UCLA Integrated Substance Abuse Programs (ISAP) Program Evaluation Services
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Project Team


Principal Investigator:
Christine E. Grella, Ph.D.
(cgrella@mednet.ucla.edu)

Project Director:
Kira Jeter, M.A.


Funding Period


September 2011 to September 2014

Program Evaluation for Federal Grantees

Evaluation of the Bridges to Housing Project

The Bridges to Housing (B2H) Project was a community-based partnership with the goal of helping chronically homeless individuals with co-occurring disorders in West Los Angeles to access permanent housing, apply for MediCal and other public benefits, and obtain treatment and other services in the community.  The collaborative project was led by CLARE Foundation (substance abuse treatment), with St. Joseph Center (outreach, prevention, and case management services), Step Up on Second (psychosocial rehabilitation and support), Venice Community Housing Corporation (housing provider), New Directions (case management, treatment, and housing for veterans), Edelman Mental Health Center, and Venice Family Clinic (health care provider).  B2H utilized the Housing First intervention approach, motivational interviewing, and assertive case management.  Partner agencies referred participants (n=91) across agencies for needed services; provided linkage to transitional and permanent housing; provided comprehensive team-based case management to support recovery and housing retention; and assisted participants in applying for benefits.  An annual Community Consortium meeting was held to disseminate evaluation study findings and review policy developments regarding health care reform, housing strategies, and public benefits. The evaluation study assessed barriers to project implementation, characteristics of participants, and participant outcomes at a 6-month follow-up; staff completed annual evaluation surveys regarding the community partnership and intervention model.  Findings will be used to support continued program development for provision of comprehensive services to homeless individuals with co-occurring substance use and mental health disorders.

Evaluation of the Bridges to Housing Project was funded by the CLARE Foundation, contract no 20114621, through SAMHSA grant No. TI023570, from September 2011 to September 2014.

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Project Team


Principal Investigator:
Richard Rawson (rrawson@mednet.ucla.edu)

Project Director:
Anne Bellows (abellows@mednet.ucla.edu)


Funding Period


August 2008 to October 2010

Screening And Brief Intervention in The Real World: Project Summary and Lessons Learned from SBIRT in the Jails

The LA County Screening, Brief Intervention, Referral, and Treatment Project* (LA SBIRT) was an LA county Substance Abuse Prevention and Control (SAPC) project funded by the federal Substance Abuse and Mental Health Services Administration. The project provided SBIRT for adult substance users in short-term detention at the Los Angeles County Sheriff’s Department Men’s Central Jail and the Los Angeles Police Department (LAPD) at Parker Center, as well as comparable individuals in the community, to help them reduce their alcohol and other drug use. Staff at two Community Assessment Service Centers (CASCs), Behavioral Health Services (BHS) and Homeless Healthcare Los Angeles (HHC) conducted the screenings and provided services.

*This project began on April 1, 2008, and received a no-cost extension to September 1, 2010.

Participants Received:

  1. Screening with the Alcohol, Smoking, and Substance Use Involvement Screening Tool (ASSIST), which assesses risk of developing future problems related to substance use,
  2. A brief intervention session based on the individualized results of the ASSIST using a motivational interviewing (MI) style, and
  3. When indicated, referral to a standard course of treatment or brief treatment sessions.
  4. In some cases, in order to facilitate recruitment, potential participants were given the Alcohol Use Disorders Identification Test Consumption Questions, Plus 2 Drug Use Questions (AUDIT C+) prior to the ASSIST as a brief prescreen. Those who scored positive were referred to receive the ASSIST (See below).

Participant Flow

(Click here to see participant flow diagram).

The Evaluation

UCLA ISAP used the AUDIT C+ prescreen data, GPRA tool interview data, and ASSIST interview data gathered by project staff for the outcome evaluation. ASSIST interviews were conducted at intake and GPRA interviews were conducted at intake and at a 6-month follow-up in order to compare pre/post outcomes. SBIRT staff conducted 7,909 AUDIT C+s, 2,199 ASSISTs, 2,033 intake GPRAs, and 504 follow-up GPRAs. UCLA ISAP also conducted a process evaluation to track the progress toward full implementation and integration of this new public health intervention, which included stakeholder interviews and regular conference calls.

