Domain I: Planning and Evaluation

Question 1

The Behavioral Health Continuum of Care
is a _____________________

Answer 1

classification system that presents the scope of behavioral health interventions and services, including: promotion of health, prevention of illness/disorder, treatment, and maintenance/recovery.

Question 2

Continuum of Care: Prevention

Answer 2

focuses on interventions that occur prior to the onset of a disorder and which are intended to prevent the occurrence of the disorder or reduce risk for the disorder.

Question 3

Continuum of Care: Promotion

Answer 3

involves interventions (e.g., programs, practices, or environmental strategies) that enable people “to increase control over, and to improve, their health.”

Question 4

What are the three types of Prevention interventions?

Answer 4

Universal - focus on the “general public or a population subgroup that have not been identified on the basis of risk.”

Selective - focus on individuals or subgroups of the population “whose risk of developing behavioral health disorders is significantly higher than average.”

Indicated - focus on “high-risk individuals who are identified as having minimal but detectable signs or symptoms” that foreshadow behavioral health disorders, “but who do not meet diagnostic levels at the current time.”

Question 5

What is included in Treatment according to the Behavioral Health Continuum of Care model?

Answer 5

case identification and standard forms of treatment (e.g., detoxification, outpatient treatment, inpatient treatment, medication-assisted treatment).

Question 6

What is included in Recovery according to the Behavioral Health Continuum of Care model?

Answer 6

standard treatment, Long Term treatment, & After Care/Rehabilitation

Question 7

What is included in Maintenance according to the Behavioral Health Continuum of Care model?

Answer 7

interventions that focus on participation in long-term treatment to reduce relapse/reoccurrence, and aftercare including rehabilitation and recovery support.

Question 8

behavioral health (def’n)

Answer 8

“a state of emotional/mental well-being and/or choices and actions that affect health and wellness”

used to describe the service systems surrounding the promotion of mental health, the prevention and treatment of mental health disorders and substance use disorders, and recovery support

Question 9

What are the 6 CSAP prevention strategies?

Answer 9

1. Dissemination of Informatiom
2. Prevention Education
3. Alternative Activities
4. Community based processes
5. Environmental Approaches
6. Problem Identification & Referral

** see study guide book for what occurs during each strategy **

Question 10

Environmental strategies are prevention efforts aimed at ____________________________________

Answer 10

changing or influencing community conditions, standards, institutions, structures, systems and policies. Environmental strategies enhance public health by altering the physical, social, legal, and economic conditions that influence behavior.

Question 11

Data collected during the assessment step of the SPF helps to answer what questions?

Answer 11

● What are the problems and related behaviors that are occurring in the community?

● How often are the problems and related behaviors occurring?

● Where are the problems and related behaviors occurring?

● Which populations are experiencing more of the problems and related behaviors?

● What are the risk and protective factors that influence problems and related behaviors in the community?

Question 12

Strategies focused on changing the community environmental context that influence individual behavior include:

Answer 12

● Enhance access/reduce barriers — Improving systems and processes to increase the ease, ability and opportunity to utilize systems and services (e.g., access to treatment, childcare, transportation, housing, education, cultural and language sensitivity).
In prevention efforts, this strategy can also be “turned around” to ‘reduce access/enhance’ barriers, for example, reducing access and enhancing barriers to purchasing alcohol, tobacco products or marijuana for people under 21.

● Change consequences (incentives/disincentives) — Increasing or decreasing the probability of a specific behavior that reduces risk or enhances protection by altering the consequences for performing that behavior (e.g., increasing public recognition for desired behavior, individual and business rewards, taxes, citations, fines, revocations/loss of privileges).

● Change physical design — Changing the physical design or structure of the environment to reduce risk or enhance protection (e.g., parks, landscapes, signage, lighting, outlet density).

● Modify/change policies — Formal change in written procedures, by-laws, proclamations, rules or laws with written documentation and/or voting procedures (e.g., workplace initiatives, law enforcement procedures and practices, public policy actions, systems change within government, communities and organizations).

● Various Communication Strategies

Question 13

Prevention professionals use __________________ to plan prevention initiatives.

Answer 13

SAMSHA Strategic Prevention Framework (SPF)

Question 14

What is the SPF?

