Guidance

TASK 1: Prioritize intervening variables

Intervening variables are those factors identified in the literature as helping to explain opioid misuse in a particular community. They include both risk and protective factors.

When prioritizing intervening variables, it is important to look at opioid misuse in a comprehensive way and to consider the potential consequences of addressing one risk or protective factor versus another.

  • Example: There is some evidence that reducing access to prescription opioids without reducing the demand for these drugs could increase the use of heroin.

For each intervening variable you consider, think about the potential for unintended consequences and how you might anticipate and address these issues.

You might also consider the time lapse, or the amount of time between opioid misuse and its consequences. A short time lapse may make it easier for you to show a relationship between your activities and improved outcomes.

Communities often use two criteria in particular—importance and changeability—to decide which intervening variables to address. You may want to select intervening variables that are high in both.

Importance

Importance refers to the extent to which various intervening variables impact the problem in question. When examining the data you’ve collected, ask yourself how important a particular factor is in addressing opioid misuse in your community. If the answer is “very important,” then this factor should be considered high in importance; if the answer is “not that important,” then it should be considered low in importance.

  • Example: The problem is youth misuse of prescription opioids, and the data show that youth are more likely to obtain these drugs from peers (social access) than from parents (via unlocked medicine cabinets in their homes). Therefore, social access is high in importance, whereas access through parents is low.

When weighing the importance of intervening variables, consider the following:

  • Does the intervening variable impact other behavioral health issues?
  • Example: Poor parental monitoring is a risk factor for both opioid misuse and other risky behaviors, such as alcohol use and early sexual activity. Therefore, focusing on this risk factor will likely impact more than one issue, so it can be considered high in importance.
  • Do the intervening variables directly impact the specific developmental stage of those experiencing the problem?
  • Example: If the identified problem is the misuse of opioids among 18–25 year olds, the risk factor of parental monitoring is less important than it would be for 12–17 year olds.

Changeability

Changeability refers to how easy it may be to change the intervening variable. Consider the following:

  • Whether the community has the capacity—the readiness and resources—to change a particular intervening variable
  • Whether a suitable evidence-based intervention exists
  • Whether change can be brought about in a reasonable time frame (i.e., changing some intervening variables may take too long to be a practical solution)

For each intervening variable, consider whether your community has ample resources and sufficient readiness to address the variable, if a suitable evidence-based intervention exists, and if change can occur within a reasonable time frame. If the answer to all three questions is yes, then the factor is high in changeability. If the answer is no (there are not adequate resources, there is no suitable intervention, and/or the community is not ready to address the intervening variable), the factor is low in changeability.

Tool
MOAPC Planning Tool