THE BRIDGE BETWEEN RESEARCH AND PRACTICE

1
THE BRIDGE BETWEEN RESEARCH AND PRACTICE

• Karol L. Kumpfer, Ph.D.
• Director, CSAP

2
Increases In Substance Abuse in Adolescents
(30-Day Use of Illicit Drugs)

• 27 Increase in Illicit Drug Use in 12 to 17 Year
  Olds
• 73 Increase in Illicit Drug Use in 12 to 13 Year
  Olds
• 32 Increase in Marijuana Use in 12 to 17 Year
  Olds
• 33 Increase in Cigarette Use in 12 to 13 Year
  Olds
• Highest Rates in New Cocaine Users in Youth
• Highest Incidence Rate in Heroin Use in Youth

Source 1998 National Household Survey (DHHS)
3
CSAPs Mission

• To Decrease Substance Use Abuse and Related
  Problems Among the American Public Through
• Bridging the gap between research and practice
• Field-testing scientifically defensible programs
• Disseminating comprehensive, culturally
  appropriate prevention strategies, policies, and
  systems
• Capacity-building for states and community-based
  providers

4
CSAPs Leadership Role

• Increase Substance Abuse Prevention Knowledge
  Base
• Increase Public Awareness and Perceived Risk As
  Well As Disapproval of Substance Abuse
• Increase Access to Prevention Services
• Increase Quality and Effectiveness of Prevention
  Services
• Increase Assistance to States and Communities in
  Building Comprehensive Prevention Systems

5
The Great Disconnect
Research
Practice
6
Building the Bridge
Research
Practice
7
CSAPs Vision for the Future
Research
Practice
8
Continuum of Substance Abuse Prevention Research
NIH NIDA/NIAAA/NIMH
CSAP/DoEd/OJJDP/CDC
STATES
Basic Biomedical Research
Nationwide Prevention and Health Services Program
(Block Grants)
II Methods Develop-ment
I Hypothesis Develop-ment
III Controlled Intervention Trials
IV Defined Population Studies (KDs)
V Demonstra-tion and Imple-mentation (KAs)
Research on Applications
Applied Research
Applications of Research
Sources Jansen, Glynn Howard, 1996
Greenwald and Cullen, 1995
9
CSAPs Activities

• 1. Knowledge Development (KD)
• Developmental Predictor Variable Study
• Workplace Cross-Site Study
• Starting Early/Starting Smart
• New Cross-Site Knowledge Development Studies
• Children of Substance Abusing Parents
• Teen Parents and Welfare Reform
• Project Connect

10
CSAPs Activities (Continued)

• 2. Knowledge Application (KA)
• State Incentive Grants (SIGs)
• 5 14 19 SIGs

• 3. Knowledge Synthesis
• National Center for the Advancement of Prevention
  (NCAP) I and NCAP II
• Prevention Enhancement Protocols System (PEPS)

11
CSAPs Activities (Continued)
4. Knowledge Transfer and Dissemination

• National Clearinghouse for Alcohol and Drug
  Information (NCADI)
• Media Campaigns
• Publications
• Five Regional Centers for the Application of
  Prevention Technologies (CAPTs) and Border CAPT
• Faculty Development Program

12
SAMHSA-CSAPCommunity Partnership Program
Location of the 251 Partnerships
2
3
4
5
22
1
6
5
13
7
3
7
1
5
6
1
6
11
1
6
1
4
1
2
1
3
9
26
2
5
5
5
3
5
8
5
8
1
1
3
4
2
13
10
2
1
1
13
A Rigorous National Evaluation

• Age Groups Surveyed in the 24 Partnerships and 24
  Comparison Communities

1994-95 1996
Total Adults Tenth graders Eighth
graders Total
14,807 12,092 26,899 12,842
13,042 25,884 14,151 16,539 30,690 41,800
41,673 83,473

• Annual Site Visits to 24 Partnerships
• Annual Site Visit Reports (N24)
• Composite Reports (N24)

14
Adults are Less Likely to Use Illicit Drugs When

• Living in partnership communities,
• Participating in drug prevention activities,
• Living in neighborhoods safe from drugs, and
• Disapproving of drug use.