Answer 14

5 step planning process that guides the selection, implementation, and evaluation of evidence-based, culturally appropriate, sustainable prevention activities

Question 15

The SPF begins with ___________________ and depends on ________________________

Answer 15

a clear understanding of community needs; the involvement of community members in all stages of the planning process.

Question 16

What are the 5 steps of the SPF?

Answer 16

1. Assessment - Collect data to define behavioral health problems and needs within a geographic area.
2. Capacity - Mobilize and/or build capacity within a geographic area to address identified needs.
3. Planning - Develop a comprehensive, data-driven plan to address problems and needs identified in the assessment phase.
4. Implementation - Implement evidence-based prevention programs, policies, and practices.
5. Evaluation - Measure the impact of implemented programs, policies and practices.

** Sustainability and cultural competence should be integrated into all steps of the SPF.

Question 17

In the SPF, the first step ASSESSMENT helps communities ______________________________

Answer 17

better understand the extent and nature of behavioral health problems present in the community

• AKA needs assessment

Question 18

What should be considered to prioritize results from Assessment?

Answer 18

Magnitude - Which problem/behavior is most widespread in the community?

Severity - Which problem/ behavior is most serious?

Trend - Which problem/ behavior is getting worse or better?

Changeability - Which problem/behavior are you most likely to influence with your prevention efforts?

Question 19

What are the types of resources that need to be assessed to address the problem?

Answer 19

● Fiscal resources – such as grants and donations, and tangible, physical resources such as meeting space and supplies

● Human resources – such as trained staff, consultants, volunteers, stakeholders, partners, local champions

● Organizational resources – such as vision and mission statements aligned with the prevention effort, and organizational policies, organizational budgets, and technology

● Community resources – such as previous efforts to address the problem, local policies and regulations, community awareness of the problem

Question 20

What are the 9 stages of readiness according to the Community Readiness Model?

Answer 20

STAGE 1 – Community Tolerance/No Knowledge: The community or leaders do not generally recognize that there is a problem. Community norms may encourage or tolerate the behavior in social contexts.

STAGE 2 – Denial: There is some recognition by some members of the community that the behavior is a problem, but little or no recognition that it is a local problem.

STAGE 3 – Vague Awareness: There is a general feeling among some in the community that there is a local problem and that something ought to be done, but there is little motivation to act.

STAGE 4 – Preplanning: There is clear recognition by many that there is a local problem and something needs to be done. There may be a committee to address the problem, but no clear idea of how to progress. No action to address problem/beginning stage of acknowledging the necessity of dealing with the problem

STAGE 5 – Preparation: The community has begun planning and is focused on practical details. Leadership is active and energetic. Decisions are being made and resources are sought and allocated. Pros/Cons of prevention activities , actions, and/or policies may not be based on collected data

STAGE 6 – Initiation: Data are collected that justify a prevention program. Action has begun. Staff are being trained. Stereotypes exist of risk factor knowledge

STAGE 7 – Institutionalization/Stabilization: Several planned efforts are underway and supported by community decision makers. Staff are trained and experienced. No in-depth evaluation for effectiveness; No perceived need for change or expansion

STAGE 8 – Confirmation/Expansion: Programs have been evaluated and modified/Support for expansion and/or improvement in efforts to deal with the problem; Leaders support expanding funding and scope. Data are regularly collected and used to drive planning.

STAGE 9 – Professionalism/High Level of Community Ownership: Universal, selective, and indicated efforts are in place for a variety of focus populations. Staff is well trained and experienced. Effective evaluation is routine and used to modify activities. Community involvement is high.

Question 21

What are the 3 ways to increase resources and improve readiness?

Answer 21

1) Engage diverse community stakeholders
2) Develop and strengthen a prevention team
3) Raise community awareness of the problem to be addressed

Question 22

What are the 3 tasks involved in planning prevention program/intervention according to the SPF?

