NIATx in New Places: Insights on Using NIATx in Prevention

By Erin Ficker, Prevention Manager, Great Lakes PTTC, and Maureen Fitzgerald, Communications Manager Great Lakes ATTC, MHTTC, PTTC

Erin Ficker, CPRS, MPAff, has over 18 years of experience in substance use prevention, helping communities adopt evidence-based strategies and data-driven processes for prevention planning and execution. Since 2019, Erin has teamed up with NIATx coach Scott Gatzke to conduct NIATx Change Leader Academies for prevention professionals. An August 2023 CLA for prevention included four 90-minute weekly virtual sessions over four weeks.

According to Erin, prevention has always involved elements of process improvement. “During the implementation phase of prevention programs, it’s very common to review data and make  mid-course corrections," says Erin. “But a structured approach to this process has been the missing piece. NIATx provides a great framework for addressing this gap."

In the August prevention CLA, Erin and Scott revamped the language and presentation to resonate with the prevention audience. For example, NIATx Principle #1: “Understand and involve the customer,” was fine-tuned to “Understand and involve the participant,” with prevention participants identified in multiple settings: community, schools, government, and families.

Erin and Scott also work to reframe the concept of  “process” within the context of prevention work. "Prevention professionals don’t typically view their work as process-driven. We used the flowcharting tool to help participants identify their prevention work as processes, while integrating quality improvement concepts."

She continues, "Processes in prevention are less obvious than, say, the daily routines in hospitals dealing with new mothers and babies, which are straightforward to define. In areas such as recruiting coalitions and implementing policy, it may not always be apparent that there are well-defined processes at play.”

NIATx Tools

Erin cites the Plan-Do-Study-Act (PDSA) cycle as one of her favorite tools for streamlining the change process. She explains, "Prevention efforts often require ongoing adjustments and enhancements. The PDSA cycle enables a coalition to make gradual, incremental changes to their strategies and interventions and then assess the impact of those changes.” 

The training offered sample prevention-focused aim statements to guide a prevention-focused PDSA Cycle:

• Increase number of schools using Project Towards No Drug Abuse program from 7 to 11 by April 
• Increase number of parents completing 80% or more of Strengthening Families sessions from 20 to 50% by May
• Increase coalition meeting attendance from 50 to 85% by March

Another favorite NIATx tool for Erin is the Nominal Group Technique (NGT). "The NGT has been a game-changer for engaging participants in structured idea generation,” she says.

“Aha!” Moments

“Participants saw the potential for these tools to enhance their work, even though they had not yet identified a specific change project,” says Erin.

“For the next iteration of the prevention CLA, we’re planning to embed activities in the sessions that will give attendees the skills to apply what they’ve learned immediately.”

The Great Lakes PTTC will offer a NIATx Change Leader Academy for Prevention Professionals again in 2024.

Erin Ficker, CPRS, MPAff, serves as a prevention manager for the Great Lakes PTTC. She has worked in substance use prevention for more than 18 years, supporting communities to use evidence-based strategies and data-driven processes in substance abuse prevention planning and implementation. Erin works with community-level prevention practitioners and schools to develop, implement, evaluate, and sustain prevention interventions.