Prevention Professionals Summary of qualitative data
Data for this summary was collected between November 2003 and May 2004. All respondents were asked the same set of questions, regardless of implementation method:
1. What challenges do you think the field of prevention as a whole is facing?
2. What needs to happen to help the field as a whole address these challenges?
3. What do you think state agencies can and should do to help meet the needs of the field?
The methods used to obtain data are as follows:
1. Seven regional focus groups were conducted at the Statewide Conference. Approximately eight participants were in each group. Participants were selected based on sector representation (e.g. school, law enforcement, public health, human services, public safety, community coalition, etc.) and geographical distribution within the region. Minnesota Institute of Public Health staff facilitated the focus groups. Each focus group also had a recorder.
2. Twenty-two key informant interviews were conducted with prevention professionals. Professionals represented each of the seven regions of the state work in law enforcement, public health, public safety, schools, community organizations and service organizations.
3. Seven regional forums were conducted and participants were invited to participate in small group discussions that used the above questions as a guide. Over 370 professionals attended these forums.
Key Findings
Challenges
· Utmost in the minds of many is the current funding situation. Long-term stability of funds that are being granted and budget cuts were mentioned frequently.
· Several interviewees noted that they are expected to do more work with less funds and find that there is more competition between agencies for the funding that does exist.
· Prevention professionals are frustrated because they are forced to be reactive rather than proactive. Many attribute this to the legislature and the general public’s lack of understanding of the benefits of prevention over the long-term. In addition, the government and general public do not perceive many public health issues to be a “crisis,” hence there is no perceived need to take action.
· Within the field, there appears to be variable understanding of what prevention is and what it intends to do. This poses a challenge as professionals implement programming and collaborate with others.
· Recruitment and retention of professionals to work in the field is problematic.
· Professionals are frustrated by the perceived lack of teamwork between state agencies.
· Professionals in rural areas face unique challenges due to a lack of available staff and needs that differ from urban areas. Rural professionals feel that they are not being acknowledged.
· There is a lack of understanding about the benefits of prevention and a lack involvement from parents, youth and community members.
· Cultural norms that are too accepting of risk-taking behavior are also a challenge to overcome.
· Respondents feel that grant periods do not last long enough for program implementation to be successful.
· Professionals are discouraged by the emphasis being placed on using programs that work or proving that programs work. This is exacerbated by too much record keeping and paperwork.
· Opportunities for professional collaboration are lacking.
Addressing the Challenges
· Increase the flexibility allowed for spending grant money so that dollars do not have to be returned to the state.
· Look for innovative ways to disseminate grants through sub-contracts and mini-grants.
· Educate and build relationships with legislators.
· Educate youth, parents and the community about the importance of prevention using innovative approaches such as advertising successes and the cost effectiveness of prevention.
· Increase opportunities for networking and collaboration between agencies and prevention professionals.
· Provide technical assistance in the areas of technology and grant writing. Technical assistance should be delivered using a hand-on manner that focuses on application rather than background and statistics.
· Start prevention programming with students as early as kindergarten.
· Mandate health education in schools.
· Increase service availability for 18-21 year olds.
The Role of State Agencies in Meeting These Challenges
· Better support grantees by employing the following methods:
Increase the number of site visits,
Recognize and acknowledge successes,
Offer more trainings, and
Coordinate meetings to help professionals connect.
· State agencies should work together to:
Coordinate funding,
Market the cost-effectiveness of prevention,
Increase communication between agencies, and
Streamline reporting mechanisms.
· Increase practitioner networking opportunities by creating a database of prevention professionals throughout the state that can be accessed on a website. The database should include project descriptions and contact information.
· Provide materials (e.g. brochures) and speakers at no cost to grantees to disseminate as part of their project.
· Increase services and attention paid to rural communities.
· Educate legislators and other decision-makers about the long-term commitment that needs to be made in order for prevention efforts to be effective.
Overall Observations
There appears to be an overall lack of leadership in the field of prevention. The field as a whole lacks a clear vision for the future. Practitioners do not feel valued for the work they complete and this is causing frustration. Finally, the prevention professionals that participated in this project were very open with their answers to these questions and many were pleased to be asked for their feedback.
