370]How much money to do you need?
[00:10:40.530]Where do you get it?
[00:10:42.140]What other resources are needed and how do you get them?
[00:10:44.770]When people think about capacity, here's where I struggle.
[00:10:47.380]The first thing people tend to think about is money.
[00:10:52.690]I can't build capacity, I can't move forward
[00:10:55.520]unless I have money.
[00:10:58.610]But the building capacity can come in the form of trainings.
[00:11:01.490]You're building capacity right now.
[00:11:04.700]Like, us spending this three hours together
[00:11:07.320]is you building capacity.
[00:11:09.330]You might only take 25 per cent of what I'm talking about
[00:11:12.500]and actually use it.
[00:11:13.810]That's fine.
[00:11:15.080]The person next to you might actually use 75 per cent of it.
[00:11:18.540]That's fine.
[00:11:19.650]You're all in different stages of where your capacity needs
[00:11:22.160]to be built, and that's okay.
[00:11:24.460]I'm not ever gonna say that 100 per cent
[00:11:26.920]of what I have to share,
[00:11:27.930]or any presenter has to share can be used.
[00:11:30.010]You'll just take from it what you can.
[00:11:31.860]But this training is building capacity.
[00:11:34.610]This didn't cost you much money, right?
[00:11:36.560]I mean, sure, time to get here, to drive here.
[00:11:41.740]And your staff time.
[00:11:43.830]But that was about it, right?
[00:11:46.690]So, when I worked in New York State and was
[00:11:49.780]overseeing our state efforts, we didn't have any money
[00:11:52.540]that went into our state efforts.
[00:11:54.020]It was my salary, that was it.
[00:11:56.430]So trying to pull together the state-wide consortium,
[00:11:59.180]which we had in New York, just like Nebraska does
[00:12:02.179]and staging a conference that we did every two years,
[00:12:06.800]you know, a lot of that was often done without any kind of
[00:12:10.430]grant money or any kind of operational money
[00:12:12.650]from the state agency.
[00:12:15.370]So it can be done.
[00:12:17.160]I'm not saying it's easy, but money is not
[00:12:20.550]the be all and the end all.
[00:12:21.970]But where I struggle is that most people will think
[00:12:24.900]but in order for me to do training,
[00:12:27.500]to have coalition meetings, to do these types of efforts
[00:12:31.020]in the community, it does take money.
[00:12:33.860]So I get it, I mean, it's hard.
[00:12:37.277]But that's where I talk about leveraging your resources.
[00:12:40.470]You know, who else on your campus
[00:12:42.830]is working towards this issue?
[00:12:44.330]Who else in your community is working toward this issue?
[00:12:46.820]Maybe a community group has a grant,
[00:12:49.600]and you can work with them.
[00:12:51.030]So the building capacity piece is just really there
[00:12:54.710]to get you started.
[00:12:56.420]Now that you've identified the problem,
[00:12:58.950]what are the resources?
[00:13:00.100]Let's now start to identify the resources that can help us.
[00:13:03.470]So that's where we are in the building capacity piece.
[00:13:07.710]So the third step is actually not only developing
[00:13:10.000]the comprehensive plan,
[00:13:11.070]but implementing the program and such.
[00:13:12.770]And so, I talked earlier today about the fact that
[00:13:16.370]we're at a point now where we can no longer say that we
[00:13:19.850]don't know what works.
[00:13:21.660]I mean, I reiterate that again, that in the college arena
[00:13:26.260]there was a time, and it was really kind of prior to 2002,
[00:13:30.990]you know, that was the year the NIAAA came out with the
[00:13:33.500]call to action that identified those
[00:13:35.400]four tiers of effectiveness.
[00:13:37.670]And that was a watershed moment in our field,
[00:13:41.540]because prior to that
[00:13:43.550]it really was a hit or miss, as I talked about,
[00:13:46.720]what made us feel good, what do we traditionally do?
[00:13:50.060]What were the things that,
[00:13:51.470]we would bring in the crashed car
[00:13:53.960]and we would do those types of things.
