STEP 3: Strategic Planning

Step 3

Strategic planning is pivotal to prevention success. It brings together all your data collection and capacity-building work to create an overall vision of what your coalition is attempting to do and how it will evaluate the results of its efforts. Strategic planning increases the effectiveness of your prevention efforts by focusing energy, ensuring that staff and other stakeholders are working toward the same goals, and providing the means for assessing and adjusting programmatic direction as needed.

In this step, you will use the information you obtained during Steps 1 and 2 to develop a comprehensive plan and logic model for addressing substance misuse and abuse in your community.

Guidelines for PFS 2015 grantees on developing a strategic plan and logic model are provided in the PFS 2015 Strategic Plan Development Guide and the PFS 2015 Logic Model Development Guide. While the guidelines are targeted to PFS 2015 grantees, the guidance in these resources will also be useful to other groups. 

STEP 3: Strategic Planning comprises the following primary tasks:

TASK 1: Prioritize Intervening Variables

Intervening variables are those factors identified in the literature as being related to substance misuse and abuse, including risk and protective factors present in your community. Identifying these factors and prioritizing among them is a critical part of the SPF planning process.

While different criteria can be used to prioritize these variables, communities often consider two in particular when making this decision:

  • Importance—the extent to which various intervening variables have the potential to meaningfully impact the problem in question
  • Changeability—how easy it would be to change the intervening variable given existing time, resources, and capacity

You may want to select intervening variables that are high in both.

Importance

When weighing the importance of intervening variables, consider the following:

How much does the intervening variable influence the problem?

  • Example: If you identified youth prescription opioid consumption as a problem, and the data show that youth are more likely to obtain prescription opioids from peers (social access) than from pharmacies (via a personal script from a doctor), then social access would be considered high in importance, whereas retail access would be considered low.
  • Does the intervening variable impact other behavioral health issues or other identified problems?
  • Example: A younger age at first prescription is a risk factor for not only initiation into opioid misuse, but also stimulant and tranquilizer misuse.54 Therefore, focusing on this risk factor may impact more than one issue.
  • Do the intervening variables directly impact the specific developmental stage of those experiencing the problem?
  • Example: For the identified problem of NMUPD among high school-age youth, the risk factor of being a member of a social fraternity or sorority is less important than it would be for college-age populations.

Changeability

When assessing the changeability of a factor, you may want to consider the following:

  • Whether the community has the capacity—the readiness and resources—to change a particular intervening variable
  • Whether a suitable evidence-based intervention exists that has been shown to impact the intervening variable
  • Whether change can be brought about in a reasonable time frame—changing some intervening variables may take too long to be a practical solution
  • Whether the changes can be sustained over time

If the community has ample resources and sufficient readiness to address this intervening variable, a suitable evidence-based intervention exists, and sustainable change can occur within a reasonable time frame, then the factor would be considered high in changeability.

If there are not adequate resources or if the community is not ready to address the intervening variable, the changeability of the factor may be low.

Other Considerations

Additional questions you may want to consider when prioritizing intervening variables include:

  • Is the intervening variable identified independently by multiple sources?
  • How reliable and valid are the data supporting it?
  • How actionable is the variable?
  • Are other efforts already in place to change the variable?
  • Does addressing this intervening variable have the potential for unintended consequences?
  • Are data systems in place to effectively evaluate changes in the variable?
TASK 2: Select Interventions

When developing a plan to address substance misuse and abuse in your community, it is important to identify and select strategies that have been shown through research to be effective, are a good conceptual fit and practical fit for your community, and are likely to promote sustained change.

Although it is natural to want to jump directly to strategy selection, this step should only occur after your intervening variables have been identified. The intervening variables should drive strategy selection—not vice versa. 

Evidence of Effectiveness

Literature reviews, published studies, unpublished evaluation findings, and other resources can help you identify strategies with the greatest potential to affect the intervening variables you identified as a priority.

For the PFS 2015 initiative, the Bureau of Substance Abuse Services recommends consulting a SAMHSA/CSAP publication, Identifying and Selecting Evidence-Based Interventions for Substance Abuse Prevention, as the basis for determining the extent to which a strategy has suitable evidence of effectiveness.

