August Monthly Newsletter
Sustaining Prevention Programming During a Pandemic
In this Issue:

  • Sustaining Prevention Programming During a Pandemic
  • Additional Resources
  • What's Happening Around the Region?
  • Epi Corner: Sustainability: A Data-Driven Dynamic Process

As I write this article, the world remains in crisis due to the corona virus pandemic. Many of us have to restrict our activities and work under very stressful conditions, and the immediate future is uncertain as individuals, local communities, states, and countries deal with a pandemic that is causing turmoil and loss of life across the country and the world. The challenges are numerous. Those of us who have dedicated our professional and/or personal life to preventing negative outcomes due to the misuse of alcohol, tobacco, and other drugs have been tasked with continuing services using different modes of communication and contact with participants and stakeholders. This increases the challenge to provide services that have the reach and strength to protect the members of our communities; yet, It is vitally important that the prevention profession continues to provide services that protect community members and make individuals and groups healthy and successful.

Sustaining effective prevention programs is challenging in the best of times. Many funding agencies only provide support for three to five years. There are exceptions such as the Drug-Free Communities Program which allows successful programs to apply for a second five years of funding, allowing for programs to be funded for a maximum of ten years. Many times it takes some time for a new project to reach full implementation and achieve meaningful outcomes. It is detrimental to a community when a program that is effective is abandoned due to a lack of funds and support. Intentionally attending to the factors that make prevention efforts sustain over time and developing sustainability plans from the outset of the program make it more likely that the program will last.

One of the major challenges in prevention work is how to sustain effective prevention activities as funding cycles end and new sources of support are needed to keep projects operating. Sustainability is an important area of emphasis for any prevention project. There have been many attempts at developing guidance on how to sustain effective outcomes over time. The guidance varies in the level of research support that informs the recommendations. As we continue to advance the field of prevention, it becomes even more important to use “evidence-based” approaches to sustaining programs. One model that has been used by various federal and state agencies is based on an article published by Johnson, Hays, Center, & Daley (2004). This article was developed using an extensive literature review and several “think-tanks” that were conducted across the country with local prevention providers, state-level prevention providers, and federal prevention staff. The model has received continuing research support by Johnson and others (Johnson, Collins, & Wandersman, 2013; Johnson, Collins, Shamblen, & Wandersman, 2017) and provides evidence that intentionally attending to and planning for sustainability makes it more likely that effective prevention activities will sustain over time.

The Johnson et.al. (2004) sustainability model includes ten actions that should be the focus of any plan to sustain effective programs and practices. More information on these actions can be found by accessing the article cited above. I would like to focus on two actions that are vitally important at this point. Sustainability plans need to focus on: 1) the relationships between all the stakeholders and the prevention providers, and 2) the development and nurturance of champions for the program or practice. Studies indicate that the quality of relationships among stakeholders, committee members, contractors (such as an independent evaluator), and prevention staff increase the likelihood of sustaining the effort. This is challenging, especially in these times, but efforts to continue to have regular meetings, sending newsletters, and posting in social media should continue and possibly be increased so that everyone stays connected to the program. Using technology, meetings can be held remotely using platforms that are easy to access and provide for face-to-face meetings. Also, a special emphasis should be focused on keeping program champions informed about services that are being provided and adaptations that are being implemented. Evaluation plans may need to be modified as evidence-based programs are adapted, when possible, to continue to provide services remotely. Communication channels need to be used often to keep stakeholders and champions informed that services are continuing, even in these challenging times.

Preventionists are resilient, persistent, and creative. Coming up with innovative methods to deal with new challenges is important in today’s world. The global pandemic is stressing many of our mental health, substance use disorder, and prevention providers. The need for effective programs and policies is even more important during these stressful times. The work we do in prevention is important and does make a difference. We need to redouble our efforts to provide effective programs in our communities, states, country, and around the world. We need to also use approaches that can make a difference today and be sustained tomorrow and far into the future. 
 
References  
Johnson, K., Hays, C., Center, H., & Daley, C. (2004). Building capacity and sustainable prevention Innovations: A sustainability planning model. Evaluation and Program Planning, 27, 135-149.
 
Johnson, K.W., Collins, D., & Wandersman, A. (2013). Sustaining innovations in community prevention Systems: A data-informed sustainability strategy. Journal of Community Psychology, 41(3), 322-340.
 
