implementation primer: putting your plan into action · tation phase, coalition members must step...

Community Anti-Drug Coalitions of AmericaNational Community Anti-Drug Coalition Institute

Implementation Primer:Putting Your Plan into Action

CADCA’s National Coalition Institute, developed in 2002 by an Act of Congress, serves as a center for training, technicalassistance, evaluation, research and capacity building forcommunity anti-drug coalitions throughout the U.S.

In 2005, the Institute initiated development of a series ofprimers aimed at providing guidelines for coalitions navigat-ing the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administra-tion’s Strategic Prevention Framework (SPF). Each primer is designed to stand alone and work with the others in theseries. While we have focused on the implementationprocess of SAMHSA’s SPF, the elements can be applied byany community coalition.

Too often, community coalitions administer prevention pro-grams that serve relatively small groups of individuals andhave limited impact. This primer will assist your coalition inthe implementation of comprehensive strategies designed to achieve population-level reductions of substance abuse. Itdescribes the importance of community mobilization andthe necessity of seeking meaningful environmental changes—two strategies that research indicates can influence ratesof substance abuse in an entire community.

You will find additional information on implementation andthe other elements of the SPF on the CADCA Web site,www.cadca.org.

Arthur T. Dean Major General, U.S. Army, Retired Chairman and CEO CADCA (Community Anti-Drug Coalitions of America)

1CADCA’s National Coalition Institute

Contents

INTRODUCTION 2 Drug-Free Communities Support Program 2Strategic Prevention Framework 3A word about cultural competence 4

CHAPTER 1. IMPLEMENTATION BASICS 5What is implementation? 5Getting started 5Implementing evidence-based strategies 6Monitoring implementation of the plan 7Documenting community change 9No one can predict the future 9

CHAPTER 2. COMMUNITY MOBILIZATION 11Coalitions are powerful 11Researching the issues 11Build capacity 13Recruit allies 14Know the opposition 14Direct action campaigns 16Media advocacy campaigns 16A few things to remember about being advocates 16

CHAPTER 3. USING ENVIRONMENTAL STRATEGIES TO MAXIMIZE YOUR EFFECT 18

Policy development 21A word to nonprofits about advocacy and the law 22Enforcement 24

CHAPTER 4. SUSTAINING YOUR WORK 26Institutionalization 28Financial sustainability 28

CONCLUSION 30

A WORD ABOUT WORDS 31

GLOSSARY 32

2 Implementation Primer

INTRODUCTION

Drug Free Communities Support ProgramIn 1997, Congress enacted the Drug Free Communities SupportProgram (DFC) to provide grants to community-based coalitions toserve as catalysts for multi-sector participation to reduce localsubstance abuse problems. By 2009, more than 1,600 commu-nity coalitions received funding to work on two main goals:

•Reduce substance abuse among youth and, over time, amongadults by addressing the factors in a community that increasethe risk of substance abuse and promoting the factors thatminimize the risk of substance abuse.

•Establish and strengthen collaboration among communities,private nonprofit agencies and federal, state, local and tribalgovernments to support the efforts of community coalitions toprevent and reduce substance abuse among youth.

Strategic Prevention Framework This is one of a series of primers based on the Strategic Prevention Framework (SPF)1. CADCA utilizes the SPF to assist

ImplementationWhat you need to know:

• How to develop interventions• How to advocate for change• How to influence policy development• How to develop grant applications for funding

What your community needs to do:• Implement effective interventions• Sustain the work

The products your community needs to create:•Sustainability plan

Sample implementation materials are available on the CADCA Web site,www.cadca.org.

1 The federal Substance Abuse and Mental Health Services Administration (SAMHSA) developed the SPF to facilitate implementation of prevention programming.


community coalitions in developing the infrastructure needed forcommunity-based, public health approaches that can lead to ef-fective and sustainable reductions in alcohol, tobacco and otherdrug (ATOD) use and abuse. The SPF elements shown in Figure 1,below, include:

•Assessment. Collect data todefine problems, resourcesand readiness within a geo-graphic area to addressneeds and gaps.

•Capacity. Mobilize and/orbuild capacity within a geographic area to addressneeds.

•Planning. Develop a compre-hensive strategic approachthat includes policies,

A word about words

What is your goal? Your aim? Your objective? Perhaps more importantly,what is the difference? At times, theterms seem interchangeable. Often,the difference depends on who isfunding your efforts.

To minimize confusion, we haveadded a chart (see page 31) thathighlights terms often used to de-scribe the same or similar concepts.

Figure 1


programs and practices creating a logical, data-driven plan toaddress problems identified in assessment.

•Implementation. Implement evidence-based prevention strate-gies, programs, policies and practices.

•Evaluation. Measure the impact of the SPF and the implemen-tation of strategies, programs, policies and practices.

A word about cultural competence as it relates to implementationCoalitions can mobilize entire communities to implement multiplestrategies designed to reduce substance abuse. However, toachieve that goal, they must reach out to all segments of the com-munity and inform them of the potential effects of different policyoptions. Developing a process that involves major stakeholders—especially individuals or groups affected by or concerned with the problems that have been identified—brings credibility to andcommunity ownership of the coalition’s strategic plan. Includingdiverse groups who have direct history and experience with theissue helps to ensure that the strategies contained in the plan are appropriate for the communities in which they will be imple-mented. Remember, diversity encompasses more than race andethnicity—it also includes such factors as gender, age, disabilityand political affiliation.

As you attempt to implement population-level strategies to reducesubstance abuse, you should simultaneously build capacity andleadership among diverse populations within your community thatare vital to the success of the coalition’s efforts. This way, poten-tial conflicts that could affect the outcome of the coalition’s work—as well as other issues that will undoubtedly arise—can be dealtwith sooner, rather than later. Ultimately, those most affected bythe problems will determine, in large part, the extent to which thecoalition achieves success in reducing the community’s alcoholand drug problems.


CHAPTER 1. IMPLEMENTATION BASICS

What is implementation?During the planning process (see the Institute’s Planning Primer)you selected multiple strategies to address the problem(s) yourcoalition seeks to change. This primer focuses on the SPF’s fourthelement, implementation, or putting your plans into practice.

