Minority SA/HIV Initiative

1. Minority SA/HIV Initiative MAI Training SPF Step 1 – Assessment Dortha Cummins, CSAP’s Southwest CAPT

2. Learning Objectives • Review Strategic Prevention Framework • Overview assessment • Define components of assessment • Explore assessment in context of MAI grant • Discuss the role of cultural competency in capacity building • Explore sustainability as it relates to capacity

3. Outcomes-Based Prevention Evidence-Based Programs, Policies, & Practices Contributing Factors & Intervening Variables Substance abuse & related problems Planning, Monitoring, Evaluating, and Replanning

5. Strategic Prevention Framework • Step 1: Assessment Profile population needs, resources, and readiness to address needs and gaps • Step 2: Capacity Mobilize and build capacity to address needs • Step 3: Planning Develop a comprehensive strategic plan • Step 4: Implementation Implement evidence-based programs, policies, practices • Step 5: Evaluation Monitor, evaluate, sustain, and improve

6. Goals of the Minority SA/HIV Initiative • Build foundation for delivering and sustaining quality, accessible state-of-the-science SA and HIV prevention services • Engage community groups to prevent and reduce the onset of SA and transmission of HIV/AIDS • Focus on high risk sub-populations

7. Assessment - Definition • Process of collecting data to define problems, resources, and readiness within a geographic area to address needs and gaps

8. Why Do Assessment? • Answers the question, “What is going on in my community?” • More specifically, it identifies: • The nature and extent of the problem • The conditions that contribute to the problem • The resources that currently exist • The gaps in resources • The readiness of the community to address the problem

9. Defining the Problem • Involves examining the data related to the community’s substance abuse and related problems • Quantitative data – are expressed in numerical terms and answers the question “How Many?” • Qualitative data – are non-numeric data rich in detail and description and helps answer the question “What Does it Mean?”

10. Defining the Problem (cont.) • Develop an Epidemiological (Epi) profile • Admission to treatment facilities by drug of choice • Substance consumption and consequence data • Rate of HIV by gender, exposure category (MSM), reported cases, age breakdown • Conduct focus groups with these sub-groups • Identifies populations most at risk • Defines target population in more detail

11. Collecting Data • Collect qualitative data from the identified focus population • Conduct focus groups • Conduct key informant surveys • Provides more specific information about the problem and ways to address it

12. Management Reporting Tool (MRT) –Needs Assessment Information • Target Geographical Area • Target Gender • Target Race • Target Ethnicity • Target Sexual Orientation • Target Age Group • Target Sub-Population(s) • Needs, Resources, Gaps • Findings of Epi Data • Target Risk and Protective Factors

13. Assessing Existing Resources • Resource Assessment is a systematic approach to identify existing resources for a specified defined service or need • Also assists in the identification of resource gaps

14. What Resources Do We Assess? • Assess those resources currently addressing substance abuse, HIV/AIDS and any other consequences identified in the data examination. Specifically: • Organizations • Programs • Individuals

15. Identifying Gaps Conduct a gaps analysis: • Create a table with two columns • List the need in the first column • List the identified resource in the second column • Gaps exist where no resources are identified • Create a plan to address the identified gaps

16. Sample Gaps Analysis

17. Creating a Plan to Address Gaps • Identify potential evidence-based strategies and interventions to address the identified gaps • Search for evidence-based strategies and interventions to fill gaps • SAMHSA, NIDA, and CDC all have resources addressing substance and HIV/AIDS

18. What is Community Readiness? Community readiness is the community’s (or state’s or organization’s) awareness of, interest in, and ability and willingness to support prevention initiatives

19. Stages of Community Readiness • Community Tolerance • Denial • Vague Awareness • Preplanning • Preparation • Initiation • Institutionalization • Confirmation/Expansion • Professionalization

20. Community Readiness Activity • Consider your own community/organization • At what stage of readiness is your community community/organization? • Find one strategy that might improving readiness in your community/organization

21. Readiness Assessment Tools • Community Readiness Survey, Tri-Ethnic Center for Prevention Research • Community Prevention Readiness Index, Community partner Institute • CSAP’s Prevention Platform • Community Key Leader Survey, Goodman and Wandersman • Community Readiness Survey, MIPH • Organizational Readiness for Change, Lehman, Greener & Simpson

22. Ensuring Cultural Competence in Assessment Cultural Competence: “A set of behaviors, attitudes and policies that come together in a system, agency, or program or among individuals, enabling them to function effectively in diverse cultural interactions and similarities within, among, and between groups.”