[00:13:56.330]But now we had an agency through extensive research,
[00:13:59.960]had said we've taken all these strategies
[00:14:02.820]and lumped them into four tiers of effectiveness.
[00:14:06.640]From the gold standard of tier one down to
[00:14:10.123]ineffective when used alone,
[00:14:12.330]and that's where I mentioned education.
[00:14:14.560]Like, education alone is not gonna do it, right?
[00:14:18.260]So this whole idea of implementing, you know,
[00:14:20.720]once you've developed your comprehensive prevention plan,
[00:14:23.470]and you can call this whatever you want.
[00:14:24.950]Some people will call it a logic model,
[00:14:26.480]which is one of the steps on here,
[00:14:27.970]that the whole thing is a logic model, you know?
[00:14:30.520]Other people will call it a roadmap
[00:14:33.880]to where we're going to go.
[00:14:36.085]It's really just your plan, but that's the operative word.
[00:14:41.770]Having the plan.
[00:14:43.390]Sitting down and taking the time to strategically think out
[00:14:47.240]what it is we're going to do.
[00:14:49.260]So, you know, the implementation piece,
[00:14:52.940]which really comes down to these three tasks,
[00:14:55.720]once you've built capacity
[00:14:56.687]and you carry out the intervention and you evaluate
[00:14:59.742]and adjust moving forward.
[00:15:01.420]When I talk to people about
[00:15:03.530]implementing a prevention program, I always advise them
[00:15:07.920]to resist temptation to join what I call the
[00:15:11.710]prevention strategy of the month club,
[00:15:14.477]right?
[00:15:16.980]That because you've heard about it elsewhere,
[00:15:19.780]at a conference or a colleague,
[00:15:22.300]maybe that that's what we should be doing here.
[00:15:25.310]And I will tell you, the model programs,
[00:15:27.790]and I've worked on them for years,
[00:15:30.440]it was a curse and a blessing at the same time,
[00:15:33.320]because when you identify models,
[00:15:36.210]people will immediately gravitate toward them
[00:15:39.210]and want to do what they're doing
[00:15:41.750]and skip a bunch of steps in between, right?
[00:15:45.120]So I used two examples.
[00:15:48.110]We use social norms programming and I use basics,
[00:15:51.020]because both of those
[00:15:52.737]got an awful lot of press and attention,
[00:15:56.670]both nationally, in the press and in the media and at
[00:15:59.380]national conferences and at professional development
[00:16:01.280]meetings that we've all gone to.
[00:16:03.440]And so, you hear about social norms programs and
[00:16:08.350]you immediately run out, and I'm gonna talk about them
[00:16:10.923]in just a minute, about fidelity.
[00:16:12.430]The same thing with basics.
[00:16:13.560]If you go to a national conference, and there are some
[00:16:15.660]great campuses and great folks at those campuses who are
[00:16:19.350]really seeing success with doing brief motivational
[00:16:22.350]interviewing with students,
[00:16:25.370]but just because there's a lot of attention given to it.
[00:16:28.020]Make sure it's the right approach for your campus, right?
[00:16:31.560]And,
[00:16:33.069]and Jason will talk about this when he's here in a month,
[00:16:36.550]that there was, you know, basics was built around
[00:16:39.470]the alcohol use issue.
[00:16:41.110]So now the question is, does basics have applicability
[00:16:44.670]around the marijuana use issue?
[00:16:47.290]Which I would guess that it does, you know,
[00:16:49.890]as somebody who's not even trained in basics,
[00:16:51.910]the formal training, but I would happen,
[00:16:54.890]I would like to think that the principles behind having
[00:16:59.610]a one on one or small group interaction
[00:17:03.800]that is non-judgemental and listening to the student
[00:17:07.010]and comparing their use with the actual norms
[00:17:10.770]around marijuana
[00:17:12.700]would work just as well as it does around the alcohol issue.
[00:17:15.950]And that's why basics, which is the program by the way,
[00:17:19.350]they always talk about terminology and make sure that
[00:17:22.240]you get it straight that way.
[00:17:24.276]Brief motivational interviewing is the strategy,
[00:17:28.100]that's the gold standard.