SAMHSA-CSAP
COMMUNITY PARTNERSHIP
15
Outcome Evaluation ResultsCharacteristics of
Successful Partnerships
16
30 Day Illicit Drug UseMALES
Adults
10th Graders
8th Graders
Adjusted Prevalence Rates ()
p??036
p??005
p??025
Comparison Communities
Partnership Communities
one-tailed
17
30 Day Alcohol UseMALES
Adults
10th Graders
8th Graders
Adjusted Prevalence Rates ()
28

Partnership Communities
one-tailed
18
30 Day Illicit Drug UseFEMALES
Adults
10th Graders
8th Graders
24
24
6
22
22
5
Adjusted Prevalence Rates ()
20
20
18
18
4
p??026
1
0
0
0

Comparison Communities
Partnership Communities
one-tailed
19
30 Day Alcohol UseFEMALES
Adults
10th Graders
8th Graders
42
32
30
40
Adjusted Prevalence Rates ()
28
38
26

0
0
Comparison Communities
Partnership Communities
20
1998 Drug-Free Communities Support Grant Program

• Partnership Between OJJDP, ONDCP and CSAP
• Supports 105 Existing Coalitions to Develop
  Prevention and Treatment Strategies

21
1998 Drug-Free Communities Support Grant Program
Partnership Activities to Date

• Five One-hour Regional Telephone Conferences
• Training and Technical Assistance (TTA) for
• 1. Application and Review Process
• 2. Needs Assessment
• 3. Community Mobilization
• 4. Evaluation
• 5. Best Prevention Practices
• Program Introduction and Q A from Agency
  Directors (Kumpfer, McCaffrey Bilchik)

22
1998 Drug-Free Communities Support Grant Program
Partnership Activities to Date (Continued)

• TTA CSAP/ONDCP
• Objectives
• Increase Grantee Knowledge and Skills
• Strengthen Grantees Networks and Linkages With
  CAPTs
• Increase Dissemination and Application of
  Relevant Science-based Knowledge

23
1998 Drug-Free Communities Support Grant Program
Telephone Conference Evaluation Outcomes

• Reduced the Number of Applications From
  Ineligible Organizations
• Listeners Liked Telephone Conference as a
  Convenient Way to Access Information
• Q A Rated As Most Informative Aspect of the
  Telephone Conference
• Convenient to Participate From Work or Home

24
Pathways to Substance Use for High Risk Youth
Family Bonding
Family Supervision
Family and Peer Norms
No Substance Use
25
Pathways to Substance Use for High Risk Youth
Family and Peer Norms
Family Bonding
No Substance Use
Family Supervision
26
Thirty-Day Use of Various Types of Drugs,
1995(Cases Where Female Use is Higher than Male
Use)
Prevalence Rate
Source 1995 Monitoring the Future
27
Thirty-Day Use of Various Types of Drugs,
1995(Cases Where Male Use is Higher than Female
Use)
Prevalence Rate
Source 1995 Monitoring the Future
28
CSAP Female Adolescent Program

• Lei Ilima - Health Connections for Female
  Adolescents
• Decrease Use of Tobacco and Difficulty Refusing
  Drugs
• Decrease Family Conflict and Argument
• Decrease Depression
• Increase Satisfaction With Physical Appearance
• Young Womens Health Initiative at Boston High
  School
• Decrease Use of Alcohol and Beer Relative to
  Comparison Group
• Nuevo Dia Female Adolescent Program
• Increase Positive Self-esteem for High Attenders
• Increase Decision-making Skills for High
  Attending Females

29
Female Adolescent Programs

• NUEVO DIA (NEW DAY) FEMALE ADOLESCENT PROGRAM
  (Centro De La Familia De Utah)
• Intervention
• After-school Program
• Alternative Recreational Activities
• Advocacy services
• Outcomes
• Increase Self-esteem
• Increase Decision-making Skills
• Increase Social Skills
• Increase Positive Mother/Daughter Bonding and
  Attachment
• Decrease Substance Use

30
Female Adolescent Programs (continued)

• LEI ILIMA -- HEALTHY CONNECTIONS FOR FEMALE
  ADOLESCENTS (Coalitions for a Drug-Free Hawaii)
• Intervention
• Intermediate School
• Prevention Education Class
• Strengthening Hawaii Families Program (SHFP)
• Lei Ilima Club
• Lei Ilima Network
• Outcomes
• Decrease Family Conflict and Argument
• Decrease Depression
• Increase Satisfaction With Physical Appearance
• Increase Refusal Skills

