Prevention Services within a Physically Distanced Environment
Background
In response to the physical
distancing requirement through California’s “Shelter-in-Place Order” during the COVID-19 pandemic, the Community Prevention Initiative (CPI) is facilitating a bi-weekly County Roundtable for county prevention coordinators. Physical distancing has created new challenges for the Substance Use Disorder (SUD) prevention field. The County Roundtable is a forum where counties can discuss challenges and share best practices in a physically distanced environment. The first two County Roundtables were held on April 21 and May 13, 2020.
This briefing compiles challenges, best practices, and resources county prevention coordinators identified for further information during the County Roundtables.
The content of this Brief is not comprehensive and is not a directive from the Department of Health Care Services. DHCS SUD Prevention Services promotes county collaboration efforts to support one another to address local needs.
County-Identified Challenges
- Closure of primary institutions (schools, colleges)
- Modification of essential services were impacted (social services, medical, public health)
- Some counties deemed prevention as essential; other counties did not
- In-person events and activities are cancelled
- Many prevention staff were re-assigned to disaster relief preparedness
- Some prevention participants do not have access to a computer or internet.
- Unemployment is creating increased stress for individuals which leads to increasing substance use and mental health issues (such as depression and suicidality).
- School is a safe place for youth away from family challenges; now this protective factor is obsolete.
- Prevention staff need time to build capacity to meet the need of implementing virtual services.
- The challenges increase the impact of social determinants of health on marginalized populations and increase health disparities.
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Best Practices
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- Be flexible. Staff, teams, partners, and communities must be able to respond and adapt to changing conditions. Adaptive work is challenging, but it also creates opportunities for innovation, such as learning how to conduct meetings online.
- Provide current, relevant information. Teach colleagues, stakeholders, and community members about how prevention activities can mitigate the challenges of physical/social isolation across health and wellness domains.
- Assess prevention priorities. Staff will need to reflect and reassess prevention program implementation that will best address community needs during social/physical distancing. This period of distancing can be used to create or update relevant plans through shared documents and small group virtual planning meetings.
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Transitioning to Virtual Program Implementation
- Consider alternative ways to engage community members who do not have adequate equipment or internet access to participate in videoconferencing. Think about traditional tactics about how work was done before widespread internet access and smartphones. For example, post information at community message boards or grocery stores, conduct phone-based surveys to assess needs, and collaborate with other agencies who can fulfill the need.
- Contact participants through phone calls and emails. Show participants that you are thinking of them, acknowledge the uncertainty and challenges they face, reaffirm the continued importance of prevention, and provide them with information about accessible local resources for their basic needs and wellness. Since work and school schedules may have shifted, discuss their schedules and availability to participate with prevention activities online.
- Assess if existing curricula can be presented in virtual formats. Research developer websites and/or contact developers directly to see if virtual implementation guidance or resources are available.
- Inform participants about what to expect before a virtual meeting. Explain how they will login or join the meeting. Make sure they consent to be on video, and if possible, provide alternative options to join (such as a call-in number). Explain specific expectations around the virtual service, such as that participants call from a quiet, private place, as available.
- Explain relevant privacy protections and risks before and during the meeting. For example, inform participants if they are being recorded, what will be done with the recording, if screenshots will be taken from the session, and privacy measures that facilitators are using (e.g., calling from a closed room). Discuss and acknowledge privacy limitations and participation agreements (e.g., it is possible that someone else could see the session on a participant’s computer). Recognize that many youth do not have access to resources such as microphones, scanners, or a private place in their home to participate in a Zoom call, and creative solutions will be needed to foster their participation.
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Empowering Youth During Challenging Times
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- Avoid making assumptions about young people’s technical abilities. Some youth are savvy users of social media and videoconferencing programs; however, others will need help learning how to use virtual formats.
- Improve established strategies for indirect youth outreach. For example, if youth already follow a coalition’s or organization’s social media account, engage them through messaging and posts.
- Give youth space to share their feelings and perspectives. Do not edit or reframe their experiences for them. Engage youth in activities to make meaning, contextualize, and learn from their experience. Some activities include photovoice, art, or journaling. It’s normal for youth to have different concerns than adults. Many youth may be deeply impacted by isolation from their peers; disruptions to school, extracurricular, and college activities or plans; and cancellations of special events such as concerts, graduation, or school trips. Do not judge or dismiss their feelings.
- Affirm the strengths and supports of youth. Ask them about the resources, people, or mindsets that helped them get through previous challenges or hardships.
