ASP OFFICE OF HUMAN BRIEF ¢ rsisman sccnerane ron | OSERVICES POLICY PLANNING AND EVALUATION June 2023 In August 2022, the U.S. Department of Health and Human Services held a convening focused on increasing the use of primary prevention in human services systems. Participants considered the opportunity for human services to shift from responding to families after they arein crisis to preventing the crisis before it occurs. Participants indicated that incorporating primary prevention into human services delivery can uproot the causes of adverse outcomes by reducing risk factors and promoting protective factors, thereby creating the safety and stability needed to avoid adverse experiences in the first place. This brief highlights key considerations for policy designers and funding partners, such as federal staff, technical experts, and philanthropic partners. THEMES AND RECOMMENDATIONS FROM THE CONVENING To advance the use of primary prevention® in human services, convening participants noted the need to designa national framework for delivering prevention services and support that framework with buy-in from policymakers, the public, and funders. This framework should focus on equity and elevate lived experience by co-creating and delivering services with the individuals and communities served. Figure 1 presents key considerations that emerged at the convening related to designing and supporting this national framework. Figure 1. Key themes and recommendations Engage communities to Adopt a human-centered approach to support prevention service design that co-creates at all levels and stages of prevention services Support a Leverage evidence of Integrate infrastructure across - : ' program areas and sectors i national effectiveness to build -_- system for polmcal will 0 delivering prevention Build a primary : services prevention workforce with a person-first Finance primary prevenhon services Design a national approach to service delivery z frame:work for Focus on the root causes dellverl_ng of adverse experiences: Continuously prevention poverty and a lack of improve service services accessibility and Identify key effectiveness by risk and engaging those with protective lived experience factors high-risk populations to universal systems and approaches . economic opportunlty Il Expand beyond targeting * Primary prevention services include programs, policies, or other strategies that aim to prevent adverse outcomes from occurringby promoting protective factorsand reducing riskfactors. June 2023 ISSUE BRIEF 1 KEY CONSIDERATIONS FOR POLICY DESIGNERS AND FUNDING PARTNERS This section describes select recommendations from the convening for policy designers and funding partners to consider. More detail on these and other recommendations are availablein the convening summary brief: https://aspe.hhs.gov/reports/primary-prevention-convening-brief. Integrate infrastructure across program areas and sectors Convening participants indicated that advancing primary prevention will require integrating services across program areas andsectors; the root causes of many adverse outcomes are the same across contexts, and people generallyreceive services from more than one program. From a program or service participant perspective, integration starts with access (such as through a one-stop or "no wrong door" approach). From an administrator perspective, integration will require data-sharing infrastructure to guide policy, priorities, and funding. Ultimately, an integrated service infrastructure requires a s hift from programs that influence people to strategies and practicesthat influence change at the federal policy, system, and community levels in response to contextual factors (societal, environmental, interpersonal, and individual). Finance primary prevention services To support integrated services, convening participants called for a new approach to funding that provides flexibility across funding sources and centers community-based service providers. Human services programs oftenreceive funding to react to ongoing issues instead of to proactively prevent issues from arising. To effectively finance prevention services, government and philanthropic funders can dismantle funding barriers, increase flexibility of funding across sources, investin an integrated service delivery system, and adjust timelines to match the needs of primary prevention. (For example, the short-term nature of some existing grants prevents providers from offering effective prevention services). Ultimately, financing primary prevention requires trusting communities to implement programs in the way that is best for them. Leverage evidence of effectiveness Q to build political will Convening participants stressed that building and implementing the new primary prevention infrastructure and workforce needs dedication to capturing and characterizing the benefits of primary prevention at the societal level (in terms of outcomes, cost effectiveness, and cost-benefit), as well as the political will to make necessary policy and funding changes. Generating the requisite evidence will require addressing several challenges. First, itis critical to identify promising strategies that can successfully and equitably address root causes of adverse experiences and outcomes. Second, working with communities to define success and determine how to measure the effectiveness of prevention is key. Third, after identifying effective prevention strategies, policy designers and funders canturn to implementation science to guide efforts to replicate and scale those strategies as well as adapt them to community contexts. Finally, these research and development efforts will need ongoing financial support. NEXT STEPS The Office of the Assistant Secretaryfor Planning and Evaluation will hold a series of roundtables to advance selectideas thatemergedfromthe convening. Discussions will inform additional considerationsand next steps to build and supporta framework for integrating primary preventioninto human services policy and programs. FOR MORE INFORMATION Thisis one in aseries of briefs highlighting key considerationsfromthe U.S. Department of Health and Human Services Convening on Advancing Primary Prevention in Human Services. For other briefs in this series, see https://aspe.hhs.gov/primary-prevention- human-services. June 2023 ISSUE BRIEF U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Assistant Secretaryfor Planning and Evaluation 200 Independence Avenue SW, Mailstop 447D Washington, D.C. 20201 For more ASPE briefs and other publications, visit: aspe.hhs.gov/reports ABOUTTHE AUTHORS Lauren Akers is a Senior Researcher at Mathematica. Jennifer Tippins is an Analyst at Mathematica. Susan Hauanis a Senior Advisor for Human Services Policy at ASPE. Miranda Lynch-Smithis the Senior Official Performing the Duties of the Assistant Secretary for Planning and Evaluation and the Deputy Assistant Secretary for Human Services Policy at ASPE. SUGGESTED CITATION Akers, L., ). Tippins, S. Hauan, and M. Lynch-Smith. "Advancing Primary Preventionin Human Services: Key Considerationsfor Policy Designers and Funding Partners." Issue brief. Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, June 2023. COPYRIGHTINFORMATION All material appearingin this reportisin the publicdomainand may be reproduced or copied without permission; citationas to source, however, is appreciated. DISCLOSURE This communication was printed, published, or producedand disseminated at U.S. taxpayer expense. Subscribe to the ASPE mailing list to receive email updates on new publications: https://list.nih.gov/cgi-bin/wa.exe? SUBED1=ASPE-HEALTH-POLICY&A=1 For general questions or general information about ASPE: aspe.hhs.gov/about June 2023 ISSUE BRIEF 3