FY15 DAODAS Prevention Management Plan Form—Needs Assessment/Community-Based Process

Goal Statement:
To conduct a comprehensive needs assessment, examining the root causes of alcohol use/tobacco use/prescription drug abuse/marijuana use, in Sunny County. (Complete the highlighted part with your county’s information and selected substance).
Strategy/Program Name: Needs Assessment / Evidence Based:
Yes No / If no, list the organization or research suggests evidence basis exists for this strategy: Needs assessment is an important step in comprehensive prevention planning.
Target Population: (check all that apply)
Pre-School Youth Elementary Youth Middle School Youth High School Youth College Parents
Business/Merchants General Population Older Adults Other:______/ Strategy Type: Information Dissemination Education Alternatives Community-Based Process Environmental Management
Problem Identification/Referral
Needs Statement (Identify the key data points that suggest this strategy is needed. Be sure to include data sources.) / Risk Factors / Protective Factors / Community Fit: Include a brief explanation addressing why your program/strategy choice “fits” best in your community and how the program or strategy is culturally relevant to the target population.
A needs assessment helps you prioritize substance abuse problems, ground planning in actual needs and resources, and identify gaps for implementing solutions to address the needs. The assessment should give you concrete information about your county that will help you form a comprehensive picture or profile to guide the rest of your planning process. Without the breadth and depth of comprehensive data collection, your prevention plan may overlook some problems, and focus the county’s resources on inadequate interventions. Data also can illuminate previously unidentified challenges and resources. The better you understand your county and the more complete your data collection, the more likely your prevention project will be successful. / Ambiguous, lax, or inconsistent rules and sanctions regarding drug use and student conduct / Caring and support (social networks and support systems within the community) / The Strategic Prevention Framework (SPF) is or has been implemented in all but one U.S. state and territory. It is used to address ATOD consumption and consequences in rural, urban, suburban, frontier, island, and select Native American reservation communities across. The first step in the SPF is needs assessment.

Process Objective (PO): Specific statements describing the activities you want to implement. **Repeat chart if multiple POs.

Who is the target population? / General Population
What are you hoping to do? / Conduct a comprehensive needs assessment focusing on: insert substance
Where do you want to implement these activities (target area)? / Sunny County
When do you want to complete these activities? / By June 30th, 2015
How much are you hoping to do AND how many are you trying to reach? / 1 needs assessment report
Projected number reached by December 31, 2014 / 1 needs assessment plan
KIT Entry: Service Code(s) identified for this process objective / USE SERVICE CODE STC04 for needs assessment related activities with other partners/groups such as meetings and meeting preparation, time spent reviewing or working on deliverables/documents, training and t/a with coaches, etc. . . USE SERVICE CODE STC02 for data collection, preparation, analysis, etc.

Outcome Objective #1 (OO1): Specific statements describing the change you hope to accomplish. **Repeat chart if multiple OOs.

Who is the target population? / Outcomes cannot be accurately assessed
What is being changed? / Outcomes cannot be accurately assessed
Where do you want this change to occur (target area)? / Outcomes cannot be accurately assessed
When do want this change to occur by? / Outcomes cannot be accurately assessed
How much change do you want to see? / Outcomes cannot be accurately assessed
Implementation Plan: (Include a brief narrative to accompany the timeline outlining the steps that will be taken to implement the plan throughout the fiscal year) / Conduct needs assessment following resources/guidance provided by DAODAS and regional capacity coach.
Evaluation Type (If “outcomes cannot be accurately assessed,” check here ) / DAODAS Standard Survey Yes No
Other (please describe, including design, data collection instrument, etc.):
Milestone/Activity Grant Year: Jul 1, 2014– June 30, 2015

**All process data will be entered into the KIT system

/ Months (Fiscal Year)
Jul / Aug / Sep / Oct / Nov / Dec / Jan / Feb / Mar / Apr / May / Jun
Deliverable 1 / X
Deliverable2 / X
Deliverable 3 / X
Deliverable 4 / X
(Add rows as needed)

LEGEND: + = Continuous activity x = milestone

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