Answer 22

1. Prioritize risk and protective factors associated with the identified priority
2. Select prevention interventions that are evidence based, most likely to influence the identified risk factors (conceptual fit), and feasible and relevant to the focus population (practical fit).
3. Develop a comprehensive, data-driven prevention plan

Question 23

Planning stage of SPF: Prioritizing Risk and Protective Factors

Answer 23

IMPORTANCE and CHANGEABILITY can be used to help decide which risk or protective factors to address with prevention interventions

• Importance - how much/how strongly a risk or protective factor impacts the targeted behavioral health problem in a community
• Changeability refers to 3 issues:

● Whether the community has the capacity to change a particular risk or protective
factor
● Whether a suitable evidence-based intervention exists to address a particular problem
● Whether change can be brought about in a reasonable time frame

Question 24

3 criteria for Selecting effective interventions with good “fit” (planning stage of SPF)

Answer 24

● Effectiveness: Is the intervention effective?

● Conceptual fit: Will the intervention(s) impact the selected risk or protective
factor?

● Practical fit: Is the intervention appropriate to the community, and/or the specific population or subgroup of focus?

Question 25

Questions to ask to assess conceptual fit

Answer 25

● Does it address the targeted problem? ● Does it address the risk/protective factors and conditions associated with the problem? ● Does it focus on a relevant population and/or context?

Question 26

Questions to ask to assess practical fit

Answer 26

● Is it feasible? Does the community have the resources needed for the intervention? ● Is there synergism? Does the intervention add to or reinforce other prevention interventions? ● Is the community ready? Will stakeholders and the community support the intervention? ● Is the intervention culturally relevant? Will the cultural groups that are the focus of the intervention be receptive to it? Are they involved in the planning and implementation?

Question 27

A comprehensive prevention plan (planning stage of SPF) includes:

Answer 27

● A description of the priority problem and why it was selected ● A list of the prioritized risk factors and how they were prioritized ● A description of community resources, resource gaps, readiness, cultural issues, and how challenges will be addressed ● A description of the interventions chosen to address the selected risk factors ● A logic model with short- and long-term outcomes ● An action plan with timetables, roles, and responsibilities for implementing interventions.

Question 28

Tasks that encompass the implementation stage of the SPF

Answer 28

1. Deliver programs and practices 2. Balance fidelity with planned adaptations 3. Establish implementation supports and monitor implementation

Question 29

What does DELIVERING PROGRAMS AND PRACTICES (part of implementation stage of SPF) do?

Answer 29

● Increase community awareness of the problem and of the intervention(s) selected to address it. ● Introduce the intervention to stakeholders to obtain their buy-in and expand partnerships. ● Select settings where the intervention will be implemented, and provide resources and support as needed. ● Develop and carry out an action plan detailing what is to occur, who is responsible, and a timeline.

Question 30

What should be done in order to establish implementation supports and monitor implementation (part of implementation stage of SPF)

Answer 30

● Build leadership and administrative support in the settings where the intervention is happening ● Provide training for the people implementing the intervention if they do not have the necessary skills ● Monitor the delivery of the program and make mid-course corrections as needed. Your evaluation activities can help you to monitor implementation of the intervention.

Question 31

Fidelity (def'n)

Answer 31

the degree to which an evidence-based prevention program is implemented as its developer intended.

Question 32

Adaptation (def'n)

Answer 32

how an intervention is changed and customized to meet local needs and circumstances. modifications made to a chosen intervention such as audience, setting, and/or intensity of program deliver

Question 33

Why is it important to balance fidelity and adaptation when implementing a prevention intervention?

Answer 33

changes to an intervention can compromise its effectiveness.

Question 34

Guidelines for adaptation of an intervention

Answer 34

● Select programs with the best practical fit to local needs and conditions ● Consult with the program developer ● Retain core components of the original intervention ● Add, rather than subtract

Question 35

What does the evaluation do in the SPF model?

Answer 35

● Helps to assess the progress and impact of an intervention ● Identifies what does and does not work in a particular setting ● Is used to improve implementation and performance ● Helps determine which interventions and outcomes should be sustained

Question 36

What are the different types of evaluation?

Answer 36

Process - occurs during the implementation of an intervention, and monitors how the intervention was carried out Outcome - looks at short-term and long-term results, to see what changes occurred due to the intervention

Question 37

What question does the process evaluation answer?

Answer 37

“Did we do what we said we would do?” * Process evaluation describes how the intervention was implemented

Question 38

What question does the outcome evaluation answer?

Answer 38

“Did our intervention make a difference— did it impact the risk factors and problems we wanted to address?” * documents effects achieved after the intervention is implemented, such as short- and long-term changes in a population group’s knowledge, attitudes, skills, or behavior

Question 39

What does process evaluation data help to determine?

