IOWA CONSORTIUM FOR SUBSTANCE ABUSE RESEARCH AND EVALUATION

 

 

The Iowa Consortium is a multi-disciplinary statewide organization that was created in 1991 to encourage and facilitate collaborative research in the area of substance abuse.  The impetus for the Consortium came from state government officials interested in greater involvement in and contact with research.  University officials and researchers from four universities in Iowa responded to this interest and came together with the state and the field to develop the consortium concept, one believed to be relatively unique across the country in its commitment to broad based involvement of all three sectors in the planning, development, and implementation of research and evaluation projects. 

 

The Consortium is advised by a coordinating board, composed of representatives from each of the following organizations: 

 

·   University of Iowa

·      Iowa Dept. of Corrections

·   University of Northern Iowa

·      Iowa Dept. of Public Health      (IDPH)

·   Iowa State University

·      Office of Drug Control Policy (formerly Governor’s Alliance on Substance Abuse-GASA)

·   Iowa Substance Abuse Program Directors Assn. (ISAPDA)

                                                                                               

The universities are represented by researchers from various disciplines, including psychiatry, social work, sociology and education. The state agencies are represented by key individuals responsible for substance abuse related activities within their departments.  Field representatives are agency directors from both community-based and hospital-based programs and include leadership from the Iowa Substance Abuse Program Directors Association, a key and active entity within the substance abuse system in Iowa. 

 

The Consortium is supported by a small special appropriation from the State of Iowa, which enables it to carry out its basic mission of bringing together academic, state, and field resources to plan and implement research.  The remainder of the funding for the Consortium comes from federal, state, and local sources supporting various research and evaluation projects.

 

During the past ten years, the Consortium has evolved from a small office with one part-time staff person to an active, vibrant center supporting all types of research, development, educational, and administrative activities.  Although hosted by the University of Iowa and housed on the UI Oakdale Research Campus, the Consortium now serves as a central liaison and coordinating center for a network of researchers, state officials, and practitioners from across the state.

 

The following section offers a brief overview of key projects that the Consortium has been involved in, briefly illustrating the evolution of the Consortium, its research direction and goals, and the relationships that have been established through these projects and activities.  

 

Five-Year SAFE Project Evaluation Plan (Cedar Rapids SAFE Coalition) 10/90-9/96

The SAFE Coalition of Cedar Rapids began its work in 1989 as a community mobilization program. The Consortium assisted in the grassroots development of the SAFE Coalition whose original mission was to create a community that demands a substance abuse free environment.  Its prime goal was to reduce alcohol and other drug use by youth, adults, special populations, and employees.  The Coalition implemented its goals and objectives through a task force and committee structure that included a Business Task Force, Citizens Alive Committee, Clergy Committee, Communications Committee, Community Task Force, Family Task Force, Neighbors Coalition, and Treatment Task force.  Each of these committees initiated multiple prevention activities aimed at specific target populations.

 

Newton Correctional Program Evaluation (GASA) 04/92-03/93

This project evaluated the effectiveness of the substance abuse treatment program at Iowa’s Riverview Release Center, Newton, Iowa, and studied recidivism rates, and differences in successes and failures among participants in the treatment program. Two other programs at the Center, the Critical Thinking Program and Relapse Treatment Unit were also evaluated, looking specifically at the effects of identified substance abuse problems on the success rates of these two programs.

 

Polk & Warren County Case Management Evaluation (IDPH) 7/93-6/95

During 1993-1995, IDPH contracted with the Consortium to evaluate a substance abuse case management pilot project implemented by the Department in Polk and Warren Counties of Iowa.  The primary objectives of the evaluation were to determine the quality, costs, and outcomes of the demonstration program in the two counties.  The evaluation combined qualitative and quasi-experimental methods, using structured interviews with treatment and case management providers, an audit of the assessment process, analysis of SARS records, interviews with clients regarding their substance use/abuse and related issues, and case manager activity information. 

 

Iowa Drunk Driver Education Project (Iowa Department of Education) 4/93-12/95

The Consortium evaluated the effectiveness of the Talking About Alcohol-Driving Unimpaired curriculum purchased by IDOE from the Prevention Research Institute of Lexington, KY, a private, non-profit corporation that developed the Risk Reduction Model of Prevention in the early 1980’s and has developed a series of risk reduction programs for populations at various school levels and court referrals, particularly driving under the influence.