[00:17:29.480]Brief, motivational interviewing.
[00:17:31.760]Basics is the program,
[00:17:33.820]is a program that gets at that.
[00:17:36.070]So people tend to interchange the two
[00:17:38.340]and they're really not, so I'm always really clear
[00:17:41.450]when talking to people about that.
[00:17:43.280]But, this needs to be thought of,
[00:17:45.537]and this is why I brought it up in the earlier part
[00:17:48.450]this morning, talking about let the buyer beware.
[00:17:53.160]Which is Basics or any other program,
[00:17:55.610]any other strategy, is it right for your campus?
[00:17:58.240]Is it right for what you want to do?
[00:18:00.960]You need to do your homework around that.
[00:18:03.230]So, the challenge, as I mentioned earlier, is around
[00:18:08.200]adapting these programs
[00:18:10.890]and remaining true to how they were developed,
[00:18:13.210]the fidelity of those programs, because
[00:18:17.520]once you start changing it and adapting it too much,
[00:18:20.680]then it's no longer the program that was effective
[00:18:24.720]or has an evidence base behind it.
[00:18:26.820]And then you're left with wondering why you
[00:18:29.320]didn't get the results that you were hoping for.
[00:18:31.750]So, I used the example of social norms programming.
[00:18:35.410]For example, in the 90s this was getting a lot of press.
[00:18:39.980]I was fortunate, working in New York state to have
[00:18:42.420]two of the leaders right in our backyard, so to speak,
[00:18:44.840]three hours away, Wes Perkins and Alan Berkowitz,
[00:18:49.142]who worked at Hobart William Smith Colleges,
[00:18:50.350]who really took social norms to a whole new level
[00:18:54.230]with colleges and universities talking about
[00:18:57.820]breaking down and correcting the misperceptions that
[00:19:01.240]students have that the majority of their peers drink
[00:19:04.730]and that if you reduce that misperception,
[00:19:07.040]you'll actually reduce the rates
[00:19:09.390]and the negative consequences.
[00:19:10.690]Well, with that research and that theory
[00:19:14.570]that was well-researched, there were many other campuses
[00:19:17.710]who were using social norms programming and seeing
[00:19:21.100]some degree of success on their campuses.
[00:19:23.180]So Northern Illinois University, with Michael Haines
[00:19:26.620]and Coreen Johannes and Peggy Glider at the
[00:19:28.960]University of Arizona, Pat Fabiano at Western Washington,
[00:19:32.610]for example.
[00:19:33.443]These are just a few of the names.
[00:19:35.120]The Higher Ed Center even came out with a publication
[00:19:37.260]on how to implement use of social norms program.
[00:19:40.960]Well, what happened was when, you know,
[00:19:43.200]we kind of were our own worst enemy when we had the
[00:19:45.750]national meeting, and we did have it here in Lincoln
[00:19:48.580]one year,
[00:19:49.430]oh, it was in Omaha, okay,
[00:19:51.639]when we were up in Omaha.
[00:19:53.950]So, and this would have been around the time,
[00:19:55.510]'cause it was about 15 years ago that we had had the
[00:19:57.760]national meeting when this,
[00:19:59.400]social norms was the big thing at the time.
[00:20:02.030]We had a lot of workshops where people were talking about
[00:20:04.010]social norms programming.
[00:20:05.450]And what happened was people then left that conference
[00:20:08.260]hearing about social norms programming and ran
[00:20:10.030]right back to their campus and thought,
[00:20:13.060]well, all I have to do is.
[00:20:16.200]And I've always cautioned people if you ever start your
[00:20:18.490]prevention programming sentence off with
[00:20:20.720]all I have to do is,
[00:20:22.330]you're probably setting yourself up for failure,
[00:20:24.690]'cause that sounds like it's simplistic.
[00:20:26.780]And you're gonna skip some steps.
[00:20:28.270]But what happened was all I have to do is
[00:20:31.550]do a survey, get the data, slap the data on a poster,
[00:20:33.890]slap the poster on a wall, boom,
[00:20:35.210]I'm doing social norms programming.
[00:20:38.320]And yet, what was happening?