Answer 39

● Were interventions implemented as planned? ● Who participated and for how long? ● What adaptations were made? ● Were the resources sufficient? ● What obstacles were encountered?

Question 40

What should a prevention specialist consider when selecting interventions?

Answer 40

1. Effectiveness 2. Conceptual Fit 3. Practical Fit

Question 41

What does outcome evaluation data help to determine?

Answer 41

● What changes actually occurred ● How these changes compare to what the intervention was expected to achieve ● How these changes compare with those not exposed to the intervention

Question 42

What can evaluation results be used for?

Answer 42

Improve programs, sustain positive outcomes, and improve a community’s overall plan for addressing behavioral health problems and promoting wellness To help obtain funding or to build community awareness and support for prevention

Question 43

What are some types for reporting evaluation results?

Answer 43

* Brief stakeholders regularly, throughout the process, not just at the end. * Create a dissemination plan, tailored to the various audiences that need to see the results, including the focus population * Select appropriate reporting formats. Think carefully about the best venues or vehicles for delivering results. * Help stakeholders understand the data. Remember that each stakeholder has their own interests, and will be most interested in findings that relate to these interests.

Question 44

What are the components of the Institute of Medicine's (IOM) Continuum of Care?

Answer 44

1. promotion 2. Prevention: universal, selective, indicated 3. Case Identification 4. Standard Treatment 5. Maintenance: Long-term treatment, after-care, and rehabilitation

Question 45

What is an assessment/needs assessment?

Answer 45

systematic gathering and examining of data related to a health problem within a community, as well as related conditions and consequences ** Identifies the problems, populations most affected, conditions that put the community at risk, and what within the community can protect against the problems being identified

Question 46

When are adaptations of a prevention program more effective?

Answer 46

when underlying program theory is understood, core components have been identified, and both the community and needs of a population of interest have been carefully defined

Question 47

An assessment is a process of _______________, _______________, and _____________ information about your community. What should an assessment include?

Answer 47

gathering; analyzing, and reporting should include: ● geographic and demographic info ● collective review of needs and resources within a community that indicates what the current problems are that could be addressed by a coalition

Question 48

What are the 2 assumptions of the IOM continuum of care model?

Answer 48

1. The possibility of prevent the occurrence of a health consequence - can happen at anytime throughout the continuum of care model 2. Different strategies/approaches to prevention will be needed - based on where target population is among the continuum of care model in addressing the problem/behavior

Question 49

What are the 3 types/levels of prevention?

Answer 49

Primary, Secondary, and Tertiary

Question 50

Goal of Primary Prevention

Answer 50

goal: Reduce INCIDENCE of disorder (occurrence of NEW cases)

Question 51

Secondary Prevention

Answer 51

Reduce Prevalence (total number of new and old cases)

Question 52

Tertiary Prevention

Answer 52

Reduce the consequences and complications arising from disorder/problem once it has manifested

Question 53

Universal Prevention provides the population with _________________ and _______________________ to prevent the problem

Answer 53

Knowledge/Information and Skills

Question 54

What is the Drug Abuse Continuum?

Answer 54

Use, Misuse, Abuse, Dependence, Addiction

Question 55

What are the 7 steps of the Community Prevention Planning Model (Hawkins, 1992)

Answer 55

1. Assess Community Readiness 2. Needs Assessment - levels of risk and protective factors within the community 3. Prioritize Results - Risk/Protective Factors data from assessment into priorities 4. Conduct Resource Assessment - examine what resources are in the community that are reducing prioritized risk factors and enhancing protective factors 5. Identify Target Populations 6. Identify appropriate Programs/Services - Apply "best practices" and "guiding principles" 7. Logic Model & Evaluation

Question 56

What are the two primary activities that take place during needs assessment?

Answer 56

Data Collection and Data Analysis

Question 57

Data Collection

Answer 57

Gathering of information that is either archival (already exists) or primary (data that are created)

Question 58

Data Analysis

Answer 58

An examination of data to establish meaning and set priorities for community change

Question 59

Data Literacy

Answer 59

the ability to access, understand, and interpret information in order to identify questions, find answers, and support decisions

Question 60

Three steps to improve the process of a needs assessment

Answer 60

Step 1: Define your purpose and scope Step 2: Gather the archival data Step 3: Decide on the need for primary data

Question 61

Archival Data

Answer 61

already exists * Can provide baseline during needs assessment

Question 62

Primary Data

Answer 62

Data collected firsthand

Question 63

According to The National Institute of Drug Abuse (NIDA) prevention guidelines, what are 3 areas for developing and implementing evidence-based prevention strategies?