31
Short-Term OutcomesDevelopmental Predictor
Variable (Cross-Site Study - 10 Sites)

• Decrease Family Conflict
• Decrease Harsh Parenting Strategies (Spanking,
  Yelling, and Threatening)
• Increase Parent Involvement in Classroom
• Decrease Aggression
• Decrease Conduct Disorders
• Increase Cooperation and Behavioral Control
• Increase Academic Performance
• Decrease Substance Use

32
Predictor VariablesEarly Risers Program -
Results of Phase II
Severity of Problem
33
High Risk Youth Demonstration Programs

• CHILD DEVELOPMENT PROJECT
• (Developmental Studies Center - California,
  Kentucky, Florida, NY)
• Intervention
• Elementary Schools
• Students, Families, and School Staff
• Promote Attachment to School Community
• Outcomes
• Decease Delinquent Acts - Gang Involvement,
  Carrying a Weapon, Fighting
• Increase Social Competence
• Increase Conflict Resolution Skills
• Increase Acceptance of Differences
• Increase Motivation to be Kind and Helpful
• Decrease Loneliness in School
• Increase School Enjoyment
• Decrease Substance Use

34
High Risk Youth Demonstration Programs

• INVOLVING PARENTS OF HIGH RISK YOUTH IN
  PREVENTION - THE FAMILY ADVOCACY NETWORK/ FAN
  CLUB (The Pennsylvania State University)
• Intervention
• 4 Boys Girls Clubs in Large and
  Intermediate-sized Cities
• High Risk Boys Girls Clubs Members Ages 11 to
  13 and Their Parents
• Multi-cultural
• 27-month Offering of 3-year Start SMART, Stay
  SMART, and SMART Leaders
• FAN Club Program
• Outcomes
• Increase Knowledge of the Health Consequences of
  Drug Use
• Increase Negative Attitude About Drug Use
• Increase Refusal Skills
• Decrease Substance Use

35
Findings from the Replication Programs

• Growing Up Well
• Decrease Rate for 7th Grade Participants in
  Alcohol, Marijuana, and Tobacco
• Decrease Fighting and Threatening Behaviors
• Across Ages
• Increase Negative Attitudes Toward Substance Use
• Increase School Attendance
• Asian Youth Substance Abuse Prevention Program
• Decrease Social Anxiety Skills
• DARE To Be You
• Increase Parents Use of Appropriate Disciplinary
  Techniques and Parent-Child Communication

36
CSAPs Future Plans

• Secretarys Youth Substance Abuse Prevention
  Initiative (YSAPI)
• National Families Strengthening Initiative
• State Incentive Grants
• Core Measures SIG Pilot Study
• Positive Activities Campaign
• More Field-Initiated Cross-Site Studies That Meet
  Local Needs
• Data Coordinating Center
• Science Symposia
• Colorado CD-ROM Project

37
National Families Strengthening Initiative

• Increase the Familys Role in the Secretarys
  Youth Substance Abuse Prevention Initiative
  (YSAPI)
• Emphasize the Role of Family in Deterring
  Negative and Unhealthy Behaviors in Youth
• Five Levels of Family Involvement
• 1) Receive Media Messages
• 2) Participate in National Family Strengthening
  Day
• 3) Participate in National Child Health Day
• 4) Join Parent and Peer Support Groups
• 5) Join Family Skills Training Groups

38
CSAP Core Measures Initiative

• GOALS
• Increase Knowledge of Effective Prevention
  Strategies
• Increase Ability to Analyze Results Across
  Cross-site Studies
• Increase Quality of Evaluation Data for
  Researchers and Practitioners
• OBJECTIVES
• Identify and Foster the Use of the Best
  Instruments for Identified Core Variables
• Increase collaboration Across Federal Agencies In
  Use of Core Measures

39
Phases of the Core Measures Initiative

• 1. Develop Core Measures Catalogue
• 2. Develop Draft List of Recommended Core
  Constructs, May 28-29
• 3. Convene Five Measurement Task Forces,
  September 2
• 4. Field Test of Core Measures in SIG States
• 5. Develop Culturally Valid Measures
• 6. Develop and Disseminate a CD ROM Expert System
• 7. Use CSAP Data Coordinating Center for Analysis
  and Reporting

40
Outcomes of the Core Measures Initiative

• Examine data on existing/past funded activities
• Promote the use of common data definitions across
  funding activities whenever possible
• Promote the ability to coordinate and/or compare
  data wherever possible within and across
  activities through linked databases
• Promote the collection of data needed for GPRA,
  ONDCP, HP2010
• Use data to guide future CSAP-wide program and
  policy development
• Use data to inform programmatic technical
  assistance and training
• Disseminate relevant cross-cutting information to
  interested constituents