23. Data Collection and Cultural Competency Assessment Data Questions • What is your priority population(s)? • Who is collecting the data and information? • Who is interpreting the data? • Is the data collected reflective of your priority population? • Is there is a lack of reliable information on your priority population? If yes, where can you go to get data?

24. Data and Epidemiology Help Agencies, Individuals, and Communities… • Identify and understand the cultural compositions of the target communities • Identify the need for data at the community level • Assess adequacy of the data for key tasks • Identify alternate data sources and methodologies for obtaining them

25. Cultural Competency Integration • What is our working relationship with the community? • How do we gain community buy-in, support, approval of the data collection and analysis process? • How do we make sure that we are collecting cultural competence-related data? • How do we make sure that the data are culturally appropriate and responsive? • Is our priority population represented in the data collected? • How do we ensure that we are collecting culturally relevant data on risk and protective factors?

26. Addressing Sustainability in Assessment

27. Sustainability • Sustainability is the process of ensuring an adaptive prevention system and a sustainable innovation that can be integrated into ongoing operations to benefit diverse stakeholders • Ultimately, sustainability is about maintaining positive outcomes in communities

28. Keys to Sustainability • Research document and Training Curriculum • Looked across organizations at what allows them to sustain their outcomes • Applied the research findings to our prevention organizations at the state and sub-state level

29. Keys to Sustainability • Aligning SPF process researched elements of Sustainability • Identifying elements of Sustainability within the 5 SPF steps • Articulation of these elements with in Action plans and other documentation

30. Key Objectives for Sustainability: • Organizational Capacity: Assure that the community agencies, organizations and institutions have adequate internal organizational capacity to achieve positive outcomes • Effectiveness: Assure effectiveness and alignment of the prevention system to produce positive outcomes • Community Support: Cultivate community support for the prevention system and its positive outcomes

31. The ten related actions for sustainability are: 1. Structures and Formal Linkages 2. Policies and Procedures 3. Resources 4. Expertise 5. Quality and Accountability 6. Effectiveness 7. Reach and Alignment 8. Relationships 9. Champions 10. Ownership

32. Elements of sustainability in SPF Step 1: Assessment • What elements of sustainability are present in Step 1? • How do we know if those elements are present? • What indicators might be present? >>> some guiding questions…

33. Action areas for SPF Step 1: Assessment … 1. Structures and Formal Linkages (step 1) 2. Policies and Procedures 3. Resources 4. Expertise (step 1) 5. Quality and Accountability 6. Effectiveness 7. Reach and Alignment 8. Relationships 9. Champions (step 1) 10. Ownership (step 1)

34. Guiding Questions • What internal and external linkages, could be formalized to ensure the capture and use / prioritization of needs assessment data? • Which current skills and expertise will your organization rely to obtain and utilize needs assessment data? • Dose your organization have champions in place to assist in obtaining hard to access data?

35. Action Plan Development Session

36. Tough Questions

37. MRT – Sample Guiding Principles Example • Cultural Competence – affected people in our community must be allowed to play a role in identifying prevention and treatment strategies, tools, and technologies. • Data collection – data collection must be continually recorded, stored, and made accessible across silos.

38. MRT – Sample Accomplishment & Barrier Entry Accomplishment • Completion of 20 focus groups with topics including cultural view of HIV/AIDS and participants perceived risk associated with substance use and IV drugs. Barrier • A lack of intervention service awareness exists.

39. MRT – Sample Conclusions & Recommendations Entry Conclusion • Incorporating key guiding principles and implementing evidence-based strategies for reentry adults is imperative to address the needs. Recommendation • Coalition must use the needs assessment data to more effectively tailor evidence-based strategies to the needs of the community.

40. Questions & Discussion