- Support youth reflection regarding their principles, values, and goals. What is most important to them, within and beyond current challenges? What are their plans, and how have they changed? How can prevention activities continue to support their values and goals?
- Help youth identify ways they can develop leadership skills during physical distancing. Prevention and coalition work continue to support youth leadership activities. Youth may want to initiate projects related to physical distancing, such as contacting their public officials, delivering groceries to older adults (if safe), or volunteering at a local food bank. Among their peers, youth can initiate a virtual team meeting while role modeling social distancing and healthy decision-making. Remember, physical distancing does not have to equal social isolation.
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Engaging Staff, Partners, and Coalition Members
Adjust your outreach and engagement methods for different sectors and community members. For example
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- Prevention Practitioners: Acknowledge that prevention staff are also experiencing personal and professional challenges at this time. Model self-care and encourage colleagues to practice self-care. Allow time to learn new technology and virtual learning platforms, both individually and with colleagues.
- Youth: Provide meaningful entertainment. For example, give youth ambassadors the opportunity to engage their peers on platforms that are familiar to them (Snapchat, Instagram, TikTok, etc.). This engagement can be used to collect community-level data and perspectives from youth.
- Parents: Be solution focused and consider ways to address challenges parents experience (furloughs, unemployment, remote work, feeding their families, etc.). Provide materials parents can use at home, such as conversation starters to talk about substance use. When engaging parents in prevention planning or coalition work, use platforms that are comfortable for them (e.g., Google Docs, Zoom meetings).
- Essential workers, such as law enforcement and health care workers: Show appreciation and encouragement for their work, especially if they are participants. Be sensitive and mindful of their time when trying to engage essential workers in prevention activities, as many are overextended and exhausted.
- Schools: Champion and promote the work they are doing to address family and student needs. For example, many schools offer remote services (such as meal pick-up/delivery, at-home curricula, computer and internet access). If there are school staff that are not as engaged in remote services, they might be available to support coalition work.
- Media: Share stories about prevention efforts and programs. Many local media outlets are seeking content to inspire communities; maybe work with youth to highlight youth leaders in the community!
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Meeting the Need: Prevention Programs/Efforts in Transition
The Iowa State University SFP program developer is offering resources and activities for families that can be shared virtually. Many California counties have implemented the SFP curriculum in a virtual setting, adapting for families with low technology access by sending session materials to participant homes.
Prevention Messaging
DCCCA
, a behavioral health and social services organization in Kansas and Oklahoma, transitioned their entire youth conference online and launched a weekly prevention training series.
- The “Training Hour Thursdays” are weekly, low-commitment training series on Zoom focused on community-based prevention services. Session topics include the SPF, vaping, opioid use prevention, suicide prevention (signs and symptoms), and shared risk and protective factors – topics that the DCCCA’s local community has been asking for. The weekly trainings also provide an opportunity to engage non-traditional partners (e.g., hospitals, youth-serving organizations, community mental health centers).
- Moving KYC3 (Kansas Youth Community Change Conference) conference to an online platform had multiple benefits. It allowed participation from youth who were unable to travel to the event; expanded event capacity; and allowed for real-time recording of sessions and fast upload to the conference website. The agenda was adapted to the online format by spreading the sessions out over many days across April and May. One key recommendation from DCCCA is to ensure speakers are engaging and interactive.
notMYKid, a nonprofit serving youth and families in Arizona and nationwide, has transitioned all of their on-site and school-based programs online. Programs include:
- Youth “Talk About It” and #TeenTalk Support Group are now weekly, live, online chat rooms.
- Preventionist “On Call” allows parents to text in their questions to a dedicated text line for response from a program staff member.
- Project Rewind, an early intervention family program, is being transitioned to a group videoconferencing format to engage families in their homes.
- Parents can receive peer support through one-on-one coaching video calls.
In Wisconsin, the Community Alliance for Prevention Coalition and its county and community partners have formed a new coalition in response to physical distancing. The new coalition is designed to centralize and coordinate resources and engage youth in prosocial activities.
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Helpful Resources
Webinar Wednesdays
: CADCA hosted these sessions through June 17 on topics related to coalition work in the current situation. All sessions are being recorded and posted to the website.
Prevention Practitioner’s Role in Disaster Response:
Available through the
South Southwest Prevention Technology Transfer Center (PTTC), the checklist identifies how prevention practitioners’ unique skills and abilities align with needs during and following a disaster.
Virtual Learning Guide:
This new resource from SAMHSA’s Pacific Southwest Mental Health Technology Transfer Network (MHTTC) provides detailed guidance on how to facilitate digital learning opportunities and trainings.
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