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27.11.2013
The most diverse gathering of races and ethnicities from across the world is living in one place here in the United States. The following are four recent examples of immigrant cultural gifts that have inspired American society.
In the same way that the Bible teaches one to "know thyself," Asian spiritual teachings offer their own path towards this same spiritual goal. Across the board, be it Korean, Ethiopian, or Armenian food, most traditional cuisines emphasize a diet of whole grains, many vegetables, and good fats.
Ethnic communities from around the country come together at the annual Immigrant and Minority Farmer's Conference where they discuss combining traditional farming techniques with modern cultivation methods. Nearly every community – large or small, urban, suburban, or rural – must cope, to some extent, with the use and abuse of alcohol, tobacco, and other drugs. The difference is sometimes in the way they approach the problem.Those that are most successful often try to prevent the problem from starting.
Most of the models we’ve described in this chapter look to both the present – addressing a current issue – and the future. The Strategic Prevention Framework (SPF) outlines a process that an organization, initiative, community, or state can follow in order to prevent and reduce the use and abuse of alcohol, tobacco, and drugs. This framework can also be applied to other community issues, such as violence, health-related problems (obesity, heart health, diabetes, HIV), homelessness, or racial tensions and discrimination. The availability of alcohol in the community (number of liquor stores, willingness of adults to buy alcohol for teens). The Strategic Protection Framework addresses risk and protective factors with a five-phase process. The Community Tool Box has hundreds of how-to sections that can be used to help implement the Strategic Prevention Framework in your community.
Given that there are a large number of models available, what are the advantages of using SPF? SPF aims to create long-term social change by focusing on risk and protective factors that can be influenced by short- or medium-term prevention efforts. SPF’s focus on risk and protective factors can improve the long-term well-being of the community. These disadvantages largely apply to those who seek CSAP grants to implement SPF, either through state funds, or directly from CSAP. The reality in most communities, however, is that given the problems that already exist, most issues don’t get addressed until they reach crisis proportions, or at least become cemented in the public consciousness. You can often hurry this process along by assessing where the community is at, and beginning a campaign to raise that readiness to the next step, or whatever step is necessary for the community to get on board with a prevention plan.
When a community problem has entered the public consciousness, but before it has reached crisis stage.
When there’s a community economic development effort under way, and people are looking at the community’s quality of life. When a grassroots movement for community improvement has arisen, and is looking for a way to address community issues. State Incentive Grants (SIGs), which go to states to fund statewide assessments and to be distributed among communities for state-monitored local prevention programs.
Drug Free Community Support Program grants, which go directly to local community coalitions. Grants to state and local organizations, institutions, and agencies to address methamphetamine use.
The first answer, then, is that SPF should be implemented by those who administer these grants at the state and local levels. If you take a community perspective on prevention, then stakeholders comprise all sectors of the community, and should be represented in planning, implementing, and evaluating the framework. All or most of these groups would probably be part of the Epidemiological Working Group mandated under the various grants, but should also be part of any SPF effort. In addition, there are those who might run SPF programs that aren’t funded by CSAP, but that simply use the framework to structure their work. A typical universal program might involve community education efforts through the media, schools, and organizations. Populations at risk that might be the subjects of a selective program vary from one community to another. Indicated programs focus not on probabilities (populations likely to be at risk, for example), but on specific individuals who are known to be already involved in substance use. One of the ironies of a prevention effort is that those most affected and damaged by the issue – substance users and abusers – are those least likely to want to be involved. A community assessment of substance use can be conducted using some or all of a number of methods. In surveys, and particularly in talking to community members, there may be some people you specifically want to reach. Community leaders – those people from various walks of life whom others look to for leadership and guidance. Those who deal with the population of interest – health and human service workers, teachers, police, youth outreach workers, etc.
Determine the most pressing need that a prevention effort can influence.There may be many possible areas where prevention is needed – among teens, among elders, among people below the poverty line, etc. Not only does the community have to be ready to take on a prevention effort, but it has to have the capacity to do so.
This doesn’t mean that everyone in the community has to understand, support, and be willing to participate in a prevention program, although this may be an ideal.
