November 17, 2015 Strengthening the Air Force Reserve Command's Substance Abuse Prevention Workforce: A Case Study in the Implementation of a Comprehensive Prevention Approach SAMHSA s Center for the Application of Prevention Technologies (CAPT) Wayne Harding, Ed.M., Ph.D. Principal Investigator & Director of Evaluation for SAMHSA s Center for the Application of Prevention Technology (CAPT), Waltham, Massachusetts Don Jenrette, M.S., Ed.D., GS-12, Air Force Reserve Command (AFRC) Drug Reduction Program Manager, Air Force Reserve Command, Robbins Air Force Base, Warner Robbins, Georgia
This training was developed under the Substance Abuse and Mental Health Services Administration s Center for the Application of Prevention Technologies task order. Reference #HHSS283201200024I/ HHSS28342002T. For training use only. 2
Introductions 3
What is the CAPT? The Center for the Application of Prevention Technologies is a national training and technical assistance (T/TA) system that serves Substance Abuse and Mental Health Services Administration Center for Substance Abuse Prevention (SAMHSA/ CSAP) grantees from the Strategic Prevention Framework State/Tribe Incentive (SPF SIG/TIG), Partnerships for Success (PFS), and the Substance Abuse Prevention and Treatment Block Grant (SAPT-BG). See: www.samhsa.gov/capt. 4
Agenda/Topics During a 3-year collaboration, the CAPT and the Air Force Reserve Command (AFRC) adapted, implemented, and evaluated the Substance Abuse Prevention Skills Training (SAPST) to prevent substance abuse among Air Force Reservists Over the next 3 years, the AFRC diffused the training and complementary prevention activities Results of the diffusion have been positive 5
Population At Risk In both its 2011 1 and 2014 2 Leading Change strategic planning documents, SAMHSA identified military service members, Reserve, and National Guard components, veterans, and their families as being at high risk for behavior health problems such as substance abuse and suicide. 6
AFRC Was Focused on Drug Testing AFRC efforts to address substance were focused primarily on drug testing Little attention was paid to substance abuse education or prevention The AFRC was good at detecting drug use, but the rising number of positive drug tests, showed it was not good at preventing it. 7
What is the Substance Abuse Prevention Skills Training (SAPST)? A workforce development curriculum to prepare entry-level prevention practitioners Based on SAMHSA s Strategic Prevention Framework (SPF) Provides an introduction to the fundamentals of substance abuse prevention, including current research and theory, planning, evaluation, and the cultural context of prevention 8
The AFRC SAPST Three annual trainings (2009-2011) to 112 Drug Demand Reduction Program personnel Delivered to Drug Demand Reduction Program technicians Delivered face-to-face over 5 days by multiple CAPT trainers Adapted to reflect AFCR language and culture Included development of action plans 9
Results Quality of the Training Satisfaction 100% were satisfied with the overall training and with 7 aspects of the training Utility 100% reported they were likely to apply the information/ideas received 10
Results Impact of Training on Knowledge Subjective Knowledge Significant pre- to post-test increases on overall score, and on all 67 items Objective Knowledge Significant pre- to posttest increases on overall score, and improvement on 17 of 20 items 11
Results Impact of Training on Capacity How well prepared 100% were A Good Deal More or Much More prepared to fulfill their roles as AFRC preventionists Capacity Significant pre- to post-test increases on overall score, and on all 16 items 12
Ending the CAPT AFRC Partnership In 2011, due to a lack of funding, collaboration between the CAPT and the AFRC ended Since 2012 the AFRC has demonstrated independent capacity to both sustain and expand its prevention activities 13
Citations 1. Substance Abuse and Mental Health Services Administration, Leading Change: A Plan for SAMHSA s Roles and Actions 2011-2014 (2011). HHS Publication No. (SMA) 11-4629. SAMHSA, Rockville MD. 2. Substance Abuse and Mental Health Services Administration, 2011. Substance Abuse and Mental Health Services Administration (SAMHSA), (2014). Leading Change 2.0: Advancing the Behavioral Health of the Nation 2015 2018. HHS Publication No. (PEP) 14-LEADCHANGE2. SAMHSA, Rockville MD. 14
If you have questions or comments, please don t hesitate to contact:" " Wayne Harding" Principle Investigator" and Director of Evaluation" 781-273-4206" wharding@ssre.org" 15
United States Air Force Reserve I n t e g r i t y - S e r v i c e - E x c e l l e n c e Drug Demand Reduction (DDR) Dr. Don Jenrette DDR Program Manager Air Force Reserve Command (AFRC) Health Services Directorate 16
