Prevention Profiles: Take Five - Dr. Kimberly Dash (Senior Research Scientist, Education Development Center)

Rich Lucey: Hi, this is Rich Lucey in the Drug Enforcement Administration's Community Outreach and Prevention Support Section and I welcome you to this episode of "Prevention Profiles: Take Five," our podcast series that we post on our website, campusdrugprevention.gov.

I am pleased to have as our guest today, Kim Dash from Education Development Center.

So before we say hello to Kim, let me tell you a little bit about her.

Dr. Kim Dash is a Senior Research Scientist at Education Development Center, with more than 25 years' experience translating research and practice on disease and risk prevention into evidence-informed interventions that improve public health.

She collaborates with a variety of clients, including healthcare professionals, school officials and community-based organizations to support the best practices in real-world health settings.

Most recently Kim directed a national evaluation designed to increase professional and organizational knowledge and skills required to develop and evaluate innovative mental health promotion and substance misuse prevention, treatment and recovery programs for typically underserved populations.

And with that introduction, Kim, welcome to the podcast.

 

Dr. Kim Dash: Great, thanks.

I'm happy to be here.
 

Lucey: Absolutely.

So the theme for today's podcast is going to be around a brand-new resource that DEA has released with significant help from Kim and EDC and also talking about strategic planning in general.

So Kim, I'm going to jump right into our first question.

The strategic prevention framework, let me start off by saying that for our listeners who may not be well-versed what the  strategic prevention framework or SPF, as it's often referred to in the field, if you're not sure or haven't really heard about what it is, let me tell you really high level, it's intended to address five basic questions.

First, what's the drug problem that I'm working to address? Secondly, what do I have to work with? Third, what should I do and how should I do it?

Fourth, how do I put my plan into action and fifth, is my plan succeeding? I always like to tell people the questions may seem basic, but the processes are not.

They are a bit complex and involved; we'll talk a little bit about that.

The, the SPF has been around for a while, it's been, been around for about 25 years, but what didn't exist was a publication that exclusively tied the SPF to drug misuse prevention on college campuses.

And we knew that this was a publication that DEA wanted to make available to the field.

So Kim, when I shared that vision with you and the team at EDC, what was your strategic planning process like to actually determine the guide's content and help make it come to life?

Dash:  Well, so  my colleague, Rashmi Toari and I were aiming to develop something for busy prevention practitioners working in college settings.

We wanted to create something that would meet their unique needs, their levels of knowledge, their capacity, readiness, learning styles and motivations.

So we first met with you all at the DEA to discuss your priorities and vision for the finished product and we identified challenges to implementing prevention programs for the college population based on focus groups with college prevention professionals that you all at the DEA had conducted at a 2019 meeting of the National Association of Student Personnel Administrators.

We conducted a literature review to identify risk and protective factors that contribute to drug misuse among college students.

We also gathered information on the patterns of substance misuse among college students and described patterns, by diverse student populations and risk groups informed by reports and analyses of data from such essential sources as monitoring the future and the National Survey on Drug Use and Health that the substance, that that SAMHSA, the Substance Abuse and Mental Health Services Administration Commission.

We conducted an updated literature review of evidence-based substance misuse prevention practices appropriate for colleges and universities based on previous work that we and others had done in this regard.

We also conducted semi-structured interviews with select prevention professionals about their experiences implementing prevention interventions on college campuses.

And so we took all the findings from this formative research and it determined the content and format of the publication, as well as the specific pedagogies for this product, which included a combination of structured guidance, case studies and stand-alone learning tools and worksheets.

And you know, as you know, it's really important to get feedback on anything you develop, so we shared drafts with multiple groups of reviewers and these reviewers included DEA officials, as well as representatives from other federal agencies, including the Substance  Abuse and Mental Health Services Administration, the U.S. Education Department and the National Institute on Drug Abuse.

And we also sought input from other reviewers, other experts in the field of substance misuse prevention among college students and this included representatives from the National Association of Student Personnel Administrators or NASPA and prevention professionals working at colleges and universities across the country.

I think we talked with more than ten, maybe almost 15 prevention professionals based at universities, who provided some really critical real-world input and feedback on the draft.

And so based on all of this, we, you know, we, we produced a number of drafts, we used plain language, we tried to avoid jargon and, and terminology specific to prevention science, because we wanted something that everyone could understand and relate to.