Use what you know about the community’s level of readiness to publicize the issue and encourage participation. If the community is already well aware of the problem – you may be able to concentrate on gathering support and volunteers to start planning your program. Protective factors for CTC reside in individual characteristics, in bonding (with family, particularly, but also with mentors and other significant adults), and in the healthy beliefs and clear standards imposed on adolescents by families and the community.
Developmental assets (similar to protective factors) for children and adolescents can also be divided into external and internal.
The goal here is to understand how these factors operate in your community – which are important and which less so, which are most likely to influence substance abuse among populations at risk.
Research and choose an evidence-based approach that can be used with the risk and protective factors you’ve settled on. Individual programs are aimed at helping individuals to develop the knowledge, attitudes, and skills they need to change their undesirable behavior, or to maintain healthy behaviors. Environmental programs seek to alter the environment to make it easier for people to change or maintain their behavior.
In some cases, however – because communities and populations often differ in subtle and not-so-subtle ways – even the program that comes closest to addressing your situation may have elements that are unlikely to work in your community, or lack elements that would improve its effectiveness.
If you’re funded by CSAP, you might try to negotiate appropriate changes in the implementation of the evidence-based model you’ve selected.
Your plan should be detailed enough that it could still be followed even if everyone involved in the planning suddenly decided to retire to a tropical island and left no forwarding address. Only by monitoring and evaluating your effort can you tell just how successful it is, and know what parts of it you need to change or strengthen. The results of your evaluation should be reassessed on a regular basis (typically once a year), and used to adjust your program to respond to changing community needs or to change or improve areas of it that aren’t working as well as they could. When you make major changes, tell the community about them, and ask for help if you need it. The Community Tool Box considers evaluation such a valuable part of any intervention or initiative that it devotes four chapters – 36 through 39 – to it.
CSAP’s Strategic Prevention Framework is intended as a structure for substance abuse prevention programs, although, because of its generality, it could easily be used for other prevention programs as well. The Strategic Prevention Framework, like several of the Other Models for Promoting Community Health and Development. CSAP provides funding for prevention both through states and directly to organizations.  More important for the majority of prevention programs not funded by CSAP grants, the agency also provides web-based tools and information to help with each phase of development and implementation. On May 19, 2010, Youth for Change and the Butte County Department of Behavioral Health opened the African American Family and Cultural Center (AAFCC) located at 3300 Spencer Avenue in Southside Oroville. While the highest concentration of African Americans in Butte County is in Oroville, African Americans only represent 2.67 percent of the city population. Since its opening, the AAFCC has implemented mental health programs for Southside Oroville residents.
While the AAFCC was created to fulfill the needs of the African American community at large, the center welcomes and encourages people of all ethnicities to utilize the center. The AAFCC has also worked to create an environment where residents are not only encouraged to use the services already implemented, but also to use the center as a resource for other programs in the community. The uplifting environment has had a positive influence on behavior, motivating children to step out of their comfort zone to reach their full potential, Jones said. While the 30-minute drive can be discouraging, Jones urges students at Chico State to take advantage of the opportunity to become involved with the center, because he realizes the impact it can have on the children at the center.
The next step the AAFCC wants to take is adding programs that focus specifically on uniting and strengthening families. Even though the AAFCC is in its infancy, the center's community advisory team is actively working with the public to strategize ways to best serve and involve members in Southside Oroville.
Steven Thomas, the arts and leisure activities coordinator, has seen the center improve the lives of people around him, which, in return, has improved the community as a whole. While the center continues to develop and implement programs, Jones highlights the opportunity to step up and make a difference.
For more information about these or other AAFCC programs, please call the center at 530-532-1205.
We often focus on the economic contributions of immigrants, but this tends to draw attention away from the tremendous social and cultural impacts that these communities have on American society. This is only a sampling of the remarkable ways in which immigration has impacted the United States throughout history. As the American understanding of Eastern Spirituality continues to deepen, our culture is being enriched with a fuller understanding of religion and faith.