The role of coalition members now moves from planning to over-sight, mutual accountability and monitoring. During the implemen-tation phase, coalition members must step up and honor thecommitments made during theplanning process to carry outand/or oversee various aspectsof the coalition’s work.

This also is the time tostrengthen members’ commit-ment to the plan and for themto demonstrate their effective-ness in solving communityproblems. Remember, coalitionmembers, not staff, should im-plement interventions. Engagemembers in the monitoringprocess through meetingswhere people come together totalk about implementation is-sues, brainstorm ways to ad-dress challenges and makemid-course corrections.

Getting startedCoalitions generally implement their plans in two ways—by coali-tion members (not staff) and/or other organizations or individualscommitting to do specific work. For example, many coalitions en-gage outside consultants for program evaluation. Contracts can bemade directly with individuals or organizations. The coalition also

Stop and check!

Review your logic model before beginningto implement your plan. Keep in mindthat if you have a DFC grant you are work-ing toward population-level change in atleast the four core indicators required bythe grant: 1) age of first use, 2) 30-dayuse, 3) perception of harm of use and 4) perception of parental disapproval of use.

Does your logic model realistically con-tain enough “power” to accomplish thejob? Does your plan include a compre-hensive approach with multiple strate-gies? If not, go back to your logic modeland make adjustments.

Remember! No single strategy canachieve population-level change.


Three Levels of Prevention (Institute of Medicine)

Universal Prevention Interventions address the general population with programs aimed at delaying substance use and preventing abuse. Participantsare not specifically recruited for the prevention activities. Universal preventionactivities also include efforts to bring community members together to plan forservices and to change norms and laws reducing risk factors and promoting amore protective environment.

Selective Prevention Interventions target specific subgroups believed to be atgreater risk for substance abuse than others. Risk groups may be identified onthe basis of biological, psychological, social or environmental risk factorsknown to be associated with substance abuse and addiction. Program activitiesare designed to address the identified risk indicators of the targeted subgroup.

Indicated Prevention Interventions target individuals who exhibit early signs ofsubstance abuse and problem behaviors associated with substance abuse andaddiction including early substance use, school failure, interpersonal socialproblems, delinquency, other antisocial behaviors and psychological problemssuch as depression and suicidal behaviors. Substance Abuse Prevention BlockGrant funds cannot to be used to support indicated prevention programs.

Office of Substance Abuse Services, Guidance Bulletin No. 2003 03.

can issue a request for proposals which defines the work it wantsdone and invites community-based organizations or individuals todevelop and submit proposals outlining in detail how they plan tocarry out specific activities.

Implementing evidence-based strategiesDuring the planning process, your coalition researched and thenselected evidence- or theory-based strategies—or their core com-ponents—proven to be effective. Funders want assurances that theactivities they support grow out of approaches that together likelywill reduce alcohol and drug rates in the community.

In 1994, the federal Center for Substance Abuse Preventionadopted the Institute of Medicine (IOM) prevention continuum, extending from primary prevention through maintenance. (Seechart on Page 6.) The IOM identified three levels of primary pre-

vention: Universal, Selective and Indicated and stressed the needfor multiple strategies and approaches to prevention. An effectivecommunity coalition can facilitate the development of a compre-hensive community plan which identifies and articulates all threestrategies. Some of its coalition members may administer preven-tion programs that utilize Selective and Indicated interventions.However, the coalition should focus on Universal prevention strate-gies in its aim to achieve population-level reductions in substanceabuse rates. Environmental prevention strategies, more fully dis-cussed in Chapter 3 and the Institute’s Environmental PreventionStrategies publication, generally fall within the category of Univer-sal Prevention Interventions.

Monitoring implementation of the planIt is not enough to carry out the activities reflected in your plan.Your coalition should document the implementation process anddescribe any changes you make to your original plan along theway. Funders may ask your coalition to report on the accuracy withwhich it has implemented its evidence-based interventions and ap-proaches. A complete program description helps provide such in-formation and usually forms part of the process evaluation. (Seethe Institute’s Evaluation Primer for more information.)

Suppose, for example, your coalition engages in policy change asone way to affect the retail alcohol environment and reduce youth


Create a checklist

One way to systematically monitor implementation is to create a fidelity checklist. First, list all the activities in your action plan/scope of work and makeroom for a check box next to each activity.

Check off each activity as you complete it and document the following:• Any activities not implemented in the order listed,• Any activities tried that did not work, and • Any new activities you create to take the place of one that did not work.

At the end of this process, you will have a good record of what you did and did notimplement, the challenges you faced and how you overcame them.


access to alcohol. After learn-ing that other coalitions havebeen successful in changingpolicy with a full-time com-munity organizer, your coali-tion decides to hire someone.However, the coalition cannotto find a suitable person whocan work 40 hours per week,so you hire a well-qualified,half-time person instead. Youneed to document thischange in your implementa-tion description so you cantrack whether it impacts yourcoalition’s outcomes.

Monitoring strategies fromthe business world—“Continu-ous Quality Improvement”(CQI) and “Total Quality Im-provement” (TQI)— refer toprocesses of analyzing imple-mentation to determinewhether your work is on tar-

get. If you are not seeing the anticipated short-term results, theyprovide the time and tools to make the mid-course correctionsneeded to accomplish your coalition’s longer term outcomes.

Generally, within 3-6 months of beginning a new strategy or activ-ity, your coalition staff should use these processes to develop asystematic way to review your logic model and strategic plan to accomplish the following:

•Document program components that work well,•Identify where improvements need to be made,•Provide feedback so strategies are implemented

more effectively,

Process description data

Advocate/Coalition Member Information• Demographics• Methods of recruitment• Actual attendance• Attrition/retention

Implementation/intervention Issues• Planned and implemented

adaptations• Cultural issues that arise and how

they were addressed• Indications of unmet needs/

resources development

Implementation problems/issues• Organizational capacity• Community resistance

Unrealized or under-realized outcomes• The difference between expected

and actual change (outcomes) asmeasured by the change betweenbaseline and new measures at thecompletion of a component.


•Make timely adjustments in activities and strategies to better address identified problems,

•Assess whether enough resources have been leveraged andwhere you might find more, and

•Engage stakeholders/sectors (community members, providers,staff, etc.) so they feel a sense of responsibility and pride inhelping to ensure that the goals and objectives of the coalitionare met and alcohol and drug problems in the community are reduced.

