Form GLI Implementation GLI Implementation GLI Implementation

ATTACHMENT A1a: SPF SIG IV & V GLI Implementation

Form Approved

OMB No. 0930-0279

Expiration Date XX/XX/XXXX

Strategic Prevention Framework (SPF)
Grantee Level Instrument (GLI)

SPF Implementation Survey

SPF SIG COHORTs III & IV CROSS-SITE EVALUATION

APril 2013

Date: |___|___| / |___|___| / |___|___|___|___|

Respondent’s Name:

Respondent’s Title/Position:

Respondent’s Organizational Affiliation:

Jurisdiction: ________________

Submission Approval Provided By: ________________

Public Burden Statement: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  The OMB control number for this project is 0930-0279.  Public reporting burden for this collection of information is estimated to average 30 minutes per respondent, per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 2-1057, Rockville, Maryland, 20857.

Information and Directions

The Grantee Level Instruments (GLIs) are designed to collect information at the jurisdiction (state, tribe, territory) levels. The GLI is designed as two instruments: the Infrastructure Survey and the Implementation Survey. The GLI Infrastructure Survey collects data about the workings of the overall prevention system. The GLI Implementation Survey collects data about the execution of the strategic prevention framework process.

The intent of the GLI Implementation Survey is to provide information about how the SPF was implemented in the jurisdiction. Data collected from the survey will be used to evaluate the effectiveness of the SPF. Baseline data collection will be completed at the date of the approval of the grantee’s Strategic Plan and is designed to provide a retrospective picture of the period of time during the development and approval process of the Strategic Plan. It will be completed again 36 months after the approval of the Strategic Plan. The purpose of the follow-up data collection of the GLI Implementation Survey is to gather information about ongoing activities related to the SPF planning steps. A select number of questions will be asked only at baseline or only at follow-up.

As you respond to the questions in this survey please focus your attention on how the strategic planning process of the SPF was implemented in your jurisdiction. Throughout this document, the term “you” refers to the grantee—state, jurisdiction, or tribal entity.

Make sure to read all of the directions and examples. Directions for skipping questions are indicated where appropriate to minimize the time needed to complete the questionnaire. This web-based survey is designed to automatically take you to the appropriate question, but you should still follow the directions closely.

There are several terms used throughout this instrument for which CSAP provides the definitions on the following page.

DEFINITION OF TERMS

• Sustainability is the process through which a prevention system becomes a norm and is integrated into ongoing operations. Sustainability is vital to ensuring that prevention values and processes are firmly established, that partnerships are strengthened, and that financial and other resources are secured over the long term.

• Cultural competence is the attainment of knowledge, skills, and attitudes to enable administrators and practitioners to provide for diverse populations. This includes an understanding of that group’s or members’ language, beliefs, norms, and values, as well as socioeconomic and political factors that may have a significant impact on their well-being, and incorporating those variables into programs.

• Jurisdiction refers to the politically or geographically defined area that encompasses the grantee, its sub-recipients, and target population (usually used to describe a state, tribe, or territory).

• Grantee refers to the administrative entity of a jurisdiction (such as the state, tribe, or territory) receiving SPF SIG funds for delivery of substance abuse prevention programs.

• Community refers to the politically or geographically defined area or culturally or epidemiologically defined target population that the grantee chooses for any given prevention intervention.

• Sub-recipients are the entities (usually community based organizations, schools, or coalitions) that receive funds from the grantee (see grantee definition above) to carry out SPF SIG activities or prevention interventions.

• Interventions are funded activities carried out under the auspices of the SPF SIG grant, and target a variety of subpopulations with the objective of improving substance use outcomes.

• Participants are the recipients of the SPF SIG prevention interventions.

• Capacity refers to the various types and levels of resources that an organization or collaborative has at its disposal to meet the implementation demands of specific interventions.

• Region refers for the purposes of this survey to a politically or geographically defined area or district within a jurisdiction that may cross counties or encompass more than one county.