As Pollan affirms, there is a very low incidence of 'first world' diseases like diabetes and heart disease among people eating traditional diets.
Immigrant farming communities living in America include the Punjabis in California's Central Valley, the Somali and Hmong people in Minnesota, the Japanese, Mexicans, and Koreans. They focus on the community as a whole, and try to devise ways to help the community members who are most at risk – typically youth – to avoid the behaviors or situations that would put them in harm’s way.
In this section, we examine another that does the same – the Strategic Prevention Framework developed by CSAP, the Center for Substance Abuse Prevention, part of the Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. By the same token, while SPF focuses primarily on youth, there is no reason that the model can’t be adapted to any population group.
Risk factors are those elements within an individual or her environment that make her more susceptible to particular negative behaviors or conditions.
We’ll list the phases here, and discuss them in more detail later, in the “How-to” part of the section. The above Strategic Prevention Framework diagram is overlaid with the core competencies for community health and development found in the Community Tool Box.
To begin, a working group is assembled that includes representatives of all stakeholders (those who will be affected, directly or indirectly, by the prevention effort) to survey the community and decide on the most pressing issue that can be successfully addressed with the resources available. Developing the community’s capacity to engage in a prevention effort involves mobilizing the human, organizational, and financial resources necessary, and then providing the appropriate training and technical assistance so that the community has the knowledge and skills to plan and do the work.
In this phase, a diverse group of stakeholders creates a plan with goals, objectives, and action strategies aimed at meeting the needs of the community.
The framework involves the representation of all stakeholders in the process from the very beginning, including the group the effort is aimed at. A cornerstone of the framework’s philosophical base is that prevention only works when the whole community supports it, and when the real needs of the community are taken into account. The emphasis on risk and protective factors both makes prevention manageable and makes it seem more manageable.
Rather than prescribe a particular program, SPF provides resources to help communities find best practices that suit their own needs. Through its website, CSAP links communities and prevention programs to a great number of online resources from a variety of sources.
Over and above their influence on the issue at hand, most risk and protective factors are general as well. It should be noted that, while CSAP makes grants to states and communities, those grants are relatively few. While it certainly makes sense to use proven practices, rather than trying to reinvent the wheel, it is also important to understand that even the best programs don’t necessarily work everywhere, and that all parts of a given program may not be appropriate in a particular situation.
Reporting requirements on CSAP and SAMHSA grants are considerable, and cover every aspect of the development, implementation, and evaluation of the prevention effort.
For those who simply want to use the framework, CSAP does provide access to a large amount of information, and can make it possible to put together an effective prevention program using local resources. Thus, the best time to embark on a strategic prevention initiative may be when the community is ready to turn its attention in that direction.


The first part of a prevention initiative may in fact be an effort to increase community readiness.
Some of those resources may come from CSAP, in the form of grants and technical assistance. The ideal time to begin a prevention effort is before the problem has become so large that prevention may take a back seat to dealing with its immediate effects, but after people have become aware that it could get considerably worse without some intervention. The best way to reduce the risk for any population, and particularly for youth, who are still unformed in many ways, is to keep them from embarking on high-risk behavior. Because SPF has the potential to influence substance abuse over the long term, it’s an ideal way to approach quality-of-life issues. The multiple answers here stem both from the way CSAP grants are made and from the fact that SPF is intended to be inclusive and participatory. They might be state and local health and human service officials, coalition coordinators, human service providers, universities, hospital and clinic administrators, etc. As stated constantly in the Community Tool Box, we believe that, in most cases, participatory planning and implementation of programs leads to efforts that both meet real community needs and assure community support. They are likely to be community-based health or human service organizations, community coalitions, local health departments, or similar groups that engage in prevention efforts either to respond to community needs or as part of a larger local initiative.
It might try to explain the effects of alcohol and various other drugs, conduct prevention classes in middle or elementary school, identify risk and protective factors, let people know where they can get more information, and generally raise community consciousness and concern about the issue. Older people who live alone, far from family and often isolated, may be at risk for alcohol abuse. Depending on the program, these individuals could be identified and referred by school personnel, parents, the court system, law enforcement, social workers, therapists, or others who have contact with them. In the assessment phase, you determine community needs and resources, and identify existing risk and protective factors. Perhaps the best way around this, in addition to recruiting workgroup members from the population(s) most at risk, is to include those recovering from alcohol and drug dependency.