While there are few published studies demonstrating NMUPD prevention outcomes at the community level, nonetheless, a number of resources can assist prevention practitioners in identifying evidence-based strategies in this area, for example:

For each strategy you consider:

  • Review the research evidence that describes how the strategy is related to your selected intervening variable(s)
  • Based on this evidence, present a rationale describing how the strategy addresses the intervening variable(s)

Conceptual Fit

Think about how relevant the strategy is to your community and how it is logically connected to your intervening variable(s) and desired outcomes. To determine conceptual fit, consider the following questions:

  • Has the strategy been tested with the identified target population? If so, how? If not, how can it be applied to this population?
  • How will implementing this strategy in your local community help you achieve your anticipated outcomes?

Practical Fit

Given your community’s readiness, population, and general local circumstances, how effectively could you implement this strategy? Consider the following:

  • Resources—cost, staffing, access to target population, etc.
  • Organizational or coalition climate—how the strategy fits with existing prevention or reduction efforts, the organization’s willingness to accept new programs, buy-in of key leaders, etc.
  • Community climate—the community’s attitude toward the strategy, buy-in of key leaders, etc.
  • Sustainability—community ownership of the strategy, renewable financial support, community champions, etc.

Selection

Based on your analysis, select a strategy or strategies that you propose to implement to prevent NMUPD among your target population.

If there is not an evidence-based strategy for your target population and the intervening variables you’ve chosen, you may propose another strategy, but you must be able to make a case for it based on available evidence.

TASK 3: Develop a Comprehensive Plan that Aligns with the Logic Model

At this point in the SPF process, you have identified your community’s priority problem(s), intervening variables, and resources and readiness. Additionally, you have identified appropriate strategies for addressing NMUPD among high school-age youth within your community. The next step is to bring all these elements together to create an overall vision of what your group is attempting to do and how you will evaluate the results of your efforts.

Developing a comprehensive plan requires you to do the following:

Establish Outcomes for Each Strategy

For each selected strategy, you will need to establish measurable outcomes:

  • Identify the intervening variable being addressed
  • Indicate the strategy you have chosen
  • List the anticipated outcomes: short-term (the change in the target group who received your strategy), intermediate (the change in the intervening variable), and long-term (the ultimate impact of the strategy on the issue identified in your problem statement)

Example:

  • Problem statement: The rate of current misuse and abuse of prescription pain relievers among high school students (8%) in our community has increased by 10% over the past five years.
  • Intervening variable: Low levels of parental disapproval44
  • Strategy: Parent media campaign
  • Outcomes:
    • Short-term: Increase in parents’ awareness of NMUPD as an issue
    • Intermediate: Increase in parents’ level of disapproval of NMUPD
    • Long-term: Decreased current (30-day) misuse and abuse of prescription pain relievers among high school students

Identify Resources for Implementation

Specify all resources needed to implement each selected strategy and to measure the related outcomes. Be sure to consider the following:

  • Human resources—staffing, partnerships, volunteers, coalition membership, etc.
  • Skills—prevention and intervention knowledge and skills, data collection and analysis, etc.
  • Fiscal resources—both monetary and in-kind
  • Material resources—space, equipment. etc.
  • Existing resource gaps that will limit your ability to effectively implement the selected strategy or strategies

Develop a Logic Model

A logic model is a chart that describes how your effort or initiative is supposed to work and explains why your intervention is a good solution to the problem at hand. Effective logic models depict the activities that will bring about change and the results you expect to see in your community. A logic model keeps program planners moving in the same direction by providing a common language and point of reference.

Logic models may be used for various purposes (program planning, implementation, evaluation, etc.) and can feature different elements (inputs, activities, outputs, outcomes, etc.).