We organized the publication according to the steps of the SPF, which Rich, you just outlined at the outset of the podcast.

We included cases, graphics, appendices and you know, as, as I stated, we worked very closely with a graphic designer to make this, this truly engaging and visually appealing.

Lucey: Well, you, you definitely have hit the mark and, and you and I have, you know, talked about that prior, just as the, the publication was crossing the finish line.

You know, there were a couple of things that you said that, that really resonated with me.

First of all, so aiming to create a resource for the, the busy professional, if you will.

And I think it's been my experience over the last 10, 15 years in this field, rarely is the person who's working drug misuse prevention on campus, they don't get the luxury of that being the only hat that they wearing, unfortunately.

But you know, I, I do put a little bit of a caveat out with this, this guide and, and with prevention in general and that's people do have to do their homework.

You know, I'm a little concerned if people are wearing four or five hats, that the work they're doing in prevention is getting short shrift, they're trying to take shortcuts and they're not really learning the craft, if you will.

This is one of two or three resources in the field that I definitely say is a cover-to-cover read.

It's a very quick read, it's an easy read, if you will, but I think that professionals, whether new to the field or seasoned, really should take the time to read it cover-to-cover and then go back to delve into the specific chapters or areas where they need to, to focus on, whether it's needs assessment or capacity building or evaluation.

Whatever step of the SPF, you know, that they're, that they're struggling with or they want more, you know, they're doing some more work on.

So I think, you know, I've said before, this is a probably one of, if not the most, proud I've been of producing a resource for the field.

So I again, I want to thank you and to Rashmi and like I said, the whole team at EDC for producing this.

The other thing you mentioned was that I think a challenge that we had in developing the guide was to present something that is comprehensive, as you, as you've said, but that also addresses the different learning styles for individuals, as well as the various, varying degrees of readiness that we know so many campuses are at, when it comes to prevention.

And so when we talked about that issue of readiness, I, I think that that's addressed in each chapter, it depends on how, you know, far along you are in your efforts on campus as to, you know, where you'll be at in the chapters, in terms of starting point, midpoint, you're further along, what have you.

So all of you did a really nice job in addressing that in the publication.

 

Dash: Great, great, yeah, no, I think, I think you're correct.

I mean, readiness is an important issue and we, we tried to craft the guide so that someone who was completely unfamiliar with the SPF could pick this up and use it to launch prevention programs on their campus.

And for those who have more expertise in doing this, there are ways in which they can use this and the, the many resources and worksheets included within, to kind of take it to the next level.

Lucey:  So that, that actually presents a really nice segue to, to my second question and it, it really deals with the, the SPF, you know, specifically.

You have a lot of experience with the SPF, you are a strong proponent of it I know you've done work around the SPF with SAMSA and various others ways and different projects.

Why is the SPF beneficial to colleges and universities?

Dash:  Well, mainly I think guidance is needed to help college communities select and implement proven effective strategies, such as those featured in the National Institute on Alcohol Abuse and Alcoholism's College Aim or even to develop innovative interventions that best align with their unique situations and capacities.

And you know, we know when prevention solutions are designed to address the risk and protective factors, context and capacities unique to specific college campuses, colleges are more likely to implement them and they are more likely to be effective in addressing prevalent substance misuse problems.

And the SPF also helps colleges avoid this proclivity to react to crisis by implementing solutions that don't address the factors that led to the crisis.

Rather than jumping to a solution for a substance misuse issue, the SPF guides prevention practitioners, as you point out, to a process that answers those critical questions, like what's the problem, what capacity do I have to address this problem? What should I do and how should I do it and how can I put my plan into action? And how do I know my plan is working? And, and by answering these questions, prevention practitioners develop a very, a much, much deeper understanding of the conditions associated with substance misuse issues on their campus.

That includes individual risk factors or environments and context where misuse is more likely to occur and perhaps most important, the SPF provides a method to build support and foster a shared understanding in a college community on the reasons why substance misuse issues are occurring and how to best address them.

Lucey: Yeah.

The thing that I have, when I'm talking about the SPF to a variety of audiences, there are various benefits to using it that I, that I talk about and I think that in our field typically, people think that we focus on primarily on youth, those that are say under the age of 17.

And perhaps with good reason.

We know there's a lot of research to show that, you know, preventing early onset of youth, whether it's alcohol or other drugs, at an early age is beneficial, that we want to, you know, prevent the early onset.