• Fidelity refers to the degree of fit between the developer-defined components of a substance abuse prevention intervention and its actual implementation in a given organizational or community setting.

• Process evaluation focuses on how a program was implemented and operates. It addresses whether the program was implemented and is providing services as intended, assesses the reasons for successful or unsuccessful performance, and provides information for potential replication.

As you respond to the questions in this survey please focus your attention on how the 5 steps of the SPF have been implemented in your jurisdiction.

A. SPF SIG PROJECT MEMBERSHIP

The first series of questions is about the individuals and groups involved in the development of the SPF SIG prevention strategic plan. Several questions address the working relationship between the Epidemiological Outcomes Workgroup (EOW) and the Advisory Council during the development and approval process of the grantee’s strategic plan and since the plan’s approval. . (NOTE: AT BASELINE THE QUESTIONS SHOULD BE ANSWERED WITH REGARD TO HOW THE GROUPS INVOLVED IN THE DEVELOPMENT OF THE STRATEGIC PLAN OPERATED DURING THE DEVELOPMENT AND APPROVAL PROCESS OF THE STRATEGIC PLAN.)

^{B, F}1. How well does the SPF SIG project membership reflect the diverse demographic and cultural subpopulations in your jurisdiction?

• The diverse demographic and cultural subpopulations of the jurisdiction were not considered when identifying project members.

• The diverse demographic and cultural subpopulations of the jurisdiction were considered when identifying project members but all known subpopulations are not represented.

• The diverse demographic and cultural subpopulations of the jurisdiction were considered when identifying project members and all known subpopulations are represented.

^F 3a. Which best describes the working relationship of the EOW and Advisory Council since the approval of the grantee’s strategic plan?

• Uncooperative

• Independent

• Complementary

• Cooperative

• Collaborative

• Other (please describe)

^F 3b. Rate the efficiency of the EOW and Advisory Council since the approval of the grantee’s strategic plan?

Very Inefficient	Inefficient	Somewhat Efficient	Efficient	Very Efficient
1	2	3	4	5

^F 3c. Rate the effectiveness of the EOW and Advisory Council since the approval of the grantee’s strategic plan?

Very Ineffective	Ineffective	Somewhat Effective	Effective	Very Effective
1	2	3	4	5

B. DATA-DRIVEN PLANNING AND NEEDS ASSESSMENT ACTIVITIES

This section asks questions about data-driven planning. Questions address the examination of Alcohol, Tobacco, and Other Drug (ATOD) data for assessing the project’s needs and capacity at the jurisdiction and community level. (NOTE: AT BASELINE THE QUESTIONS SHOULD BE ANSWERED WITH REGARD TO PLANNING AND NEEDS ASSESSMENT DURING THE DEVELOPMENT AND APPROVAL PROCESS OF THE STRATEGIC PLAN.)

^F 5. Who has had responsibility for examining Alcohol, Tobacco, and Other Drug (ATOD) data since the approval of the grantee’s strategic plan?

• EOW as a whole

• EOW as a whole, plus some other entity

• Subset or individual on the EOW

• Subset or individual on the EOW, plus some other entity or individual

• Other (please describe):

• Not applicable—the strategic plan has not been approved

• Not applicable—the strategic plan has not been examined again since its approval.

^{B, F} 6.a. Does the SPF SIG project plan to continue, enhance, or update any needs assessment activities?

• Yes – there are plans to continue, enhance, or update needs assessment activities

• No— No plans to continue, enhance, or update needs assessment activities. (Skip to Question 8)

^{B, F} 6.b. What needs assessment activities does the SPF SIG project plan to continue? (Check all that apply.)

