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April Monthly Newsletter
The Role of Prevention During and Following a Disaster
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In this Issue:
- The Role of Prevention During and Following a Disaster
- What's Happening Around the Region?
- Epi Corner: Data Collection Considerations During Disasters, Pandemics, and Other Crises
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When a disaster strikes a community, it is sometimes unclear how prevention practitioners should
respond and what their role might be.
This month we address common questions that prevention practitioners ask when the communities they serve experience a disaster.
- What do substance use patterns tend to look like in the aftermath of a disaster?
It is commonly assumed that the stress of disasters and other types of community trauma lead directly to significant increases in substance misuse and associated consequences. However, the pattern of substance use related to disasters is much more complex and is strongly shaped by pre-existing risk factors.
Substance Use and Disasters: A Brief Review of the Literature
developed by the South Southwest Prevention Technology Transfer Center team provides additional details on the relationship between substance use and disasters, including a short section on substance use and infectious disease outbreaks. To read the literature review in its entirety go to
https://pttcnetwork.org/centers/south-southwest-pttc/product/substance-use-and-disasters-brief-review-literature
. Our Epi Corner below discusses considerations for collecting new data during, and following, a disaster.
- What relevant resources or skills can prevention practitioners offer to support disaster response efforts?
The work of prevention continues to be critical during, and following, a disaster. Disasters tend to disrupt or place additional burdens on community systems, like health care, that regularly respond to substance misuse and associated consequences. Prevention plays an important role to reduce the burden on those systems. Disasters may also place additional stress on both physical and behavioral health. Prevention focuses on building protective factors and enhancing community and individual wellness, which can mitigate some of the damage of disasters, particularly for vulnerable populations.
The work of prevention spans across individuals, families, organizations, and systems and involves extensive coordination and collaboration across community sectors. Prevention practitioners are skilled at building community readiness and capacity. These and other skills make the prevention practitioner a valuable partner in disaster response efforts. The checklist linked
here
provides additional ideas for ways prevention practitioners can leverage their unique skills to support disaster response efforts.
- How can prevention efforts be sustained? Should our current prevention priority change?
Disasters may or may not disrupt implementation of prevention interventions in the community, but the burden of substance misuse that existed pre-disaster likely will continue during, and following, a disaster. It is important to maintain focus on achieving and sustaining prevention outcomes even if specific activities are disrupted. Disasters and associated emergency response policies (curfews, changes in alcoholic beverage and tobacco sales rules, quarantine etc.) may alter the context of community risk factors, particularly those related to enforcement and availability. Disasters may reduce the participation of community partners or the accessibility of physical infrastructure. New partners may emerge. Prevention practitioners can go back to their strategic plan and logic model, collect data on any changes in community capacity, risk and protective factors, or community context, and use that data to adapt planned interventions. The tool linked
here
can guide a review of an existing strategic plan. Excerpts from a toolkit created by one community coalition, linked
here
(Don’t Let One Disaster Lead to Another) illustrate how coalition members worked through the steps of the Strategic Prevention Framework following a disaster in their community.
Resources
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What's Happening Around the Region?
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Prevention Technology Transfer Center, Substance Abuse Prevention Skills Training (SAPST) Trainer Learning Community and Materials Portal
The PTTC Network now has a Learning Community and Materials Portal specifically for SAPST trainers and training coordinators who plan and coordinate the delivery of the SAPST four-day face-to-face training. Inside this virtual community, one will have access to the updated SAPST materials, upcoming SAPST and SAPST ToT events, and training tips from SAPST master trainers. Individuals will be able to connect with other SAPST trainers from across the U.S. and share ideas and resources. To register for the PTTC SAPST Trainer Learning Community and Materials Portal, visit
www.tinyurl.com/SAPSTLearningCommunity
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NEW Self-guided Learning Courses
Informing Prevention: Adolescent 6-part Webinar series
- Informing Prevention: Understanding Adolescent Development (1 of 6)
- Informing Prevention: Effectively Engaging Adolescents in Interventions (Part 2 of 6)
- Informing Prevention: Effective Use of Epidemiological Data (Part 3 of 6)
- Informing Prevention: Effectively Using Technology for School-Based Prevention (Part 4 of 6)
- Informing Prevention: The Effects of Drug Use on Adolescent Brain Development (Part 5 of 6)
- Informing Prevention: Vaping Among Adolescents (Part 6 of 6)
Today’s Marijuana: Stronger, More Edibles, Confusing Information about Driving
Early Childhood Development: Toxic Stress and Adverse Childhood Experiences
Online Courses
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The South Southwest PTTC is currently suspending in-person training and meetings until further notice. Virtual services will proceed as scheduled.
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2020 PFS Academy: Making the Steps of the Strategic Prevention Framework Work for You.