Documenting community changeAs you implement your plan, you will want to quantify and/or categorize successful actions in the community designed to leadto population-level change. While you should always “keep youreyes on the prize” and pick strategies capable of delivering themaximum effect, you also should measure and document short-term changes along the way. This is the purpose of developing a logic model: to think through the shorter term changes or out-comes you may see on the way to accomplishing long-term popu-lation-level outcomes.

The coalition also should create a reporting process for those indi-vudal or organizations responsible for implementing various partsof the plan. This will result in a good description of the implemen-tation as it unfolds. If you have an evaluator, have him/her helpset up a reporting system. Otherwise, identify someone in yourcoalition who has the skills to oversee this aspect of your work.

No one can predict the futureWe all know that plans we make for the future do not alwayscome to fruition. This also holds true for coalitions. You can havethe best strategic planning process or the most detailed actionplan, but unanticipated, unforeseen or unintended events canoccur and impact implementation of your plan. Alternately, issuesmay arise that alert you to something not included or under-estimated in your plan that can affect the coalition’s ability to address the identified problem(s).


The COMET SystemIf you are a DFC grantee, you are required to participate in this Web-basedreporting system. This is a grants management reporting tool. The informa-tion gathered by COMET also is used for the national cross-site evaluation.

For more information and a demonstration go to the following Web site:http://www.ondcp.gov/DFC/comet.html.

For example, the logic model example in the Institute’s PlanningPrimer describes local methamphetamine (meth) labs as a prob-lem. Over time the landscape of meth sales may change and in-stead of being manufactured locally, meth may be brought in byinternational drug traffickers. Your coalition becomes aware of thechange because you continue assessing the community land-scape. Your planned strategy to increase barriers to local methproduction might be outdated and you will need to rethink how toaddress this new aspect of the meth problem in your community.


2 Adapted from Community Tool Box. See section “Organizing for Effective Advocacy” at http://ctb.ku.edu/tools/en/tools_toc.htm.

CHAPTER 2. COMMUNITY MOBILIZATION2

For successful implementation of the strategies identified in yourplan, your coalition members may need to step out of their normalroles to become advocates rather than program developers orplanners. As a part of that process, your goal may be to influencepolicy- and other decision-makers, hold officials and companiesaccountable for their actions or increase cultural awareness andcompetence among health and human service providers servingthe community. To accomplish your goals, you will need the sup-port of many sectors of the community.

Coalitions are powerfulCoalitions are uniquely positioned to identify and bring aboutneeded changes in community practices that can reduce the riskfor—and consequences of—substance abuse. These changes cantake many forms. For example, advocacy can be used to:

• Develop new practices such as police officers attending neighborhood meetings.

• Pass ordinances to limit over-concentration of retail alcoholoutlets in particular areas.

• Include the people affected by the problem in all aspects of implementing and evaluating a particular program.

• Implement new policies such as new workplace rules that limit smoking.

• Enforce new and existing policies, e.g., sales to minors laws.

Researching the issuesNo matter the scope of your effort, you will need information tochange laws and policies, prompt an official investigation or affectpublic opinion. For example, your coalition may need to know howmany stores that sell tobacco or alcohol display those products oradvertisements in close proximity to items that typically attractchildren or youth. How many drug arrests have been made on aparticular corner of the neighborhood in which you work?


Learning all you can about yourissue enables you to supportyour statements with facts andstatistics, and gives you credibil-ity and the means to counterthe arguments of your oppo-nents. Your advocacy work maybe perceived as adversarial—such as trying to pass an ordi-nance to ban smoking in theworkplace—careful researchhelps you prove your case andknow what needs to be done tochange the situation.

As outlined in the Institute’s As-sessment Primer, research anddata collection take a variety offorms—from getting informationfrom published or original-

source materials in libraries, archives, the government or the Inter-net to taking photos or conducting interviews, surveys and studies.

You may have collected relevant secondary data during your as-sessment, e.g., outlets that sell alcohol to minors, but it mightmake sense to collect additional primary data. If the data you col-lected indicate that some outlets sell alcohol to minors, you maywant to have advocates survey stores to measure the extent towhich they adhere to retail standards. For example, in California,the state business code stipulates “No more than one-third of thesquare footage of windows and clear doors (e.g., glass) of an alco-hol retailer may have signs of any sort, including all types of adver-tising.”3 Your state may have similar retail standards.

Regardless of the type(s) of research you do, your coalition canbenefit from a few general guidelines:

A word to the wise…

Being clear about how you want to usesensitive data can make or break yourchances of getting it at all.

School districts that regularly surveystudents on ATOD and other pertinent is-sues, for example, may be reluctant torelease data that could make individualschools look bad.

It is helpful for the coalition to form apartnership with the school district andmake it clear that the data will be usedfor planning and monitoring purposesonly. Data from individual schools willnot be highlighted or end up on the frontpage of the local newspaper or theevening news without prior permissionfrom the school district.

3 This stipulation is incorporated in California’s Lee Law, one of nine alcohol retail operating standards in the California State Business and Professions Code.


• Ask for help. • Find out if someone else has already done the research and

is willing to share it with you. • Understand the basic information about your issue.• Be clear about how you want to use the information.• Ensure information comes from reliable sources and double

check everything. Your coalition’s credibility is at stake. • Be persistent if the information you need is hard to find.

Build capacityThis is a good time to build additional capacity specific to thestrategies your coalition is implementing. Suppose you have iden-tified some problem areas around housing projects where drugsales frequently occur. You can mobilize and train residents whowant to get rid of drug dealers about how to use municipal nui-sance laws or compel the city code enforcement department toclean up or fence off abandoned lots where drugs are sold. Or, ifyou are working to reduce alcohol outlet density, involve congrega-tions in neighborhoods with high density. Together, the faith com-munity and coalition can mobilize and train residents from theaffected area to advocate for a zoning change or increased law en-forcement to deal with the problems that a high concentration ofoutlets can bring to a neighborhood.

During implementation—particularly doing mobilization work—youwill educate communities, increase their knowledge and reach outto areas that have problem AOD environments. Capacity buildingis an ongoing challenge, not something separate, that needs to beintegrated into your coalition’s day-to-day work.

