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June 7, 2017

Planning community prevention part 1

Start with some questions

The misuse of alcohol and other drugs (AOD) has enormous impacts on communities around Australia: from influencing crime, to public violence and property damage, to reducing workplace productivity. It impacts families too, leading to serious health risks, causing family violence, and taking household income away from essentials such as food and rent.

The prevention of harmful AOD use has therefore become a priority for many communities. If yours is one of them, and you would like to take action, this series of articles is where you can start.

Primary prevention

Research has found that strengthening communities leads to increased wellbeing and healthier people. Primary prevention strategies at the community level are important for enabling change and, importantly, for ensuring that these changes are lasting.

Reducing AOD use and related harm can be significantly influenced by locally driven efforts, such as the work being done by Local Drug Action Teams.

Learn more about the primary prevention approach.

Getting started – the importance of good design

The design of preventive activities is a complex and potentially time-consuming process. While initiatives may sometimes be based on a ‘good idea’ or ‘gut feel’, by and large it is preferable that they are developed using widely accepted and scientifically grounded design principles.

Precede–Proceed: a model for guiding the process

One commonly used model is the Precede–Proceed approach. This model guides planners through a process that starts with desired outcomes and works backwards in the causal chain to identify a mix of strategies for achieving these outcomes.¹

These models generally require planners to answer several key questions that influence intervention design. These questions include:

  • What is the issue?
  • What is its prevalence?
  • Who is most at risk?
  • What are the individual, family, community and societal risk and protective factors that influence the issue?
  • What is the relative strength of association between different risk/protective factors and the issue? (i.e. are some factors more important than others?)
  • Can a particular risk/protective factor be manipulated? If so how, and at what systems level/s?
  • What has already been done – and does it work?
  • Who else is already doing it and can we partner with them?
  • How do we measure and evaluate our intervention?

Answering these questions helps create a ‘program logic’, which outlines the sequence of changes that can be anticipated if the program is properly implemented and effective. The program logic lets planners see how all the pieces of the jigsaw (i.e. the suite of interventions) fit together. Furthermore, this program logic informs the selection of process, impact and outcome measures used in evaluation.

References

Green, L, Kreuter, M. (2005). Health program planning: An educational and ecological approach. New York : McGrawhill.