[00:20:40.460]They weren't putting the posters and the brochures
[00:20:42.970]in high traffic areas,
[00:20:44.780]they weren't being seen by the students,
[00:20:46.730]the students were not believing the data.
[00:20:48.700]I'm sure you deal with that still now.
[00:20:51.080]Do people not believe the data that you're producing
[00:20:53.900]and putting up on the posters and such?
[00:20:56.720]That's why the clicker technology and all of those types of
[00:20:59.120]things with real time data has been nice as a,
[00:21:03.570]been a nice complement, and even settings like this,
[00:21:06.480]if you get a whole bunch of students in a room,
[00:21:08.410]and they're on their phones and you give them the text app
[00:21:12.000]for getting real time data,
[00:21:14.070]and you ask them some questions and the charts come up,
[00:21:16.850]and they don't wanna believe the data.
[00:21:18.200]And I'll say, well, why don't you wanna believe the data?
[00:21:19.760]It came from you, right here, right now.
[00:21:22.640]Right?
[00:21:24.300]But this issue of fidelity is, again,
[00:21:27.260]people are impatient, they don't,
[00:21:29.630]they want to see results yesterday.
[00:21:31.860]They take something that they've heard at a conference,
[00:21:35.810]and what's even worse is your boss has heard something
[00:21:38.520]at a conference and then has come back and has
[00:21:40.690]plopped in on your desk and said, implement this,
[00:21:43.100]we need to be doing this.
[00:21:46.670]Kind of hard to say no to your boss, I get it,
[00:21:48.500]but you really do have to figure out, well, why?
[00:21:52.250]Just because this worked at Arizona State University
[00:21:55.550]or at Oklahoma State,
[00:21:57.840]that doesn't mean it's gonna work here.
[00:22:01.010]So,
[00:22:02.240]as we drill down,
[00:22:03.250]as you drill down further into this issue of identifying
[00:22:06.280]the evidence-based program, you do have to figure out
[00:22:09.265]which one is best for you.
[00:22:11.120]I'm gonna show you a couple of tools for that in just a bit.
[00:22:15.040]So, this is why, you know, this graphic,
[00:22:17.790]it is a balancing act, this whole idea of
[00:22:21.440]we're not in a cookie cutter type of industry but I need to
[00:22:25.340]take a strategy or a program and now move it
[00:22:29.020]to here on our campus, which is not exactly like where this
[00:22:33.631]program was developed.
[00:22:35.170]I need to figure out how to adapt it.
[00:22:38.630]How many of you might work with,
[00:22:39.900]I know somebody had to leave, worked in student conduct,
[00:22:42.890]but how many of you worked with, say, like,
[00:22:44.330]mandated students, students who had an infraction against
[00:22:46.770]the policy and maybe had to go and do mandatory education
[00:22:51.520]on the campus, right?
[00:22:53.100]And so there are several programs that people can do
[00:22:55.880]around that and such, and there are some good
[00:22:57.710]evidence-based programs around working with
[00:22:59.700]mandated students and such, but those programs, for example,
[00:23:03.580]may say that this is, you know, ten two hour sessions
[00:23:07.100]over a two and a half month period.
[00:23:09.750]And you're sitting there thinking I am never gonna get
[00:23:11.810]this student to come here and sit for two hours
[00:23:14.600]for ten weeks in a row in this program.
[00:23:17.780]So,
[00:23:18.780]how about we do five half hour programs?
[00:23:21.600]That I can live with, and I think I can get the
[00:23:24.060]students here for five weeks.
[00:23:26.720]Okay, so you get the students in, five weeks,
[00:23:28.760]do a half hour with them.
[00:23:30.210]You cut a few, you cut more than a few corners on that
[00:23:33.200]and then
[00:23:34.790]you're seeing those same students come back around
[00:23:37.170]or you're not seeing any of your rates going down.
[00:23:40.950]Why?
[00:23:42.720]'Cause you've changed an evidence-based program
[00:23:44.940]so much that it's no longer the evidence-based program
[00:23:47.910]that it was to begin with.
