Substance Abuse & Mental Health Services Administration

The Substance Abuse and Mental Health Services Administration (SAMHSA)

Tri-County Mental Health Services: Northland Coalition’s System for Change

The Northland Coalition brings together prevention leaders and agency representatives from the Clay, Platte, and Ray counties in Missouri. The Coalition employs a unique and multifaceted structure called System for Change to implement evidence-based substance abuse prevention programming. First, local teams conduct substance abuse prevention assessment and planning. Then, prevention specialists and local coalition leaders compile local data and program plans at the three-county level to determine regional programming, allowing better leveraging of resources and to develop consistent strategies across the region. Finally, the local teams then implement community-level programs that fit with the regional plans.

Using a comprehensive “bottom-up” assessment of the entire tri-county area, beginning with local communities and schools and expanding to city and county levels, Northland Coalition identified underage drinking as the primary focus of its prevention programming.  The System for Change model, however, has allowed the Coalition to take on other issues as well (e.g., synthetic drugs, prescription drug misuse) by building the capacity, structures, and systems to support its diverse prevention activities. Through social marketing and social norming (among youth and the community), education (adults and youth), information dissemination, and environmental change, the Coalition targets three primary risk factors: perceptions of harm and risk associated with substance use, acceptability of substance use, and availability of substances to minors.

With funding from SAMHSA’s Service to Science Subcontract to Build Evaluation Capacity of Evidence-Based Interventions, staff will strengthen processes for assessing Northland Coalition’s System for Change structure and functioning and the extent to which they contribute to outcomes of interest.  By implementing a two-case coalition comparison, the Northland Coalition will compare outcomes of interest for a community it serves versus those for a similar community served by another differently structured and functioning coalition. Specific evaluation enhancements include the following:

  • Using key informant interviews with staff of both coalitions to identify how the two coalitions are similar and different in terms of structure and functioning (e.g., communication patterns, coordination patterns) and what components of each are most essential to prevention programming.
  • Using data from the key informant interviews to create and administer an online survey for members of the Northland Coalition and the comparison coalition regarding coalition structure and functioning.
  • Collecting other clear descriptive data (e.g., rural, urban, number of counties) on the catchment areas and populations served by the Northland Coalition and the comparison coalition.
  • Analyzing five years of historical alcohol-, tobacco, and other drug-related outcomes data from Northland and comparison coalitions’ catchment areas for trends, similarities, and differences.
  • Disseminating findings through a professional publication or presentation.


Vicky Ward
Manager of Prevention Services
Tri-County Mental Health Services, Inc.
3100 North East 83rd Street, Suite 1001
Kansas City, Missouri 64119
Phone: 816-877-0411