Key Findings and Implications: Qualitative Data Analysis of 2002 Prevention Success Stories

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Key Findings and ImplicationsQualitative Data
Analysis of2002 Prevention Success Stories

• Conducted Fall/Winter 2002
• By OMNI Research Training, Inc.

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Presentation Overview

• Section 1 Background
• Section 2 Key Findings and Implications
• Section 3 Limitations
• Epilogue Q A and discussion of next
  steps, future directions

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Section 1

• Background

• Success Story Format
• Sample
• Analysis Process

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Success Story Format

• Referral sources or ways a given service/program
  came to be delivered

• Reasons for referral or service delivery (i.e.,
  the salient set of issues)

• Stated objectives of service/program delivery

• Services/programs delivered/provided

• Observed successes or impacts

• Lessons learned

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Sample

• Service types distribution
• Direct Youth spilt out mentoring from
  non-mentoring (give relative numbers)

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Number of Stories Received by Service Provider
Type
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Generating the Sample of Direct Youth Provider
Stories

• Sampling involved a two-step process
• Random selection of one story from the four
  submitted by each direct youth provider

Random sampling was used in an effort to increase
the likelihood that themes emerging from the
analysis would be relevant to the stories not
included in the sample.
2. Purposeful selection of other stories in
which substance abuse prevention among youth
emerged as a more central theme.
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Generating the Sample of Direct Youth Provider
Stories

• Derived an overall sample size of 51
• 13 stories (25) featured substance abuse as a
  prominent theme
• 38 stories highlighted interventions designed to
  address substance abuse prevention more
  indirectly, with other needs/issues serving as
  the primary focus of intervention

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Qualitative Data Analysis Process

• The main components of each prevention success
  story served as the codes of an initial code book

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Success Story Format

• Referral sources or ways a given service/program
  came to be delivered

• Reasons for referral or service delivery (i.e.,
  salient issues)

• Stated objectives of service delivery

• Services delivered/provided

• Observed successes or impacts

• Lessons learned

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Qualitative Data Analysis Process

• Secondary codes followed from these initial
  categories used to organize the data
• These more refined codes emerged as data analysis
  progressed

Iterative process of qualitative data
analysis Initial coding and understandings of the
data were revisited/re-examined as new insights
emerged. Consequently, each prevention success
story was read and analyzed multiple times.
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Section 2

• Key Findings and Implications

By Provider Type

• Referral Pathways
• Salient Issues, Interventions, Successes
• Implications for the Field of Prevention

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Referral Pathways Direct Youth

• The school system served as a major conduit for
  youth referral into programs

• School counselor

• School psychologist

• School social worker

• Student advisor

• Site coordinator

• (Assistant) Principal

• Teacher

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Referral Pathways Family

• Staff or program outreach

2. Recruitment by current participants who served
as ambassadors of the programs/services
3. Through family/family members participation
in another program
4. As a result of the referral of a child into
direct youth services (ultimately led to a
family/family members receiving needed services
and support)
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Referral Pathways Community

• These providers typically described the context
  of
• Prevention issues in community-based settings
• Processes involved in organizing/orchestrating a
  community-wide or community-level response

• Process of referral, therefore, tended to be
  replaced with descriptions of the process of
  engaging or involving key stakeholders

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Referral Pathways Statewide

• Referral to statewide providers most often
  occurred as a result of professional connections
  established through
• Networking
• Training
• Coalition building
• Outreach

• These professional activities frequently resulted
  in the solicitation of additional
  information/resources, technical assistance, or
  consultation by other professionals

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• Key Findings Salient Issues, Interventions and
  Successes

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The Logic Guiding Prevention
Salient set of issues drives the determination of
prevention strategies
Delivery of prevention approaches designed to
achieve specific objectives
Identified outcomes and successes related to
specified objectives
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The Profile of Youth Referred to Direct Services

• Salient Issues
• Home and family not providing a safe haven
• Being left to grow up on ones own

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Home and Family Not Providing a Safe Haven

• Dimensions
• Broken (e.g., separated or divorced) families
• Transience and poverty
• Drug, and other forms of, abuse

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Number of Children Referred to Direct Services by
Grade Level
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Key Finding Youth-Focused Prevention

• Risk factors associated with the family domain of
  the Risk and Protective Factor Inventory were a
  persistent feature of the profiles of children
• Family History of ATOD Problems
• Family Relations/Cohesion
• Poor Discipline
• Family Conflict
• Favorable Parental Attitudes towards Drug Use
• Family Conflict

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Mentoring as Major Youth-Focused Prevention
Strategy

• Direct service providers most often matched
  children with mentors who had the resources to
  give at-risk children the types of support they
  were not typically receiving at home
• Academic assistance
• Individual attention
• Enrichment
• Socialization

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Measuring the Success of Mentoring

• The success of mentoring relationships could be
  measured in terms of
• Their enduring nature
• The depth of commitment mentors and mentees
  exhibited toward one another

• Research suggests that support from a family or
  community member is one of the main external
  contributors to resilience in at-risk children

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Implication of Key Findings Youth-Focused
Prevention

• Findings suggest that direct youth and
  family-based intervention approaches should be
  delivered in combination to maximize the
  effectiveness of youth-focused services
• Salient issues leading to referral most often
  surfaced within the context of childrens
  family/home life circumstances

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• Family-Based Prevention and Intervention

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The Profile of Families Referred to Services

• Salient Issues
• Substance Abuse
• Basic, subsistence-level needs (e.g., affordable
  housing, WIC, public transportation, other social
  services)
• Mental Health Counseling