In general, the more methods of collecting information you use, the better picture you’ll get of the issue in your community. A focus group is a specific kind of guided discussion intended to get information on a particular topic from a group.
They may hold leadership official leadership positions in government or institutions, be respected for their professional status or social leadership, or they may simply be known as people of integrity and wisdom.
Legislators and others who determine laws and regulations regarding substance use, as well as those opinion leaders in the community who help to determine attitudes toward it. There are different ways that observation might be used in this kind of community assessment.
Much of your work may have been done for you by various federal, state, and local agencies.
Community readiness is the degree to which a community is ready to take action on an issue.
An instrument for determining community readiness that can be easily applied and scored by community members can be found in Community Readiness, and related Community Tool Box sections that support improving readiness. The questions are where your effort can have an impact, and what you have the resources to do. Rather, it implies that there has to be a critical mass of support and knowledge in order to run an effective program. The group that conducted the community assessment and others that have been interested in the prevention effort from the beginning constitute a core group. A logic model will expand the SPF framework to help you map out exactly how you’ll approach. Depending on what people in the community are aware of, you may want to draw attention to the issue of substance abuse, and emphasize its existence and nature in the community. As the community grows more knowledgeable about substance abuse, it should be easier to recruit people to help with the prevention effort. You may be able to find volunteers who are experienced in curriculum development, public relations, youth work, filmmaking, and other areas that might benefit the effort. This team might be the same as the assessment team, might include some members of the assessment team and some others, or might be entirely different. If the planning team is truly inclusive, at least some members of it may never have had experience in meetings or in group problem-solving, let alone in planning a community intervention. Respecting everyone, making clear that everyone’s opinions are equally valued, drawing in those whose thoughts haven’t been heard, dealing with ideas rather than personalities, listening carefully to everyone without interruption, keeping an open mind, being willing to compromise, not allowing anyone to dominate, reaching consensus, etc. Methods of approaching problems in a group, including such techniques as brainstorming, small-group discussions, and role plays. This might mean information on the effects and health implications of various widely-abused substances, which substances present the greatest problems, which populations are most at risk, etc. What they are, how they work, how they can be used in the context of a prevention program, and some examples. Many team members might not have thought about figuring the cost of a prevention program into their plans, or that program resources include not only funding, but also volunteer time, community knowledge about the issue, community and media support, local expertise (from professionals, organizations, and institutions), and the willingness of local officials and the community to change bylaws and policy to favor prevention.
What constitutes an evidence-based program, how to sort out those that can be reproduced from those that are specific to the situations in which they operate, and how to tinker with such programs to make them more appropriate for a particular community. CSAP recommends hiring a consultant – The KU Work Group or a similar organization – to work with the community on this step, but the reality is that many organizations or communities won’t have the resources for that. CSAP (see Tool # 2) adds a societal domain to these four, encompassing the roles of the national media, the Internet, and the wider culture in forming community and adolescent attitudes and behavior. The adolescent has the opportunity to exercise responsibility, and to feel in control of important parts of his own life. The adolescent understands the value of learning and education, and can apply herself in school and other areas of learning. The adolescent possesses the personal and interpersonal skills to conduct his own life and to engage in positive relationships with others. You should select a manageable number of factors – you can’t address everything at once: that will almost undoubtedly doom you to failure by overextending your capabilities and resources and diluting your efforts in any one direction.
Drugs may be equally available in the next community or neighborhood, or through sources other than those you crack down on. Evidence-based programs are those that have been formally studied using carefully-structured research designs, and have been found to be effective in preventing substance abuse with the populations they served. We’ve already discussed universal (aimed at the whole community), selective (aimed at a particular at-risk population), and indicated (aimed at identified at-risk or substance-involved individuals) programs.  Another way to look at programs is as either individual or environmental. At the same time, for programs it funds directly or indirectly, it requires that, once they choose an evidence-based model to implement, they copy that model exactly. In these cases, it’s important to acknowledge your experience and understanding of the community and its history. If you’re not funded by CSAP, but are simply using SPF as a framework for a community prevention program, you can make your own adjustments as you plan your program. Reinventing the wheel is unnecessary, especially if you already know that the wheel works quite well.
