Performance Improvement 1998. Substance Abuse and Mental Health Services Administration

02/01/1998

Contents

Findings from the Evaluation of the Faculty Development Program, Volume I: Final Report

Report on the CTS National Evaluation

CSAT Demonstration: Evaluation of Job Corps Drug Treatment Enrichment Program

NTIES: National Treatment Improvement Evaluation Study: Final Report

Evaluation of Model Projects for Pregnant and Postpartum Women and Their Infants

Final Report: Review of the CMHS Mental Health Care Provider Education in HIV/AIDS Program

TITLE: Findings from the Evaluation of the Faculty Development Program, Volume I: Final Report

ABSTRACT: The Health Professions Clinical Training Program in Alcohol and Other Drug Abuse (Faculty Development Program, or FDP) was established in 1989 and offers training to faculty from schools of medicine, nursing, social work, and graduate psychology programs. The purpose of the FDP was to enhance research, teaching, and clinical practices on issues of alcohol, tobacco, and other drugs (ATOD) within these fields. Specifically, the program seeks to (1) improve the knowledge and practice of participating faculty on ATOD-related issues; (2) incorporate ATOD-related issues into the curriculum at participating institutions; and (3) increase the level of institutional and professional support for ATOD in both policies and programs. The 5-year projects involved two phases: (1) faculty development and implementation efforts, and (2) an evaluation of the program's impact. The report finds that (1) all projects held meetings and seminars, provided mentoring to fellows, supported fellows' attendance at conferences and meetings, and promoted collaboration between fellows and other faculty members; (2) some project directors with extensive prior ATOD experience provided strong organizational leadership and fostered a group spirit among fellows, while others provided less direct guidance and worked with fellows individually; (3) less experienced directors tended to work with the fellows as peers in organizing activities and formulating a training program; (4) at least two-thirds of the fellows participated in all training activities (except for academic courses) during Years 1-3, while during Year 4, two-thirds continued to meet as a group, attended conferences, and engaged in independent studies; and (5) fellows noted three types of particularly helpful training experiences-literature collection and synthesis, participation in experiential learning, and collaborative curricula development and research. (Draft report: variously paginated.)

AGENCY SPONSOR: Office of the Administrator

FEDERAL CONTACT: Cynthia Prather

PHONE NUMBER: (301) 443-4969

PIC ID: 4510

PERFORMER ORGANIZATION: Cosmos Corporation, Bethesda, MD

TITLE: Report on the CTS National Evaluation

ABSTRACT: The Center for Substance Abuse Prevention national Training System (CTS) included the development and delivery of more than 30 distinct curricula on hundreds of occasions to more than 10,000 participants through 1996. Recipients included community teams, health professionals, State administrators, and a range of volunteers engaged in prevention activities. The report finds that CTS was innovative in several important ways, including (1) a focus on community coalitions and associations of health professionals that are responsible for planning and delivering prevention services, rather than concentrating on target populations; (2) curricula were developed quickly in response to emerging issues in the field; and (3) a continuing commitment to quality control and continual curricular improvement. The report also finds that, of three common levels of prevention training (introductory training, training directed at treatment providers and other health professionals, and approaches that contribute to broad systemic changes, usually directed at teams or coalitions), CTS was far more effective at delivering training at the lower two levels, given the complex nature of training for systemic change. The report then focuses on obstacles to training for systemic change, including (1) the difficulty of disseminating best practices, and (2) resistance to change by the prevention community. The report then discusses the principles of effective training. These include (1) attention to post-training application of the knowledge gained; (2) providing a blueprint or schema by which participants may understand the entire framework for a training effort; (3) focus on barriers to application, as well as advantages; (4) ensuring that training is culturally appropriate; and (5) training should encourage participants to use their intellectual and collective intellectual, verbal, emotional, artistic, and imaginative skills. See also PIC ID No. 4514.

AGENCY SPONSOR: Center for Substance Abuse Prevention

FEDERAL CONTACT: Gwyndolyn Ensley

PHONE NUMBER: (301) 443-0581

PIC ID: 4514.1

PERFORMER ORGANIZATION: Pacific Institute for Research and Evaluation, Bethesda, MD

TITLE: CSAT Demonstration: Evaluation of Job Corps Drug Treatment Enrichment Program

ABSTRACT: The Center for Substance Abuse Treatment within the Substance Abuse and Mental Health Services Administration sponsored a 4-year demonstration project of the Drug Treatment Enrichment Program (DTEP), which was put in place within the Department of Labor's Job Corps program. DTEP was implemented in four experimental Job Corps centers, which were matched with four control centers that provided the standard Job Corps Alcohol and Other Drugs of Abuse (AODA) program. The report finds that (1) the organizational location of DTEP within each Job Corps center's operations was problematic, since DTEP staff reported a lack of managerial support for the program, high staff turnover, and long periods for staff replacement; (2) the average cost per program participant for DTEP was twice the amount required for AODA; (3) DTEP reduced marijuana and crack/cocaine use post-Job Corps significantly more than did AODA; (4) DTEP students were less likely to engage in moderate to extensive use of marijuana or to use other drugs, but no differences were found for alcohol abuse; (5) DTEP improved students' mental health; (6) DTEP students were less likely to report selling or helping to sell drugs after Job Corps; (7) no differences between DTEP and AODA were found for other criminal activities; (8) DTEP students with mental health problems experienced a significantly higher job placement rate after Job Corps, although the program had no effect on job placement rates of other students; and (9) DTEP appeared to have no significant positive effect on duration of stay in Job Corps or on educational and vocational gains. The report makes recommendations regarding the integration of DTEP into Job Corps and other topics. (Final report: variously paginated, plus appendices.)