 

Drunk Driver Education Analysis (Iowa Department of Education) 5/98-6/98

This analysis is a re-evaluation of the state of Iowa’s Drunk Driver Education Curriculum.  This study looks at the recidivism rate of the 1995 GASA Talking About Alcohol-Driving Unimpaired curriculum data set that the Consortium and IDOE assembled and examined from 1993 to 1995 as a part of a curriculum program evaluation.

 

Women’s Residential Treatment Center Evaluation (ASAC) 10/93-6/96

Innovative in the field of substance abuse treatment, the Heart of Iowa Mother and Child Recovery Center provides services to both pregnant women and women with child care responsibilities that would otherwise preclude admission into a traditional treatment program. The Consortium’s evaluation plan determined substance abuse and related outcomes for women served by the Heart of Iowa Center.

 

Violator Program Evaluation at Newton and Mitchellville prisons (GASA) 7/94-6/95,

This project involved a four-year evaluation funded in part by GASA.  Initially established at two institutional sites, Newton and Mitchellville prisons, the Violator Program employs a cognitive approach aimed at changing thinking styles that result in sub-optimal choices (such as criminal behavior).

 

Substance Abuse Reporting System Study (SAMHSA) 10/94-9/95

IDPH and the Consortium conducted an analysis of client baseline data from the State of Iowa’s Substance Abuse Reporting System (SARS).  The analysis consisted of three phases:  1) a descriptive analysis of the client baseline data and treatment services provided in the state, 2) an examination of the “typical” client profile for clients at high and low risk of not completing treatment, and 3) a re-examination of the relationship between the length of treatment stay and treatment outcome.

 

Managed Care Evaluation (IDPH), 6/96-5/97

This evaluation assessed the impact of a relatively unique model for managing substance abuse and mental health treatment after the first year of implementation. The design of the study had three components:  analysis of changes in the accessibility of treatment, the process of treatment, and the immediate outcomes of treatment.  Utilization rates and appropriateness review were used to assess changes in accessibility of services.  Changes in the quantities of care received were also being examined to evaluate treatment patterns.  Additionally, client satisfaction and completion rates were used to assess outcomes of treatment, and provider feedback was used to qualitatively assess the impact of the program on access, process, and outcomes.

 

Treatment Evaluation (House of Mercy) 1995-1997

This project was an outcome and process evaluation of the four programs at the House of Mercy Treatment Center in Des Monies, IA.  The four HOM programs include treatment for: women who are pregnant and or/ parenting; women who are homeless; and teens who are pregnant and have children.  The sample included women from each program interviewed at intake, discharge and follow-up stages.

 

Prevention Needs Assessment (CSAP) 7/95-6/97

The focus of this project was to develop a needs assessment project focused on prevention.  The goals of the Iowa State Prevention Needs Assessment Project were to: a) develop a set of reliable and valid indicators of risk/protective, asset/deficit, and resource factors to guide the state’s comprehensive prevention service needs and planning efforts; and b) apply these data to the development of a service needs assessment model that builds upon the groundwork laid by CSAP.  Study components include a statewide telephone household survey, separate “model” comprehensive studies in three Iowa sub areas, a student survey, and social indicator data analysis. 

 

East Central Iowa SAFE Evaluation (Cedar Rapids SAFE Coalition) 04/96-09/96

The Iowa Consortium, in cooperation with the CR SAFE committee developed a six-month contract to initiate the ECI SAFE Evaluation and to support the activities necessary to lay the foundation for a meaningful evaluation of process and outcomes for the new, expanded Coalition.

 

Iowa State Treatment Needs Project (IDPH) 09/96-09/99

The Iowa State Treatment Needs Assessment Project involved an integrated approach to assessing the need for substance abuse treatment services statewide.  The mixed model approach involved the implementation of four studies: 1) An adult household survey, 2) A cost effectiveness study; 3) A study of high-risk youth; and 4) An indirect public record indicators study.  The three-year project involved multiple researchers, institutions, state agencies, and service agencies. 

 

Adult Household Survey

The purpose of the Adult Household Survey was to: 1) Add a trend analysis to the State's previous treatment needs assessment results (1993); and 2) Strengthen the State's substance abuse treatment needs database by improving the measurement of substance use and dependency rates in Iowa.  The objectives were to: provide more comprehensive geographic and sociodemographic breakdowns of substance abuse prevalence rates; introduce "levels of care" as a significant dimension in defining treatment needs; provide more detailed information regarding the barriers to treatment exposure; and upgrade the questionnaire to meet current CSAT National Technical Center (NTC) recommendations.

