Effectiveness of student assistance programs in Nebraska schools.

BACKGROUND: This study investigated whether Nebraska schools with Student Assistance Programs (SAP) are associated with reduced adolescent alcohol use and a higher level of academic achievement than students from schools without a SAP. METHODS: In 1992, the Toward a Drug Free Nebraska (TDFN) survey was administered to 3,454 students in grades seven to twelve at eighty-three Nebraska schools. A second survey, the TDFN "team activity report" collected from each school's team, the presence of a SAP (n = 34 schools) or absence of a SAP (n = 49 schools). Student responses for alcohol use and academic achievements were linked with the presence of a SAP through use of a school identification number on both surveys. RESULTS: Students from schools with a SAP reported a lower use of alcohol in the last thirty days, compared with students from schools without a SAP program (p < 0.05), and they also reported a significant difference in academic achievement (p < 0.05). CONCLUSIONS: While this study used post hoc analysis of data, the results suggest lower alcohol use and higher academic achievement among students from SAP schools. Given SAPs' popularity, these trends suggest that further research should be conducted to demonstrate the effectiveness of student assistance programs.     

Promoting Employee Assistance Program Services to Employees

ABSTRACT

The purpose of this study is to examine the use of various types of employee assistance promotional tools, including the types of promotion used and their relationship to program type (internal or external), program utilization, and promotional budget.

Our study suggests that a variety of tools are used by both internal and external EAPs. Employee and supervisor training is the most popular form of program promotion. Statistically significant relationships were found between program utilization rates and several types of promotional activities. Our research suggests that promotional materials affect EAP utilization rates, and consequently, the interaction between promotional activities and/or promotional materials and EAP utilization deserves additional research.     

Estimating the Expense of a Mandatory Home- and Community-Based Personal Assistance Services Benefit Under Medicaid

Abstract

Personal assistance services (PAS) are essential for many people of all ages with significant disabilities, but these services are not always available to individuals at home or in the community, in large part due to a significant bias toward institutions in the Medicaid program. This study aims to provide an estimate of the expense of a mandatory personal assistance services (PAS) benefit under Medicaid for persons with low incomes, low assets, and significant disability.

Design and methods: We use year 2003 data from the Survey of Income and Program Participation to estimate the number of people living in households who would be eligible, based on having an institutional level of need and meeting financial criteria for low income and low assets, combined with additional survey data on annual expenditures under Medicaid programs providing PAS.

Results: New expenditures for PAS are estimated to be $1.4–$3.7 billion per year (in 2006 dollars), depending on the rate of participation, for up to half a million new recipients, more than a third of whom would be ages 65 and older. These estimated expenditures are a tenth of those estimated by the Congressional Budget Office for implementing the Medicaid Community-Based Attendant Services and Supports Act (MiCASSA).

Implications: Creating a mandatory PAS benefit for those with an institutional level of need is a fiscally achievable policy strategy to redress the imbalance between institutional and community-based services under Medicaid.     

Trends in marijuana and other illicit drug use among college students: results from 4 Harvard School of Public Health College Alcohol Study surveys: 1993-2001

The authors examined changes in college students' illicit drug use, patterns of polydrug use, and the relationship between students' ages of initiation of substance use and later use of marijuana and other illicit drugs between 1993 and 2001. Data from 119 US colleges and universities in the Harvard School of Public Health College Alcohol Study were used in the study. They found significant increases in percentages of students' use of marijuana in the past 30 days (from 13% to 17%), past year (from 23% to 30%), and lifetime (from 41% to 47%) between 1993 and 2001, with most of the increase occurring between 1993 and 1997. Past 30-day use of other illicit drugs increased from 4% to 7% and past year use increased from 11% to 14%. More than 98% of marijuana and other illicit drug users used another substance. They also either smoked, were binge drinkers, and/or were users of another illicit drug. Drug prevention programs should emphasize heavy alcohol use and smoking and should start when students are in high school or earlier.     

Evaluation of a comprehensive elementary school curriculum-based drug education program

This study was designed to evaluate the effectiveness of a province-wide chemical abuse prevention education program for grades two through six. Two separate studies were conducted. Study 1 measured pre- and post-scores on a test with 1101 experimental and 991 control subjects in a quasi-experimental design. Study 2 surveyed 500 elementary school teachers on their opinions and practices regarding drug education, and on the prevalence of the program in schools. The study found that: 1) students had a high initial knowledge level; 2) students showed modest but statistically significant knowledge gains for urban schools and grades three, four, and five of rural schools; 3) the program was most effective with students with a low base knowledge; 4) an estimated 20 to 30 percent of Manitoba elementary teachers had been in-serviced and/or were using the program across the province; and 5) the program was received well among teachers.     