AFRC DDR Overview Air Force Reserve Command (AFRC) History of DDR Program (1998-2008) History of DDR Program (2009-Present) Implementation and Sustainment of Evidence-based Prevention AFRC Logic Model (Strategic Plan) AFRC Discharges for Positive Drug Test Results (2010-2014) Way Ahead 17
Air Force Reserve Command (AFRC) Established April 14, 1948 and located at Robins AFB, Georgia One of twelve Air Force major commands 67K serve at 66 locations in 29 states to include AK, HI, Guam Serve one weekend a month & a 2 week annual tour 18
Air Force Reserve Command (AFRC) Average age of officers is 7 years older than active duty AF Average age of enlisted is 5 years older than active duty AF 74% male and 26% female / 71% Caucasian, 17% Black, 10% Hispanic, 7% Other, 5% Asian/Pacific Islander/ Indian Core functions include global precision attack; intelligence, surveillance & reconnaissance; rapid global mobility; agile combat support; special ops; personnel recovery; space & cyberspace superiority; nuclear deterrence ops; command & control; and education & training 19
History of DDR Program (1998-2008) From 1998-2008, substance abuse prevention program involved dissemination of promotional items with TRUE BLUE logo Worked with Civil Air Patrol to educate future AFRC members In 2005, implemented TRUE BLUE initiative using four pillars: career, health, workforce leadership, and family Positive drug test results continued to rise Early 2009, contacted SAMHSA requesting help to drive down positive drug test results and subsequent discharges In 2009, began partnership in providing Substance Abuse Prevention Skills Training (SAPST) to reservists because no available AF- or AFRC-centric training 20
History of DDR Program (2009-Present) 2009 SAPST iteration taught by Center for the Application of Prevention Technologies (CAPT) instructors; not AFRC-centric 2010 SAPST included some AFRC-centric demographics and issues Last SAPST taught by the CAPT in 2011 and was more AFRC-centric 2012 SAPST postponed 21
History of DDR Program (2009-Present) 2013 SAPST taught by Prevention Resource Team (PRT) made up of civilians from standalone AFRC bases & totally AFRC-centric 2013 & 2014 SAPST delivery twice each year included building of Logic Model to take to bases for implementation and sustainment 2014 SAPST included assignment of PRT member to serve as technical advisor and to follow up with each SAPST attendee 2015 SAPST delivery combined with drug testing administration training delivery (back-to-back) 3 days SAPST + drug testing admin training (more bang for $) 22
AFRC DDR Substance Abuse Multi-Pronged Prevention Strategic Plan Integrated Delivery System/ Community Action Information Board Substance Abuse Prevention Specialist Training Yellow Ribbon Program Frontline Supervisors Training Wingman Toolkit Website Squadron Commanders Briefings 23
Implementation and Sustainment of Evidence based Prevention (IDS/CAIB) DDR uses Integrated Delivery System (IDS) in collaborative efforts to get buy-in in direct support of implementing and sustaining evidence-based substance abuse prevention initiative IDS is team of helping professionals serving as action officers (JAG, Safety, Military & Civilian Personnel, Sexual Assault Response Coordinator, Yellow Ribbon, Chaplains, First Sgts, Command Chief, Physical Fitness, Finance & DDR) IDS recommends people program implementation to the decision-making body of the Community Action Information Board (CAIB) membership CAIB is made up of CV (major general) and all the directorate-level team members (brig generals, colonels, and SES) 24
Implementation and Sustainment of Evidence-based Prevention IDS team meets monthly and presents status of their collaborative work to CAIB membership semi-annually In 2010, DDR garnered support from IDS and CAIB to implement multi-pronged prevention approaches learned and suggested by CAPT Multi-pronged approach includes: SAPST, Yellow Ribbon event participation, Frontline Supervisors Training participation, Wingman Toolkit entries, and squadron commander briefings 25
Implementation and Sustainment of Evidence-based Prevention (SAPST) SAPST occurs twice annually for newly assigned DDR pros SAPST broken into East and West Region deliveries in Atlanta and San Antonio SAPST facilitated by extremely talented and seasoned PRT members from base-level DDR Program locations PRT analyzes pre- and post-test questionnaires to measure successes for each module of instruction & overall training Post-SAPST analysis assists in tweaking for next delivery SAPST attendees leave with own individually developed Logic Model for implementation and sustainment PRT members assigned to a specific number of attendees to provide follow-up on sustainment efforts at base-level 26
