Monitoring and Evaluating Efforts to Address Health Disparities through Samhsa/Csap's Partnerships for Success Program

Introduction: Substance abuse-related health disparities manifest as a stronger impact of substance use rates or consequences on groups of people who have “systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion” (Healthy People 2020).  Spurred by mandates of the Affordable Care Act (P.L. 111-148), the Substance Abuse and Mental Health Services Administration (SAMHSA) recently placed an emphasis on monitoring and evaluating efforts to impact health disparities through its programs. This was first applied in the prevention area in the evaluation of SAMHSA’s flagship substance abuse prevention initiative, the Strategic Prevention Framework Partnerships for Success (SPF-PFS).  SPF-PFS addresses underage drinking, prescription drug misuse, and other issues across over 600 communities within grantees in 47 states, 8 territories/jurisdictions, 13 tribal organizations, and the District of Columbia. Grantees and their SPF-PFS funded high need and low capacity communities work together to address their substance abuse prevention priorities. This presentation describes new measures developed to assess SPF-PFS health disparities efforts and related data collection challenges.

Methods: Grantees use quarterly progress reports to provide information on their health disparities accomplishments and related barriers faced for each SPF step (assessment, planning, capacity building, implementation, and evaluation).  Community subrecipients do the same through twice yearly Community Level Instruments, which also collect intervention implementation information including health disparities related adaptations, population targets and demographics of individuals reached.  Grantees provide annual outcomes data related to substance use consumption, risk/protective factors, and consequences for each community subrecipient.  The outcomes estimates come from various survey and administrative sources.

Discussion: The primary challenges for assessing SPF-PFS health disparities efforts include the variety of populations targeted by the grantees in this national program, community subrecipients’ sometimes limited knowledge of the demographics of their intervention participants (especially for environmental strategies), and the limited availability of outcomes data for relevant sub-populations. Discussion will focus on how to adapt SPF-PFS health disparities measures for other prevention efforts, including a description of their recent adaptation for SAMHSA’s Minority AIDS Initiative evaluation.