 

Cost Effectiveness Study

The Iowa Cost Effectiveness Study was modeled after the work of Michael Finigan Ph.D., author of "Societal Outcomes and Cost Savings of Drug and Alcohol Treatment in the State of Oregon".  Like the Oregon study, the objective of the Iowa project was to identify costs and cost savings that result from substance abuse treatment utilization.  The Iowa study included the following characteristics: a representative sampling of substance abuse treatment clients who completed their treatment; development of a matched comparison group using clients who began, but did not complete their treatment; extraction of cost and identifying data from existing state agency databases rather than self-reported data; and collection of selected client characteristics data collected over a period of time (two years prior and three years after treatment).

 

Alternative School Study (High Risk Youth Study)

The purpose of the Alternative School Study was to provide an estimate of the substance use prevalence rates in a high risk, juvenile population in Iowa.  The objectives of the Alternative School Study were to: 1) Obtain alcohol, tobacco, and other drug related substance use/abuse prevalence rate estimates for those juveniles in Iowa who are most at risk of using and abusing drugs; and 2) Identify any changes in the prevalence rates for high risk youth between 1993 and 1996.  Due to the prohibitive costs associated with completing a field study, a secondary data analysis approach was selected, focusing on data from the Iowa Department of Education's (IDOE) Iowa Youth Survey of regular and alternative school youths and the Iowa Department of Public Health's (IDPH) Substance Abuse Recording System (SARS). 

 

Social Indicators Study

The needs assessment Social Indicators Study collected public record data regarding mortality, hospital discharges, law enforcement, automobile accidents, tobacco and alcohol sales, family abuse, and infectious diseases from a variety of agencies in the State of Iowa.  Analysis of prevalence rate differences between social indicator data and field data from the adult household survey were conducted

 

Alcohol Problems & Violence Against Women (NIJ) 10/96-9/98

This study involved an assessment of women with alcohol problems and women who received counseling for domestic problems.  Researchers compared treatment services and examined the integration between the two services.  The sample included over 200 women in substance abuse treatment agencies, domestic violence shelters and safe houses across Iowa City and Northern Iowa sites.  Three interview packages were used to address attitudes of childhood, adulthood and self- administered tests.    

 

Iowa Youth Survey (IDPH) 10/98-02/01

The Iowa Consortium for Substance Abuse Research and Evaluation, The Iowa Department of Public Health’s Division of Substance Abuse and Health Promotion, Iowa Department of Education, Office of Drug Control Policy (formerly GASA), Iowa Department of Human Rights, Criminal and Juvenile Justice Planning and Statistical Analysis Center and The Higher Plain, Inc. (with funds obtained from the Federal Department of Education), collaborated on the Iowa Statewide Data Project to develop and implement the 1999 Iowa Youth Survey (IYS). The 1999 IYS questionnaire included questions that are relevant to positive youth development in Iowa. The findings in these reports have helped schools and communities better understand their students and identify youth-development related needs, develop relevant programs, and assess the outcomes of those programs.  It is expected that school personnel, parents, youth and other community members and organizations will come together to study the reports and open a dialog regarding what these data say about life for young people in their community. 

 

Clarinda TOW Evaluation (GASA) 07/97-09/98 (NIJ) 04/99-03/01

The National Institute of Justice (NIJ) awarded a two-year grant to the Consortium to continue the evaluation of the Clarinda TOW (The Other Way) program at the Clarinda Correctional Facility.  The TOW evaluation addressed the following questions: 1) Does the program accomplish its stated intermediate goals (i.e. influence attitude change regarding substance use)?; 2) Are there differences between clients that completed the cognitive unit program at TOW versus the two 12-step based units?; and 3) Are certain types of clients better served by the TOW program than others?

 

Treatment Outcomes and Performance Pilot Studies (TOPPS) (IDPH) 10/98-09/01

The TOPPS project award is funded by SAMHSA’s Center for Substance Abuse Treatment (CSAT). The Iowa Department of Public Health, Division of Health Promotion, Prevention and Addictive Behaviors, and the Iowa Consortium are working together to implement the three-year course of project activity.  Current TOPPS funding supports four different research projects: the implementation of a computerized instrument for assessment (in seven treatment agencies), the pilot of a co-occurring screener, the analysis of treatment outcomes for the state’s methamphetamine users, and the linking and analysis of various state-level data sets to the TOPPS data set.