• Monitoring the project’s identified priorities (e.g., updating with new data)

• Addressing identified limitations of the original needs assessment (e.g., addressing data gaps pertaining to the identified priorities)

• Identifying other issues that may emerge as priorities

• Other (please describe):

^{B, F} 7. Who will be involved in the continuation of the needs assessment activities:

• EOW as a whole

• EOW as a whole, plus some other entity or individual

• Subset or individual on the EOW

• Subset or individual on the EOW, plus some other entity or individual

• Project staff, other than the EOW, possibly in partnership with another entity or individual

• Community organization as a whole

• Some other entity as a whole

• Other (please describe):

^{B, F} 8.a. Has Alcohol, Tobacco, and Other Drug (ATOD) prevention capacity been assessed at the jurisdiction level as part of the SPF SIG process?

• Yes

• No— Capacity has not been assessed. (Skip to Question 13)

^{B, F} 8.b. Who has been involved in the capacity assessment activities?

• EOW as a whole

• EOW as a whole, plus some other entity or individual

• Subset or individual on the EOW

• Subset or individual on the EOW, plus some other entity or individual

• Project staff, other than the EOW, possibly in partnership with another entity or individual

• Community organization as a whole

• Some other entity as a whole

• Other (please describe):

^{B, F} 8.c. What has been done as part of the SPF SIG process to assess Alcohol, Tobacco, and Other Drug (ATOD) prevention capacity? (Check all that apply.)

• Compiled information from existing documents.

• Conducted primary data collection (e.g., surveys, key informant interview, focus groups).

• Other (please describe):

^{B, F} 9. What type of capacity assessment has been conducted? (Check all that apply.)

• Readiness assessment

• Resource assessment

• Other (please describe):

^{B, F} 10. What areas have been identified for capacity enhancement? (Check all that apply.)

• Training of stakeholders regarding SPF SIG model

• Training of stakeholders regarding cultural competence

• Enhancement/coordination/standardization of data collection/analysis/utilization for planning/reporting

• Collaboration between jurisdiction and community-level stakeholders and/or inter-agency or inter-coalition collaboration

• Coordination/standardization/ improvement of prevention service delivery (e.g., increase use of Evidence-Based Programs, Policies, and Practices; EBPPPs)

• Activities geared toward sustainability

• Strengthening/coordination/standardization of professional development

• Coordination/standardization of resource allocation

• Technical assistance on SPF SIG process activities (other than examples listed above)

• Other (please describe):

• Not applicable—no areas have been identified for capacity enhancement.

^{B, F} 11.a. Does the SPF SIG project plan to continue, enhance, or update any capacity assessment activities?

• Yes— the project plans to continue, enhance, or update capacity assessment activities.

• No— no plans to continue, enhance, or update capacity assessment activities. (Skip to Question 13.)

^{B, F} 11.b. What capacity assessment activities does the SPF SIG project plan to continue at the jurisdiction level? (Check all that apply.)

• Monitoring the areas for capacity building (e.g., training on SPF SIG model)

• Addressing limitations of the original capacity assessment

• Identifying other capacity issues that may emerge as priorities

• Other (please describe):

^{B, F} 12. Who will be involved in the continuation of capacity assessment activities?

• EOW as a whole

• EOW as a whole, plus some other entity or individual

• Subset or individual on the EOW

• Subset or individual on the EOW, plus some other entity or individual

• Project staff, other than the EOW, possibly in partnership with another entity or individual

• Community organization as a whole

• Some other entity as a whole

• Other (please describe):

C. PRIORITIZATION PROCESS

These next questions ask about the project’s process of prioritizing ATOD prevention issues. (NOTE: AT BASELINE THE QUESTIONS SHOULD BE ANSWERED WITH REGARD TO HOW PRIORITIZATION WAS DONE DURING THE DEVELOPMENT AND APPROVAL OF THE STRATEGIC PLAN.)

^{B, F} 13.a. Has the grantee begun its prioritization of ATOD prevention issues?

• Yes

• No (Skip to Question 16.)

