Cross-system data linkage for treatment outcome evaluation: lessons learned from the California Treatment Outcome Project

Using administrative data to evaluate health care outcomes has become increasingly common, but the reliability and validity of outcome measures based on cross-system data linkage have been little scrutinized. Applying a deterministic data matching methodology, we linked 6545 Californians admitted to 43 substance abuse treatment programs between 2000 and 2001 to administrative data acquired from three state agency databases. We compared self-reported treatment outcome measures to equivalent measures derived from official records on motor vehicle driving incidents, criminal history, and mental health services utilization. Administrative data provided analogous results in some measures (e.g., percent of people using mental health services, percent ever arrested) and more accurate results in others (e.g., frequency of service utilization, and frequency of arrests). Similar to findings based on the interview data, the administrative data also revealed improvements in several domains 1-year post-treatment compared to 1-year pre-treatment. Experiences with data linkage procedures and strategies for enhancing record linkage accuracy are discussed. Findings illustrate the value of using administrative records for substance abuse treatment outcome evaluation, while highlighting areas for improvement for future cross-system data linkage efforts.     

Three high school after-school initiatives: lessons learned

Alarmed by the large numbers of high school-age youth who are disengaged at school and leaving high school without a diploma or the important skills for the workplace, policymakers and youth advocates are beginning to see high school after-school as the new frontier in after-school programming. Although older youth represent a sizable percentage of American students, they garner only a small fraction of the federal, state, and local investments for after-school programs. This chapter reviews the insights and lessons learned from three after-school initiatives that have shown success in attracting high school students to their programs and engaging them in meaningful activities to support their success in school and transition to early adulthood: the After School Safety and Education for Teens, After School Matters, and the After-School Corporation. Emerging from these pioneering efforts are some promising practices and program models that can guide the development of future after-school programs, but not without the help of policymakers and funders, both public and private.     

Changing attitudes about self-injury prevention management: lessons learned

In the behavioral health environment, nurses often use continuous staff monitoring and, at times, physical restraints, to manage the severity of patients' self-injury. Both options put staff in control, are the most restrictive in nature, and can be financially draining on the hospital's budget. This can result in negative reactions by both patients and staff. It is important to develop a program that will empower patients to control their behavior and allow staff to be aware of their perceptions and attitudes toward patients who self-injure. This article describes the leadership initiative that drove the development, training, and implementation of a self-injury prevention project and the lessons learned by staff.     

Multicultural supervision: lessons learned about an ongoing struggle

This article examines the experiences of seven diverse therapists in a supervision course as they wrestled with the real-world application of multicultural supervision. Existing literature on multicultural supervision does not address the difficulties that arise in addressing multicultural issues in the context of the supervision relationship. The experiences of six supervisory candidates and one mentoring supervisor in addressing multicultural issues in supervision are explored. Guidelines for conversations regarding multicultural issues are provided.     

Disseminating science-based prevention: lessons learned from CSAP's CAPTs

A wide variety of prevention approaches that reduce substance use and associated problems have been developed and tested. But successes have been limited in promoting the use of these scientific advances by the policy makers, practitioners, and concerned citizens. The Center for Substance Abuse Prevention's six regional Centers for the Application of Prevention Technologies (CSAP's CAPTs) are a major mechanism by which CSAP brings research to practice. This article synthesizes the issues that the CAPTs have faced, the solutions they have developed, and conclusions concerning the work that still needs to be done to increase the application of science-based approaches to prevention. These discussions highlight the particular importance of addressing issues related to the larger systems in which prevention programs and strategies operate.     

Teaching economics across cultures: challenges and lessons learned in Tajikistan and Kyrgyzstan

Nine years of experience teaching economics in the Tajikistan and Kyrgyzstan provides knowledge on the nuances and challenges of teaching economics across cultures. Particular categories and difficulties are presented with some examples of how to address them. Conclusions and findings are used to form general guiding principles for teaching economics in the increasingly diverse US classroom. The principles offered in the paper are valuable to English speakers providing economic teaching and training in post-Soviet nations and, more broadly, to anyone teaching economics across cultures. Finally, suggestions based these principles are offered to encourage all professors of economics to carefully consider language, illustrations, diversity of views regarding economics and the multi-cultural nature of university classrooms to better relate to students and be more effective teachers.     