Estimating the expense of a mandatory home-and community-based personal assistance services benefit under Medicaid

Personal assistance services (PAS) are essential for many people of all ages with significant disabilities, but these services are not always available to individuals at home or in the community, in large part due to a significant bias toward institutions in the Medicaid program. This study aims to provide an estimate of the expense of a mandatory personal assistance services (PAS) benefit under Medicaid for persons with low incomes, low assets, and significant disability. DESIGN AND METHODS: We use year 2003 data from the Survey of Income and Program Participation to estimate the number of people living in households who would be eligible, based on having an institutional level of need and meeting financial criteria for low income and low assets, combined with additional survey data on annual expenditures under Medicaid programs providing PAS. RESULTS: New expenditures for PAS are estimated to be $1.4-$3.7 billion per year (in 2006 dollars), depending on the rate of participation, for up to half a million new recipients, more than a third of whom would be ages 65 and older. These estimated expenditures are a tenth of those estimated by the Congressional Budget Office for implementing the Medicaid Community-Based Attendant Services and Supports Act (MiCASSA). IMPLICATIONS: Creating a mandatory PAS benefit for those with an institutional level of need is a fiscally achievable policy strategy to redress the imbalance between institutional and community-based services under Medicaid.     

Effects on students of teacher training in use of a drug education curriculum

The study reported here examines the effects of differential teacher training in use of a drug education curriculum on students' knowledge levels, problem-solving and coping skills, attitudes towards planned decision making, behavioral intentions and tobacco and alcohol use. An experimental design was used to compare the effects of exposure to teachers who had either intensive staff development, in-service training or no training. The findings indicate a statistically significant difference between groups of students on the intention to drink alcohol. Students whose teachers had intensive staff development were less likely to intend to take a drink if offered than students whose teachers had in-service or no training. Possible reasons for a lack of significant results on other variables are the confounding influences of school, classroom and teacher effects.     

Impact of a Student Assistance Program

A half-time Student Assistance Program (i.e., 20 hours per week) was designed and implemented for two semesters in an urban high school in New Jersey. The findings indicate that the proportion of the students who used the SAP increased with time. In both time periods, males outnumbered the females in use of the SAP and the most frequently cited of the presenting problems for both males and females were alcohol and drug issues and problems. Educators were the primary source of referral to the SAP.     

Shredding the Safety Net

Abstract

Recent federal legislation bans receipt of cash and food assistance to individuals convicted of a drug felony. This study examines the different definitions and methodologies used in estimating substance abuse among welfare recipients. It then analyzes a stratified sample of predominantly low-income young mothers on the basis of welfare receipt and consequences associated with alcohol and drug use. Results indicate that young mothers who received welfare for more than two years had lower reported drug use consequences than mothers who never used welfare or relied on it for a period of less than two years. Variables measuring consequences of drug use were not found to mediate length of time on welfare.     

Treatment services received in the CASAWORKS for Families program

This article presents information on treatment services received by women participating in an initial multistate evaluation of CASAWORKS families. Results indicated most women received services to address medical, employment, basic needs, alcohol and drug, family, and psychiatric problems during the first six months of the program. The clients also had frequent contact with their case managers and were retained in the program for an average of 222 days. Considerable variation was observed across sites in the percentage of clients who received various services and the number of sessions they received. In Cox regressions, shorter retention in the program was predicted by referral to program from Child Protective Services or parole/probation, social conflicts, employment, and marijuana use at baseline, whereas a history of suicide attempts was associated with longer retention. Longer retention was associated with better alcohol use outcomes but was unrelated to employment or drug use outcomes.     

Student desires for a university drug education program

A questionnaire was designed to determine the type of drug education program most desired by undergraduate students attending a major university. The survey was to provide the basis for a comprehensive drug education program. The 101 item questionnaire elicited responses from 656 undergraduates in categories ranging from knowledge base to credible information sources. The analysis of student desires as they relate to program design is included in this article. The students strongly believed the university should provide a drug education program. In particular they desired a credit course dealing with both drugs and alcohol. They also wanted regularly published articles on drugs in school publications. The most credible knowledge sources were PhDs and MDs. Students also wanted contact with former drug users. More than half the students believed that values clarification and "coping skills" training would decrease their drug use. In general more women than men were likely to utilize such resources.     