 

Targeted Capacity Expansion (IDPH) 10/99-09/01

The TCE project is a three-year Center for Substance Abuse Treatment (CSAT) grant awarded to the Iowa Department of Public Health (IDPH) in 1999.  This grant is one of 100+ TCE grants awarded nationwide over the past two years.  The Consortium is sub-contracted through IDPH as the grant evaluator.  IDPH was awarded this grant to improve methamphetamine treatment for adults in the Des Moines area.  The Consortium is concentrating on follow-up interviews to evaluate treatment experiences for each client, and analyze the collection for outcomes measures and indicators for successful treatment completion.  

 

Outcomes Monitoring System Predictions Model (IDPH) 7/98-9/01

OMS, a collaborative project between the Iowa Consortium and the Iowa Department of Public Health (IDPH), Division of Health Promotion, Prevention, and Addictive Behaviors, was designed to assess three primary treatment issues: the status of client outcomes following publicly funded treatment, the impact of different levels of care on treatment outcomes, and the costs associated with the tracking and follow-up of the state’s treatment population.  In May 2000 the OMS project published its second annual report. Highlights of the report include: an overview of IDPH client tracking and follow-up procedures, comparisons between client data at admission and follow-up, and year one descriptive statistics.  The OMS project has just begun its third year.

 

Iowa Practice Research Collaborative Developmental Phase (SAMHSA) 09/99-09/00,

The Consortium, in conjunction with the Prairielands Addiction Technology Transfer Center (ATTC), undertook a one-year planning and development process, for the purpose of establishing new and enhanced mechanisms for collaboration between academic researchers, policy-makers, intervention and prevention service providers, and consumers in Iowa.  The goals of the project are to: a) renew and expand the Consortium network; b) conduct a formal assessment of needs and develop a three-year research plan; c) develop a structure and mechanism for collaborative technology transfer, training in the field, and an organized flow of input between practice, policy and research in deciding future research development to benefit the field of substance abuse.

 

Practice Research Collaborative Implementation Phase (SAMHSA) 09/00-09/

The Iowa Practice-Research Collaborative is a statewide network of substance abuse providers, policy makers, and researchers dedicated to the implementation and sustaining of evidence-based practices into substance abuse treatment at the community level.  The Iowa PRC implementation plan has two parts.  The first section describes the development phase activities that resulted in the operational PRC, and the second section describes specific projects that were generated from development phase activities such as the identification and endorsement of a statewide research agenda.  The implementation phase describes ten pilot studies and three knowledge application studies that address the highest priority concerns on the research agenda.  The focus is on implementing integrated treatment for clients with co-occurring disorders, improving services to women and children by implementation of gender-specific treatment and evidence-based practices for children of substance abusing mothers, addressing the technical assistance and data management needs of the state, developing information systems for providers and policy makers who have very different informational needs, revising the statewide substance abuse reporting system to provide more useful and timely information to providers, policy makers, and researchers, and addressing the needs of substance abusing clients who have some involvement in the criminal justice system. 

                                                                                                      

Predicting Successful Treatment Outcomes (IDPH) 4/01-3/02

This project involves the following four major steps: a literature review for identifying predictors and evaluating treatment success; an analysis of existing data using state SARS data to create a prediction/evaluation model; a review of the model with agency directors and IDPH officials; and the development of suggestions for future data collection.

 

Iowa State Incentives Grant (IDPH) 10/01-9/03

The Consortium is conducting a process and outcome evaluation of this project that will focus on: 1) coordinating prevention funding in the state, and 2) awarding subgrants to Iowa communities for local prevention activities. The overall goals of the program evaluation plan are to 1) document the state-level activities associated with the State Incentive Program in Iowa, 2) document the activities and accomplishments of the State Incentive Program’s subrecipient community projects, and 3) measure changes that occur in Iowa that guide the assessment of the State Incentive Program.

 

Domestic Violence/Substance Abuse Staff Education Project (UNI) 10/01-9/03

The Consortium is conducting a process evaluation of this project that addresses the barriers to collaborative efforts in the provision of services between domestic violence shelter and substance abuse treatment agency staff.  The goal of the project is for staff at the participating agencies to work together to develop and implement a plan for joint service provision to clients. This will be accomplished by providing training to staff in both service areas through a collaborative learning environment that focuses on mutual exchange of philosophical aspects of treatment approaches. Project success will be evaluated by: 1) attainment of objectives; 2) participating agency staff degree of satisfaction with educational programming; and 3) degree of positive increase in attitudes toward interagency cooperation.

 

Polk County Jail Treatment Follow-up (IDPH) 11/02-10/06

The Consortium will conduct an independent evaluation of the project that will include establishing a framework for data collection to document the extent to which project goals and objectives are met. The evaluation plan involves the collection of performance monitoring data using an instrument that addresses the Government Performance and Results Act (GPRA) requirements. The State of Iowa uses the Substance Abuse Reporting System (SARS) to collect outcome data regarding substance abuse treatment services in the state. The SARS instrument will be used to collect data to determine the outcomes related to employment, mental health, physical health and criminal justice status.

