The review of new evidence 5 years later: SAMHSA's National Registry of Evidence-based Programs and Practices (NREPP).

The Substance Abuse and Mental Health Services Administration (SAMHSA) decided that NREPP should offer a second review option for interventions that have already been reviewed and included in the registry for 5 years. Principals from 135 such interventions were invited to participate in a second review, and an exploratory study of the Principals' responses to this invitation was conducted. The study used a mixed-method approach, quantitatively describing characteristics of Principals and their interventions and qualitatively summarizing feedback from phone interviews with a convenience sample of Principals participating in a second review. Of the Principals invited, 21% accepted a second review, 24% were interested but unable or not ready to submit materials, and 56% did not accept or did not respond. Mental health treatment interventions were more likely to undergo a second review, and substance abuse treatment interventions were less likely. Similar percentages of interventions undergoing a second review had received funding from the National Institutes of Health (86%) and had been evaluated in a comparative effectiveness research study (79%). Overall ratings for interventions improved in each second review completed. The interviewed Principals perceived potentially lower ratings as the only risk in participating in a second review.

A longitudinal study of a pediatric practice-based versus an agency-based model of care coordination for children and youth with special health care needs.

BACKGROUND: Care coordination has been shown to improve the quality of care for children and youth with special health care needs (CYSHCN). However, there are different models for structuring care coordination in relation to the medical home and most Title V agencies use an agency-based model of care coordination. No studies have prospectively compared a practice-based care coordination model to a Title V agency-based care coordination model. OBJECTIVE: Report the results of a prospective cohort study comparing a practice-based nurse care coordinator model with Title V agency-based care coordination model. DESIGN/METHODS: Three pediatric practices received the intervention, placement of a nurse care coordinator onsite within the practice, along with training and quality improvement on the principles of the medical home. Three practices continued to rely on agency-based care coordination services. CYSHCN in the practices were identified, interviewed at baseline, and re-interviewed after 18 months. We interviewed 262 families/children at baseline and 144 families/children (76 in the intervention and 68 in the comparison group) at 18 months. Families rated the quality of services they received from the care coordinator and the pediatric practice, and their experience of barriers to services for their CYSHCN. RESULTS: Families in the practice-based care coordination group were more likely to report improvement in their experience with the care coordinator (P = 0.02), fewer barriers to needed services (P = 0.003), higher overall satisfaction with care coordination (P = 0.03), and better treatment by office staff (P = 0.04). CONCLUSIONS: We found that for families of CYSHCN, practice-based care coordination in the medical home led to increased satisfaction with the quality of care they received and a reduction of barriers to care. The practice-based care coordination model is utilized by a minority of State Title V agencies and should be considered as a potentially more effective model than the agency-based approach.

A multi-method assessment of satisfaction with services in the medical home by parents of children and youth with special health care needs (CYSHCN).

OBJECTIVE: To assess satisfaction of parents of children with special health care needs with treatment by office staff, communication with the pediatrician, involvement in decision-making and coordination of services outside the practice. PATIENTS AND METHODS: We used a mixed-method (qualitative and quantitative) approach to collect parental perceptions of the Medical Home services provided by their pediatricians. Six practices were selected to participate in the study based on geographic and patient demographic characteristics. In total, 262 (75% response rate) families completed surveys, and 28 families of these participated in focus groups. The Family Survey collected information (corroborated and enriched with focus group interviews) on parent and child demographics, severity of the child's condition and the burden on parents. We assessed parental satisfaction with treatment by office staff, communication with the pediatrician, involvement in decision-making, and connection to services outside the practice. Survey responses were analyzed using SAS with all associations considered significant at the P < 0.05 level. Focus groups were recorded, transcribed into EZ-Text and analyzed by a team of three researchers to identify patterns and themes inherent in the data. RESULTS: Families reported in focus group interviews that they experienced significant stress due to the demands of caring for a child with special health care needs. Overall, only a small percentage of families reported being dissatisfied with their treatment by office staff (13-14%), communication with the pediatrician (10%), and involvement in decision-making (15-16%). However, a majority of families (approximately 58%) were dissatisfied with the ability of the pediatrician and his/her office to connect the families with resources outside the pediatric office. Families whose children had more severe conditions, or whose conditions had more of an impact on the families, reported being less satisfied with all aspects of communication and care coordination Families of youth with special health care needs (>12 years of age) were less satisfied than families of younger children with the practice's ability to connect them to resources outside the practice. CONCLUSIONS: Both the focus groups and surveys demonstrated that families of children with special needs are under very significant stress. Pediatricians must become better equipped to identify and communicate more proactively with families of CYSHCN that are experiencing significant parent burden. Pediatricians and their staff also need to improve their knowledge of community resources and proactively make referrals to community services needed by families of CYSHCN.