Strategy includes not just what the program itself will look like, but a number of other elements as well. The assumption here is that a prevention effort, to be successful, must be aimed at and involve the whole community. This phase isn’t easy, but it will be a lot easier if you’ve done a good job planning and have the support of the community. Whether your program uses paid staff or volunteers – or a combination of both – it’s important to find the right people to work in it. While timelines can often be affected by external factors – how long it takes to hire staff, a contractor’s work on space, etc. You’ve chosen an evidence-based model because it has proven itself and because it seems to fit your community, your population, and the issues they’re dealing with. You may have obtained the resources you need for the moment, but that doesn’t mean you should relax. Through placing news articles and press releases, presentations to groups, maintaining a presence at community events, and other actions, you can broadcast the program’s successes and continue to generate community interest and support. Is the program having the desired effect on the risk and protective factors you’re aiming at? Has the effort led to the desired outcomes – lower rates of drug and alcohol use, fewer drunken driving deaths, better services for elders?
Adjustments may require more volunteers, more funding, a different method of reaching people, or some other change that the community can assist with. You can find information about almost any aspect of evaluation in the more than 30 sections that comprise these chapters.
The components of its process – assessment, capacity building, planning, implementation, and evaluation – are similar to those of the other logic models and frameworks described in this chapter.
The institution was designed to unite a community in need of reclaiming, restoring, and revitalizing African American cultural heritages, values, and identities. For years, residents longed for a sense of belonging in a community lacking diversity and adequate services to meet the needs of its people. The programs include mental health counseling, alcohol and drug intervention programs, anger management classes for youths, arts and crafts, and many more. Because the AAFCC is a nonprofit organization, each volunteer has made a personal commitment to have an impact on those looking for encouragement. However, as the number of children using the center rises, so does the need for volunteers. College students mentoring, tutoring, and being a friend or role model to the children gives them a chance to see opportunities they might not be exposed to otherwise. For members closely involved, the AAFCC is a place where people can convene, connect, and celebrate the essence of the community. Immigrant communities bring time-tested traditional practices, customs, and knowledge from their countries that can inform and uplift American culture. In the past two decades, Eastern spiritual teachings have blossomed in the hearts and lives of Americans.
As a society, we are greatly informed by the presence of immigrant communities that bring their traditional cuisines to this country.
Others find themselves doing everything they can think of, and barely staying even, or – worse – losing ground. Although they don’t ignore law enforcement, medical treatment, policy decisions, public education, or other actions necessary to address the problem as it already exists, these successful communities try to reduce substance abuse permanently by taking a long-term perspective. Protective factors are the opposite – those elements within an individual or his environment that make him less susceptible to those negative behaviors or conditions. In many upper-class communities, at least until 20 or so years ago, large amounts of alcohol were consumed at dinners, weddings, etc., with the assumption that guests – many of them underage, and most at least slightly drunk – would then drive themselves home. The program is evaluated in terms of process (Did you actually carry out what you planned to do in the way and time period you planned?), impact (Did your program have the intended effect on the targeted risk and protective factors?), and outcome (Did the program achieve its overall community-change goals?). This leads to community ownership of the prevention program, which in turn leads to community participation and support, both major factors in its potential for success. It provides a broad range of proven options to choose from, and encourages communities to develop their own variations where appropriate, thus empowering them to solve their own problems and develop their own assets for the future. The fact that it doesn’t seem overwhelming makes communities more likely to keep at it and be successful.