Globalisation and gender training for the media: challenges and lessons learned

This article discusses the experiences of the author in developing gender training for media professionals. The media has been known to be a key institutional player in holding governments and other institutions accountable for adhering to the democratic ideals of transparency, accountability, and good governance. Likewise, this article discusses the experience of Inter Press Service (IPS), a global information and communication service that aims to report more competently on gender issues. During the implementation of the IPS, several steps were taken: 1) examination of gender roles and responsibilities; 2) creation of gender-responsive editorial and employment policies towards better practices; 3) provision of training and seminars. In the same manner, there have been several challenges faced by media during gender training: the need to understand the basics, and the move from awareness-raising to provision of professional tools. To conclude, several lessons were learned during the course of its implementation: 1) the significance of policy as the initial step in mainstreaming; 2) training as the key to change; 3) the difficulty of practicing what has been learned; 4) monitoring; and 5) the importance of new partnerships.     

Exploring challenges and lessons learned in cross-cultural environmental education research

The field of environmental education (EE) has been criticized for scarcity of research findings that can be used to compare the approaches and outcomes of various interventions and contexts. This is particularly problematic for EE programs that are implemented across multi-cultural settings because very little academic attention has been devoted to cross-cultural EE research methods. Intending to address this gap, we set out to develop and pilot a pre/post survey in Costa Rica that could help us investigate the impacts of a bird-focused curriculum on Latin American children’s knowledge, attitudes, behavioral intentions, and behaviors toward birds and the natural world. This article describes the challenges encountered and subsequent adaptations made throughout our ongoing, iterative survey development process, in order to appropriately address language, sociocultural context, audience, and research-to-practice tensions. We present key lessons learned, including the importance of having strong local partners, the need to create a realistic research timetable that accounts for unique challenges involved in undertaking cross-cultural EE research, and the limitations of quantitative methods in this sort of research.     

Surveying a Chicago public housing development: methodological challenges and lessons learned

During the winter and spring of 2003, the Survey Research Laboratory conducted a survey of residents of the Ida Wells and Madden Park housing developments on Chicago's near-south side. This article reviews existing research findings on using indigenous interviewers and reports the findings about the benefits and challenges of using residents as interviewers versus drawing from a regular pool of interviewers. Specifically, the authors talk about the challenges faced in using indigenous interviewers and then look at some data quality indicators among these two groups of interviewers, including cooperation rates, item nonresponse, and differences in responses to sensitive questions.     

Project northland in Croatia: a community-based adolescent alcohol prevention intervention

War and social transition in Croatia have increased unemployment and rates of substance abuse. A decrease in prevention programs places adolescents at an increased risk. Data collected from the 2002 Split Youth Behavior Risk Survey (YRBS) showed that adolescents are at risk for alcohol use and related problems. Thus, there is a need to strengthen primary and secondary prevention activities to empower adolescents and counteract negative societal change. A public health partnership between the University of Medicine and Dentistry of New Jersey-School of Public Health (UMDNJ-SPH) and Split, Croatia was formed in 2001. Adolescent alcohol prevention was identified as our focus and Project Northland, a model U.S. program, was selected. A strong network of NGOs and government officials support the project. Qualitative evaluation showed strong parent, teacher, and student satisfaction. Preliminary analysis shows a heightened awareness on the part of students that will likely contribute to the overall success of the program.     

Coalitions on mental health and aging: lessons learned for policy and practice

Elders with mental health needs have been poorly served. Private and government agencies have given this issue a low priority, which is reflected in service delivery and funding. Coalitions have developed in states around the country and have engaged in a variety of tasks, including training techniques and collaborative efforts to advocate successfully for appropriate services. While accomplishments vary, the coalitions should continue their work, and others should organize in order to reach the goal of having accessible and appropriate elder mental health services.     

Context-driven gero-infusion: lessons learned from a curriculum development institute cohort

This article describes and compares the successes and challenges experienced by three social work programs in the United States working to infuse geriatric competencies into foundation Master of Social Work (MSW) courses, including field education. Adhering to the Planned Change Model each project utilized a range of approaches and strategies that emerged in each setting’s unique organizational and community context. This article examines and analyzes three context-driven accounts of curricular infusion for gerontological social work and lessons learned in this effort to establish gerontology as part of the implicit curriculum in social work programs in universities diverse in mission, size, programming priorities, and student population. Given the experiences of these programs, following the Planned Change Model, maintaining the context as being central to the process, anticipating common challenges, and preparing to engage strategies to overcome challenges are offered as recommendations for successful infusion and sustainment of the efforts.     