AGENCY SPONSOR: Center for Substance Abuse Treatment

FEDERAL CONTACT: Ron Smith

PHONE NUMBER: (301) 443-7730

PIC ID: 4523

PERFORMER ORGANIZATION: Caliber Associates, Fairfax, VA

TITLE: NTIES: National Treatment Improvement Evaluation Study: Final Report

ABSTRACT: The National Treatment Improvement Evaluation Study (NTIES) is a comprehensive assessment of the results of 157 3-year demonstration grants and cooperative agreements funded by the Center for Substance Abuse Treatment within the Substance Abuse and Mental Health Services Administration beginning in 1990-1991. These grants were intended to improve alcohol and drug treatment in selected target cities with severe substance abuse problems; among critical populations such as minority groups and women; and in the criminal justice system. Based on a final sample of 6,600 clients, the evaluation produced several results. For clients who entered treatment for alcohol and illegal drug use, the evaluation found that the program produced (1) a 78-percent reduction in selling drugs and committing violent crimes; (2) a 56-percent reduction in high-risk sexual behaviors related to HIV transmission; (3) a 53-percent reduction in medical visits; (4) a 42-percent reduction in homelessness; (5) a 28-percent reduction in inpatient mental health visits; and (6) a 19-percent increase in employment. See also PIC ID No. 5346. (Final report: 310 pages, plus appendices.)

AGENCY SPONSOR: Center for Substance Abuse Treatment

FEDERAL CONTACT: Ron Smith

PHONE NUMBER: (301) 443-7730

PIC ID: 5346.1

PERFORMER ORGANIZATION: National Opinion Research Center (NORC), Chicago, IL

TITLE: Evaluation of Model Projects for Pregnant and Postpartum Women and Their Infants

ABSTRACT: In 1989, the Center for Substance Abuse Prevention (CSAP) implemented a national demonstration program to provide prevention, education, and intervention services to substance-abusing pregnant and postpartum women and infants (PPWIs). CSAP contracted this study in 1993 to (1) assess the effectiveness of the PPWI programs in enhancing services coordination and increasing the availability and accessibility of substance abuse prevention services delivered to clients; and (2) document the extent to which program models are effective in decreasing the use of alcohol and drugs among substance-abusing women and enhancing the healthy development of their children. Ten PPWI programs funded by CSAP in 1992 were selected to participate in a 4-year cross-site evaluation. The wide range of interventions and possible outcomes required that program evaluations were augmented by a process evaluation to explain the relationships between mediating variables and outcomes. The project found that (1) there were significantly lower prevalence rates in the use of alcohol, marijuana, crack, and other illicit substances in the treatment group from intake to delivery, and in recent (30 day) marijuana and crack use in the treatment group from intake to delivery (these differences disappeared by the 6-month postpartum followup); (2) the effect of PPWI treatment group membership for lower recent crack use appears to be attributable to participation in day treatment, rather than case management programs; and (3) in general, treatment and comparison group members gave birth to infants with similar birth-related outcome characteristics, but when the mother's crack use histories were taken into account, treatment babies had significantly higher birthweights than comparison group babies. (Final report: variously paginated, plus appendices.)

AGENCY SPONSOR: Center for Substance Abuse Prevention

FEDERAL CONTACT: Soledad Sambrano

PHONE NUMBER: (301) 443-9136

PIC ID: 5674

PERFORMER ORGANIZATION: Johnson, Bassin and Shaw, Silver Spring, MD

TITLE: Final Report: Review of the CMHS Mental Health Care Provider Education in HIV/AIDS Program

ABSTRACT: This report presents findings from a review of the Center for Mental Health Services' (CMHS) Mental Health Care Provider Education in HIV/AIDS Program, from its inception in 1986 through 1994. The program supports the provision of state-of-the-art training for (1) traditional mental health care providers (psychiatrists, psychologists, nurses, and social workers), (2) other first-line providers of mental health care services (primary care physicians and medical students), and (3) nontraditional providers of such services (clergy or alternative health care workers). The program also supports the development and dissemination of curricula and teaching materials for providing training on the mental health aspects of HIV/AIDS. The goal of the program is to improve access to appropriate and adequate mental health services for people living with HIV/AIDS and for their families and partners. The review examines the activities and outcomes of 27 projects funded by the program. The report finds that (1) the program has trained tens of thousands of mental health service providers, representing the full spectrum of assistance to persons infected with HIV and to their families; (2) training participants are likely to have increased their knowledge about the mental health aspects of the disease, their willingness to serve HIV-infected individuals, and their confidence that they can effectively do so; (3) program funding has served as a catalyst for systemic changes within teaching institutions and hospitals for the development of alliances with concerned groups; (4) the need for training in the mental health aspects of HIV/AIDS is needed throughout the country, especially as affected areas and populations change over time; (5) at the program level, there is a pressing need to obtain systemic knowledge about the efficacy of various approaches to training mental health providers; and (6) the program must identify its priorities and how different projects can meet them.

AGENCY SPONSOR: Center for Mental Health Services

FEDERAL CONTACT: Martha Ann Carey

PHONE NUMBER: (301) 443-3653

PIC ID: 6695

PERFORMER ORGANIZATION: KRA Corporation, Silver Spring, MD