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I want to thank NIDA for the opportunity to participate in this conference and to share with you some of New Jersey's experiences in keeping with the theme of the conference, which is putting research to work for the community.
Today we have a wonderful panel composed of State and local community leaders who have experiences in linking research and practice with service delivery issues and who are ready to share their experiences.
Yesterday we heard over and over again that there are certain questions that the community needs to focus on when selecting a particular model program. These questions include, Does the program address the needs and problems identified by a needs assessment? Is the program ready for distribution? Has it demonstrated efficacy and effectiveness? What aspects of the program would have to be adapted to fit the needs of this particular community, such as cultural issues?
Practitioners want to know how much the program costs. How long must it be administered to achieve positive effects? Will training, technical assistance, and protocols be available? Are manuals developed that will assist in the implementation process?
Some of those questions were answered yesterday, and some of them will be answered today by our panel. First, I will talk about New Jersey's approach to conducting a statewide needs assessment study. Next, Mr. William Crimi, executive director of the Franklin County Prevention Institute in Ohio, will share with you that county's perspective in undertaking a needs assessment project to plan prevention services. Mr. Harry Montoya of Hands Across Cultures in New Mexico will talk about cross-cultural issues specific to Hispanic-Latino populations and how these must be integrated into a needs assessment process and also into program planning and program implementation. Finally, Mr. Thomas Connelly, an educator and implementer of the Life Skills Training program in New York, will talk about implementing that program in the school system.
Putting research to work for the community is the theme for this conference and also the philosophical approach adopted by the New Jersey Prevention Needs Assessment Project. New Jersey is undergoing a major initiative called Prevention Unification, which is designed to coordinate the needs assessment and planning process on a county-by-county basis so they all work in unison. Counties were asked by the State to submit a single, countywide prevention plan based on a risk and protective factor model, including a comprehensive needs assessment and measurable outcomes.
Some of you who are representing State agencies or who are local county and community planners may already be doing this. However, this is a major shift in our State. Formerly, New Jersey did prevention planning on the basis of an intuitive, gut feeling of what types of pro-grams were needed and why. Now we are shifting that focus. We are saying that we are going to conduct science-based needs assessment projects and studies - actually a family of studies - to determine where the problem is, who is having the problem, and the extent of the problem, and to guide our planning process.
As part of the unification process, each county is already forming working groups with representatives from the entire community, and we have heard how important that task is. The working groups include the schools, community agencies, businesses, municipal and county governments, faith communities, and others. In that way, many community institutions become knowledgeable about the community's prevention needs and how best to meet them as they are forming the planning process.
In the midst of this, CSAP announced a major initiative, the CSAP Prevention Needs Assessment Contracts. We applied and were fortunate enough to get one. It is one of the best Federal initiatives to help develop the State's infrastructure, and for this we thank CSAP and CSAT. These contracts have enabled New Jersey to produce data-driven planning and resource allocation processes that otherwise would not have been possible.
I will briefly describe the different types of studies we have been undertaking for the past 3 years, as well as our three overriding concerns when we decided to undertake these studies:
- One concern was [assessment of] the gaps in services. We looked at what data we already had and at what data were missing, and then we decided to design a study to get that data.
- Our second concern was to make sure that the data being derived from these studies and other kinds of activities being undertaken at the State level would also fill the needs of the local, county, and municipal planners. We asked planners what kind of data they needed and in what format and how we could help them develop their needs assessment studies.
- Our final concern was that we needed to come up with a formula for the reallocation of prevention resources based on these data. That was pivotal to the whole process.
With this in mind, we decided to look at seventh and eighth graders because we had no data on this population. We have protocols for all of the surveys I am going to talk about, and we are in the process of finalizing the report. If you are interested in the particulars of the design and some of the results, you can contact me, and I will send them to you.
The mature citizen survey is a unique undertaking, and we are very proud of it. We decided to look at individuals 65 and older to determine the prevention needs in this overlooked population. We seem to concentrate on kids; however, our seniors also have prevention needs that should be addressed.
We also decided to undertake a community leader survey, which I will describe later because I want to give you more particulars; this survey looks at community readiness from a different perspective.