D. CULTURAL COMPETENCE

These next questions are about the extent that cultural competence concepts are addressed by the SPF SIG project. CSAP defines cultural competence as the attainment of knowledge, skills, and attitudes to enable administrators and practitioners within systems of care to provide for diverse populations. This includes an understanding of that group’s or members’ language, beliefs, norms and values, as well as socioeconomic and political factors that may have a significant impact on their well-being, and incorporating those variables into assessment and treatment. (NOTE: AT BASELINE THE QUESTIONS SHOULD BE ANSWERED WITH REGARD TO HOW CULTURAL COMPETENCE WAS ADDRESSED DURING THE DEVELOPMENT AND APPROVAL OF THE STRATEGIC PLAN.)

^{B, F} 17. How has the SPF SIG project addressed cultural competence at the jurisdiction level? (Check all that apply.)

• Project has not addressed cultural competence.

• Project has articulated attention to cultural competence in its vision/mission.

• Project has tried to ensure that its membership reflects the jurisdiction’s demographic and cultural composition.

• Project has examined epidemiological data for the jurisdiction’s demographic and cultural subpopulations.

• Project has identified and/or assessed capacity and areas for capacity building regarding cultural competency for the specific populations that are served by the grant (including awareness of needs and values differences among different ethnicities or tribal cultures, as well as urban Native American issues, followers of traditional AI/AN/NH beliefs and practices).

• Project has formed an advisory group or committee focusing on cultural competence.

• Project has distributed general materials regarding cultural competence (e.g., what it is, why it is important).

• Project has provided other training and/or technical assistance (either directly or by partnering with an organization/consultant) related to cultural competence.

• Other (please describe):

^{B, F} 18. Which of the following demographic and cultural categories in your jurisdiction are specifically addressed by the SPF SIG project? (Check all that apply.)

• Race

• Ethnicity

• Gender

• Disability

• Sexual orientation

• Age

• Language facility

• Urban/rural status

• Socio-economic status

• Other (please describe):

• No demographic or cultural categories are specifically addressed

^{B, F} 19. Which of the following demographic and cultural categories in your jurisdiction still need to be addressed by the SPF SIG project? (Check all that apply.)

• Race

• Ethnicity

• Gender

• Disability

• Sexual orientation

• Age

• Language facility

• Urban/rural status

• Socio-economic status

• Other (please describe):

• No demographic or cultural categories still need to be addressed

^{B, F} 20. what, if any, barriers are there to improving cultural competence in ATOD prevention through your SPF SIG project? (Check all that apply.)

• Lack of commitment to cultural competence by project leadership

• Lack of understanding of cultural competence by project leadership

• Stakeholders’ lack of commitment to cultural competence

• Stakeholders’ lack of understanding of cultural competence

• Competing SPF SIG priorities

• Other (please describe):

• No barriers

E. CAPACITY BUILDING

This next question asks about capacity-building activities at the grantee and sub-recipient level. AT BASELINE THE QUESTIONS SHOULD BE ANSWERED WITH REGARD TO CAPACITY BUILDING ACTIVITIES DURING THE DEVELOPMENT AND APPROVAL PROCESS OF THE STRATEGIC PLAN.)

^{B, F} 21. What kinds of capacity-building activities has the SPF SIG project engaged in at the grantee and sub-recipient levels? (Check all that apply.)

Activity	Grantee Level	Sub-recipient Level
Project established a workgroup on capacity building		
Project convened and/or participated in meetings/trainings/workshops/summits with key stakeholders, coalitions, service providers, and communities		
Fostered collaboration between grantee and community levels and/or interagency or inter-coalition collaboration		
Addressed the enhancement/coordination/standardization of data collection/data analysis/utilization for planning/reporting		
Addressed the coordination/standardization/improvement of prevention service delivery (e.g., increase use of EBPPPs)		
Activities geared toward sustainability		
Activities geared toward evaluation		
Addressed the enhancement/coordination/standardization of professional development		
Addressed the coordination/standardization of resource allocation		
Leveraged funds		
Created website(s) for grantee or sub-recipient stakeholders		
Provided other technical assistance on SPF SIG activities		
Other (please describe):		
No capacity-building activities have occurred		

F. STRATEGIC PLAN

This series of questions covers details about strategic planning. Specific topics include the use of a logic model, identification of evidence-based policies, programs, and practices, allocation of project funds, and technical assistance. NOTE: AT BASELINE THE QUESTIONS SHOULD BE ANSWERED WITH REGARD TO HOW PLANNING WAS DONE DURING THE DEVELOPMENT AND APPROVAL PROCESS OF THE STRATEGIC PLAN.)