[00:23:49.610]So that's, you need to be really careful with that
[00:23:52.090]and I always advise people, if you can, just reach out
[00:23:55.880]to the program developers and just ask them.
[00:23:59.060]That's the thing I've loved about the
[00:24:00.360]NASPA Strategies Conference, the Higher Ed Conference
[00:24:03.250]that we used to do.
[00:24:05.300]People are very accessible, I have found,
[00:24:07.890]at these conferences.
[00:24:09.340]We are very approachable, you know,
[00:24:12.000]talk to people in the hallways and such.
[00:24:14.510]But shoot 'em an email, what have you got to lose?
[00:24:16.930]You know, or pick up the phone and call them and just say,
[00:24:18.740]look, I was thinking about implementing your program.
[00:24:21.550]Here are the challenges I think we have on our campus.
[00:24:23.680]Can you help me?
[00:24:24.610]What are some ways in which I might be able to
[00:24:27.150]modify this some, or adapt it some from our campus?
[00:24:30.610]Go right to the source.
[00:24:31.870]The program developers are often very helpful in that regard
[00:24:35.170]and that will help you with the fidelity issue.
[00:24:38.590]So the,
[00:24:39.607]reporting the evaluation results.
[00:24:42.520]So,
[00:24:44.280]we already said evaluation is key, a key component
[00:24:47.320]of an effective program.
[00:24:49.490]But how do you get the word out?
[00:24:53.547]I mean, who are you going to tell
[00:24:55.670]about your efforts?
[00:24:57.800]Obviously your funder.
[00:24:59.980]But say your funder, for them, it may just be something as
[00:25:04.900]formal as a report.
[00:25:08.510]Right?
[00:25:09.700]But,
[00:25:10.960]if you want to tell the community, maybe for them it's a
[00:25:14.010]presentation at a town hall meeting.
[00:25:16.330]You know, if you're pulling a, SAMHSA oftentimes has,
[00:25:21.220]every couple of years, the town hall meetings around
[00:25:23.240]preventing underage drinking.
[00:25:24.650]So, it may be there that you're talking about some,
[00:25:28.510]an effort for them.
[00:25:29.770]You know, for the media, obviously, it's a press release.
[00:25:32.400]That's what's gonna trigger their interest.
[00:25:34.710]So it's all figuring out, it goes back to that
[00:25:36.550]communication piece that I talked about,
[00:25:38.380]is how are you gonna communicate in different ways
[00:25:40.890]for different audiences in different formats?
[00:25:44.200]So you've got a press release for the media,
[00:25:45.840]a public presentation for the community,
[00:25:47.700]a formal report for your funder.
[00:25:49.890]These are all ways you're taking your evaluation results,
[00:25:52.860]repackaging them differently
[00:25:55.230]depending on who it is you're talking to, right?
[00:26:01.770]So,
[00:26:03.310]that's just a quick snapshot of the SPF and I've had this
[00:26:06.710]slide up a couple of times, and I would hope that you
[00:26:09.730]would write down this website address because
[00:26:13.540]if you haven't been following the,
[00:26:15.860]the
[00:26:17.530]workings in Washington of late, specifically at SAMHSA,
[00:26:23.403]that agency is going to soon be significantly changing
[00:26:27.490]how it will be delivering
[00:26:29.150]its training and technical assistance.
[00:26:33.350]They're,
[00:26:35.520]soon,
[00:26:36.910]you've heard of the CAPT, I would hope.
[00:26:39.410]The CAPT is the Center for the Advancement of
[00:26:41.550]Prevention Technologies.
[00:26:43.590]And the CAPT has always served as CSAPs national training
[00:26:48.540]and TA center for its grantees and their sub-recipients.
[00:26:52.310]So if Nebraska is a grantee, which it is,
[00:26:55.290]and then anybody that Nebraska funds with that money
[00:26:59.100]is considered a sub-recipient,
[00:27:00.760]they get training from the CAPT.
[00:27:02.420]The CAPT is poised to go away in the fall.
[00:27:09.600]So, I'd visit this site as soon as you can and start
[00:27:13.480]downloading as many of their resources as you might
[00:27:15.770]possibly do that you could use because I have no idea
[00:27:21.160]how this information will be made available, if at all.
