STEP 1: Assessment

The first step in the SPF model is to systematically gather and analyze local data related to the substance misuse and abuse problem. These data will help you do the following:

  • Identify the nature and extent of the substance misuse and abuse problem in different groups within your community, including those defined by age, gender, race/ethnicity, or other demographic characteristics
  • Identify the geographic areas where the problem is greatest
  • Define one or more target populations (e.g., middle school youth, high school youth, young adults)
  • Identify intervening variables (factors linked to substance misuse and abuse in your community)
  • Determine your community’s perception of the problem
  • Determine whether your community or organization is ready to address the problem and what additional resources may be needed

These data will also serve as a baseline for program monitoring and evaluation.

STEP 1: Assessment comprises the following primary tasks:

TASK 1: Collect Data to Assess Needs

Local data can help you better understand the problem of substance misuse and abuse in your community. Both quantitative and qualitative data are useful to the assessment process.

Quantitative Data

Quantitative data are usually reported numerically—often as counts or percentages. These data may help you identify the extent of substance misuse and abuse in your community, the related consequences, and the areas and groups most affected by the problem.

 

Data on consumption patterns describe substance misuse and abuse in terms of the frequency or amount used. For example:

·       Percentage of youth ages 12–17 reporting current (within the past 30 days) use of alcohol

·       Percentage of young adults ages 18–21 reporting binge drinking in the past year

·       Percentage of young adults ages 16–21 reporting drinking and driving in the past year

 

Data on consequences (the social, economic, and health problems associated with alcohol misuse and abuse, including increased mortality, morbidity, injury, school dropout, and crime)27 can help you better understand the alcohol misuse and abuse issue in your community.

Quantitative data may be mined or gathered from a number of sources:

Note: Local data specific to your community may not be as readily available as state or national data. When collecting data from your local target area, it’s ideal to use the same questions and wording as used in the national and state surveys, whenever possible, in order to standardize data collection and allow for comparisons across different areas.

  • Interviews and/or focus groups
  • Public safety data (e.g., fire department data on emergency medical services for alcohol-related injury)
  • Records from public meetings or forums
  • Law enforcement data and police reports (e.g., alcohol-related arrests, including juvenile arrests and DUIs)
  • Department of Justice data (e.g., outcomes of criminal cases related to alcohol misuse)
  • School incident and discipline reports
  • Hospital data (e.g., discharge codes for alcohol-related admittances)
  • Emergency department admittances

See Archival and Survey Data Sources for Underage Drinking: A Community Data Checklist for more suggestions.

Qualitative Data

Qualitative data are usually reported in words. Sources of qualitative data include key stakeholder interviews, focus groups, case studies, and observation. These data may help you gain a deeper understanding of the substance misuse and abuse problem in your community by offering insight into the beliefs, attitudes, and values of various stakeholders. Common methods for obtaining qualitative data include key stakeholder interviews, focus groups, case studies, and testimonials.

When collecting qualitative data, it is important to use methods that are culturally competent and appropriate. For example:

  • When developing your interview or focus group guide, carefully review all questions to make sure that they will not be perceived as too personal or inappropriate
  • Consider any translation needs
  • Make sure that the interviewers or group facilitators reflect the composition of the group being interviewed
  • Select an accessible meeting space
  • Consider providing childcare if needed
TASK 2: Identify Intervening Variables

Intervening variables are factors that have been identified through research as having an influence on substance misuse and abuse. They include risk factors that have been shown by research to predict substance misuse and abuse, and protective factors that exert a positive influence or buffer against the negative influence of risks.

 

Examples:

  • Risk factors for underage alcohol consumption: Low perception of risk or harm, ineffective family management or parental monitoring, youth social and commercial access.
  • Protective factors for underage alcohol consumption: Effective family management techniques, positive school climate

 

Risk and protective factors can be found at different levels, such as individual, peer, family, and community, and they can be measured using both quantitative and qualitative data. There are many ways to organize and compare the data you gather in order to help you prioritize them; see an example here.

TASK 3: Assess Community Readiness and Resources

Assessing your community’s readiness to address the substance misuse problem and the existing resources that may be dedicated to this purpose will help you identify the most appropriate and feasible prevention and reduction strategies to implement in your community.

Assessing Community Readiness

An assessment will help you determine your community’s level of awareness of, interest in, and ability and willingness to support substance misuse and abuse prevention initiatives.

 

Readiness assessments should reflect principles of cultural competence by involving representatives from across sectors in planning and data collection and by collecting information in ways that are appropriate and respectful.

Assessing Resources

Identifying and assessing the resources that exist to address substance misuse and abuse in your community will help you identify potential resource gaps, build support for prevention activities, and ensure a realistic match between identified needs and available resources.