^{B, F} 24. What criteria has the project used for defining evidence-based policies, programs, and practices? (Check all that apply.)

• Not applicable—the grantee has not completed its strategic plan

• No criteria

• Inclusion in a federal list or registry of evidence-based interventions

• Found to be effective in a peer-reviewed journal

• Based on a solid theory or theoretical perspective that has been validated by research

• Supported by a documented body of knowledge (i.e., generated from similar or related interventions that indicate effectiveness)

• Judged by a consensus among informed experts to be effective based on a combination of theory, research and practice experience (informed experts may include key community prevention leaders, and elders or other respected leaders within indigenous cultures)

• Implemented in a similar community

• CSAP recommendation

• Evaluator recommendation

• Other (please describe):

^{B, F} 26. How does the grantee determine the technical assistance needs of the sub-recipient communities?

• The grantee does not determine the training and technical assistance needs of the funded sub-recipients.

• The grantee responds to sub-recipients’ requests regarding their training and technical assistance needs (e.g., grantee and subrecipients discuss needs as they arise).

• The grantee proactively assesses communities’ training and technical assistance needs (e.g., assessment survey).

• Other (please describe):

G. EVALUATION

This series of questions asks about the status of current evaluation activities used to monitor the SPF SIG process and how the evaluation activities may be sustained. (NOTE: AT BASELINE THE QUESTIONS SHOULD BE ANSWERED WITH REGARD TO EVALUATION PLANNING AND ACTIVITIES DURING THE DEVELOPMENT AND APPROVAL PROCESS OF THE STRATEGIC PLAN.)

^{B, F} 27. Please indicate the status of each grantee-level process evaluation activity listed below:

Activity	No plan to evaluate	Planned but not implemented	In progress	Completed
27a. Advisory Council activities				
27b. EOW activities (e.g., needs assessment process)				
27c. Grantee-level capacity building activities				
27d. Fidelity to SPF at the grantee level				
27e. Fidelity to SPF at sub-recipient level				
27f. External/contextual factors that may influence the SPF SIG project at the grantee level				
27g. Reach (extent to which the grantee-level stakeholders participated in the project) of the SPF SIG project at the grantee level				
27h Other (please describe):				

^{B, F} 28. How has the grantee planned for sustaining evaluation activities at the jurisdiction and community level? (Check all that apply.)

Activities	Jurisdiction Level	Community Level
28a. There is no plan for sustaining evaluation activities		
28b. Providing training to existing staff on evaluation activities		
28c. A group other that than a contractor will be responsible for evaluation activities		
28d. A contractor will be responsible for evaluation activities		
28e. Other (please describe):		

H. PROJECT PROGRESS

The following section asks about factors that may have facilitated or limited the progress of the project. (NOTE: AT BASELINE THE QUESTIONS SHOULD BE ANSWERED WITH REGARD TO HOW THE PROJECT PROGRESSED DURING THE DEVELOPMENT AND APPROVAL PROCESS OF THE STRATEGIC PLAN.)

^{B, F} 29. What factors have contributed to project progress? (Check all that apply.)

• Training/technical assistance provided directly by the project or partnering entity at the grantee level

• Training/technical assistance provided directly by the project or partnering entity at the sub-recipient level

• Collaboration between stakeholders (e.g., between agencies, between coalitions, between grantee and sub-recipient levels)

• Existing data infrastructure

• Enthusiasm for adopting SPF model

• Adequate time for project staff and members to devote to the project

• Adequate pool of qualified people for identifying members (Advisory Council, EOW)

• Good member attendance

• Good balance of efficiency vs. inclusiveness of project members

• Match between level of disaggregation of available data (e.g., county) and communities being funded (e.g., towns within counties)

• Agreement among stakeholders regarding the project’s priorities

• Agreement among stakeholders about resource allocation procedures

• Aligned perspectives between the project and jurisdiction-level administrators (e.g., SSA management, Governor’s Office, Tribal Entity, etc.)