Use the information you gathered in Steps 1 and 2 of the SPF to develop a community-level logic model that links local problems, associated intervening variables, evidence-based strategies, and anticipated outcomes. Your logic model should include the following categories:

  • BSAS-Identified Problem: State why the Bureau of Substance Abuse Services (BSAS) has made the grant dollars available—for BSAS initiatives, this is taken from the RFR (Request for Response)
  • Local manifestation of the problem: Describe the extent of the substance misuse and abuse problem within the local community—this is your problem statement from Step 1
  • Intervening variable(s): List the risk and/or protective factors that research has shown to be associated with substance misuse and abuse and are present within your community
  • Strategies: List the programs, policies, and/or practices chosen to address the intervening variable(s); these should be evidence-based, with measurable outputs (such as number of advertisements placed, sessions conducted, or persons trained)
  • Target group: Describe the intended audience(s) or population(s) of interest
  • Outputs: List concrete measures of the extent to which the strategies are being implemented as planned, usually measured as “counts”
  • Expected outcomes (short-term, intermediate, and long-term)
  • Complete a logic model for each problem identified (i.e., each problem statement) and include additional rows for each intervening variable you’ve targeted.
  • A sample logic model and template are provided in the PFS 2015 Logic Model Development Guide.

Develop an Action Plan

An action plan is the detailed sequence of steps that must be taken for a strategy to succeed. It is one component of your larger strategic plan. An action plan states:

  • What needs to be accomplished
  • Who is responsible
  • The timeline for completion
  • How you will measure success

An Action Plan Example and Template are available here.

When developing an action plan:

  • Have a clear objective
  • Start with what you will do now
  • Clearly define the steps you will take
  • Identify the end point for each step
  • Arrange the steps in logical, chronological order, and include the date by which you will start each step
  • Anticipate the types of problems you might encounter at each step, and brainstorm solutions.

Your action plan should be comprehensive, logical, and data-driven; it should include your community-level logic model, plans for addressing identified resource and readiness gaps, and how you have and will address issues of sustainability.

Keep in mind that good planning requires a group process. Whether decisions are made within a formal coalition or among a more informal group of partners, these decisions cannot represent the thoughts and ideas of just one person; they must reflect the ideas and input of individuals from across community sectors.

Your action plan should also include how you have and will address issues of cultural competence. To increase your group’s cultural competence, you’ll need to be open to modifying your planning and thinking processes to reflect the preferences of the target population(s).

Examples:

  • Some American Indian and Alaska Native communities prefer planning processes that are circular, such as using a Mind Map to brainstorm rather than a linear list or table.
  • Faith-based organizations may believe that action-oriented plans should be tempered by other forms of spiritual guidance about the best way to move forward.
  • As noted by the Community Anti-Drug Coalitions of America and the National Coalition Institute,56 members of your coalition may come to the table with different levels of understanding regarding substance misuse and abuse and how to plan, implement, and evaluate interventions. Some may not be familiar with logic models or may not understand how a formal logic model may differ from their usual approaches.

Ideally, you will not start working on a logic model until all coalition members understand and are comfortable with the process. Several training sessions may be needed to get everyone to the same baseline of understanding, thereby promoting fruitful discourse and consensus building.

Listening to and incorporating different viewpoints will help you develop a plan that is culturally competent and shows respect for participants’ values, and is therefore more likely to succeed.56

Develop an Evaluation Plan

It is a common misperception that evaluation starts only at the end of a project. Ongoing monitoring and evaluation are essential to determine whether your desired outcomes are achieved and to assess the effectiveness and impact of your intervention and the quality of service delivery. Data collection for evaluation purposes should be built into the project design and should be part of your strategic plan.

Your evaluation will ultimately affect the sustainability of your intervention.

You will need to make sure that all relevant baseline information is collected before implementing your intervention, and make plans to track outcomes over time by collecting quantitative and qualitative data. In addition, you should have a plan for securing and maintaining the commitment of community members, agencies, and other strategic partners who will be involved in the evaluation. By fostering relationships among all the partners involved, it is more likely that they will be inclined to provide political support, cooperation, volunteers, and other resources on a long-term, ongoing basis. Your evaluation plan will also monitor how well your group is functioning and identify areas for improvement.

For more on program evaluation see Step 5: Evaluation.