Building Community Capacity for Safety Promotion and Drug Reduction Through Prevention Coalitions

Rural Kentucky, and the Appalachian counties in particular, suffers from high rates of injury, violence and substance use disorder. After several years of decreasing injury rates, 2010 saw the beginning of an upward trend in injury-related fatalities in Kentucky. This trend was fueled largely by increases in accidental drug overdose and suicide. Kentucky's age-adjusted injury fatality rate increased from 76.1 per 100,000 population in 2010 to 81.8 per 100,000 in 2012. According to 2013 Centers for Disease Control (CDC) data Kentucky had the 2nd highest age-adjusted drug overdose fatality rate in the U.S. at 23.7 drug overdose deaths/100,000 population and 1,019 total deaths.

Community-level coalition development models have shown great success in reducing injuries, substance abuse, and drug overdoses in the United States. Coalition development models are supported by federal agencies such as the Substance Abuse Mental Health Services Administration (SAMHSA), non-profit agencies such Community Anti-Drug Coalitions of America (CADCA) and Communities That Care (CTC). These models have all been evaluated and demonstrate the value of communities working together for a common purpose. According to these prevention frameworks, community prevention coalitions are successful when they follow some basic guidelines for data-driven solutions that produce favorable process and program outcomes.

In 2012, the Kentucky Injury Prevention and Research Center (KIPRC) began an intensive outreach effort to provide communities with data, training in injury prevention and coalition development, and the use of a proven framework for collaborative community efforts to reduce injuries through the Safe Community America coalition model. The Safe Communities model was selected because of its local data driven and holistic community approach to prevention. By October, 2017 there were eight Safe Communities (including three Appalachian counties) either officially designated or in the formal application process. Several of these programs include multiple counties. These communities include major urban areas and together cover nearly 40 percent of the population of the Commonwealth.

In 2016, building on funding from the Harold Rogers Prescription Drug Monitoring Program, the Bureau of Justice Assistance, the National Safety Council, and the CDC, KIPRC began to specifically target Kentucky communities with the highest overdose burden, three urban and three Appalachian counties, by providing those communities with local, community-specific injury data and capacity building support to bolster their overdose prevention activities and existing coalitions.

This program has successfully supported existing coalitions and created diverse community coalitions that represent broad cross-sections of their communities, provided these coalitions with training, support and community level injury data, and worked with them to implement evidence-based or promising interventions to reduce injuries and substance misuse in their communities.

Our proposed presentation will focus on the model and techniques used, the value of building local coalitions that all groups and communities within the broader community, and preliminary results of our efforts. This workshop serves to provide attendees with Kentucky county-level injury and overdose data resources, the essential elements of effective community prevention coalitions, as well as the challenges and success stories related to effective community collaboration we have encountered to date. Emphasis will be placed on best practices for coalition development in the prevention of substance abuse and opioid overdose deaths.