[00:27:26.460]The
[00:27:27.530]agency is looking at
[00:27:31.030]a sort of, I use the word super center, you know,
[00:27:35.150]if you think of the Walmart super centers.
[00:27:39.056]But each center would have its own
[00:27:41.370]massive TA center.
[00:27:43.770]So Prevention would then have a TA center,
[00:27:46.682]Mental Health would have its own TA center
[00:27:50.380]and Treatment would have its own TA center,
[00:27:52.970]that is to serve all needs
[00:27:55.980]for all populations
[00:27:58.150]around prevention.
[00:28:00.330]And so,
[00:28:02.170]it would be incumbent upon that contractor,
[00:28:05.700]who would operate such a center to have expertise in K12,
[00:28:10.840]college, older adults, Native Americans, LGBTQ,
[00:28:16.040]people of color,
[00:28:17.620]all the different groups that we've talked about.
[00:28:20.640]And so
[00:28:22.850]the CAPT has some excellent resources around the SPF
[00:28:28.480]and actually, they have some, I call it one pagers,
[00:28:32.900]but they actually may be two to four pages if you will,
[00:28:36.290]on each of the five steps.
[00:28:37.860]So, that's why I've put this link up here on applying the
[00:28:41.050]Strategic Prevention Framework, because these are
[00:28:43.970]easily digestible, very easy to read guidance documents
[00:28:47.930]on each of the five steps that can be used in any setting.
[00:28:51.920]And so, I always have them at my,
[00:28:54.830]as a desk reference to go back to
[00:28:57.640]because not everything stays up here all the time, right?
[00:29:00.260]I mean, there's just so much to try and remember.
[00:29:03.350]So, if you are interested in having that kind of a
[00:29:06.830]desk reference or an easy go-to document,
[00:29:10.540]I'm telling you, the CAPT has those and
[00:29:13.190]if they'll be available after October, I have no idea.
[00:29:16.260]So,
[00:29:18.220]that's my,
[00:29:19.230]that's my push to you, to grab the resources that are
[00:29:22.680]there while you can until the super TA center
[00:29:27.140]gets shored up in each of the centers at
[00:29:32.460]SAMHSA.
[00:29:34.030]So I'm going to mention NREPP because this was
[00:29:35.870]another thing that was in the news
[00:29:37.430]that made it's way and I think,
[00:29:42.100]unfairly was, just from my perspective, I think the field
[00:29:47.490]really didn't understand what they were rallying against,
[00:29:51.290]if you will.
[00:29:52.650]So what is happening, people were saying, well,
[00:29:56.610]NREPP is down, you can't get to NREPP anymore and it's gone.
[00:29:59.260]And NREPP is the National Registry of Evidence Based
[00:30:01.840]Programs and Practices.
[00:30:03.470]So this is,
[00:30:04.760]you know, I mentioned earlier, one of the registries
[00:30:06.990]that you can go to for the list of evidence based programs.
[00:30:10.230]This is why I say we no longer can say we don't know
[00:30:13.270]what works because there's plenty of programs out there
[00:30:15.220]that are effective and, in fact,
[00:30:19.520]you can see it larger up there than I can on my screen,
[00:30:22.080]in the search box I just simply entered the phrase college
[00:30:28.130]and there were
[00:30:30.840]eight different programs that had popped up.
[00:30:33.460]And there are, you'll see they're color coded green,
[00:30:36.260]yellow and red, just like the traffic lights.
[00:30:38.350]Green are those with effective outcomes,
[00:30:40.890]yellow, promising and red are ineffective.
[00:30:44.500]And so you can do that with any search words
[00:30:47.970]that you've put in there but
[00:30:51.360]you can still get to NREPP, just go to samhsa.gov/nrepp
[00:30:56.180]and see this.
[00:30:57.730]What SAMHSA is doing, though, is overhauling the way
[00:31:02.560]in which programs
[00:31:05.290]prove their evidence of effectiveness
[00:31:07.370]to get listed on NREPP.
[00:31:09.790]That's what's changing.
