North STAR: An Evidence-Based Framework for Community Prevention of Adult Secretive Problems

           We conducted a randomized controlled trial at 24 Air Force volunteer base communities. The trial assessed a data-driven approach to Community Action Planning (CAP) and community-based prevention (the NORTH STAR framework). Specifically, the study investigated the following: (a) does a data-driven approach enhance community effectiveness in preventing secretive behavioral health problems (suicidal thinking and behavior; alcohol abuse and drug use; partner abuse and child maltreatment); and (b) can prevention be enhanced by targeting more palatable community risk/resilience factors (e.g., depression, couples’ coping) rather than problems (e.g., suicide, abuse)? The key components of NORTH STAR are to

·         Provide structure and focus to guide planning teams;

·         Use community level data to help set priorities;

·         Target risk/protective factors, not secretive problems themselves;

·         Implement scientifically-proven activities to modify risk/protective factors;

·         Monitor impact and evaluate effectiveness.

             Results indicated the following:

• ·         NORTH STAR bases — compared with control bases — significantly reduced alcohol abuse and likely reduced child emotional abuse.
• ·         When taking prevention team functioning and command support into consideration, NORTH STAR bases — compared with control bases — significantly reduced suicidality, prescription drug misuse, and partner physical abuse
• ·         NORTH STAR bases — compared with control bases — improved prevention team functioning while reducing the time and resource demands on team members
  • o   Better CAP development
  • o   Greater likelihood of CAP success
  • o   More collaborative style in inter-agency communications
  • o   Increased orientation to use of data on risk factors in CAP development
• ·         NORTH STAR improvements were most pronounced when prevention team faced adversity
  • o   NORTH STAR was most powerful when the initial climate was less than optimal
  • o   NORTH STAR provided a buffering effect given less than optimal team competencies

            Implications of the study to be discussed are that

• ·         The NORTH STAR approach was straightforward for teams to learn and implement with minimal training, suggesting that over time, this approach could be self-sustaining.
• ·         NORTH STAR provides a useful structure especially when team/leadership is not functioning optimally.
• ·         Although evaluated within the Air Force, NORTH STAR could be used by anyone with an interest in more than one secretive problems and in research-proven prevention interventions. It is does not need to be linked to the AF’s prevention infrastructure.