Quotes Summary
Listed in the next section are direct quotes from participants. This is not intended to be an exhaustive list of comments. Rather, the quotes presented are intended to give the reader an overall understanding of how participants responded to the questions. The quotes are categorized in three topic areas based on the interview questions: perceived challenges, how these challenges might be addressed and the role of state agencies in addressing the challenges.
Challenges
Funding
Budget cuts
“Causes more competition and less teamwork.”
“Frustrating and insane when money is taken away. They know how important it is to do prevention over time and yet usually the resources go to another hot topic.”
“So much more work to do with cuts – and less to work with.”
“Money, positions terminated at schools for safe and drug free school counselors, prevention counselors, identification.”
“Funding cuts affects the field people personally. For example burnout, stress, worry.”
Long-term
“There is no long term funding.”
“There is not enough time to show that a program really works. It takes 3, 5 or up to 10 years for a program to make a difference, not 2 or 3. Fund us for the long term.”
Instability
“Must follow the money even if work in a previous area is incomplete.”
“Lack of stable funding.”
General
“We are expected to do more with less.”
“I’m disappointed in the elimination of the tobacco endowment funds. In reality, its hard when the money just isn’t there.”
“Finding funding. The money from the foundations is fine, but the focus is changing all of the time.”
“There are barriers in rural areas that make a program more expensive, yet because rural areas have fewer people, they get less money.”
“Funding is competitive. People can’t and won’t help each other because the fear of losing money is imminent.”
“Getting the money you need is at the existence of every program.”
“Once you get the funding and program up and running you naturally protect your own turf.”
“People see funding for prevention as a luxury.”
Government
“They don’t understand.”
“Less buy-in by higher ups.”
“Our credibility is questioned despite years of proof.”
“You need a strong police chief in the city/county if compliance checks are to happen.”
“Lack of knowledge of prevention services.”
The field is reactive
“My world is early intervention. We must get on the side of prevention but money is a big issue.”
“More resources go to intervention rather than prevention.”
“Primary prevention is not mandatory.”
“Prevention isn’t mandated.”
“Prevention pieces are gone. Can’t be proactive.”
Community’s perception that we are not in crisis
“Some people have problems, but its not that big of a problem. We did that when we were kids.”
“Its pushed aside in our busy society.”
“It can’t happen here.”
“The willingness of the community and education staff to admit there’s a problem.”
“Community apathy, its not our problem, they stick their heads in the ground.”
“Courts and law enforcement don’t take the challenges of prevention seriously.”
“The accountability of community members ‘not my job/none of my business’ attitudes are prevalent.”
“How the public sees prevention. It doesn’t seem to be a crisis, so politicians and the public don’t see it as a priority.”
Variable understanding of prevention
“No common language about prevention.”
“It is tough when we can’t even come to an agreement around this table about what prevention is.”
“There are too many different titles in this field.”
“Prevention needs to be more narrowly focused rather than broad brushed.”
“There are so many things to be addressed. Trying to figure out where to start can be overwhelming.”
“Not everyone is at the same level in prevention.”
Professional recruitment and retention
“We need to recruit new prevention professionals.”
“We need man-power, current people are already stretched.”
“Good prevention people move on to other areas when the money is gone.”
“We can’t hire new people.”
“I’m fighting for my job while trying to do my job.”
Rural
“Programs are really designed for the urban areas and aren’t flexible enough to fit the different communities.”
“Rural communities have a lot of poor people, but because the funder wants us to show ethnic diversity, we’re left out. We’re not ethnically diverse, but we still need to address economic issues.”
“There are barriers in rural areas that make a program more expensive, yet because rural areas have fewer people, they get less money.”
“A lack of funding which leads to a lack of work force. Especially in the rural areas this is a problem.”
Youth
“Kids are different now and things that worked before may not work now.”
“Teens don’t understand prevention.”
“Kids don’t understand or they don’t care.”
“Youth don’t think of the ramifications and seriousness, including the traffic issues of underage alcohol use.”
