Report date
August 2017

What has been most instrumental to your progress?

We prepared a comprehensive website/webpage to provide detailed information on the purpose of the grant project and updates. The website has served to provide key advance information ahead of meetings. It also acts as a significant landing page for people seeking information about our work in North Dakota and for social media posts.

We have been able to use the website to provide updates on all our activities. Specifically, it has give us a place to publish results of our Community Awareness & Attitudes Survey. This data has been critical when focusing stakeholders thoughts and attention toward solutions.

Throughout the course of the last six months, we often get asked about the difference between our affiliate work and the community innovation work. What is published on the website makes this distinction clear. Thus, we are able to differentiate our state initiative work from our affiliate development work and keep key stakeholders focused.
We sought to understand the addiction challenges facing North Dakota through listening sessions, gap analysis, and ecosystem analysis. Each of the listening sessions included a participant survey. The primary purpose was to understand where the community lacked necessary services. We sought discussion on community strengths, challenges, and needs. The gap analysis report incorporates learnings from listening sessions and the survey. Every subsequent conversation with stakeholders is informed by this knowledge. Stakeholders felt included in the process and collaboration was more meaningful.

We engaged Augustana Research Institute to conduct an ecosystem analysis of the state of North Dakota. ARI surveyed addiction care providers and other stakeholders, analyzed databases, and interviewed stakeholders. Aggregation of available data and surveys provided an assessment of care gaps, challenges, and barriers from which recommendations were outlined for a statewide approach to the micro and macro issues. Our research indicated that the care delivery system had not been mapped in North Dakota. This analysis and system map will serve as the foundation for crafting a statewide strategy.
Face It TOGETHER has been building relationships and exploring development of affiliates in North Dakota for approximately two years. This activity has been helpful in some ways, but also not helpful in others. The negative aspects of affiliate development include the blurring of our interests that lead some to believe that Face It TOGETHER is in competition with other providers or services. The positive aspects of affiliate development, however, are that we now have local team members who are ingrained in or directly from these North Dakota communities. This gives us a greater level of credibility and authenticity of voice, especially when attempting to collaborate. What we are beginning to see, as described below, is a more focused strategic path for a state initiative due to unanticipated forces; e.g., North Dakota’s governor and first lady taking on addiction as a key state initiative. This is positive, but at the same time has forced us to reconsider our direction as initially described for this work.

Key lessons learned

There’s a lot of attention on the problem, but in some communities little attention on solutions. In many of the larger towns in ND, there are coalitions led by mayors, law enforcement, and others. But in many rural towns there is only the deep negative impact of addiction. Increased attention on addiction has allowed us to learn directly what some communities feel is important for them. We’ve learned that in some areas people are not interested in the same conversations of the past, they want forward thinking solutions and action — even if it comes from outside their community.

Our work began just as numerous mayors announced the creation of blue ribbon panels and task forces on addiction. These groups began holding town halls and listening sessions. In Grand Forks we had to work directly with the Mayor’s office to coordinate our listening session to augment their town halls. We had great communication, but unfortunately, our listening session may have caused confusion. Nonetheless, more voices came to the issue, whether through our efforts or other efforts. More people are engaged in the conversation. Hopefully, that will translate to more people being part of the solution.
The biggest challenge to-date has been something we could not anticipate: the Governor and First Lady of North Dakota announcing addiction as their primary public health issue. In many ways this is a positive development. The issue is so big it needs the attention of the highest public office in the state. On the other hand, the intention to establish a task force to create a statewide strategic plan for solving addiction is somewhat impaired. Through the convergence of all the activities occurring around the state, we were able to invite both Governor and First Lady Burgum to our Fargo Listening Session. Both very graciously shared their time and vision for a state that has solved addiction. Their message was simple: a solution will require everyone’s involvement.

Our intended outcome through this process may be modified. Over the course of the next month, we will begin exploring opportunities to engage communities where there is a big need but little attention — smaller towns and rural areas. There are also opportunities to engage existing coalitions to expand collaboration. Our next phase will explore these collaborations and identify statewide strategies.

Reflections on inclusive, collaborative or resourceful problem-solving

The most important element of the community innovation process to-date has been inclusiveness. In many of the communities we visited, a common theme was that people felt like someone was listening, not just to their problem, but to their ideas for solving the problem. In many cases, attendees to the listening sessions were actively engaged in identifying their specific community needs. Having the listening sessions facilitated by a neutral party permitted self-directed dialogue without an agenda or motivations. The community awareness & attitudes survey, broadly deployed using social media and focused communication techniques, allowed for an extensive variety of voices to be heard. The gap analysis supports the broad and open engagement directed toward solutions. The analysis also illustrates attendees sensitivity toward important stakeholders not present at the listening sessions; e.g., business owners. By identifying sectors of the community needed to be part of addressing addiction in their community, we are given pathways for next steps.

Other key elements of Community Innovation

Nothing different than what is mentioned above.

Understanding the problem

The greatest clarity from our process was the need for services, both physical and virtual, in rural areas of North Dakota. This need was articulated around all sides of a continuum of care, from basic information and navigation to already existing services to long-term peer support services or support groups.

If you could do it all over again...

One piece of advice would have been to do some advance meetings with business owners, mayors, and other individuals who can effect change. These advance meetings would have helped get more business leaders in the rooms for the Listening Sessions. We know the importance of building relationships and the length of time it takes to build trust, but we did not apply that knowledge to this process. We relied on a few local champions to help get key people to the Listening Sessions, but because of all the attention around addiction in various communities, simple invitations got lost in the increased activity.