For more information on planning resources and capacity building,see the Institute’s Planning and Capacity primers available on theCADCA Web site at www.cadca.org.

Recruit alliesAfter you research the underlying causes of your issue, identify po-tential allies—people or groups who have the same interests—tohelp your cause. Allies may have capacity or resources to share in


the interest of achieving acommon goal. As more peopleor groups advocate for anissue or goal, the communityand those whose behaviorsyou want to change becomemore likely to pay attention.

The easiest way to find allies isto ascertain who is alreadyworking on the same or similarissues and who might be inter-ested in becoming involved.Even if you do not agree with them on all aspects of the problem,a collaborative effort could still result in a positive impact.

As you develop a list of possible allies, you could find that you haveso many that you need to rank and prioritize them by how muchinfluence they might bring to your coalition’s issue. Potential allieshave different levels of power or ability to effectively help youachieve your goals. The chart on page 15 can help your coalitionanalyze and prioritize potential allies.

Know the opposition Identify the groups or organizations likely to oppose your work be-fore you implement your campaign. That way you can anticipatethe type and degree of opposition you may encounter and effec-tively direct your resources toward defeating your opponents. In

short, identifying adversaries andanticipating their oppositionshould increase your chances of success.

Direct action campaignsAt this point, the coalition will belooking at how it can best get theissue noticed by those who have

Who are your constituents and allies?• Whose problem is it? Who are directly

and indirectly affected?• What are the benefits of participation?

What do they gain if you win?• What risks are they taking? What might

they lose?• Into what groups are they organized?Adapted from Midwest Academy StrategyChart, available online at http://midwestacademy.com

Who are your opponents?• What will your victory cost them?• What will they do or spend to

oppose you?• How strong are they?• How are they organized?

Source: Midwest Academy StrategyChart, available online at http://midwestacademy.com


Organizing for effective advocacy

Type of power Rational Example

Members: How manymembers does the grouphave?

The more members agroup has, the less likely itis to be ignored.

A group with 500 members shows up at a city/county meeting.

Money: Will they donatemoney to your issue?

Donated money and otherresources are a welcomeaddition to help achieveyour goals.

The local teacher’s uniondonated money to yourcoalition.

Credibility: Do they bringspecial credibility?

A group with strong positive recognition in the community will helpbring credibility to yourcoalition.

A respected clergyman froma local church speaks onbehalf of your coalition’swork.

Appeal: Do they have special appeal?

Being connected togroups with universal ap-peal can help your image.

A poster child is used topromote an emotional re-sponse.

Network: Are they part of a large, organized network?

A group connected toother groups in its network will have financialresources, credibility andsome political power.

The local chapter of theUnited Way offers staff support to your group.

Reputation: Do they havea reputation for tough-ness?

Groups with a tough reputation may discourage opponents.

The local law enforcementofficer’s union says they willsupport policy changes forimproved enforcement.

Skills: Do they have special skills?

An ally may bring technical, business orlegal skills to your group.

A local law firm donates free(pro bono) legal support.

Newsworthy: Are they particularly newsworthy?

Some groups have connections or a reputation to media thatmight bring positive mediaattention to your issue.

An activist group for children’s rights that re-cently won a major victory offers to providetechnical support.

Source: Community Tool Box


the power to help. The advocacy work your coalition engages inmay take several forms that can be used together or alone.

You may decide to conduct a direct action campaign. This type ofadvocacy can involve:

• Writing letters to elected officials,• Filing a complaint,• Seeking enforcement of existing laws or policies,• Persuading decisionmakers,• Conducting a petition drive,• Registering voters,• Conducting a public hearing,• Organizing public demonstrations,• Initiating a legal action and/or• Organizing a boycott or strike.

Media advocacy campaignsOr, your coalition might decide to undertake a media advocacycampaign that includes:

• Working with the media,• Cultivating relationships with the media,• Creating news stories the media will use,• Using paid advertising and/or• Changing the media’s perspective on community issues.

Or, you could implement a direct action campaign with a mediaadvocacy component.

A few things to remember about being advocatesWhatever form of advocacy you choose to follow, keep a fewthings in mind:

• Frame the issue. Framing is a method of structuring or pre-senting a problem or an issue in a way that explains and de-scribes the context of the problem to gain the most supportfrom your audience. When framing an issue you should be specific—who is involved, what factors contribute to the prob-lem and the solution. Successful framing puts your coalitionin a good position to direct discussion of the problem.


Getting the word out to the communityYour coalition is working on or has created something of value to benefitthe community. So how do you get the word out to the people you are aim-ing at and beyond so that the community can make the most of the long-term benefits of your initiative?

Look at what you have accomplished and what you have not, re-examinethe mistakes you may have made along the way, get a good idea aboutwhere you are and where you're going and communicate this to your audi-ence. If you want more community involvement, make that clear.

What publicity have you received so far? How can you let more peopleknow about what your coalition is doing? A coalition has many optionswhen it comes to the best ways of getting the message out to raise aware-ness. An organization may consider using publicity by press releases, ar-ranging news and feature stories, approaching editorial boards, preparingguest columns and editorials, arranging a press conference, coordinatingwith national awareness weeks/months, conducting community forumson the topic and/or hosting a Web site or coalition blog.

Depending on your audience, you may want to put flyers on cars aroundthe city, advertise in the newspaper or on radio, orchestrate a media eventor arrange a press conference to proclaim the existence of your programor initiative.

Depending on your budget and availability of staff and volunteers, youalso can create blogs, podcasts, Webcasts and/or special promotionslike bumper stickers.

• Never rest on your laurels. Undertaking advocacy on difficultissues tends to be a lengthy, incremental process. Once youachieve some success, you need to remain vigilant. Remem-ber, any policy or law passed can be changed, watered down oreliminated by determined opponents. The only way to ensurethat your issue remains on the “front burner” is to plan to en-gage for the long term and put monitoring systems in place.


CHAPTER 3. CREATING COMMUNITY CHANGE TO MAXIMIZE YOUR EFFECT

Using the Institute’s Planning Primer, your coalition selected com-munity-focused approaches to include in your strategic plan. Un-doubtedly, most fell into the one of the overarching approachesthat coalitions use to achieve the desired outcomes. (See “Sevenstrategies to achieve community change” on page 19.)

