Identifying and Overcoming Data Use Barriers in Local Communities Implementing the Strategic Prevention Framework (SPF)

Introduction

The Division of Substance Abuse Services (DSAS) in partnership with local prevention coalitions throughout the state, has sought new sources of public funding to combat the prescription drug crisis by building capacity of local communities to implement needs-driven, evidence-based environmental prevention strategies. DSAS was recently awarded a federal SPF Rx grant to implement the Strategic Prevention Framework (SPF) in seven high need communities across the state. As a key step in the SPF, coalitions are required to use community-level data on prescription drug availability (PSMD), morbidity, and mortality to drive the strategic planning process, and to identify sub-populations at risk for health disparities. Although coalitions understand the SPF process conceptually, in practice, they face significant challenges obtaining reliable community level data and understanding how to use and interpret data sources to define and prioritize needs, to match needs with appropriate EBPs, and to monitor and evaluate outcomes based on changes in data indicators.

Methods

The SPF Rx evaluation team is assessing implementation fidelity of the SPF at the state level and within the seven SPF Rx funded coalitions to specifically document state and local challenges related to data sharing, data quality, and data interpretation that pose as barriers to the SPF process. The team will produce an SPF implementation toolkit specific to data use to help coalitions overcome challenges and enhance data use capacity. The team is monitoring SPF implementation using fidelity worksheets, document reviews, and qualitative interviews with key stakeholders, and is conducting semi-structured baseline and follow-up interviews with DSAS agency staff, State Epidemiological Outcomes Workgroup (SEOW) members, and coalition directors to document the nature of data use challenges within the SPF context prior to introducing the toolkit, and to determine how the toolkit enhances community capacity to use data effectively.

Results

There are a number of data use challenges that create barriers to implementing the SPF with fidelity. At the state level, challenges include concerns about data sharing due to confidentiality issues and potential misuse of public health data, as well as technical challenges related to disaggregation of controlled substances data (CSMD) at the county level; at the local level, barriers include data quality challenges related to reliability of data for small populations, challenges obtaining and disaggregating sub-population data to document needs within groups at risk for disparity, and challenges understanding how to meaningfully use data to interpret community needs, and match needs with appropriate EBPs. The dissemination of a data use toolkit is expected to minimize many of these challenges.

Conclusion

There are a number of significant issues related data use that impede implementation of the SPF in practice, but that may be resolved through active technical support to enhance data access and promote data use capacity at the state and community levels. Study findings will be used to enhance understanding of practical challenges with SPF implementation and to identify lessons learned from the Tennessee SPF Rx experience.