[00:31:11.210]They're changing their whole process by which
[00:31:14.600]programs get on there.
[00:31:15.970]Admittedly, it wasn't,
[00:31:18.050]it was a whole self-nomination process before.
[00:31:20.530]I mean, program developers, and I mentioned earlier,
[00:31:23.580]remember, buyer beware, program developers will use words,
[00:31:27.240]evidence, science, effective, you know,
[00:31:29.420]and maybe without any regard to the actual
[00:31:32.450]quality of their data or their results.
[00:31:35.570]That they went through, you know, they could self-nominate
[00:31:38.150]and they went through a review process,
[00:31:41.750]but they got listed on here and
[00:31:44.310]the current leader, the Assistant Secretary for
[00:31:47.300]Mental Health and Substance Use
[00:31:50.540]wasn't too keen on the fact that there were people
[00:31:52.860]that are listed on NREPP that maybe didn't have
[00:31:56.250]real rigor when it came to effectiveness and evaluation.
[00:32:00.920]And so they're changing that.
[00:32:02.350]And that's what they're overhauling.
[00:32:04.180]So,
[00:32:05.080]and they are even looking at some of the legacy programs.
[00:32:07.870]Those are the programs that currently exist on there.
[00:32:11.890]But you still can get to some of the college programs
[00:32:14.150]on NREPP and I would go so far as to say that you
[00:32:17.350]then compare them against what's on CollegeAIM.
[00:32:21.040]Because this is another repository that you can go to.
[00:32:24.980]This really was like the next step
[00:32:27.750]of the four tiers of effectiveness.
[00:32:29.970]We had waited two plus years
[00:32:34.330]for, and you know, I was in plenty of meetings with
[00:32:37.000]Doctor Hinkson, with Ralph and with Vivian Faden
[00:32:39.660]and others at NIAAA, really good colleagues of ours still
[00:32:44.540]and they would report out on the fact that
[00:32:46.530]there was this new matrix that was going to be developed
[00:32:48.920]and we heard that for, like, two plus years.
[00:32:51.980]But it was a painstaking process, but it was a process
[00:32:54.560]that needed to be painstaking in order to have the utility
[00:32:57.410]that it does for the field.
[00:32:59.410]Hopefully the field is using it,
[00:33:02.120]but basically what CollegeAIM now did was take
[00:33:06.030]all of those different tiers of effectiveness,
[00:33:08.660]those strategies that were lifted into those tiers,
[00:33:11.940]which were not all equally effective,
[00:33:14.380]and put them in this interactive matrix that you can
[00:33:17.280]now go to to learn about the cost effectiveness,
[00:33:20.500]the burden, the level of effectiveness,
[00:33:23.800]what population do these strategies work with?
[00:33:27.770]You know, take your campus specifically,
[00:33:30.570]you go into CollegeAIM and you're punching in
[00:33:33.040]exactly the types of things you're looking for,
[00:33:35.770]and then you'll run it and here will come the strategies.
[00:33:38.740]That doesn't then mean take those strategies
[00:33:40.590]and immediately implement them, but it's a starting point
[00:33:43.930]for you to figure out where you wanna go from there.
[00:33:47.050]What people are hoping for next is what can you imagine?
[00:33:51.660]We need something like this for what?
[00:33:55.000]Marijuana.
[00:33:56.660]All the other drugs.
[00:33:57.950]'Cause this is all based on the alcohol issue.
[00:33:59.543]This is the alcohol intervention matrix.
[00:34:01.700]So people would like to see a repository
[00:34:03.980]that deals with that, but NIAAA is alcoholism
[00:34:06.850]and alcohol abuse, remember,
[00:34:09.380]and that's not their research area.
[00:34:11.840]That would probably be NIDA,
[00:34:13.660]which is the National Institute on Drug Abuse.
[00:34:16.300]But in the meantime, you do have the NREPP.
[00:34:18.610]So again, there are databases and repositories out there
[00:34:23.274]that really can help people figure out maybe the direction
[00:34:27.310]in which they want to go.

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"Experiences in Effective Prevention: Past, Present & Future" 3 of 4

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