Among these approaches the first three can help the coalitionstrengthen its internal structure and impact individuals and fami-lies. These strategies have demonstrated impact, but because ofresource constraints, they generally affect small numbers of indi-viduals rather than the community at large. Consequently, theyoften are best left for implementation by direct service organiza-tions in your community.

For example, suppose your needs assessment indicates that anumber of children and youth in your area could benefit from hav-ing a caring adult in their lives and the local Big Brothers Big Sis-ters organization operates an effective mentoring program. Ratherthan develop new mentoring programs, the coalition might work tocoordinate with and enhance existing efforts by assisting BigBrothers Big Sisters with recruiting additional mentors.

The first three approaches can help to build the capacity of thecoalition or focus on the needs of individuals and families—theyhave obvious limitations and will not, by themselves, achievemeasurable change in substance abuse rates in your community.However, the last four approaches—enhance access/reduce barri-ers, change consequences, change physical design of the environ-ment and modify policies—are more externally focused and morelikely to transform communities. (See logic model in the Institute’sPlanning Primer.)

Each of the seven strategies is important to building and maintain-ing healthy communities and should be included in your coalition’slogic model and sustainability plan.


Seven strategies to achieve community change

1. Providing information—Educational presentations, workshops or seminars or other presentations of data (e.g., public announcements,brochures, billboards, community meetings, forums, Web-based communication).

2. Enhancing skills—Workshops, seminars or other activities designed to in-crease the skills of participants, members and staff needed to achievepopulation level outcomes (e.g., training, technical assistance, distancelearning, strategic planning retreats, curricula development).

3. Providing support—Creating opportunities to support people to partici-pate in activities that reduce risk or enhance protection (e.g., providingalternative activities, mentoring, referrals, support groups, or clubs).

4. Enhancing access/reducing barriers—Improving systems and processesto increase the ease, ability and opportunity to utilize those systems andservices (e.g., assuring healthcare, access to treatment, child care,transportation, housing, education, special needs, cultural/languagesensitivity).

5. Changing consequences (incentives/disincentives)—Increasing or de-creasing the probability of a specific behavior that reduces risk or en-hances protection by altering the consequences for performing thatbehavior (e.g., increasing public recognition for deserved behavior, indi-vidual and business rewards, taxes, citations, fines, revocations/loss ofprivileges).

6. Physical design—Changing the physical design or structure of the envi-ronment to reduce risk or enhance protection (e.g., parks, billboardslandscapes, signage, lighting, outlet density).

7. Modifying/changing policies—Formal change in written procedures, by-laws, proclamations, rules or laws with written documentation and/orvoting procedures (e.g., workplace initiatives, law enforcement proce-dures and practices, public policy actions, systems change within gov-ernment, communities, organizations).

Implementation of community-focused approaches also meansthat the coalition needs to build its bench strength by seeking outadditional members who can help move the coalition’s agendaforward. Pay careful attention to building capacity by training


members on relevant topics, using team-building exercises to fos-ter trust and respect among coalition members and provide oppor-tunities for partners to use newly learned skills and participatefully in the coalition’s decision-making processes.

Significant evidence exists showing that the most effective way toprevent abuse of alcohol or other drugs is to change the environ-ment(s) in which the problems occur. Environmental prevention ef-forts focus on changing the settings and circumstances in whichpeople use drugs or alcohol rather than solely focusing on chang-ing individuals. Identifying and collecting data on problem environ-ments usually are done during community assessment. Problemsettings might include the parking lot of a liquor store wheremethamphetamine use is known to occur, a park where youthsmoke marijuana and drink beer; bars where sales to minorsoccur; or areas near college campuses where students go to drink.

REMEMBER that environmental strategies are only a means to anend—to acheive the longer term goals of the coalition by employ-ing strategies that emphasize community approaches.

Coalitions may use some or all of these approaches. A few briefexamples are provided below for (4) enhancing access, (5) chang-ing consequences and (6) changing the physical environment. Alarger discussion follows about (7) policy development.

Enhance access/reduce barriers: Establish a comprehensive student assistance program in local high schools.

Change consequences: Increase penalties so stores cited for selling cigarettes to minors lose permits to sell tobacco products.

Change physical environment: Anhydrous ammonia is used as afertilizer in farming. It also is a precursor chemical used to manu-facture methamphetamine. Tanks that appear to be unattendedoften are targeted for theft. Access to these precursor chemicalsmay be curtailed if farmers park the tanks in public areas.


Policy development4

Community coalitions can effectively create policy change. Broad-based coalitions that represent many points of view are idealagents for policy change and can have considerable credibility. Byincluding a wide cross-section of the community—leaders, opinionmakers and especially community members affected by the is-sues and new policy options—coalitions can provide a variety ofperspectives that generate better ideas about how to proceed.

Good reasons exist to work for policy or sytems change:• It provides one road to permanent social change.• The process can start community dialogue about the issues

in question.• It can change minds, atti-

tudes and norms. Once anissue is addressed in aparticular way, new poli-cies become part of thecommunity and can leadto long-term change.

• Changed policies affectthe next generation. Whenare the best times to try tochange policy?

• When something impor-tant is at stake, either forpolicymakers (e.g., anelection) or the commu-nity (e.g., the looming pas-sage of a disastrous law orregulation);

• When the issue hasreached a crisis point;

Guidelines for changing policies• Preparation includes doing the neces-

sary research and becoming expert onexisting policies.

• Personal contact with policy makers,other change agents and anyone elsewith whom you must deal.

• Pulse of the community involves know-ing the community's attitudes, what citi-zens will accept, where to start to besuccessful.

• Positivism in framing policy changes andtheir outcomes.

• Participation by including those affectedby or concerned with the issue in plan-ning and implementing policy change.

• Publicity for your effort in general andfor your suggested policy changes—andthe reasons for them—in particular.

• Persistence in monitoring and evaluat-ing your actions, and keeping at it for aslong as necessary.

Source: Community Tool Box

4 Adapted from Community Tool Box. See section “Organizing for Effective Advocacy” athttp://ctb.ku.edu/tools/en/tools_toc.htm


• When the issue is already under discussion, especially for thefirst time;

• When public opinion/support benefits your cause; and/or • When new information or media coverage brings attention to

the issue.