The fifth Holocaust Dialogue Interactive Group session: lessons to be learned

This article describes the fifth Holocaust Dialogue Group meeting between descendants of both victims and perpetrators. This process began in 1994 and has continued into 1999. It is held in conjunction with the annual International Association of Family Therapy Conference. Those in attendance report that this process has facilitated their catharsis regarding long-repressed issues and feelings of shame and guilt, enabled them to ask probing questions of relatives, and contributed to a profoundly desired healing. Repetitive themes that have emerged in the sessions are highlighted.     

Thirty years of advocacy in San Francisco: lessons learned and the next generation of leadership

Professional advocacy organizations are often challenged by the question of their authentic community representation and their ability to balance short-term pragmatism with strategic plans for long-term, systemic change. Coleman Advocates, one of the nation's most effective child advocacy organizations, has taken up this challenge under the leadership of a next-generation leader of color who followed a dynamic director of the baby boom generation. In this piece, Coleman's thirty years of social change strategies are analyzed from the perspective of this new executive director, who has facilitated the latest organizational shift that deepens its commitment to building bottom-up grassroots leadership and community power while keeping the best of the professional, staff-led advocacy model. Issues of race, accountability, power, and movement building are addressed through the lens of one organization's evolution, with the goal of building a long-term movement that will achieve racial and economic equity for all children and families.     

Bridging between academia and the workplace: lessons learned about translational research on work-family balance

ABSTRACT

Balancing work and family is a continuous and growing challenge, requiring carefully chosen coping strategies. In spite of the growing amount of research on work-family balance, successful, long term solutions are still not readily available to most workers who are trying to cope with the tensions involved in fulfilling both work and family roles. One possible explanation for this lack of translation of research findings in applied settings may lie in how we do work-family research. The present research note presents translational research as a solution to bridge academia and the workplace. More specifically, it shares our experience of a participatory approach to translational research that was adopted in an interdisciplinary research project on work-family balancing strategies. The main objective of this research note is to provide an example of how translational research was carried out in this kind of community-initiated study, and how this approach can facilitate short-term, concrete applications of the knowledge gained from and with the research partners.     

The PALS parenting support programme: lessons learned from the evaluation of processes and outcomes

Although there has recently been a rise in parenting support programmes within the UK, only a minority of these programmes have benefited from evaluation of either outcomes or processes. This paper describes the development of the PALS programme (Parents Altogether Lending Support), reporting both on its effectiveness in improving parents' interactions with their children and on the lessons that were learned about embedding such a programme within the local community. Over the 18‐month period of the programme, a total of 17 courses were run, with 75 parents and carers (primarily mothers) participating in the programme overall. Evaluation results indicated that participants enjoyed the course and found it beneficial, particularly in terms of altering their own actions in specific ways that were able to promote better behaviour on the part of their children. Participants also valued the opportunity to share their experiences with other parents. The key lesson identified in regard to the development of parenting programmes concerned the need for the community to feel a sense of ownership for the initiative. Copyright © 2002 John Wiley & Sons, Ltd.     

Unexpected barriers in return to work: lessons learned from injured worker peer support groups

Some workers who are injured at work have unexpectedly prolonged absences from work. Experiences of workers who constitute a disproportionate cost to the return-to-work system and the systemic and compliance-related barriers they encounter during the process of returning to work are reported. A qualitative interview based study was conducted with 37 members of three injured worker peer support groups in a Canadian province. Four dimensions of peer support were identified: worker experience of being misunderstood by system providers, need for advocates, social support, help with procedural complexities of the workers' compensation, and health care systems. Peer support constitutes a partial return-to-work solution for workers with injuries, but injured workers encounter an uneven playing field. Injured worker peer support group needs and activities show us that sensitivity to structural and social issues may lead to better return-to-work outcomes.     

Changing the culture of alcohol abuse on campus: lessons learned from secondhand smoke

Alcohol abuse is the single greatest public health hazard on American college and university campuses, but the culture of abusive alcohol consumption continues to be highly resistant to change. The author argues that secondhand smoke campaigns can be used as models to change the culture of alcohol abuse on campus. He proposes the implementation of "secondhand alcohol" campaigns and describes their essential components and advantages.