 

When people hear the word resources, they often think of staff, financial support, and a sound organizational structure. However, resources may also include the following:

·       Existing community efforts to address the prevention and reduction of substance misuse and abuse

·       Community awareness of those efforts

·       Specialized knowledge of prevention research, theory, and practice

·       Practical experience working with particular populations

·       Knowledge of the ways that local politics and policies help or hinder prevention efforts

 

It is important to focus your assessment on relevant resources (i.e., resources related to your priority problem). A well-planned and focused assessment will produce far more valuable information than one that casts too wide a net. At the same time, keep in mind that useful and accessible resources may also be found outside the substance abuse prevention system, including among the many organizations in your community that promote public health.

TASK 4: Analyze the Assessment Data

By identifying the types and the extent of substance misuse and abuse, and the populations and areas most affected, you can better understand the actual problem in your community.

Analyzing Quantitative Data

Examine the quantitative data you have collected to see if specific groups of people or other factors stand out. HealthyPeople 202028 defines health disparity as “a health outcome [that] is seen in a greater or lesser extent between populations”

 

Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion.

 

Do any of your data suggest a particular impact on a group or subpopulation who may be vulnerable to health disparities? For example:

·       Is alcohol more accessible and available in a specific urban neighborhood vs. another?

·       Are there gender differences in use patterns or with respect to risk and protective factors?29

 

If quantitative data are available for multiple years, then examining trend data may suggest factors that influence substance misuse and abuse and/or intervening variables.

Example: If there was a sharp rise in binge drinking in the past year, what happened or what changed that may explain this? Did your community see an influx of an at-risk population? Was there a decrease in retail access initiatives?

 

Examine local data in relation to state data to determine if there may be something unique or unusual about the community associated with substance misuse or its intervening variables. Is there something different about the problem in your community? Does the difference point to an intervening variable that may be important, or perhaps to a strategy to consider later in the process?

Analyzing Qualitative Data

The first step when analyzing qualitative data is to read and reread the materials you have gathered (e.g., key stakeholder interviews, focus group notes, answers to open-ended survey questions) and identify the different themes that emerge for each question. To increase confidence in the process, it is best to have two or more people do this independently. The themes generated by each coder are then compared. If the themes identified by coders differ, the coders need to reconcile their views and reach consensus.

 

Record and report comments for each theme (verbatim responses or quotes may be preferred) and count the number of respondents who mentioned each theme. This is a good indicator of the importance of a particular theme to participants. In addition, be sure to note the passion and strength of respondents’ comments, which is likewise important.

Comparing the Data

Compare quantitative data with qualitative data or vice versa to see if they reinforce one another or raise new questions. Do any of the qualitative data shed additional insight into why the problem exists or who experiences it?

 

Analyzing the data you collected during the assessment process will help you answer a key question: “Why are substance misuse and abuse happening here?” This may help you select strategies that get to the unique root causes of substance misuse and abuse in your community.

TASK 5: Develop Your Problem(s) Statement

Crafting a clear problem statement will help you focus on where to build capacity and how to measure outcomes and plan for sustainability. Interventions without a clearly articulated problem statement may lose steam over time; it’s also difficult to know whether they have made a difference. Communities should use their data about consumption, consequences, readiness, and resources to frame their problem statement in specific terms.

A good problem statement will meet each of the following criteria:

  • Identify one issue or problem at a time
  • Avoid blame (e.g., say, “Young people do not have enough positive activities” rather than, “The kids here have nothing to do and are troublemakers”)
  • Avoid naming specific solutions (e.g., say, “Young people in our neighborhood are getting into trouble during after-school hours” rather than “We don’t have a youth center”)
  • Identify outcomes that are specific enough to be measurable
  • Reflect community concerns as heard during the assessment process

Examples of good problem statements:

  • Too many college freshmen in our community (22%) report binge drinking on a regular basis (weekly)
  • Too many eighth-graders (15%) in our town report trying alcohol for the first time

Some communities find that they need to develop more than one problem statement. For example, you may need to develop a problem statement that addresses an issue related to consumption and one that addresses an issue related to consequences.

When you develop your problem statement, be sure to describe what actually exists that is problematic, rather than what is lacking.

Example: A problem statement that reads “Teachers lack training on how to address students drinking in school” assumes that addressing this lack by offering training alone will solve the problem. In reality, many factors may also contribute to the problem.

A better statement might be, “The number of high school students who are misusing alcohol is higher than the national average.”

Defining a problem simply as a lack of something will narrow your planning focus and direct energy and resources to strategies that are not likely to be sufficient on their own, while other important factors are missed.

Keeping the focus on the priority behaviors, consequences, and/or underlying intervening variables at this stage in the planning process will help you select a comprehensive array of strategies that will be more effective in addressing the problems you have identified.

TASK 6: Gauge Your Groups Cultural Competence

Step 1 is a good time to find out how your group is currently functioning in regard to cultural competence. The following questions can help you assess your group’s strengths and weaknesses in this area:30

  • Does your community assessment include information about the major cultural groups in your community?
  • Do members of diverse group(s) assist in the analysis and interpretation of your data?
  • Does your organization or coalition engage all sectors of the community in community-wide prevention efforts?
  • Are all groups adequately represented or “at the table”?
  • Do your organizational plans incorporate cultural competence concepts?

 

More information on cultural competence is available here.