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Implementation and Sustainment of Evidence-based Prevention (YRP) Yellow Ribbon Program (YRP) designed to assist reservists and family members prior to, during, and after military deployments YRP events include participation from DDR professionals Provide literature, briefings to reservists Provide literature, SWAG, and briefings to youth of reservists Use Fatal Vision Goggles to simulate visual impairment and discuss effects of alcohol and drugs on the body and mind Review YRP participants formal and informal feedback after each event to improve delivery and share results with others 28
Implementation and Sustainment of Evidence-based Prevention (FST) Frontline Supervisor Training (FST) designed initially to target audience with historically highest number of suicide attempts and completions Audience is made up of two specific Air Force specialty groups and FST designed to train their newly assigned supervisors to effectively recognize substance abuse and where to go for help Historical review of positive drug test results and subsequent discharges since 1998 show same audience Garnered IDS and CAIB support in implementing and sustaining substance abuse prevention questions for use during FST delivery 29
Implementation and Sustainment of Evidence-based Prevention (Toolkit) Wingman Toolkit initially designed by Army National Guard and was made AFRC-centric AF learned of our successes and it s now AF-centric, too Wingman Toolkit stresses Airmen Never Leave Their Wingman Alone and ACE (Ask, Care, Escort) Toolkit emphasizes Four Pillars of Comprehensive Airman Fitness: Spiritual, Mental, Physical, and Social Contains in-house developed outreach material (videos, downloadable literature and posters) Available by app and other social media http://wingmantoolkit.org/ 30
Implementation and Sustainment of Evidence-based Prevention (CC Briefs) Squadron Commander briefings are designed to educate newly appointed first-echelon commanders on DDR program and their roles in drug testing and evidence-based substance abuse prevention education Present statistical information on drug testing detection and prevention education deterrence Demonstrate Fatal Vision Goggles and discuss their outreach roles and responsibilities during 101 Critical Days of Summer, end-of-year family celebrations, and other safety office programs 31
AFRC Logic Model (Strategic Plan) Overarching AFRC Logic Model contains broad brush, multi-pronged substance abuse prevention education approaches Includes the Problem (Prevalence), Why (Root Causes), Why Here (Local Factors), and Strategies Next slide provides a snapshot of the AFRC Logic Model 32
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AFRC Discharges for Positive Drug Tests (2010-2014) If you want to keep gettin what you re gettin, keep doin what you re doin Current work shows fruits of our labor using multipronged, evidence-based substance abuse prevention approaches Provides last 5 years of number of reservists discharged for positive drug test results while maintaining same percentage tested annually CAIB leadership says slide should be on a tee shirt Next slide shows those results 34
Drug Demand Reduction 100 80 60 40 20 Details 0 38 AFRC Discharges for Positive Drug Test Results 84 75 31 ASSESSMENT Analysis Current as of 1 Jan 2015 OPR: AFRC/SGSD 10 CY10 CY11 CY12 CY13 CY14 Objective: Reduce number of positive drug tests and admin discharges Measure: Left Vertical Axis: AFRC members administratively discharged for positive drug tests & Right Vertical Axis: Percent of assigned tested annually Data Source: ARPC, AFRC/JA & AF Drug Testing Lab 45 40 35 30 25 20 15 10 5 CYs 10-14 statistics Number of AFRC members admin discharged for positive drug tests Annual strength at 48,897 Countermeasures FY10/11: 60 DDR pros SAPST trained FY13/14: 88 DDR pros SAPST trained FY15: 30 Scheduled for SAPST class AFRC FST educated Yellow Ribbon Events SQ/CC Crse Briefings Substance Abuse prevention placed on Wingman Toolkit site 35
Way Ahead Continue multi-pronged approach designed to further drive down positive drug test results & subsequent discharges of reservists Show Office of the Secretary of Defense (OSD) that our prevention education measures are working for AFRC in driving down positive drug test results and subsequent discharges Show OSD our CAIB supported initiative is serving as a preeminent deterrent to substance abuse among AF reservists Play role in supporting AFRC efforts to continue at current rate of annual testing versus increasing numbers tested Share our success with anyone who ll listen Provide resounding support for SAMHSA s CAPT and how they changed the way we do business in prevention & our results 36
AFRC DDR Review AFRC Drug Demand Reduction Program Air Force Reserve Command (AFRC) History of DDR Program (1998-2008) History of DDR Program (2009-Present) Implementation and Sustainment of Evidence-based Prevention AFRC Logic Model (Strategic Plan) AFRC Discharges for Positive Drug Test Results (2010-2014) Way Ahead 37