In particular, we refer you to the Community Tool Box supports for Strategic Prevention Framework founding in Tool #1 of this section. Such protective factors for youth, for instance, as parent-child communication, attachment to the community, self-respect, and high expectations are likely to lead not only to a reduction in dangerous and self-destructive behavior, but to young people themselves developing into better parents and citizens, and becoming role models for the next generation. States distribute much of their funding to communities, but grants are competitive, and it may be difficult, particularly for communities with few resources, to obtain the funds that might increase those resources. While the total amount of these grants is relatively large, the number of recipients is still quite small, and most are large organizations and institutions. An insistence on following program implementation guidelines exactly can ignore the knowledge of the community that may be a local organization’s greatest asset. For many small community-based organizations with limited staff, this requirement may make it impossible to compete for grants. In that case, having to contend with the potential problems raised by points 2 and 3 is not an issue. In fact, with its emphasis on risk and protective factors, particularly for youth, the framework could act as prevention for nearly any undesirable issue, as well as promotion of healthy behaviors and environments. You may not begin to devise and implement a prevention program for a while, but the readiness development is all part of the same effort.
Others may come from the community itself, and consist of people with successful prevention experience, local sponsorship for prevention efforts, funding from community foundations or municipal agencies, media support, etc.
It’s a good time to persuade the community that a prevention program can help to create a future where the issue at hand simply isn’t an issue at all. Working with young children and their families, for instance, can have its effects not only when those children become adolescents, but – more profoundly – when they become parents themselves. An ongoing, successful prevention program is a community asset that can be used to attract businesses and their employees to a community. A prevention effort can be an ideal vehicle to address such change, because it can deal with both the current situation and the next generation.


It might be aimed at a neighborhood, at the community as a whole, or even at a whole county or state. Excessive drinking during pregnancy can lead to fetal alcohol syndrome, which produces babies with a number of serious developmental problems, almost always including brain damage and abnormal facial features, and often including growth problems and mental retardation. Their substance use is often one of the reasons that they are homeless, and contributes to their difficulty in changing their status. In such cases, it would be not only the participants, but those who referred them who are the users of SPF.
Since the prevention effort takes a community perspective, the workgroup should involve all sectors of the community. They understand the substance abuse culture from the inside, while being clear on the need to prevent people from joining that culture.
If the sponsor of the assessment is the municipality (the Mayor’s office, for example), a large institution or organization (a university or a large-city United Way), or a state agency, it will probably have the resources to do that. They can be given to groups or individuals, at random or by selection (population, geographic area, age, etc.) If they’re well-conducted, they can cover various topics, and yield a broad range of answers. It can be used effectively for assessment, but requires a trained facilitator to draw out the participants and keep them on the topic. You might focus on youth, for instance, even though the worst problems are among adults, in the hope of curbing substance use in the future. It could mean walking the streets and noting conditions, watching to see whether kids approach adults to buy alcohol for them outside of liquor stores, noting obvious crack houses, or simply watching interactions in various neighborhoods and parks. Once you understand your community’s level of readiness, you can plan your effort to start at that level and move the community to the next, and to continue to move the community, a level at a time. Until community members are aware of the problem and believe it is important, it’s unlikely that you’ll get much of the support needed for a successful prevention effort.
The substance abuse problem among a particular population may be more than you have the ability to take on at the beginning. Many or most of them may be willing to remain active in continuing to plan and implement the program. Using the stories of community members recovering from substance abuse, especially if they’re willing to tell those stories themselves, is a powerful way to emphasize the need for prevention. You can reach community members through the media, through brochures and bulletin board messages in appropriate places, and – most effectively – through personal contact.
People whose only apparent skill is a willingness to help can network, provide logistical support (stuffing envelopes, scheduling meetings, making phone calls), and help to recruit still others, as well as developing leadership capacity over the long term.
Most may have relatively little knowledge about substance abuse or its prevention, beyond understanding that it’s a local problem that they wish to address. The results of the community assessment, as well as statistics from various sources, can provide team members with a profile of community substance abuse, and some ideas about which directions to move in.
Help may be available from a local college or university, or from one or more local organizations or individuals. You should also select factors that you can truly influence, and in a reasonable period of time. Furthermore, the new sources may be more dangerous to users than the old, both in terms of the drugs they offer and in their potential for violence.