But the real, I think, benefit of the SPF is that it can be used universally with so many other populations, of course, including the college student population.

And one of the things that I've noticed that people are using it in their prevention efforts with older adults, with ... you know, and depending not only different age groups, but also on settings, you know, whether it's the workplace or whether it's K-12 or college or what have you.

I think that there's the universal appeal for this framework.

Dash: Yes.

It's very transportable.

Lucey: Absolutely.

And so, and yet, that being said, I found it interesting and that's why we set out to create a publication that was the first, if you will, that really specifically tied the SPF to this setting and this population.

I think that's one of the reasons why it's received such an overwhelmingly positive response, that it has so far, because such a document didn't exist and it was really needed out there for our field.

Dash: Yeah, I think you're absolutely right there.

I've heard from a number of people who've worked on college campuses, that, that yes, nothing like this existed and nothing like this had been designed to address the needs specific to college campuses.

Lucey:  Absolutely.

I want to move onto our third question now as we talk a little bit about the, the actual steps and the nuts and bolts of the SPF itself.

So you know, there are five steps, we know that.

We know there are also two underlying foundations, cultural competence and also now, I guess, I don't know if I want to call it an offshoot, but an aspect of that called cultural humility, which we introduce into the document and talk a little bit about that.

And the other foundation of sustainability.

So you have these five steps and two underlying foundations.

I'm sure people struggle with all of them to varying degrees, but with all the experience that you have had in providing training and technical assistance and research on this, on this very topic, are there particular steps that people struggle with the most and if so, what particular guidance do you give them?

Dash: Oh, yeah.

That's a great question.

So based on my experience, I've seen people struggle most with assessing and prioritizing substance use behaviors, like excessive drinking and associated problems, such as injury or academic failure, because they are unfamiliar with data sources and data handling.

And, and interestingly, the experts that you all interviewed at NASPA noted that campus assessment is often limited, because individuals do not dive deep enough into data collection and analysis and that's somewhat related to what you were saying earlier, Rich, about you know, really using the SPF and taking that deep dive into the specific steps and doing, doing one's homework.?And these, these same experts also noted that many campuses do not have a data collection plan or they don't use existing and archival data that might tell them something about behaviors that place students at increased risk for substance misuse.

And as we point out in the guide, there are four basic questions that need to be answered when assessing substance use problems and their related behaviors.

And these are, you know, what problems and related behaviors are occurring on campus? How often are these occurring?

Where are these occurring and who is experiencing more of these problems and related behaviors? And to answer these questions, campus prevention professionals must access the information available on student substance use by looking closely at existing data, identifying data gaps and collecting new data to fill those gaps.

And I think collecting new data can feel intimidating, but there are several standardized surveys out there that colleges can use or adapt to collect information on student risk and protective factors and substance misuse.

And so, you know, once all of this data's been collected, it needs to be analyzed and problems prioritized based on their magnitudes, severity, trending and changeability.

So, so this is a lot of data handling and analysis for college prevention practitioners and, and here's where it's important to collaborate.

It's important to involve university research departments who are comfortable working with data, especially health data or find other faculty who are particularly interested in data collection and analysis.

Again, collaboration is critical.

Another challenge I've seen is selecting appropriate interventions to address priority substance misuse problems that college students are experiencing and the factors that contribute to such problems.

Sometimes it's really tempting to select interventions that are popular or that might have worked well on a different campus or that we just read about in the press, but these aren't great reasons for selecting an intervention.

I mean, we should be looking at whether or not the program or intervention has documented evidence of effectiveness, whether it directly addresses factors driving the main substance use problems on campus and whether the intervention is appropriate for the campus given the resources available, the size of the campus, other existing programming and so on.

So I think those are the two main challenges that, that I've seen in working with others to implement the SPF.

Lucey:  Yeah.

I'm glad you brought up assessing and I want to touch on capacity building in a moment.

I'll put that in the parking lot for now.

But the whole idea of assessing and prioritizing, I really think the objective word there is prioritizing, because isn't true, you know, sometimes we're our own worst enemy, I guess, in the prevention field, because we want to do it all.

And you know, you do an assessment, you do a survey, you get all this great data and you want to basically address all of it, but that's actually a detriment, right?

Dash: Yes, yeah.

Especially with limited resources.