41
Milestones of the Core Measures Initiative

• Internal and external input on prevention data
  needs for CSAP, States, prevention constituencies
• January-May, 1998 Production of inventory of
  CSAP inventories for program variables for
  intermediate and long-term outcome measurement,
  and for process measurement (working documents)

42
Milestones of the Core Measures Initiative
(continued)

• May 28-29, 1998 Exploratory Core Data Initiative
  Meeting
• Identified Important Substance Abuse Prevention
  Evaluation Questions
• Presented Conceptual and Categorical Frameworks
  to Prioritize Data Needs
• Developed Preliminary List of CSAP Core
  Intermediate and Outcome Constructs

43
Milestones of the Core Measures Initiative
(continued)

• September 2, 1998 Initial Core Measures Meeting
• Critical Variables as Focus of Best Measures
• Formation of Task Forces and Recommended
  Participants
• Criteria for Identifying Best Measures for
  Variables
• Format for Reporting Recommendations
• Potential of Developing and Disseminating an
  Expert System

44
Milestones of the Core Measures Initiative
(Continued)

• CSAP DATA COORDINATING CENTER (DCC)
• THE CORE MEASURES INITIATIVE SOFTWARE PROGRAM
• COMPREHENSIVE CORE MEASURES STRATEGY

45
Department of Health and Human Services
Substance Abuse and Mental Health Services
Administration CENTER FOR SUBSTANCE ABUSE
PREVENTION
OFFICE OF THE DIRECTOR DIRECTOR Karol L. Kumpfer,
Ph.D. DEPUTY DIRECTOR James Sayers, Ph.D.
OFFICE OF MANAGED CARE Nancy Kennedy, Dr.P.H.
OFFICE OF MEDICAL CLINICAL AFFAIRS Lucille
Perez, M.D.
YOUTH SUBSTANCE ABUSE PREVENTION
INITIATIVE Robert Denniston
OFFICE ON EARLY CHILDHOOD Pat Salomon, M.D.
OFFICE OF POLICY PLANNING Director Elaine Parry
DIVISION OF WORKPLACE PROGRAMS Director Joseph
Autry III, M.D.
DIVISION OF KNOWLEDGE DEVELOPMENT AND
EVALUATION Director (Acting) Stephen Gardner,
D.S.W.

• BUDGET/ADMINISTRATION TEAM LEADER - Carolyn
  Nelson
• PLANNING POLICY TEAM LEADER - Melvin Segal
• NATIONAL ADVISORY COUNCIL TEAM LEADER - Yuth
  Nimit, Ph.D.
• CONTROLLED CORRESPONDENCE TEAM LEADER - Estelle
  Feil
• INTERGOVERNMENTAL EXTERNAL AFFAIRS TEAM LEADER

• HIGH RISK YOUTH/REPLICATION TEAM LEADER (Acting)-
  Rose Kittrell
• WOMENS INITIATIVE TEAM LEADER(Acting) - Francis
  Johnson
• INDIVIDUAL FAMILY STUDIES TEAM LEADER - Soledad
  Sambrano, Ph.D.
• SYSTEMS/COMMUNITY/MANAGED CARE TEAM LEADER -
  Shakeh Kaftarian, Ph.D.

Note Shadowed components represent major
components as published in the organizational
statement of the Federal Register or approved by
the Center Director as branches.
DIVISION OF STATE AND COMMUNITY SYSTEMS
DEVELOPMENT Director Ruth Sanchez-Way, Ph.D.
DIVISION OF PREVENTION APPLICATION AND
EDUCATION Director (Acting) Judith Galloway
Systems Application Branch Chief, David Robbins
Systems Development Branch Chief, Theodore Weiss
Prevention Application Branch Chief, Luisa Del
Pollard
Prevention Education Branch Chief, Joan Quinlan

• TEAM A LEADER - Clarise Holden
• TEAM B LEADER - Will Hardy
• TEAM C LEADER - Deborah Castell

46
Promoting Leadership, Vision and Excellence
Through Learning

• I. Promote a Learning Community in CSAP
• Karols Korner
• II. Improve Senior Staff Management
• Management Training
• III. Improve Staff Morale
• Fallfest New Beginnings
• IV. Continue Strategic Planning
• Vision Day - Mission Day
• V. Staff Development
• Staff College
• Support Staff Network
• 360 Assessment