Johnson, K.W., Collins, D., Shamblen, S., Kenworthy, T., Wandersman, A. (2017). Long-term sustainability of evidence-based preventive interventions and community coalition survival: A five-and one-half-year follow up study. Prevention Science, 18(5), 610-621.
Hayden D. Center, Jr., Ph.D.
 
Dr. Hayden D. Center, Jr. was most recently on faculty at Auburn University at Montgomery in the Department of Psychology, where he taught for ten years. He is also a licensed professional counselor specializing in addiction issues and has worked as a consultant in alcohol, tobacco, and other drug abuse prevention for over 30 years
Additional Resources
Pandemic Response Resources
Prevention Technology Transfer Center
The Pandemic Response Resources page on the Prevention Technology Transfer Center provides numerous resources as you seek to sustain your evidence based prevention efforts. Federal, PTTC network training, products, toolkits, leadership tools and modifications are just a few of the things you’ll be able to explore.
 
Focus on Prevention
Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention
This manual helps communities plan and deliver substance use prevention strategies. It covers conducting needs assessments, identifying partners, creating effective strategies for marketing and program evaluation. The manual also offers a sample timeline of tasks.
 
A Sustainability Planning Guide for Healthy Communities
Center for Disease Control (CDC)
The Sustainability Planning Guide is a synthesis of science- and practice-based evidence designed to help coalitions, public health professionals, and other community stakeholders develop, implement, and evaluate a successful sustainability plan.
 
Sustainability: Fostering Long-Term Change to Create Drug Free Communities Primer
Community Anti-Drug Coalitions of America (CADCA)
This primer builds on others in the Strategic Prevention Framework series by laying out a framework and describing key considerations and action steps for coalitions to include in their journey to sustainability planning.
What's Happening Around the Region?
Now Available!

New SSW PTTC Online Course! Opioid Overdose Prevention and Infectious Disease Control: Opportunities for Collaboration
This free 3-hour online course is designed to increase the capacity of prevention practitioners to collaborate with infectious disease control practitioners. The course focuses on how opioid misuse and overdose prevention strategies can be coordinated with infectious disease control efforts in order to align resources, increase access to focus populations, and address shared risk and protective factors.

Your Guide to Integrating HCV Services into Opioid Treatment Programs and the Opioid and Infectious Disease Control Online Course
The opioid epidemic has resulted in significant increases in Hepatitis C Virus (HCV) among people who inject drugs, accounting for 23% of new infections. HCV is completely curable, and testing and treatment are the path to cure. Opioid Treatment Providers (OTPs) play a critical role in comprehensive approaches to addressing HCV and this guide is one tool to help.

Your Guide to Integrating HCV Services into Opioid Treatment Programs can help build the capacity of publicly funded OTPs to integrate HCV prevention and treatment services into their programs. This guide may also be useful for Federally Qualified Health Centers (FQHCs), community and healthcare coalitions, nonprofit organizations and other substance use disorder and HCV treatment providers.  
Prevention Technology Transfer Center, Substance Abuse Prevention Skills Training (SAPST) Trainer Learning Community and Materials Portal

The PTTC Network now has a Learning Community and Materials Portal specifically for SAPST trainers and training coordinators who plan and coordinate the delivery of the SAPST four-day face-to-face training. Inside this virtual community, one will have access to the updated SAPST materials, upcoming SAPST and SAPST ToT events, and training tips from SAPST master trainers. Individuals will be able to connect with other SAPST trainers from across the U.S. and share ideas and resources. To register for the PTTC SAPST Trainer Learning Community and Materials Portal, visit www.tinyurl.com/SAPSTLearningCommunity.

For more information about how the PTTC Network supports the SAPST please visit: https://pttcnetwork.org/centers/global-pttc/network-sapst.
More Prevention Online Courses
All online courses can be accessed at: healtheknowledge.org/courses
 
If you are new to HealtheKnowledge, please log in or set up an account here: healtheknowledge.org/new-user
2020 PFS Academy: Making the Steps of the Strategic Prevention Framework Work for You.

Each webinar will begin at 8:00 PT/9:00 MT/10:00 CT/11:00 ET

SAMHSA’s Strategic Prevention Framework (SPF) provides practitioners with comprehensive guidance to more effectively address substance misuse and related behavioral health problems in their communities. This seven-part webinar series will explore this five-step, data-driven process to identify genuine prevention needs, build capacity and plans to address those needs, implement effective programs and interventions, and evaluate and continually improve prevention efforts.