One of the cornerstones of a needs assessment project is a social indicator study, which comprises three separate activities that we have been undertaking. The social indicator study is a study of archival data that we have summarized.
You often hear that prevention programming must match the nature of the problem in the community. However, few communities have the wherewithal, especially the financial means, to conduct a science-based needs assessment study that looks at all of the different, complex factors. Therefore, when we asked county coordinators what they would like, they said, " We want you to produce something for us that we can understand. Don't give us tables because it is difficult for us to interpret those data."
Keeping that in mind, this is exactly what we went about doing. We used a factor analysis procedure and developed composite risk indices to summarize all of the municipal-level data. We compiled 50 municipal profiles that looked at risk and protective factors in the four domains and in the subdomains. We gathered data from the surveys, from the census, and from other archival kinds of data and came up with risk indices and risk scores for each city and each county. In this way, local planners could easily see where their city stood with respect to all the different risk domains as opposed to the State or averages.
Some of our counties look a little bit different from some of the cities within counties because some of those cities within counties drive the data. For example, Essex County may not look as bad on the risk indices, but if you look at the city of Newark within Essex County, you will see that it is not Essex Fells in Essex County that is having the major problems but Newark and East Orange in Essex County that are having most of the problems. This approach teases out the data to the lowest possible level to allow county and municipal planners to zero in and target prevention programming and different kinds of plans and activities where they are needed.
Our chartbook is close to 100 pages, and the raw data are included at the end as an appendix. We are planning to continuously update the information as the data change. This is an ongoing process, not a one-shot deal, and we have made a commitment to the county and local planners to update this chartbook as new data become available so they will always have up-to-date data on which they can base their planning. This is especially important in conducting outcome measures for the prevention activities. Planners can look at current baseline measures in all of these risk domains and compare them with the results after the prevention programming is completed.
State employees should remember that they are collecting data not only for their needs but also so that they can be used at the local and county levels. County, municipal, and other planners should make sure that they "reach out and touch" the State people and say, "No, what you are producing is not making any sense for us. We need this interpreted for us."
Our community leader survey is a fascinating piece. It looks at community cohesion, which is a piece of the community readiness approach. Without going into the theoretical basis, I want to share with you whom we surveyed. We looked at major groups - education, law enforcement, public health, and local government. We also looked at the faith community and business. Within each one of those, we looked at two specific leaders.
In the education area, we surveyed superintend-ents of schools and presidents of the boards of education. In law enforcement, we looked at police chiefs and prosecutors. In public health, we looked at hospital directors and mental health directors. In local government, we looked at mayors and public health officers. In the faith community, we looked at religious leaders who were recognized in the community as participating in prevention activities and then at interfaith organizational leaders of major interfaith coalitions within those counties. We also looked at business, because we felt that business was an integral part of this whole prevention activity. We looked at the largest employers within that county or municipality and at chairs of the chambers of commerce.
We asked these individuals about several major areas. We wanted to know the priority of substance abuse problems in their community, the target population that they perceived needed prevention programs, the efficacy of prevention approaches that had been utilized, and the accessibility of substances within their counties and municipalities. Then we wanted them to judge the importance of these factors in the development of prevention activities.
Armed with objective data from the social indicator study from our middle school survey, we are now able to compare the perception of what the problem is versus our objective, data-driven analysis of what the problem is within
municipalities.
Eighty-five municipalities received a mail survey, which resulted in a 51-percent response rate, which is pretty good for a mail survey. We did cohesion scores to assess what these community leaders were thinking about and wanted to do in their community, irrespective of what we know from the science base - which is what kinds of programs fit best for what kinds of problems. If you are interested in knowing about this, I will send you the protocol, and we can share our final report with you.
We feel we have a very rational approach. However, policy and program implementation does not necessarily follow a rational approach, which is why we decided to look at cohesion with community leaders to try to prevent the disconnect between policy and research and program planning and research. We also wanted community coalitions and partnerships to be aware of what they were facing if they tried to implement programming that was not in concert with what community leaders felt their community needed.
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