A model for a comparative cost-effectiveness evaluation of two mental health partial care programs.

This study provides a model for comparing the cost-effectiveness of two mental health programs. The example cited examines the cost-effectiveness of a hospital-based and a community-based partial care program. Using each group as its own control, the authors compare patients' use of inpatient hospitalisation and emergency room services during one year prior to and one year subsequent to first admission in day care. In both day care programs, patients substantially reduced their number of inpatient admissions and days. Neither program, however, showed a significant decrease in patients' use of the emergency room. Reflecting the substantially lower costs of the community-based program, the benefit-cost and cost-effectiveness ratios were significantly better in the community-based program than in the hospital-based program. Based on this evidence the authors conclude that the lower-cost, equally effective community-based program should be carefully considered as an alternative for more partial care patients.     

Blending Prevention Models: An Effective Substance Use and HIV Prevention Program for Minority Youth

Illicit drug use and rates of HIV infection among youth have increased over the past decade, indicating the need effective substance use and HIV prevention programs. Particularly at risk are minority youth living in poor urban environments. This study examines effectiveness of an innovative prevention program that blends the “All Star” substance abuse prevention model with the “Popular Opinion Leader” model for HIV prevention. In general, the results indicate non-significant increases in drug and sex risk, behavior and significant positive changes and trends in related areas (i.e., changes in perception, self esteem) thought to be related to drug use and risky sexual behavior.Sally Stevens and Velia Leybas-Amedia are affiliated with the Southwest Institute for Research on Women, University of Arizona. Beth Bourdeau is affiliated with the Pima Prevention Partnership, Tucson, AZ. Lovelle McMichael and Alan Nyitray are affiliated with the Southern Arizona AIDS Foundation, Tucson, AZ. Financial assistance for this project was provided by the Substance Abuse and Mental Health Service Administration, Center for Substance Abuse Prevention Grant# SP08916. The opinions expressed herein are those of the authors and do not reflect official positions of the government. The Southern Arizona AIDS Foundation and the authors would like to acknowledge the staff at the Tucson Urban League Academy Charter School and Luz Social Services Charter School for their assistance and support of the Check Yourself Youth Team prevention project.     

Adolescent Pregnancy Prevention in a Rural Native American Community

Nationally, the United States has a higher rate of teen pregnancy than any other industrialized nation. Native American youth have a higher birth rate than the national rate. A full-year healthy relationship program, based on Native American teachings, traditions, and cultural norms, was delivered to all eighth-grade students at a rural tribal school and a new group of eighth graders every year for 5 years, to teach healthy relationships and encourage abstinence. This article summarizes the Discovery Dating curriculum and compares the participants in the healthy relationship program to the comparison group, at the end of 5 years, in regards of the number of pregnancies as well as self-reported sexual behavior. The comparison group comprises students in the same community who attended a public middle school, rather than the tribal middle school, but the same public high school. All students had a similar age, socioeconomic status, culture, and ethnicity. Students who received the healthy relationship program (treatment group) had fewer pregnancies than the students who did not receive the healthy relationship program (comparison group). Of those who reported that they were sexually active, the students who received the healthy relationship program (treatment group) reported higher condom use than the students who did not receive the healthy relationship program (comparison group).     

Explaining Client Satisfaction with an Employee Assistance Program

ABSTRACT

The first objective of this paper is to explore the psychometric qualities as well as the usefulness of an employee assistance program client satisfaction scale. The responses obtained from 82 clients of an external service provider permitted a validation of the satisfaction scale and ultimately the selection of five items showing stronger convergent validity as well as high reliability (alpha = .89). The second objective is to explore the possible relationships between demographic (gender, age), treatment (referral-type, type of problem, urgency, degree of resolution) and organizational variables (unionization, job category, sector, size), and variations in client satisfaction levels. The results of bivariate analysis indicate that the type of referral, the type of problem, and the degree of resolution of the problem are related to client satisfaction. This study provides some support for the inclusion of treatment variables in a comprehensive explanatory model of client satisfaction. It is further argued that client satisfaction is an adequate measure of the success of an employee assistance program. Finally, some methodological issues surrounding the use of such surveys are discussed.     