Some may have been tested and found to work in different circumstances and with different groups; others may be specific to a given population or situation – a program targeting rural elders, for instance, or one aimed at urban teens. There are obvious reasons for this: once a model has been proven to work, it makes a certain amount of sense to try to reproduce it perfectly, since any change in it might affect its success. You can borrow some strategies from another evidence-based program that you’ve examined, for example, or devise some strategies of your own to add on to the program you’ve chosen. Improving the wheel is not impossible, however, and if you have the opportunity and the ideas to do so, you might come up with a prevention program that works faster or more smoothly, and that avoids the particular potholes presented by the peculiarities of your community.
The greater the community ownership of the plan, the more likely it is that the plan will be carried out across the board. Paying attention at the beginning of and throughout the implementation phase to some specific aspects of it will also make the task easier. It makes sense to stay as close to the model as possible, at least for an initial period, to see if it works as well for you as it did for others that tried it. Did you meet timelines, reach the number of people and the population you planned to, provide the kinds of service or activities you intended in the way you intended?
You may be doing exactly what you planned, but it may have little or no effect on your chosen risk and protective factors, or it may be having effects you didn’t count on. Again, your program may be affecting the chosen risk and protective factors in the ways you anticipated, but that may not have led to the outcomes you were aiming at.
The opportunity to provide real aid leads to community ownership and support of the program.
Risk factors are those elements in the individual, family, peer group, or society that make it easier or more likely for someone to fall into substance abuse. The camaraderie within the center creates a constructive environment for everyone to thrive. Meditation, yoga, and qigong -- the ancient Eastern arts for connecting with the soul -- are taught throughout America.
With so many different studies and perspectives being touted, the simple question of what to eat has become very complicated. There is much that we have learned and much more that we must continue to learn from immigrants regarding our diets. Many medical systems that were brought from foreign shores have shown themselves to be effective and have gained wide popularity in American culture. In America, the most diverse place on the planet, we have the historic and unique opportunity to embody the greatest features of all the different civilizations from which our ancestors came. The results of the evaluation are then used to adjust the program to make it more effective, and the cycle begins again. Other resources include the CSAP Prevention Platform, a set of program development, implementation, and evaluation tools, the CSAP and SAMSHA websites and other best practices.
Those who are interested in implementing SPF on their own can expect a certain amount of technical assistance and guidance from the CSAP and SAMHSA websites, but little else. States may distribute their SIG’s to smaller organizations in communities, but the amount of money available is still relatively modest, and not all states have these grants.
It’s important to convince the community that a prevention effort is vital to its long-term health.
If the public understands that, prevention can become the mode of choice when addressing a population’s risk and protective factors. An ongoing substance abuse prevention program can affect what happens next year, but can have even more serious effects on what happens in 20 years. They are required to involve all stakeholders from the beginning, and that implies a much broader range of people.
Universal programs are geared toward a whole community or part of a community, even though everyone they reach is not necessarily at risk for substance abuse. Who would be served in this case would be everyone the program could reach, in the hope of establishing community norms that work toward prevention, and alerting the community to existing risk factors.
Adolescence, or just before, is also the typical age for people to start using alcohol, tobacco, and other drugs.
That doesn’t change the number of non-dependent teens killed or injured in alcohol- and drug-related motor vehicle or other accidents, or the amount of emotional and property damage they may cause or suffer while under the influence. Smoking during pregnancy can be responsible for low birth weight and other problems for the baby, over and above its effects on the mother herself.
They may be overmedicated, or their medications may interact with one another or with alcohol to produce apparent dementia or other symptoms. Substance abuse in the homeless population is also often tied to physical and mental health issues leading to the misuse of various medications prescribed for physical and psychological conditions, or self-medication with alcohol or narcotics to dull the emotional or physical pain of mental or physical illness. If it’s a small, community-based organization, or a coalition of such organizations, it may well have to rely on volunteers and on inexpensive techniques, and to focus more narrowly, unless members of the workgroup are able to provide financial and other resources. Participant observation could mean riding or walking a beat with a police officer, getting to know drug dealers or runners, or actually making a buy.
