Parents, purchasers, and other stakeholders lack information on the quality of the alcohol and other drug (AOD) treatment services typically available to adolescents. Outcomes-based performance measurement systems cannot yet identify effective programs, and few specific quality of care indicators have been identified for AOD treatment. Instead, state and federal officials encourage providers to adopt research-based treatments. Even this approach does not ensure quality improvement, however, because little is known about the effectiveness of research-based treatments when they are implemented in community-based programs. In this renewal application, we propose to develop quality of care indicators on which quality improvement systems for adolescent AOD treatment can be built. In support of this objective, SAMHSA's Center for Substance Abuse Treatment and its Office of Applied Studies will provide our team with access to a dataset of more than 15,000 adolescents assessed with a comprehensive interview at intake and 12-months later. SAMHSA will link these records to survey data on the organizational and facility characteristics of the more than 100 programs across the U.S. where the cases were treated. Using these extraordinary data resources and the causal modeling tools we have developed, we propose three new aims: (1) Test whether adoption of a widely disseminated research-based therapy (MET/CBT5) improves outcomes at community-based treatment programs;(2) Identify quality of care indicators associated with good client outcomes;and (3) Identify quality indicators for care provided to key client subgroups (e.g., clients with co-morbid psychiatric disorders). This renewal will allow our productive team, under the guidance of our longstanding advisory board, to continue to build the evidence base that effective quality improvement systems for adolescent AOD services will require.

Public Health Relevance

The goal of this project is to develop quality of care indicators on which quality improvement systems for adolescent alcohol and other drug treatment can be built. To accomplish this objective, we will use a dataset of more than 15,000 adolescents assessed with a comprehensive interview at intake and 12-months later, which will be linked to survey data on the organizational and facility characteristics of the more than 100 programs across the U.S. where the cases were treated. By pursuing this research plan, we will address multiple research priorities identified by NIDA's Blue Ribbon Task Force on Health Services Research, including evaluating the effectiveness of interventions and practices in CBTP settings, establishing conditions for successful diffusion of innovations, and clarifying the influence of organizational factors on outcomes.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA017507-07
Application #
8117527
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Duffy, Sarah Q
Project Start
2008-09-15
Project End
2013-08-31
Budget Start
2011-09-01
Budget End
2013-08-31
Support Year
7
Fiscal Year
2011
Total Cost
$175,647
Indirect Cost
Name
Rand Corporation
Department
Type
DUNS #
006914071
City
Santa Monica
State
CA
Country
United States
Zip Code
90401
Ramchand, Rajeev; Griffin, Beth Ann; Hunter, Sarah B et al. (2015) Provision of mental health services as a quality indicator for adolescent substance abuse treatment facilities. Psychiatr Serv 66:41-8
Hunter, Sarah B; Griffin, Beth Ann; Booth, Marika S et al. (2014) Assessing the generalizability of the CSAT-sponsored GAIN dataset: are the CSAT sites representative of adolescent treatment programs in the U.S.? J Subst Abuse Treat 46:238-43
Ramchand, Rajeev; Griffin, Beth Ann; Slaughter, Mary Ellen et al. (2014) Do improvements in substance use and mental health symptoms during treatment translate to long-term outcomes in the opposite domain? J Subst Abuse Treat 47:339-46
Stucky, Brian D; Edelen, Maria Orlando; Ramchand, Rajeev (2014) A psychometric assessment of the GAIN individual severity scale (GAIN-GISS) and short screeners (GAIN-SS) among adolescents in outpatient treatment programs. J Subst Abuse Treat 46:165-73
Almirall, Daniel; McCaffrey, Daniel F; Ramchand, Rajeev et al. (2013) Subgroups analysis when treatment and moderators are time-varying. Prev Sci 14:169-78
Griffin, Beth Ann; McCaffrey, Daniel; Ramchand, Rajeev et al. (2012) Assessing the Sensitivity of Treatment Effect Estimates to Differential Follow-Up Rates: Implications for Translational Research. Health Serv Outcomes Res Methodol 12:84-103
Hunter, Sarah B; Ramchand, Rajeev; Griffin, Beth Ann et al. (2012) The effectiveness of community-based delivery of an evidence-based treatment for adolescent substance use. J Subst Abuse Treat 43:211-20
Ramchand, Rajeev; Griffin, Beth Ann; Suttorp, Marika et al. (2011) Using a cross-study design to assess the efficacy of motivational enhancement therapy-cognitive behavioral therapy 5 (MET/CBT5) in treating adolescents with cannabis-related disorders. J Stud Alcohol Drugs 72:380-9
D'Amico, Elizabeth J; Ramchand, Rajeev; Miles, Jeremy N V (2009) Seven years later: developmental transitions and delinquent behavior for male adolescents who received long-term substance treatment. J Stud Alcohol Drugs 70:641-51
Ramchand, Rajeev; Griffin, Beth Ann; Harris, Katherine M et al. (2008) A prospective investigation of suicide ideation, attempts, and use of mental health service among adolescents in substance abuse treatment. Psychol Addict Behav 22:524-32

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