Transcript Public Prevention Policy

Presentation at County
Administrators Meeting
IOM & SPF:
What are they – and
What implications do they have for
us.
Presented by
Joël Phillips
Community Prevention Institute
January 26, 2006
NEW TERMS = NEW APPROACH
IOM - (Institute of Medicine)
Continuum of Care
SPF - Strategic Prevention Framework
IMPORTANCE
Both concepts will dominate Prevention
Planning/Policies
Need to understand how they will impact
field
Know about availability of Resources to
assist Counties.
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PREVENTION CONTINUUM – (U.S.I.)
- A Brief History 1957
1983
1987
Public Health Model – “Commission on Chronic Health Care”
- Introduces Primary, Secondary, Tertiary Prevention
(Disease/Health)
R. Gordon: Introduces U.S.I. concept to better distinguish
between Populations in need of Primary Prevention
(Disease/Health)
1994
Institute of Medicine – commissioned study examining Mental
Disorders
Use U.S.I. + Treatment + Aftercare (Continuum)
(Mental Health)
2000
CSAP introduces term to substance abuse prevention
(By 2002-03 directives went to States)
(Substance Use – but not fully developed)
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The Continuum of Care Protractor
Different levels of prevention are distinguished by the level of risk
of disorder/distress in various populations groups targeted.4

Universal Prevention Measures:
Address the entire population.
Aim is prevent/delay use of AOTD. Deter onset
by providing individuals with information/skills

Selective Prevention Measures:
Targets subsets of the population considered at
risk by virtue of their membership in a particular
segment of the population.
 Key Selective Prevention targets the entire
subgroup regardless of the degree of risk of any
individuals in the group.

Indicated Prevention Measures:
Targets individuals who are exhibiting early signs
or consequences of AOD use.
5
IOM Prevention
Circles within Circles
Selected
Subgroups
Universal Populations
Indicated
Individuals
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Potential Selected Populations







Homeless
Young Offenders
Foster Youths
Drop-outs
Students with social/academic
problems
Rave party-goers
Others
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Intensity of Intervention
High
Indicated
Moderate
Selected
Universal
Low
Low
Moderate
Degree of Risk
High
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Summary
IOM approach requires:
 Better understanding of our community –
communities within communities.
 Tired approach in thinking about prevention
services.

U.S.I
Thoughtful application of prevention
approaches to the three types of populations.
But it gives us:
 Better focus on AOD problems and individuals
involved/impacted by AOD use.
 Potentially better measurements of success.

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Strategic Prevention Framework
SPF
PURPOSE




Formalize a planning and
implementation approach
Decrease substance use and abuse
Promote Mental Health
Prevent Mental Health disorders and
reduce co-morbidity and relapse
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Strategic Prevention Framework Process
STEP 1 – ASSESSMENT
Profile population needs, resources, and readiness to
address the problems and gaps in service delivery
STEP 2 – CAPACITY BUILDING
Mobilize and/or build capacity to address needs
STEP 3 – PLANNING
Develop a Comprehensive Strategic Plan
STEP 4 – IMPLEMENTATION
Implement evidence-based prevention programs and
infrastructure development activities
STEP 5 – EVALUATION
Monitor process, evaluate effectiveness, sustain
effective programs/activities, and improve or replace
those that fail
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SPF Assumptions
i.
ii.
iii.
iv.
v.
Views health promotion across the
spectrum of Prevention – Intervention –
Treatment.
Requires Prevention and Treatment
services (AOD/MH) to work together.
Focus on community based approaches
Planning for outcomes underlies the SPF
approach.
Outcomes measures have been identified
(NOMS)

10 Domain Area impacting Mental Health,
Prevention, Treatment.
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SPF
IOM
EXAMPLE
Apply SPF Steps
1. Assessment
- Data Collection
- Data Analysis
IOM Concepts
What do we know about our
populations
- Who are most
vulnerable
- What are their
characteristics
- What risks /
behaviors are
present in their
lives.
(Measurement?)
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SPF
IOM
EXAMPLE
Apply SPF Steps
1. PLANNING
- Resource Issue
- Selecting
policies,
strategies,
program
services that
FIT best with
IOM population
under
consideration
IOM Concepts
What do we develop
prevention services for:
- Which vulnerable
population
- What specific needs /
issues are being
addressed
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www.cars-rp.org
PHONE 916-983-9506
FAX 916-983-5738
[email protected]
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TA/TRAINING SERVICES (CPI)
1. Review of current practices (needs-based
planning)
2. Assessments of community readiness to
implement SPF
Strengths
Areas for Improvements
3. Develop of SPF process specific to community
needs
(sub-populations)
4. Ongoing TA/Trainings specific to community needs
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