A word to nonprofits about advocacy and the lawNot surprisingly, seeking to change the environment where alcoholand other drug abuse problems occur often involves advocating forlegislation to change or create public policy. It is critically impor-tant to understand and abide by the rules that govern allowablebehavior related to advocating public policy. However, advocates—your coalition partners, and especially nonprofit organizations—should not be intimidated by these rules.

Advocacy can be one of the most effective public health strate-gies. Not using this strategy because of fear based on lack of un-derstanding of the law could unnecessarily restrict your effective-ness as a community change agent.

Knowledge is power! Public health advocates working in nonprofitorganizations can use thisstrategy effectively and legallyby learning about the laws thatgovern advocacy for nonprofits.(See CADCA’s Strategizer #31,Guidelines for Advocacy:Changing Policies and Laws toCreate Safer Environments forYouth.) Remember, manyforms of advocacy do not con-stitute lobbying as defined bythe Internal Revenue Service(IRS). (See chart on page 23.)

For example, several years agothe federal government re-quired that all states lower the

What advocacy is…and isn’t

Advocacy is…•One of many possible strategies

or ways to approach a problem;•Active promotion of a cause

or principle; •A process involving actions that lead

to a selected goal; •An approach to use as part of a

community initiative, along withother components.

Advocacy is not…•Direct service to individuals and •Does not necessarily involve con-

frontation, conflict or lobbying.


legal blood alcohol level to 0.08 or lose federal highway funding. As a result, one of your state legislators (who also is a championof your coalition) has introduced legislation to lower the legalblood alcohol level to 0.08. This legislation has been defeated before with opponents convincing lawmakers that it will crowdcounty jails, cripple liquor sales and bankrupt local governments.Coalition partners support the legislation and are allowed tolegally advocate on its behalf without jeopardizing their nonprofitstatus. However, keep in mind that lobbying on behalf of the legislator’s re-election (called electioneering) is prohibited for nonprofit organizations.

Examples of activities that are not lobbying

•Meeting with a legislator to talk about a social problem, without mentioning aspecific legislative proposal.

•Providing a legislator with educational materials about a specific piece of legislation, without calling for specific action on the legislation.

•Responding to a request from a legislative committee or subcommittee for information about a specific piece of legislation.

•Publishing and distributing a newsletter to your own membership providing information about a specific piece of legislation, your organization’sposition on the legislation and the names of legislators who support and opposethe legislation, but not a specific call to action (e.g., a request to call or write tolegislators).

•Tracking activities of legislators including votes, positions taken, contributions accepted, etc.

•Producing and disseminating research reports or studies that provide nonpartisan analysis on policy issues, including specific legislative issues.

•Talking to the media about specific legislative proposals.•Advocating for better enforcement of existing laws, e.g., those that control

alcohol sales to minors.•Advocating the enactment and enforcement of private or voluntary

policies, e.g., alcohol purchase restrictions in stadiums.•Conducting public education campaigns to affect the opinions of the general

public, e.g., a mass media educational campaign about the importance of notproviding alcohol to minors.

CADCA’s Strategizer #31, Guidelines for Advocacy: Changing Policies and Laws to Create Safer Environments for Youth.


EnforcementAll the hard work you put into getting a good strong policy passedcan become wasted energy if the policy is not enforced. Many fac-tors contribute to enforcement problems for new or existing poli-cies. For example, the agency charged with oversight may lack theresources to investigate or pursue violations, may not know aboutviolations or may be pressured by powerful interests to overlook vi-olations.

If your coalition has been involved in passing a new policy, you al-ready know which governmental body, agency or other organiza-tion you need to work with to ensure the policy is enforced andviolations are addressed. Ideally, the entity charged with enforce-ment not only was involved in getting the policy passed and fullysupports the new policy, but has been working closely with thecoalition to create an enforcement plan.

Lobbying with government money?

Lobbying is the practice of trying to persuade legislators to propose, pass or defeatlegislation or to change existing laws.

Nonprofit organizations need to keep an account of their lobbying activities for IRSreporting purposes but any entity that receives federal funds needs to be aware ofseparate restrictions on that money. A provision of the U.S. Code known as the ByrdAmendment prohibits the use of federal funds to lobby. Any matching money thatthe organization raises to obtain federal funding comes under the same prohibitionas the federal money itself. This prohibition was enacted under the theory that fed-eral money should not be used to lobby Congress in an attempt to ensure a steadystream of federal money.

The prohibition on lobbying activities under the Byrd Amendment is simpler—andbroader—than the reporting requirements under IRS regulations for nonprofits.Quite simply, no one can engage in any direct or grassroots lobbying with federalmoney. Organizations that accept federal money can lobby with other funds, butthey cannot use government funds to lobby at any level of government.


If, on the other hand, your coalition wants enforcement of an exist-ing policy, then you first need to identify the entity responsible forenforcing that law or regulation. Laws are not always enforced atthe level at which they were passed—some federal laws are en-forced at the state level, or state laws at the local level. Until youdo the research, it may not be clear which agency has jurisdiction,or why the policy is not being enforced.

Getting policies enforced

• Learn about the law or regulation that is not being enforced.• Get background information about how the issue is affecting the community.•Become familiar with the structure and operation of the violator as well as of

the regulatory body.• Identify specific individuals in the violating and regulatory organizations with

whom it would be the most effective to negotiate.• Report the violation or file a formal complaint to the appropriate regulatory

body.• Apply public pressure.• Take direct and/or legal action

Remember! As with any advocacy activity, you need to maintain vigilanceeven after you have achieved your goal to be sure that enforcement continues.


CHAPTER 4. SUSTAINING CHANGE

The implementation of strategies designed to acheive population-level reductions in substance abuse may require changing sys-tems, consequences, incentives or environments. Research showsthat some types of environmental approaches, such as policychanges may take a substantial period of time. For that reason,your coalition needs to be concerned about being in existence longenough to acheive its goals. A community that is motivated andmobilized to bring about major change may become demoralizedif the catalyst for that change—the coalition—disappears half-waythrough the process.

Despite the fact that many funders require grantees to addresshow they will sustain themselves once the funding runs out, manycoalitions do not begin to think about sustainability until the grantnears its end.