At each step of the SPF, and in separate sessions, practitioners will learn to incorporate the guiding principles of cultural competence and sustainability to help support the implementation of SAMHSA’s Strategic Prevention Framework (SPF). 

Certificates for prevention hours will be available upon registration and completion of the webinar.
 

Previously recorded training in the series can be found here by clicking on the training tab.
People of Color Learning Community Webinar Series

​​​​The South Southwest Prevention Technology Transfer Center will host five virtual learning community sessions for prevention professionals in Arkansas, Louisiana, New Mexico, Oklahoma, and Texas working in communities of color. The purpose of the learning community is to discuss strategies for creating change that leads to positive outcomes in communities of color. 
 
Session Two
September 1, 2:00 CT / 1:00 MT

Session two will focus on involving communities of color in data collection decision making. Participants will also use the SWOT analysis from session one to inform their work during this session. 
 
Please save the dates for these upcoming sessions!

 October 6, 2020 at 2:00 p.m. CT / 1:00 p.m. MT
 November 4, 2020 at 2:00 p.m. CT / 1:00 p.m. MT
 December 1, 2020 at 2:00 p.m. CT / 1:00 p.m. MT
The South Southwest PTTC is currently suspending in-person training and meetings until further notice. Virtual services will proceed as scheduled.
Epi Corner

Iris Smith, Ph.D., M.P.H.
South Southwest Prevention Technology Transfer Center
Sustainability: A Data-Driven Dynamic Process

Sustainability is one of the guiding principles in SAMHSA’s Strategic Prevention Framework (SPF). It refers to a community’s capacity to sustain positive prevention outcomes over time (SAMHSA, 2019). While many programs achieve their short term outcomes during an initial funding period, it is often more challenging to ensure that these short term outcomes are sustained and lead to long term impact on identified prevention goals. Research on sustainability is limited, but interest in this topic is clearly growing.
 
Planning for sustainability should begin with the first step of the SPF, Assessment. Data collection prior to planning is important in order to understand community demographics, culture, and other contextual/environmental factors. This information is critical to ensure that evidence-based interventions are an appropriate “fit” for the community conditions. Changing community conditions may support or hinder implementation, reduce, or enhance the effectiveness of the intervention strategy. 
 
Ongoing assessment may also provide information about which program components appear to be critical to the overall success of the program. Identifying these “core elements” can inform sustainability planning. Monitoring program implementation including fidelity, recruitment, retention, and attainment of short-term goals is important during implementation. Sharing information about the implementation process with stakeholders may enhance engagement. Using data to identify trends in community indicators may help staff anticipate challenges or adjustments that may need to be made. In fact, community changes may lead to changes in program components or even the need for a different type of intervention over time.1
 
Research on sustainability has shifted from a static view of sustainability to viewing it as a more dynamic process.2 Recent research on sustainability suggests that there are multi-level factors that may influence the longevity and continued success of a prevention program or strategy. These factors include internal processes and capacity, characteristics of staff responsible for implementation as well as characteristics of the intervention itself. Contextual factors such as funding, alignment with the implementing organization’s goals and priorities, and organizational leadership also contribute to the capacity for sustainability. Shelton et al. (2018) propose an integrated sustainability framework which reflects multi-level and dynamic interactions among these factors (Figure 1).3
 
Figure 1: Integrated Sustainability Framework (Shelton, et al., 2018)
Sustainability is a multilevel and dynamic process, supported by ongoing data collection and analysis, engagement of diverse community stakeholders, capacity building, and process and outcome evaluation. In other words, capacity for sustainability is built with each step of the Strategic Prevention Framework (SPF).
 
Resources

Rhoades, BC, Bumbarger BK, Moore JE (2015). Sustaining Evidence-Based Prevention Programs: Correlates in a Large-Scale Dissemination Initiative. Prevention Science 16, pg. 145-157.

Shelton RC, Cooper RH, Stirman SW (2018). The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care. Annual Reviews in Public Health 39, pgs. 55-76.


_____________________________

1 Ibid

2 Shelton RC, Cooper BR, Stirman SW (2018) The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care. Annual Reviews of Public Health 39, pg. 55-76

3 Shelton RC, Cooper BR, Stirman SW (2018). The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care. Annual Reviews in Public Health 39; pg. 66