I mean, you know, we're often having to make critical choices about where we're going to put our best efforts and our resources.

Lucey:  The thing I like about the guide as well, too, and each of the chapters, which are organized by the SPF's steps is I believe that you did a really nice job in outlining, as you just said for example, with assessing. It's, you know, what is the problem, where is it occurring, who is it affecting? You know, there was these nice steps.

Now I don't want to oversimplify this again, to say that this is easy, because I guess if it were easy, everybody would be doing it and we wouldn't have a problem, right? But it's, again it goes back to the putting it in a reader-friendly, graphically appealing guide.

And so, each of the chapters look like that and so, I want to say this to our listeners that when you pick up the guide and you look at it online especially, hopefully you will see that and experience that as well, that we've outlined for you the various steps that are involved or the checklists to follow, as you're dealing with each of the steps.

I do want to touch on capacity building for a minute, because I know that from my own experience in talking to people and sometimes I struggle with this in offering my own advice in TA to folks, it seems like people always want to say, well, yeah, sure, I could build as much capacity as I want, as long as I had the money.

And it always seems like they want to go back to the funding or the money.

I, I don't know what your experience has been with that, but my, usually my reaction to that is that's where leveraging partnerships and collaboration come into play.

Dash:  Yes.

You're, you're absolutely right.

Partnerships can or good partners can help you implement certain things that you might not be able to implement by yourself.

And we do spend a lot of time in the guide or we do cover in the guide the importance of identifying good partners and figuring out what they bring to the table, in terms of helping you address specific substance misuse problems or risk and protective factors that, that you have identified.

So yes, no, I, I, I totally agree.

Lucey: Yeah, and when people look at the guide, they'll, they'll see also what we talk about in the guide are the varying levels of collaboration and there's typically three types of collaboration.

We won't get into them now, but you know, I think that it's really helpful for folks, is that you will have some folks who are slightly involved as opposed to those who are intimately involved.

I think those are the both ends of the spectrum and it's just finding out how to use your partners strategically and win/win for both, for both sides.

Dash: Right.

You may actually have partnered to our implementing aspects of your, your strategy or specific interventions.

Lucey:  So I'll move onto our fourth question and this really doesn't have to focus solely on the college population.

I know, like I said, you've got a wealth of experience in the prevention arena, both programming side, research side, various settings.

So I want to ask you that with all that experience and all the work you've done over, over your time, what do you ... and this might be, this is focused on kind of the here and now.

What do you see as the biggest challenge facing prevention professionals today and what suggestions do you have to address that challenge?

Dash:  So in many ways, the challenge that comes to mind is, is somewhat related to what we were just discussing.

As you know, in the prevention field, there's been an increased focus on place-based system wide, data driven and bundled prevention intervention.

And compared to relatively brief clinical treatments, multi-component prevention programs are more difficult to rigorously evaluate and prove effective, so we don't, you know, we have a limited evidence base.

And these kinds of programs are harder to scale and spread or disseminate.

And a major barrier here is a lack of community knowledge and skills on how to plan and implement these kinds of comprehensive strategies, as well as a lack of coordination or integration across service providers, sectors or stakeholders that have the potential to address, you know, substance misuse or any other chronic health condition and its varied risk factors and consequences.

And you know, and, and partners are critical here and I think it's, it's also by applying models like the SPF that prevention professionals can begin to promote system-wide change through strategic planning and by engaging multiple stakeholders, organizations may be able to achieve a greater impact than if they were to act alone.

Again, it's back to partners and, and similarly, I think that campus prevention professionals have to consider a tiered approach, where they address the needs of those with problem alcohol and drug use, those with risk factors for problem use and the wellbeing of the general student body.

And yet campuses with, with limited resources will need to decide on which population group to focus.

So again, I think there are some sort of mixed solutions, like it's, it's important to consider partners or partnerships and what they bring in terms of helping you implement your strategic plan as well as the specific interventions you choose or develop.

And, and at the same time, it's also important to know as we discussed earlier, where to focus your efforts, if in fact you do have limited resources.

So again, I think those would be the, the two things that I would, would emphasize.

 

Lucey:  Yeah.

And it's a lot to, to, to think about and you know, I, I, I would say that, of course, some of our other challenges are, are time and money, that you know, the landscape of, I think, just personally, observation and experience, I think that the landscape of primary prevention in our field has changed drastically over the last decade, but more recently over the last probably five or seven years, in terms of focusing solely on primary prevention and yet, we know that's really where the sweet spot is, I think, in terms of, of seeing some normative change.

