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As a science, prevention has made considerable progress in building interventions that are evidence-based, proven to be effective, and “applicable to real life situations.” (1)
An ongoing challenge, though, is determining how best to maintain and even expand prevention programming with limited supports and resources in place. Communities across the country are realizing the benefit of substance use prevention programming, causing the demand to increase exponentially. A larger, more diverse group of the population is now being served. However, even as need increases, resources are staying steady, or being cut. Prevention specialists must work to utilize their current resources for long term programming. Leveraging existing resources is a strategy known as “sustainability.” (1) Through using the Strategic Prevention Framework, communication, documentation, and relationship building, sustainability can be attained by prevention providers in their communities.
Sustainability is one of the guiding principles of SAMHSA’s Strategic Prevention Framework. Prevention programming is not an instantaneous science. There are some short-term outcomes, but true change can take several years to occur. Communities, providers, coalitions, and key stakeholders that utilize the SPF are working toward the overarching goal of their work carrying on for several years. This is often in the face of funding cuts, loss of resources, staffing changes, and community growth. The longer that prevention programming can be sustained, the more impactful the results may be.
Throughout the five steps of the SPF, sustainability must be a guiding principle for all prevention providers. The steps and their involvement with sustainability are as follows:
Assessment: When assessing the needs and capacity of a community, providers must work to build new relationships and foster existing relationships, with key stakeholders that show the interest and ability to see the programming through for several years. Community data is essential at this step, in order to assess the most prevalent issues and identify individuals who can assist in programming, whether through hands-on work, funding, networking, etc. (2)
Capacity: Building capacity involves increasing public awareness and garnering public support for programming while connecting with partners and stakeholders who will be instrumental in the success and sustainability of evidence-based prevention programs. (2)
Planning: When providers and community members enter the planning stage of prevention programming, they must consider what interventions will best fit the needs and culture of the community. When programming meets these needs, sustainability is much more likely to occur. (2)
Implementation: When implementing evidence-based programming, providers will work to monitor their interventions closely, making mindful adaptations as needed, and celebrate “small wins” along the way. This helps to ensure that the interventions become ingrained into the daily processes of the community. (2)
Evaluation: Honest and open evaluation of prevention programming will help to ensure that changes are being made as needed, community members are all on the same page with modifications that should occur, and all are striving for long-term sustainability. (2)
The word “sustainability” is heard more frequently in recent years. In discussions about existing programs as well as new community efforts, prevention professionals tend to have some important questions regarding the sustainability of their efforts. These questions include “does this strategy make sense as a long-term effort?” and, “can we keep this up, or can future leaders take over and maintain this work?” (3)
When looking at the long-term sustainability of a program, providers must remember that the substance use issues in a community didn’t begin overnight. Prevention efforts aren’t going to create change that quickly, either. It may take several years for programming to have a measurable impact, and it is the responsibility of the prevention provider to have properly assessed a community for readiness, capacity, and commitment to change.
Sustainability in prevention programming requires both human and material resources. As time carries on, the individuals who were once committed to substance use prevention efforts may change. Perhaps they move out of the area, take a new job, or just simply can no longer commit the time to these efforts. When this happens, it is essential that the transition between the outgoing and incoming professionals is done thoughtfully and with as much open communication as possible. Change is inevitable, so as a person is setting up programming, assessing a community, and implementing evidence-based efforts, communication throughout an agency, coalition, and community are imperative.
Material resources often fluctuate within the prevention and recovery communities as well. Available funding streams will change, bringing new requirements, levels of financial resources, and opportunities. (3) The issues that a community face will change over time as well. This makes continual evaluation a necessity if sustainability is going to be achieved.
Long-term success is achievable in substance use prevention. Communication, documentation, and evaluation are key in doing so. Partnerships with key stakeholders, open and honest dialogue with community members, and flexibility as the social landscape changes are just a few ways that sustainability can be attained through this work.
(1) Nolfo, P. (2014). Prevention Tactics: Sustaining Prevention: Eight Capacity Building Factors for Success.
(2) A Guide to SAMHSA’s Strategic Prevention Framework. https://www.samhsa.gov/sites/default/files/20190620-samhsa-strategic-prevention-framework-guide.pdf
(3) Sustainability Primer: Fostering Long-Term Change to Create Drug-Free Communities. https://internationalcredentialing.org/resources/Candidate%20Guides/PS_SustanibilityPrimer.pdf