Alcohol-related fan behavior on college football game day.

UNLABELLED: High-risk drinking on game day represents a unique public health challenge. OBJECTIVE: The authors examined the drinking behavior of college football fans and assessed the support for related interventions. PARTICIPANTS: The authors randomly selected 762 football fans, including college students, alumni, and other college football fans, to complete an anonymous online game-day survey. METHODS: The authors collected data on participants' drinking behaviors and support for specific game-day interventions. RESULTS: Analysis revealed that, overall, fans drank significantly more on game day than they did the last time they partied or socialized. Nondrinkers were the most supportive of game-day interventions, followed by moderate drinkers, whereas heavy drinkers offered the least support. CONCLUSIONS: With the exception of limiting tailgating hours on game day, fans support game-day interventions, including alcohol-free alternatives, designating tailgating areas where open containers are permitted, and increasing law enforcement efforts.

Alcohol self-control behaviors of adolescents.

PURPOSE: The aims of the present study were to: (1) factor analyze a 13-item adolescent alcohol self-control behavior scale, (2) examine associations between frequency of self-control behavior use and alcohol consumption, and (3) to determine which self-control behaviors best predict alcohol use and consequences. METHODS: A confidential standardized survey was used to collect data on participant's 30-day frequency, quantity, and heavy use of alcohol; alcohol-related consequences; and alcohol self-control behaviors. RESULTS: A principal component factor analysis produced the following three components: Healthy Alternatives (alpha=.81), Self-regulation (alpha=.72), and Assertive Communication (alpha=.73). MANOVAs indicated strong associations between frequency of use of the three types of self-control behaviors and alcohol consumption (p values< or =.001). Logistic regression analysis revealed that Self-regulation behaviors were the best predictor for all alcohol use measures and consequences (p values< or =.001). CONCLUSION: Self-control behaviors differ in their ability to predict alcohol use and consequences. Self-regulation strategies emerged as the most consistent predictor of alcohol use patterns and consequences among adolescents, followed by Healthy Alternatives.

Translation as a function of modality: the potential of brief interventions.

The purpose of this article is to examine the potential of brief intervention (BI) as a modality for translating health behavior intervention research into practice. We discuss common definitions of BI, applications within common models of translation research, effects of BI on a range of health behaviors and across various populations, current and potential mechanisms, and uses for dissemination to practice. A number of advantages of BI suggest they are well suited for translating behavioral research. In addition, findings from 13 systematic reviews of BI effects show their potential versatility. Basic research on motivation, decision making, and persuasion may be applied to the design of BIs (Type 1 translation). Suggestions for translating BI research into practice are discussed (Type 2 translation). The article concludes that efforts to use BIs to translate research into practice are currently underdeveloped. Recommendations are provided for using BI in translating research into practice.

A multihealth behavior intervention integrating physical activity and substance use prevention for adolescents.

The primary purpose of this study was to test the efficacy of a brief, multi-health behavior intervention integrating physical activity and alcohol use prevention messages for high school-aged adolescents. A total of 604 participants, 335 9th and 269 11th grade students from a suburban high school in northeast Florida participated in this study. A randomized control trial was conducted with participants randomly assigned within grade levels to receive either a brief consultation and prescription with a mailed reinforcing follow-up flyer (Project SPORT) or a minimal intervention control consisting of a wellness brochure provided in school and a pamphlet about teen health and fitness mailed to the home. Differences between intervention groups were evaluated with a series of MANCOVA tests. Project SPORT participants demonstrated significant positive effects at 3-months postintervention for alcohol consumption, alcohol initiation behaviors, alcohol use risk and protective factors, drug use behaviors, and exercise habits, and at 12-months for alcohol use risk and protective factors, cigarette use, and cigarette initiation (p's < 0.05). A post hoc analysis examining interactions between past 30-day use of marijuana and/or cigarettes by treatment group indicates significant positive effects for drug using adolescents who received Project SPORT on alcohol consumption, drug use behaviors, and drug use initiation at 3-months, and for drug use behaviors and exercise habits at 12-months (p's < 0.05). A brief, 12-min one-on-one consultation integrating alcohol avoidance messages within those promoting fitness and other positive health behaviors holds promise for influencing adolescent alcohol and cigarette use and other health behaviors at posttreatment and 1 year later. Long-term sustained effects for cigarette and marijuana use, and both vigorous and moderate physical activity, were found among adolescents using marijuana and/or cigarettes prior to intervention.