Answer 63

1. Risk and Protective Factors 2. Prevention Planning 3. Prevention Program Delivery

Question 64

Logic Model

Answer 64

roadmap for understanding how the program problem connects to the program activities that you are using to predict the program outcomes * Identifies what the program is, what it is expected to do, and what measures of success that will be used

Question 65

Public Health Model (PHM)

Answer 65

Requires an understanding of the agent, host, and environment and how they interact. Also involves a plan of action for influencing all three. Agent = substance, host = individual, environment = conditions

Question 66

All 5 steps of The Strategic Prevention Framework (SPF) work around a _____________________________

Answer 66

Sustainable and Cultural competent Center

Question 67

Sustainability

Answer 67

prevention initiative/prevention program and activities can continue beyond initial funding

Question 68

Cultural Competence

Answer 68

respect for culture and diversity of community being served

Question 69

Communities That Care (CTC)

Answer 69

This model is designed marshaling community resources to address problematic behavior in adolescents.

Question 70

5 Steps of CTC model

Answer 70

1. Get started 2. Get organized 3. Develop community profile 4. Create a plan 5. Implement and evaluate

Question 71

What is involved in the first step of the CTC model?

Answer 71

Identify lead agency, key stakeholders, and staffing needs

Question 72

What is involved in the 2nd step of the CTC model?

Answer 72

Development of a community prevention board, or work with an existing coalition to gain support for the community change initiative

Question 73

What is involved in the 3rd step of the CTC model?

Answer 73

1. Develop community risk and protective factors profile 2. Identify community resources and gaps in resources needed to address community needs

Question 74

What is involved in the 4th step of the CTC model?

Answer 74

Develop action plan to align the need, resources, and outcomes for strategies to strengthen protective factors

Question 75

What is involved in the last step of the CTC model?

Answer 75

Maintain fidelity to the plan that was created in 4th step of CTC, while also monitoring any adaptations and outcomes over time

Question 76

Evaluation

Answer 76

The systematic collection and analysis of information gathered (data) - it is not random or haphazard

Question 77

Evaluation provides information on program _________________________

Answer 77

activities, characteristics, and outcomes * Answers questions such as Who, What, How, Why

Question 78

What is the evaluation used for?

Answer 78

1. Reduce uncertainty 2. improve effectiveness 3. Make better decisions about the prevention program/strategy being implemented

Question 79

Process Evaluation

Answer 79

Involves analyzing how implementation activities are delivered

Question 80

Outcome Evaluation

Answer 80

Measures a program's results and helps determine whether a program or strategy produced the changes it intended to achieve

Question 81

What does a process evaluation include?

Answer 81

1. Who delivers the strategy and how often? 2. To what extent is the strategy implemented as planned? 3. How is the intervention received by the target population and program staff? 4. What are barriers to intervention delivery? 5. Was the data used to make improvements/refinements? If so, what changes were made?

Question 82

A comprehensive outcome evaluation will include:

Answer 82

1. An assessment of the impacts of each program component 2. Data from a population group 3. Choices of evaluation designs 4. What worked in comparison with what you thought would work?

Question 83

Outcomes or impact

Answer 83

Look at how the participants lives were changed or affected by the program activities * Includes both short term and Long term outcome measures

Question 84

Outputs

Answer 84

The number of opportunities the program has to create changes, such as the number of clients served and how many hours the program was in the field

Question 85

Archival Data can be critical to understanding ____________________________________

Answer 85

the general scope and magnitude of a community health problem

Question 86

Primary Data is needed to evaluate ____________________ and assess ____________________

Answer 86

EVALUATE the implementation activities ASSESS short-term and long-term outcomes of the prevention initiative

Question 87

3 main ways to collect data to assess impact of prevention program/strategy

Answer 87

1. posttest only 2. pretest and posttest 3. pretest and posttest with a comparison group