All DFC grantees are strongly encouraged to develop a fundingplan to solicit substantial financial support from non-federalsources to ensure that their coalition will be self-sustaining whenfederal assistance is no longer available. Grantees in their thirdand seventh years of funding are required to submit a written sus-tainability plan to their project officer.

A long-range perspectiveIt is never too early to think about how your coalition will broadenits impact and continue its work. The Institute’s Planning Primersuggests that coalitions begin to work on sustainability during ini-tial planning, as you develop a strategic plan. Your coalition shouldbe working on how to institutionalize and financially sustain itswork at least by the time you begin to implement activities, eventhough you will be busy getting your initiative off the ground. Whenyou begin sustainability planning, form a workgroup of staff andcoalition partners. Getting key stakeholders involved from the be-ginning can inspire them to become champions and fight to sus-tain the activities of the coalition.


Throughout the life of your coalition, continue building benchstrength:

• Build a strong board. Select board members who can advancethe work of the coalition. The coalition should clarify members’roles and responsibilities, agree on a decision making process,and devise a method for resolving conflict. Building a strongboard also means providing members with ongoing training inresponse to changing circumstances.

• Hold productive meetings. Hold meetings that are respectfulpeople’s time. Start and end on time, and be sure that youschedule meetings at the convenience of your members ratherthan coalition staff.

• Attract influential people. Recruit people with the capacity tomake change. Create a “buzz” that your coalition is the groupthat generates positive community change.

• Strategize effective use of existing AOD resources. Seek outschools, local service clubs, and other groups that addresscommunity improvement. Try to recruit representatives fromthese groups and work on ways they can devote at least someof their resources to the coalition’s goals and objectives.

• Increase the coalition’s influence through partnerships.When coalition partners pool resources to work on specificprojects, it can increase the capacities of all partners to obtainmore resources than they might get individually.

•Mobilize and train residents and young people. Seeking partic-ipation from the community means taking some extra steps sothat they function as contributing members of the coalitionand have the same information and skills as service providersand other professionals who are coalition members. Providingtraining opportunities to community members can help to levelthe playing field in areas such as policy development, using themedia, advocacy, and public speaking.

• Increase diversity. If you are working toward community-levelchange, ensure that all segments of the community are repre-sented in your coalition. This includes gender, age, race, ethnic-ity and political affiliation.


InstitutionalizationInstitutionalizing your work is a long-term process that requiresfinding ways to make the policies, practices and procedures youhave established successfully become rooted in the community.

Many good reasons exist for your coalition to begin to plan to insti-tutionalize its work early on. Such a process will:

• Give you the time you need to solve the problem(s) you haveidentified. It is unlikely that many of the large problems youwill be tackling can be resolved in one or two years. Often a fullsolution may not occur for quite some time and you will wantto be around to see it through.

• Help you figure out how to get from having an initiative with lit-tle structure and an uncertain future to a well-respected andreliable initiative with the structure and legitimacy it needs tokeep it going for many years.

• Help you focus on the steps necessary to achieve an initiativethat has lasting impact.

Planning ahead for ways to keep your coalition alive is more cost-effective than starting a new program or starting your initiativeover again.

Financial sustainabilityPlanning for financial stability is intricately linked to institutionaliz-ing successful initiatives and other work your coalition accom-plishes. This process involves figuring out strategies and actionsteps for your coalition to obtain and grow the resources—bothmoney and other types of community support—it needs to con-tinue. Additional resources may include finding in-kind support, re-cruiting and sustaining a volunteer staff, obtaining commitmentsfor shared resources from other organizations or persuading an-other organization to take on a project begun by your coalition.

Many resources exist in the local community and funders oftenallow or require coalitions to elicit or leverage local supportthrough matching strategies. Since cash resources can be difficultto obtain in economically distressed neighborhoods, outside


grants provide the money that, when combined with local physical,human and creative resources, can enable a strong community re-sponse to tackle substance abuse problems.

Before getting started, think as broadly as you can about what youreally need and want in terms of financial stability. Just becauseyou received a grant for $150,000 does not automatically meanyou need to continue this level of funding for the next year. Shouldyour coalition continue to work on certain strategies or should youtry to get another agency to take on that work? Think about devel-oping objectives, strategies and action steps for the short term (6-12 months) as well as the long term (5 or 6 years from now) to getand keep the resources you need.

While it may be unrealistic for many under-resourced coalitions totackle the issue of financial sustainability early on, you want to de-velop concrete plans even if you can not take it on initially or in itsentirety. What follows are fund development guidelines and issuesfor coalitions to consider when thinking about pursuing additionalsources of financial support.

Notes of caution when pursuing funds:• Be strategic in how you spend the coalition’s limited resources writing grants,

e.g., check how many grants will be given and the track record of your grantwriter.

• Research the competitiveness of your application before you decide to pay agrant writer. Check it out with experienced grant writers in your coalition andfrom outside.

• Get help—There are many local, state and federal resources available to helpyou. Learn more about the kinds of funding options available to you.

• Do not “chase” dollars—go after funding that is appropriate. • Avoid becoming overly dependent on one or two sources of grant support.

Remember, most funders do not solely fund need. They look for opportunities tomake a difference.

Local, regional and state resources exist. Links to a variety of funding resourcescan be found on the CADCA Web site, www.cadca.org.


CONCLUSION

This primer covers four major themes related to implementingcommunitywide strategies to reduce substance abuse: The basics,community mobilization, using environmental strategies to maxi-mize efforts and sustaining major activities. The first section out-lines core concepts and describes how to get started, implementand monitor your coalition’s plan and identify obstacles or facilita-tors you might encounter along the way. At this phase, your coali-tion should stop and ensure that your partners understand yourcoalition’s aims, the strategies you plan to employ and the concisecontributions they will provide. Coalition members should concurwith the selected aims and strategies and understand how the ac-tivities being carried out in the name of the coalition will lead tothe desired outcomes.

The next sections describe community mobilization and environ-mental prevention strategies, concepts that often intersect. Coali-tions that truly seek population-level changes in their communitiesfind that they require broad-based support to change policies, sys-tems or practices. They perceive the need to leave their comfortzone of administering prevention programs and engage in organiz-ing and mobilizing communities. They may seek to improve prob-lem environments, enact legislation or change the consequencesof certain practices. Coalitions that successfully affect these typesof environmental changes are more effective if they embrace thecore elements of cultural competence and reach out, incorporateand empower diverse segments of the community.