• Adequate funds to thoroughly implement SPF model

• Existing prevention infrastructure

• Other (please describe):

• No factors have contributed to project progress

^{B, F} 30. What factors have been barriers to project progress? (Check all that apply.)

• Insufficient/inadequate training/technical assistance provided directly by the project or partnering entity at the grantee level

• Insufficient/inadequate training/technical assistance provided directly by the project or partnering entity at the sub-recipient level

• Lack of collaboration between stakeholders (e.g., between agencies, between coalitions, between grantee and sub-recipient levels)

• Lack of existing data infrastructure

• Resistance to adopting SPF model

• Inadequate time for project staff and members to devote to the project

• Required timeline for completing project benchmarks and reaching outcomes

• Inadequate pool of qualified people for identifying members (Advisory Council, EOW)

• Difficulty convening members

• Difficulty balancing efficiency vs. inclusiveness of project members

• Mismatch between level of disaggregation of available data (e.g., county) and communities being funded (e.g., towns within counties)

• Disagreement among stakeholders regarding the project’s priorities

• Disagreement among stakeholders about resource allocation procedures

• Differing perspectives between the project and jurisdiction-level administrators (e.g., SSA management, Governor’s Office, Tribal Entity, etc)

• Inadequate funds to thoroughly implement SPF model

• Lack of existing prevention infrastructure

• Other(please describe):

• No factors have been barriers to project progress

I. EXTERNAL EVENTS

This last set of question is about external events that may have occurred in your jurisdiction (e.g., SSA management, Governor’s Office, Tribal Entity, etc.) recently. These could be things like significant changes in prevention funding sources or levels, new legislation, economic changes, or even natural disasters. . (NOTE: AT BASELINE THE QUESTIONS SHOULD BE ANSWERED WITH REGARD TO EXTERNAL EVENTS THAT OCCURRED DURING THE DEVELOPMENT AND APPROVAL PROCESS OF THE STRATEGIC PLAN.)

^{B, F} 31. Indicate how each event has impacted or may impact your grant's SPF SIG process.

Event	Mostly Positive Impact	Mixed: Positive & Negative Impact	Mostly Negative Impact	NA/ Event did not occur
31a. Changes in prevention funding sources or levels				
31b. Changes in jurisdiction leadership				
31c. New legislation				
31d. Economic-related changes				
31e. Natural disasters				
31f. Tragedies or losses in the community or tribe				
31g. Other (please describe):				

N/A = not applicable.

^{B, F} 32. Indicate how each event has impacted or may impact ATOD Consumption in your jurisdiction.

Event	Mostly Positive Impact	Mixed: Positive & Negative Impact	Mostly Negative Impact	N/A Event did not occur
32a. Changes in prevention funding sources or levels				
32b. Changes in jurisdiction leadership				
32c. New legislation				
32d. Economic-related changes				
32e. Natural disasters				
32f. Tragedies or losses in the community or tribe.				
32g. Other (please describe):				

N/A = not applicable

^{B, F} 33. Indicate how each event has impacted or may impact Alcohol, Tobacco, and Other Drug Related Consequences in your jurisdiction.

Event	Mostly Positive Impact	Mixed: Positive & Negative Impact	Mostly Negative Impact	N/A Event did not occur
33a. Changes in prevention funding sources or levels				
33b. Changes in jurisdiction leadership				
33c. New legislation				
33d. Economic-related changes				
33e. Natural disasters				
33f. Tragedies or losses in the community or tribe.				
33g. Other (please describe):				

N/A = not applicable.

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