Single vs. multiple drug prevention: is more always better?: a pilot study.

OBJECTIVE: The purpose of this study was to compare the effects of a single drug, i.e., alcohol, against a multiple drug preventive intervention. METHODS: A controlled trial was conducted with 448 8th grade students (mean age = 13 years old) from an inner-city middle school (n = 216) and a rural junior high school (n = 232) in 2000-2001. Students were randomized within school, and 3-month post-intervention follow-up data were collected. RESULTS: Two risk/protective factors were found to differ significantly in favor of youth receiving the single drug alcohol intervention (p's = 0.03), while the frequency of alcohol use and two additional risk/protective factors approached significance (p's < 0.10). CONCLUSION: These findings support the potential efficacy of a brief, single drug preventive intervention over a brief, multi-drug intervention in producing short-term alcohol outcomes for adolescents, and indicate differential effects of interventions for subgroups of substance using youth.

A brief experimental alcohol beverage-tailored program for adolescents.

OBJECTIVE: The objective of this study was to develop and test a brief, experimental alcohol preventive intervention matched to the use of specific alcohol beverages among adolescents. METHOD: A total of 232 high school students who drank within the last year participated in this study. Participants were randomly assigned to either the experimental intervention or a minimal intervention control. Four-month postintervention data are reported. RESULTS: Overall multivariate analyses of covariance (MANCOVAs) were significant (p's < .05) on risk factors (influenceability, perceived severity, perceived susceptibility and perceived peer prevalence) for three of six beverages (beer, wine and distilled spirits), with a fourth, malt liquor, approaching significance (p = .06). These tests showed intervention adolescents experiencing less risk for alcohol use than control adolescents. In addition, whereas the overall MANCOVA for malt liquor use was not significant, univariate analyses were significant for 30-day frequency (F = 5.69, 1/195 df, p = .01) and 30-day quantity of malt liquor use (F = 4.03, 1/195 df, p = .04) with intervention adolescents showing less consumption than control adolescents. A post hoc analysis examining differential intervention effects using preintervention drug use as a factor (i.e., 30-day cigarette or marijuana use) showed a significant overall factorial MANCOVA interaction (F = 6.90, 4/189 df, p = .000), with drug-using intervention adolescents consuming cigarettes and marijuana less frequently than drug-using control adolescents at postintervention. CONCLUSIONS: The findings of this study suggest the brief, beverage-tailored intervention reduced certain risk factors mediating individual alcohol beverage use and consumption of malt liquor (4 months after intervention) and may have reduced the frequency of cigarette and marijuana use among those already using drugs.

A sport-based intervention for preventing alcohol use and promoting physical activity among adolescents.

This study tested the potential of a novel intervention addressing alcohol prevention within the context of a sport program. Study participants were randomly assigned to one of three groups, with one group receiving the sport consultation (Sport), a second the sport consultation plus an alcohol consultation (Sport Plus), and a third a sport consultation, alcohol consultation, and mailed parent print materials (Sport Plus Parent). Researchers recruited 465 eighth graders from three schools in the northeast Florida region to participate in the study. The Youth Alcohol and Health Survey was used to collect data on alcohol and drug consumption, alcohol use risk and protective factors, and exercise habits at baseline and three-month post-intervention. Significant time effects (p's < .05) were found on three of six alcohol measures, both exercise measures, and four risk/protective factors, with all but one risk factor showing improvements over time. Time by assignment by current drinking status (yes/no) interaction effects (p's < .05) were found on alcohol initiation, length of alcohol use, quantity, heavy use, moderate physical activity, and four risk/protective factors, with preintervention drinking adolescents exposed to the Sport intervention showing the greatest improvements on all but two measures. Findings suggest that a brief sport-based screen and consultation tailored to adolescents' health habits, with and without parent materials, may potentially reduce alcohol use while increasing exercise frequency.