Local agencies, the National Institutes of Health (of which CSAP is a part), the Department of Health and Human Services, state youth service departments – all may have collected information on substance use in your community that’s just waiting for you to look up.
Your first tasks in that case may be to get the community to that point, and to involve it in planning. You may want to focus on a more manageable population, or a different issue – alcohol use as opposed to crack, for example – that you can be successful with, and thereby build your capacity to take on something more formidable. Whatever the overlap or lack of overlap, team members should represent all sectors of the community. At least some risk and protective factors may also have been identified in the course of the community assessment, and in evaluating community readiness.
You might be able to rid your own neighborhood or community of drugs, but that doesn’t mean you’ve eliminated, or even reduced, their availability. If the program you’ve chosen speaks directly to your community and your population, there is no real reason not to implement it just as its creators did.
It’s often easy to skip steps or to ignore the plan, but those almost always lose you time, cost you extra money, or simply make getting the program off the ground much more difficult. Almost all funding is time-limited (often to a year, or even less), so the need for new or continuing sources never really ends.
You’ll have to find another way to affect those factors, or determine whether you were simply not implementing the program properly. In that case, you’ll have to decide whether you were addressing the wrong risk and protective factors (and which ones you should address), or whether there’s another way to reach your goals.
Protective factors, on the other hand, are those elements in the individual or his environment that make it easier or more likely for him to avoid substance abuse.The assumption is that if you can reduce or weaken risk factors and strengthen protective factors in a population or community, its members are less likely to experience substance abuse problems.
These are rich cultural practices that Asian immigrants helped to bring from their homelands. In his book, In Defense of Food, renowned food author, Michael Pollan, discusses how the best answers for what to eat come from traditional cuisines. In many of these places, farming is organic by default because chemical inputs are not available. Acupressure and acupuncture from East Asia, ayurveda from India, and herbalism from Latin America are just a few of the many immigrant medical systems that have enriched our body of medical knowledge here in the United States. For those that lack resources, this may not be enough to make it possible to use the framework. Selective programs are intended to reach at-risk groups: particular populations, neighborhoods, age groups, or cultures.
If they can be persuaded not to start at all, or to delay until they’re mature enough to understand what they’re doing and what the results might be, the chances of their using and abusing these substances are greatly reduced.
If all a prevention program does is to convince kids to think for a second before they act, it will have performed an enormous community service.
Although the effects have not been as carefully studied as those of alcohol and tobacco, drug use – particularly of heroin and amphetamines – appears to pose dangers to fetal development as well.
The range really depends on what you’re looking for, and what you and others involved in the assessment are capable of. Once community members understand the concept of prevention and see the need for it locally, it’s more than likely they’ll support and participate in your effort. The team’s composition should be as diverse and inclusive as possible, crossing racial, ethnic, class age, gender, and other dividing lines, so that everyone in the community feels that her point of view can be heard. You don’t have to, and shouldn’t, spend every minute in pursuit of funds and other resources. Changes have to be maintained, and that means continuing at least some of the major elements of your prevention program for as long as substance abuse remains a problem in society. In classrooms, seminars, and gyms across the country, this knowledge is passed to Americans of all races and creeds.
Traditional cuisines are complete systems for eating that give a person the full spectrum of nutrition needed to thrive. Indicated programs serve referred individuals who have been identified as at high risk for substance abuse. An effective prevention program can eliminate a lifetime of difficulty for both mother and child.
Worst of all, these issues are seldom raised by health professionals, social workers, and others who work with older people, and may go unrecognized. You should, however, be aware of the program’s needs, take advantage of opportunities that arise, seek new and maintain good relations with current funding sources, and always be preparing documentation and other materials for funding and other requests. Immigrants in America who have this cultural knowledge are a valuable asset to us as we strive to grow more clean organic food here. Prevention programs can raise and address them, and lead to a longer and more productive and satisfying later life.
Just as the best treatment for substance abuse is to prevent it in the first place, the best remedy for a crisis over resources is to prevent it from arising.




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