And then when it comes to the funding issue, certainly for college campuses, I mean, a lot has happened in the last two decades, but when I started my career at the Department of Education, and, and actually that was my experience with EDC, running the Department of Ed's former Higher Education Center, there were, you know, I can say with all confidence, there were millions of dollars available in grants, specifically for colleges and universities to address their drug issues, as well as a national training and CA Center.

Unfortunately, you know, that's ... for any, you know, a whole variety of reasons, that's changed over time, but I guess that we shouldn't be surprised when we look at all the different data sources in the 18-25 age group, of which college students are a significant part, and then look at the data specifically for college students, that we see there are numbers for drug use going up.

Dash: Yeah.
 

Lucey:  So ...
 

Dash: That's very true.
 

Lucey:  You know, I think that, you know, I think the prevention field has a number of challenges it's trying to, to address, but I also think that, you know, we, we are doing as best we can and I think it does come back to partnerships and collaboration again, as you've mentioned, but I think first and foremost it will come down to having a strategic plan.
 

Dash:  Absolutely.

It all, it seems to all come back to the SPF.

Lucey: Yeah.

It does and that's again, the recurring theme and why we wanted to create the document that we did.

So I'll wrap up with our final question for you and this is your opportunity to, to talk directly to our listeners.

And, and it's basically what is the primary piece of advice that you want to give to our listeners around the SPF and using the guide?

Dash:  So I would strongly encourage those who are using the guide to engage with the many tools referenced and attached.

You'll see that the guide provides worksheets and tools people can use to work through the, the strategic prevention framework steps.

These tools are referenced throughout the text at different points in the planning process, when it makes the most sense to use them.

So for example, there are worksheets to help campus prevention professionals identify stakeholders or collaborators and the roles they might play in the planning process.

The guide also includes a list of resources that people might want to use to inform their drug misuse prevention efforts.

I think this all gets back to your point, that the point that you made earlier, Rich, about you know, sort of digging deep, doing one's homework and again, making use of those specific tools that are provided where, where folks can document their efforts and research to move the strategic planning process along.

 

Lucey:  Absolutely.

And for our listeners, I do want to let you know there are two versions of the guide, if you will.

There is the print version, the hard copy, which I view as an excellent desk reference for you.

If you don't mind not having the actual piece of papers in your hand, there is also the online version of the guide that you can find at on campusdrugprevention.gov.

And that guide has the, all of the tools and worksheets and the tips that Kim had referenced, that are so helpful for you on a variety of topics, everything from how to help develop your elevator SPF, your elevator pitch, if you will, how to communicate your findings or, or your evaluation efforts for a variety of different audiences, both on campus and in the community, how to do a logic model.

Everything, you know, at your fingertips.

That was the point here, was to provide you with the tools you need to help, help make your job, not only easier, but, but more effective.

And so Kim,  we appreciate the, the work that you and the team did to put all those different tools together.

Dash:  No, thank you.

It was, it was a very interesting project.

Lucey: And, and we don't intend to stop there.

I mean, I can say with certainty that we do intend to develop more resources around the guide.

I can't say with certainty what those are.

We always look for the field's input on what would be most helpful for, for them, but I do know that we would like to develop some supplemental materials, both in print and online, that help to supplement the guide and again, really are there intended to help support the work that's going on, on campuses to prevent drug misuse.

So I just want to put that out there for our listeners.

So with that, Kim, as we wrap up, I want to thank you again for being our guest.

I found this really helpful; hopefully our listeners will as well.

About what you and the team's thinking was behind the guide and putting it together, but then getting into the actual SPF a bit more and talking about not only its utility, but also some of the challenges people have with it and what they're doing to address it.

So we'd like to thank you for joining us on the podcast.

Dash: Yeah, I'm happy to, happy to participate.

 

Lucey: Great.

 

Dash: It's a pleasure.

 

Lucey: Thank you so much.

And for our listeners, we thank you for tuning in to this episode of "Prevention Profiles: Take Five."

Again, check out campusdrugprevention.gov and, and check out the guide itself.

We'd love to hear what you think about the guide and good luck in your prevention efforts on campus and in your communities and with that, I will say thank you and have a great day.