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The Profile of Families Self-Referred to Services

• Salient Issues/Needs
• Development of parenting skills (e.g.,
  appropriate forms/styles of discipline)
• Social support and coping skills for parents of
  children with special needs (e.g., children with
  fetal alcohol syndrome)
• Teen pregnancy

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Key Finding Family-based Prevention

• Most often, women (wives and mothers) initiated
  receiving family-based prevention and
  intervention services
• These women tended to be either single mothers or
  wives with supportive husbands who participated,
  at some level, in family-based services

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Family-based Prevention Approaches

• Developing the Leadership Potential of Wives and
  Mothers
• Enhancing Social Support Available to Parents of
  Special Needs Children
• Providing Case Management and Wrap-Around Support
  Services

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Engaging Participants as Change Agents

• Had we only looked at participants as students
  and not also so teachers, the parent profiled
  would not have received the support and
  encouragement she needed to succeed.

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Success within the Context of Family-based
Prevention

• Mobilizing multiple systems of support for
  families
• Addressing the unique needs of individual members
  of the same family
• Breaking the cycle of addiction that spanned
  multiple generations
• Providing support for parenting
• Addressing mental health needs
• Helping families get back on their feet
• Empowering women as change agents

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Implication Case Management Meets the Complex
Needs of Families

• Family-based interventions featured in success
  stories tended to utilize a comprehensive, case
  management approach
• Engaging and activating multiple systems of
  support facilitates addressing needs at multiple
  levels and among multiple members of the same
  family

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Implication Women Should be the Focus of
Empowerment

• Research suggests that women (particularly wives
  and mothers) play a pivotal role in the health
  (well-being) of the family unit
• Prevention success stories document how women
  served as linking agents, ensuring that their
  families received the support necessary to be
  successful
• Women, working through their sphere of influence,
  also served as important change agents in their
  community

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Implication Men Should Also Serve as a Focus of
Prevention

• Success stories give credence to the greater
  emphasis currently being placed on the need to
  engage men in prevention
• Children referred to direct services were most
  often estranged from their fathers
• Families in need of family-based serves also
  tended to be headed by single mothers
• When husbands/fathers were engaged in services
  with their families, this tended to lead to a
  positive disposition for the entire family

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• Community-Based
• Prevention and Intervention

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Social Norms Marketing as a Major Community-based
Approach

• Social Norms Marketing was featured in 55 of
  prevention success stories submitted by
  community-based providers
• Community groups attempting to develop a social
  norms marketing campaign found the processes
  involved to be expensive and time-consuming
• The resource-intensive nature of this approach
  served as a barrier to creating and implementing
  such campaigns

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Community-based Prevention Approaches

• Other communities used multiple-pronged
  approaches to affect change in their communities
• Examples
• Efforts to affect public policy occurred
  simultaneously with enhanced enforcement
• Provision of alternative drug-free events, also
  conducted in combination with enhanced
  enforcement efforts

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Retailers Complying with Laws Prohibiting the
Sale of Tobacco to Minors

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Implication Effective Community-based Prevention
Involves Multiple Approaches

• Stories illustrated the effectiveness of
  employing multiple approaches (including those
  targeting public policy) to prevent ATOD use,
  particularly among youth
• The successes attest to the importance of
  planning and implementing, simultaneously,
  multiple prevention approaches that work in a
  complementary fashion

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Partnering to Achieve Success at the Community
Level

• The ability of coalitions to address critical
  community issues is so powerful.

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• Statewide Services Related to
• Prevention and Intervention

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Profile of Statewide Prevention Block Grant
Providers

• Block grant providers whose efforts are statewide
  in scope represent a diverse group of
  organizations and agencies
• As statewide prevention providers, these
  professionals often serve as resources to others
  focusing on prevention at the community-, family-
  or individual-level

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Key FindingStatewide Prevention Providers

• Salient issues
• Assisting employers, schools, families, and
  community members in dealing with controversial
  or complex prevention issues
• Patient advocacy
• Suicide prevention
• Evaluation
• Building or strengthening collaborative efforts
  either at the community- or group-level
• Providing ongoing consultation and resources

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Statewide Prevention Approaches

• Two common threads linked many of the efforts of
  these providers
• The provision of impactful technical assistance
• Information (i.e., knowledge) generation and/or
  dissemination
• Focus of these approaches capacity building
• Statewide providers tended to deliver these
  services or types of support through professional
  networks

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Implication Statewide Providers Serve as an
Important Bridge in the Field of Prevention

• Working through professional networks, statewide
  providers were able to serve as an important
  bridge in the field of prevention by linking
• Local providers and stakeholders to advances in
  the field, both in terms of research and
  technology
• Change agents at multiple levels within a system
  (e.g., parents/patient advocates with providers
  and policy makers)
• Nation- and state-level leadership with the needs
  of local practitioners

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Section 3

• Limitations

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Limitation

• Stories rarely presented the data/data collection
  activities that permitted providers logically to
  link a success to specific prevention efforts
• Rarely did stories present the evidence that
  should ideally serve as the foundation on which
  to build a story of success
• Such evidence would serve to
• Strengthen the validity of prevention success
  stories
• Make these success story component a more fluid
  and complementary aspect of PEP

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Opportunity

• Prevention success stories can provide rich
  qualitative (i.e., contextual) information,
  contributing to the development of a more
  comprehensive picture of how particular types of
  services (tracked using MDS) lead to desired
  outcomes and successes (monitored relatively more
  quantitatively through the OER component of PEP)