This primer concludes with sustaining your effort. The implemen-tation of strategies to bring about significant community changerarely occurs in a short time frame. As coalitions build capacity tobring about these types of change, they must be cognizant of theneed to generate resources to sustain their strategies, not simplythe expense of operating a coalition. Truncated activities certainlywill not achieve the goals of the coalition and potentially demoral-ize community members who perceive that “nothing can be done”to bring about genuine systematic change.


A word about words

Assess Plan/Implement Evaluate

“The problem is…But why? But why here?”

What you want What you do to get there

Are you gettingthere?

Did you getthere?

•Aim•Goal•Objective•Target

•Activity •Approach• Initiative•Input•Method•Policy•Practice•Program•Strategy

•Benchmark• Indicator•Intermediate

Outcome•Input/Output•Measure•Milestone•Short-term Out-

come•Output

• Impact•Outcome•Results

Build CapacitySustain the Work

Increase Cultural Competence

A word about wordsAs noted at the beginning of this primer, there are a number ofterms that sometimes are used interchangeably. Often, the difference depends on who is funding your efforts or the field fromwhich you come. The following chart highlight terms that often areused to describe the same or similar concept.

GLOSSARY

Action plan. Ensures that all coalition members are involved in carrying out thework of the coalition with sufficient support and appropriate accountability.Activity. Something you plan and implement to conduct your program.Advocacy. Strategies devised, actions taken and solutions proposed to influencedecision-making at the local and state level to create positive change for people andtheir environment.Aim. A clearly directed intent or purpose, an anticipated outcome intended or thatguides planned actions, the goal intended to be attained.Approach. The method used in dealing with or accomplishing: a logical approach tothe problem. Capacity. Various types and levels of resources that an organization or collaborativehas at its disposal to meet the implementation demands of specific interventions.Community assessment. A comprehensive description of your target community(however your coalition defines community). The assessment process is a systematicgathering and analysis of data about your community.Community-level change. An adjustment that occurs within the target populationin your target area.Community mobilization. The act of engaging all sectors of a targeted popula-tion in a comprehensive, participatory prevention effort.Cultural competence. A set of behaviors, attitudes and policies that come to-gether in a system, agency, or program or among individuals, enabling them to func-tion effectively in diverse cultural interactions and similarities within, among, andbetween groups.Environment. In the public health model, the environment is the context in whichthe host and the agent exist. The environment creates conditions that increase or de-crease the chance that the host will become susceptible and the agent more effec-tive. In the case of substance abuse, the environment is the societal climate thatencourages, supports, reinforces, or sustains problematic use of drugs.Framework. A structure that is used to shape something. A framework for a strat-egy or approach supports and connects the parts.Goal. A goal states intent and purpose, and supports the vision and mission state-ments. For example: "To create a healthy community where drugs and alcohol are notabused by adults or used by youth."Indicator. A measure that helps quantify the achievement of a result, outcome orgoal.Initiative. A fresh approach to something; a new way of dealing with a problem, anew attempt to achieve a goal or solve a problem, or a new method for doing this.


Input. Organizational units, people, funds, or other resources actually devoted to theparticular program or activity.Lobbying. The practice of trying to persuade legislators to propose, pass, or defeatlegislation or to change existing laws. Logic model. Presents a diagram of how the effort or initiative is supposed to workby explaining why the strategy is a good solution to the problem at hand and makingan explicit, often visual, statement of activities and results. It keeps participantsmoving in the same direction through common language and points of reference. Fi-nally, as an element of the work itself, it can rally support by declaring what will beaccomplished, and how. Methodology. The means and logical procedure by which a program plan or ap-proach is implemented.Objective. Objectives are the specific, measurable results a coalition plans to ac-complish and serve as the basis by which to evaluate the work of the coalition. Eachobjective should have a timeframe by which it will be accomplished. "To reduce thenumber of youth in our community who smoke at age 15 from 18.5 percent to 10 per-cent by 2007." Outcome. Outcomes are used to determine what has been accomplished, includingchanges in approaches, policies, and practices to reduce risk factors and promoteprotective factors as a result of the work of the coalition. An outcome measureschange in what you expect or hope will happen as a result of your efforts.Policy. A governing principle pertaining to goals, objectives, and/or activities. It is adecision on an issue not resolved on the basis of facts and logic only. For example,the policy of expediting drug cases in the courts might be adopted as a basis for re-ducing the average number of days from arraignment to disposition.Program. Any activity, project, function, or policy with an identifiable purpose or setof objectives.Results. The consequences and outcomes of a process or an assessment. They maybe tangible such as products or scores, or intangible such as new understandings orchanges in behavior. Strategic plans. Policies, strategies, and practices that create a logical, data-dri-ven plan to address the problems identified in the assessment element of the SPF.Strategy. The strategy identifies the overarching approach of how the coalition willachieve intended results.Sustainability. The likelihood of a strategy to continue over a period of time, especially after specific funding ends.Targets. Defines who or what and where you expect to change as a result of your efforts.

CADCA (Community Anti-Drug Coalitions of America)National Community Anti-Drug Coalition Institute

1-800-54-CADCAwww.cadca.org

Printed 2007, Revised 2008, 2009

CADCA’s National Coalition Institute is operated by funds administered bythe Executive Office of the President, Office of National Drug Control Policyin partnership with SAMHSA’s Center for Substance Abuse Prevention.

© Copyright 2009 Community Anti-Drug Coalitions of America

Community Anti-Drug Coalitions of America (CADCA) is a non-profit organization that is dedicated to strengthening the ca-pacity of community coalitions to create and maintain safe,healthy and drug-free communities. The National CommunityAnti-Drug Coalition Institute works to increase the knowledge,capacity and accountability of community anti-drug coalitionsthroughout the United States. CADCA’s publications do notnecessarily reflect the opinions of its clients and sponsors.

CADCA® is a registered trademark.

All rights reserved. This publication, in whole or in part, maynot be reproduced in any form by any electronic or mechani-cal means (including photocopying, recording or informationstorage and retrieval) without written permission. Please citeCADCA’s National Coalition Institute in references. Reproduc-tion in any form for financial gain or profit is prohibited.

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