Each webinar will begin at 8:00 PT/9:00 MT/10:00 CT/11:00 ET
SAMHSA’s Strategic Prevention Framework (SPF) provides practitioners with comprehensive guidance to more effectively address substance misuse and related behavioral health problems in their communities. This seven-part webinar series will explore this five-step, data-driven process to identify genuine prevention needs, build capacity and plans to address those needs, implement effective programs and interventions, and evaluate and continually improve prevention efforts.
At each step of the SPF, and in separate sessions, practitioners will learn to incorporate the guiding principles of cultural competence and sustainability to help support the implementation of SAMHSA’s Strategic Prevention Framework (SPF).
Certificates for prevention hours will be available upon registration and completion of the webinar.
- April 21, Part 3: Planning, will prepare participants to plan to address prevention problems identified during the needs assessment step.
- May 19, Part 4: Implementation, will provide participants with the tools needed to implement prevention programs, policies, and practices with fidelity and effectiveness.
- June 23, Part 5: Evaluation, will offer helpful guides for the collection and analysis of prevention strategies and teach participants how to modify programming for future enhanced results.
- July 21, Part 6: Sustainability,will provide participants with the elements needed for a sustainable prevention program and how to integrate sustainability into each step of the SPF.
Previously recorded training in the series can be found
here
by clicking on the training tab.
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Epi Corner
Iris Smith, Ph.D., M.P.H.
South Southwest Prevention Technology Transfer Center
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Data Collection Considerations During Disasters, Pandemics and Other Crises
Natural and man made disasters can have far reaching and enduring impacts on a community. Epidemiologists can play a vital role in post disaster surveillance of changes in behavioral health indicators, the differential impact on vulnerable populations, and community and provider needs. The focus of data collection efforts should be on determining the severity
of impact on current prevention activities, anticipated long-term consequences, and implications for prevention planning. These data might include:
- Changes in the trajectory of substance use and or consequences in the community (for example, patterns of drug use, overdose episodes, drug related mortality);
- How the crisis and the interventions that were implemented to address it influenced other behavioral indicators following the event. For example, interventions to slow the spread of Covid-19 requires individuals to isolate themselves from others. Loneliness and isolation are known to be risk factors for depression and relapse in drug using individuals;
- How the event and response activities changed the context of risk factors in the community. For example, how does the closure of alcohol retail outlets change the availability of alcohol in the community? Is parental monitoring increased or decreased during the disaster and its aftermath?
- How the event affected prevention and treatment resources in the community;
- Identification of subsets of the population that appear to be more severely affected by the event compared to the general population, including possible disproportional impact of the disaster on those using or misusing substances.
- Evidence of disparities in outcomes related to geography, demographics, or disabilities;
- Strategies to incorporate indicators of potential long-term consequences of the event into ongoing data collection plans;
- The need for specific training, information, or other resources for prevention providers in the community.
In most cases, there is very little warning before a natural or man made disaster. Therefore, it is important to be prepared. Some things to consider beforehand include:
- Ensuring that there are inter-agency data sharing agreements in place that specify procedures, contacts, and other relevant information. Differences in data labels and compatibility of data management platforms should be identified beforehand and resolved if possible.
- Establishing back-up data storage, should power outages or equipment failure occur.
- Clarifying any requirements for internal review or approval for data sharing.
Rapid data collection, analysis and dissemination is essential to community recovery. Limitations in resources, time, and sampling considerations may be challenging, particularly when there are competing priorities among community organizations. It may be helpful to think through what data might be important to collect during or immediately post event and determine who is best positioned to collect it. Inter-agency agreements on what data will be critical, who has ownership of the data needed, what level of access is needed, and how data will be shared are some of the issues that should be discussed before a crisis or disaster occurs. However, effective data sharing requires flexibility by all stakeholders and should allow collaboration between stakeholders in the absence of pre-existing relationships as long as all collaborators agree to adhere to fundamental ethical principles governing data access and use.
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Accessing data that is already being collected is probably the most practical strategy. However, there may be a need to collect data during or shortly following the catastrophic event. In these cases, you may want to consider some of the following qualitative data collection strategies:
- Key informant interviews of community stakeholders and service providers.
- Focus groups
- Crowdsourcing
- Social network analysis
A 2018 literature review by Davis et al. (2018) identified the need for a standardized approach for After Action Reviews following a public health emergency. These authors proposed a minimum reporting standard to help ensure that results are valid and clear for others to learn from (pg. 623).
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The
FAIR Guidelines for Scientific Data Management and Stewardship
were developed by the World Health Organization to act as a guideline for those wishing to enhance the reusability of their data holdings.
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The guidelines are based on four core principles: Findability, Accessibility, Interoperability and Reusability (FAIR). Distinct from peer initiatives that focus on the human scholar, the FAIR Principles put specific emphasis on enhancing the ability of machines to automatically find and use the data, in addition to supporting its reuse by individuals. You can find more information on the FAIR principles in the Epi Resources below.
Epi Resources
References
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