“Students just don’t care these days, especially when the consequences of their behavior isn’t immediate.”
“Difficult to deter children when their parents are using at home.”
“Children, who are the targets of prevention, don’t have a voice.”
Parents/family
“The lack of prevention happening at home.”
“Parents are busy with jobs and kids may be left home alone.”
“Some families fall behind because do not have access to technology.”
“People are busy.”
“Parents lack of involvement with their children.”
“It is hard to work with kids when it is okay for them to smoke pot at home with Mom and Dad.”
“Parent participation is a struggle.”
“We have more kids to work with but less parent involvement.”
“Major problem – getting parents to be active and regularly involved.”
Community
“Energy levels have declined. Less people in general are involved.”
“Norms need to be changed.”
“Coming from the outside of the community is hard. Membership in the community is based on how long you’ve lived there. I haven’t earned the right to be heard.”
Cultural Norms
“Cultural/ritual patterns that integrate alcohol behaviors.”
“To change the learned behaviors of parents in the native culture.”
“Family and cultural traditions that don’t take this serious.”
“Changing cultural norms and acceptance.”
“Cultural norms.”
Time
“Time is always an issue.”
“People are doing more and wearing more hats.”
“Three years is the longest we’ve implemented anything.”
“Lack of time to do everything we are told to do.”
“Time is an issue. Everyone is wearing too many hats and not able to devote the time and energy needed.”
“We need more time.”
Science-based programs
“We need more science-based programs to choose from.”
“By the time they’ve become science-based programs, they are outdated.”
“Whenever anything new comes out, we throw out the old and we lose some good old programs in the process.”
“We are losing out on a lot of good programs that aren’t research based. Regardless of the program, the important point is that you have to make the kids talk.”
“Requirements around creating research proven models too much to ask and may not be reasonable.”
Evaluation
“The approaches that work are the ones that cannot be measured.”
“Higher ups question the possibilities for quality impact.”
“There is too much record keeping.”
“There is too much concern about how things look on paper. Are we successful?”
“All the paperwork is a lot.”
“How to truly evaluate the effectiveness of what we are doing.”
“Before the “prove it” phase of our work today we worked better and easier.”
Lack of Collaboration
“It can’t be done individually.”
“Absence of a local connection.”
“Feel like I’m totally on an island.”
“I’m pretty much working in isolation.”
“Collaboration is lacking.”
“Raising community involvement and collaborations that work cooperatively.”
“More collaboration.”
“Lack of collaboration among community groups.”
“Locally in communities, it is a challenge for agencies to open the doors and work with another across agencies and systems.”
Addressing the Challenges
Funding
“I wish there was more flexibility in the grant I have from the state. Money goes back to the state unspent because we can’t qualify spending it.”
“Those of us in rural areas can run a whole program on $15,000 and we have.”
“Do more with less – donations, volunteers and student leadership.”
“Provide money to communities so they could do interesting and engaging promotions.”
“Provide mini-grants or contracts to partner organizations to address the issues.”
“I feel terrible not being able to help out people who are seeking our help. Money can only go to our people.”
“Be realistic when you ask people to implement programs. What is the real cost?”
Government
“Be more political.”
“Elect new political leaders, educate the public and elected leaders.”
“Tax the problem items.”
“Give kids a stronger voice in government.”
“Allow lobbying.”
“Educate law makers.”
“Lobby to get public health standards back. Work with your legislature.”
“I need to learn how state government works – how bills go through – about committees and how they work.”
“Have a relationship with your legislator.”
“Recognizing from the top down that prevention works. To realize that maybe not so much money would need to go into treatment if more were put into prevention.”
“Legislatures need to be educated. Most don’t seem to know the cost effectiveness of prevention.”
“When the government is involved, action takes place.”
Youth
“State agencies and local professionals don’t talk with kids as much as they used to. Get back in touch with kids.”
“Get to youth early.”
Parent/family
“Work more on family prioritizing.”
“Mandatory parenting classes.”
“Getting more parents to be aware that the giving of their time is important. To give more time to family and community. Everyone is just too busy and we need to get back to some of the old family and community basics, make them a priority.”