An evaluation of immediate outcomes and fidelity of a drug abuse prevention program in continuation high schools: project towards no drug abuse (TND)

The present study provides an implementation fidelity, process, and immediate outcomes evaluation of Project Towards No Drug Abuse (TND), a drug prevention program targeting continuation high school youth (n=1426) at risk for drug abuse. A total of 24 schools participated in three randomized conditions: TND Only, TND and motivational interviewing follow-up, and no treatment control. Fidelity was high: across program schools the curriculum was implemented as intended and was received favorably by students. Relative to controls, intervention conditions produced effects on hypothesized mediators, including greater gains in program related knowledge, greater reductions in drug use intentions, and positive changes in motivation. However, few generalizations to attitudes and intentions regarding risky sexual behavior were found. The pattern of results suggests that the experimental manipulations worked as intended.     

Is County Level of Social,Creative, and Human Capital Associated with Winning Humanities Grants in Kansas?

This article examines patterns of Kansas Humanities Council grant distributions to organizations in the state's counties and then assesses social, creative, and human capital explanations for the observed patterns. Substantial numbers of counties have received no grants across a fifteen‐year period. Why is that? The analyses reveal that the presence of statistically significant relationships depends on the intersection of the type of capital in the county and the type of grant program: (1) the receipt of heritage grants is associated with county levels of network social capital, particularly those networks that are “non‐rent‐seeking”; (2) the receipt of “mini” Humanities grants and total grants are associated with levels of creative capital; and (3) the level of human capital makes little difference in grant patterns. These relationships persist under controls for racial/ethnic diversity, income inequality, and dominant political ideology. The implications of the results are assessed in terms of strategies for granting agencies to deal with building community life in low–social capital settings.     

Quasi-experimental evaluation of a national primary school HIV intervention in Kenya

This study examined the impact of a primary-school HIV education initiative on the knowledge, self-efficacy and sexual and condom use activities of upper primary-school pupils in Kenya. A quasi-experimental mixed qualitative-quantitative pre- and 18-month post-design using 40 intervention and 40 matched control schools demonstrated significant program impact on targeted objectives of (1) adequate program delivery and, for standard 6 and 7 pupils (ages 11-16 years), (2) increased HIV-related knowledge; (3) increased communication with parents and teachers about HIV and sexuality; (4) increased assistance to fellow pupils to avoid sexual activity; (5) increased self-efficacy related to abstinence and condom use; (6) decreased exposure to HIV through delayed first intercourse, decreased sexual activity and increased condom. Results support the conclusions that the existing infrastructure is adequate for national roll-out of the program; that the program has its most beneficial effect on sexually inexperienced youth and should therefore be implemented with the youngest age groups possible; and that gains are gender specific, with boys reporting increased condom use while girls are more likely to decrease or delay sexual activity. Based on these results, the program began national roll-out to all primary schools in 2005. By June 2006, the program was operating in 11,000 of the country's nearly 19,000 schools.     

Examination of the Role of Therapeutic Alliance,Treatment Dose,and Treatment Completion in the Effectiveness of The Seven Challenges

Adolescent alcohol and illicit drug (AOD) use is a major public health concern. This longitudinal study examines the effectiveness of The Seven Challenges in reducing adolescent substance use and mental health problems, as well as the process by which it is effective. Participants were 89 adolescents (72 male, 17 female) enrolled in a 3 month intensive outpatient adolescent substance abuse treatment program using The Seven Challenges and who provided self-report data at pre- and post-treatment. Results indicated that The Seven Challenges was effective at increasing the number of days refrained from using AOD, reducing use of tetrahydrocannabinol (THC) and other drugs, and reducing substance use problems and internal mental distress. Results also indicated that The Seven Challenges drug counselors effectively established and maintained therapeutic alliance but this seems to not play a role in the effectiveness of The Seven Challenges. Both treatment dose and completion played a role in the effectiveness of The Seven Challenges; they were both positively related to post-treatment days refrained from AOD use, and negatively related to days of THC use, substance use problems, and internal mental distress. However, the strength of the influence of treatment completion was stronger when treatment dose was low than when it was high. Despite a small sample and other limitations, findings add to existing literature that suggests that The Seven Challenges is an effective substance abuse treatment for adolescents. Furthermore, findings suggest that adolescent substance abuse treatment should focus on clients meeting pre-determined program goals as well as on dose.