 

Iowa Prevention of Methamphetamine Abuse Project (SAMHSA/CSAP/IDPH) 10/03 - 9/06
In conjunction with IDPH, the Consortium is conducting a process and an outcome evaluation of this prevention project.  Five communities in Iowa are participating in the project, which involves the implementation of Reconnecting Youth, Life Skills Training, and Strengthening Families model programs with an added methamphetamine prevention component. Grantee organizations also work with local coalitions to provide outreach and education on methamphetamine prevention to various community sectors.  The Consortium provides technical assistance to implementation sites on recruiting, data collection, and subject tracking for follow-up surveys.

 

Targeted Capacity Expansion-Methamphetamine Study (TCE) 10/1/03-9/30/04

The TCE project is a three-year Center for Substance Abuse Treatment (CSAT) grant awarded to the Iowa Department of Public Health (IDPH) in 2003 to enhance methamphetamine treatment for adults in the Des Moines area.  The enhanced services allow more methamphetamine clients greater access to and longer lengths of stay in treatment as well as case-management services.  The Consortium is conducting a process and outcome evaluation of the project.  The Consortium conducts follow-up interviews at 6 and 12 months post admission to gather data related to outcomes including abstinence, arrests and employment.  The process evaluation involves key informant interviews with project stakeholders to gather information related to the many aspects of implementing treatment services.

 

Jones County Prevention Project 8/1/04-7/31/05

The Anamosa Community School District was awarded funding for the Keeping Up with the Joneses project funded by the U.S. Department of Education, Office of Safe and Drug-Free Schools through the Grants to Reduce Alcohol Abuse Program. The project supports prevention programming to all 6th through 12th grade youth in the 4 school districts in Jones County. The Consortium is conducting a process and outcome evaluation to determine the degree of success in achieving project goals. The goals of the project are to: 1) reduce underage alcohol use and binge drinking by the youth targeted by the prevention programs; 2) increase the number of targeted youth who disapprove of alcohol abuse; 3) increase the number of targeted youth who believe alcohol is harmful to their health; 4) demonstrate comprehensive, county-wide alcohol prevention system change; and 5) demonstrate local capacity to implement and sustain research-based prevention programs.

 

Epidemiological Outcomes Workgroup (3/15/2006-3/14/2007), funded by IDPH through SAMHSA, involves the development of a formal state epi workgroup that systematically examines alcohol, tobacco and other drug-related data to assess the prevalence of substance use, abuse, and dependence and related problems in the State of Iowa.  The result will be an Iowa epidemiological profile of  need-patterns of consumption and consequences of substance use.  The Consortium actively participates as members of the workgroup and provides specific services to meet project objectives and deliverables including the epi profile document.

 

Prevention Through Youth Mentoring and Prevention Through Youth Development (7/1/2006-6/30/2007), funded by IDPH involves two multi-site prevention programs.  The Consortium provides technical assistance and training to the sites regarding instrument administration, data entry in an Internet-based software application, data download, analysis and report writing.

 

Prevention Data Base Analysis, Training and Monitoring (7/1/2006-6/30/2007), funded by IDPH involves a community prevention program that supports 28 communities.  The Consortium activities involve developing pre-and post-tests; training site staff on survey administration and data entry, monitoring programs as they enter data into a web-based software application; and analyze data and report on the participant outcomes related to the prevention programming.

 

The Iowa Drug Court Process Evaluation (10/1/2006-9/30/2007), funded by the Iowa Department of Human Right, Division of Criminal and Juvenile Justice Planning through the National Institute of Justice, involves the seven communities in Iowa that implement family and juvenile drug courts.  The Consortium will observe court proceedings using Satel’s criteria and will interview administrative staff regarding the drug court process. 

 

The Cedar Rapids Methamphetamine Clinic (9/30/2006-9/29/2009), funded by the Area Council for Substance Abuse through SAMHSA, involves an evaluation of a methamphetamine treatment expansion project that will be implemented in Linn, Benton and Jones Counties.  The evaluation will involve the collection of fidelity, process and outcome data at the local service provision level and multi county administration level to determine:  the degree of adherence to best practice(s); the degree to which program implementation coincides with the work plan; whether milestones have been met and program goals and objectives achieved; and outcomes through the GPRA 6- and 12-month post baseline data.