The Participants

BHS and HHC enrolled 951 detainees (BHS = 237, HHC = 714) and 1,082 community walk-ins (BHS = 712, HHC = 370), a total of 2,033 participants (BHS = 949, HHC = 1084). Approximately 92.3% of the 2,074 participants who completed an ASSIST scored at moderate or high risk overall for alcohol or drug abuse. The most popular drugs for this population were tobacco, alcohol, and marijuana.
ASSIST data revealed that the LA-SBIRT population used all substances at substantially higher rates than a comparison clinical population, indicating that LA SBIRT participants had a greater need for drug and alcohol treatment services at baseline.
Of the 2,033 participants who enrolled, the average age was 40 years, 90% were male, 45% were Hispanic, 38% were Black, 16% were White, 3% or less were Native American, Pacific Islander or “Other,” and 43% reported they were “unemployed, looking for work.”

The Challenges

Several challenges arose during this pilot project that made recruitment difficult. Criminal justice staff furloughs, coupled with an initial lack of buy-in from some criminal justice staff, restricted the amount of time CASC staff were able to spend in the jails. This problem was compounded by the short length of the grant. Additionally, the brief nature of SBIRT limited the relationship that agencies were able to build with clients, making locating this already transient population for follow-up especially difficult. Finally, staff conducted interviews in multiple locations, many of which were off-site. Thus, data collection errors occurred frequently because staff did not have the time to double check all of their paperwork, and sometimes lost entire interviews.

Project staff were very creative in overcoming these barriers. CASC staff conducted outreach to jail staff, such as bringing client “success stories” to jail staff in order to improve collaboration. Additionally, clients received incentives for completing interviews at both time points, and some staff provided incentives such as “IOU’s” for future interviews. BHS also placed interviewers in a bail bonds office near the jail in order to gain easier access to clients as they left the jail. Last, UCLA staff conducted ongoing quality assurance with interview data to help maintain a clean database. All of these efforts contributed greatly to the project’s success.

Recommendations for future SBIRT projects

Several recommendations

  1. A very brief screen in the jail (AUDIT C+) is not efficient because screens are almost all positive (76%). Additionally, only 36% of those who scored positive on the AUDIT C + completed an ASSIST. Performing the ASSIST in the jail is recommended when circumstances allow it.
  2. If possible, staff should use electronic versions of all screening tools to facilitate data collection.
  3. Some clients attempted to complete interviews twice (to obtain a second incentive). Maintaining an updated database of clients is crucial.
  4. Follow-ups are very difficult to complete with a transient population. Tracking and locating should be a high priority.
  5. Clients were often very concerned with confidentiality since interviews took place in a criminal justice setting. Staff on future projects will need training on ways to make clients in this setting feel comfortable.
  6. The success of projects such as this is highly dependent upon the collaboration of the stakeholders. Outreach and collaborative meetings should take place as early in the project as possible, and continue throughout.

The Conclusions

Despite project challenges and participants’ elevated rates of drug use, SBIRT participants reported less use of all substances at follow-up than at intake. Additionally, participants reported more stable housing, better mental and physical health, less involvement with the criminal justice system, and more use of outpatient drug and alcohol treatment services at follow-up.
The LA-SBIRT project demonstrated that an SBIRT model is feasible in a criminal justice setting with moderate- and high-risk individuals. Future projects should note the lessons learned from this project and seek to create sustainable SBIRT programs with this, and other non-traditional populations.
Most CASC staff members felt that the ASSIST followed by motivational interviewing is a very effective tool for this population.

Staff felt that motivational interviewing (the Brief Intervention) was extremely well suited to the criminal justice population as detainees are rarely asked about their own opinions or needs in the criminal justcie setting. Also, motivational interviewing is a difficult skill, and so ongoing training is key.

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Project Team


Principal Investigator:
Nena P. Messina (nmessina@ucla.edu)

Project Director:
Kira Jeter (kejeter@ucla.edu)


Funding Period


December 2007 to September 2012

Evaluation of Horizons’ Integrated Alcohol and Other Drug Abuse Treatment/HIV Services for Women Offenders

The Community Connections Program (CCP) of Horizons, Inc., was funded by a grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) to expand outpatient access to alcohol and other drug abuse (AODA) treat­ment and HIV services to women offenders, who are less likely to access treatment through formal sys­tems. The goal of the project was to increase partici­pants’ access to gender-specific, integrated outpatient AODA treatment and HIV prevention services. Objectives included:

  1. Increase the number of women who partici­pate in integrated outpatient AODA/HIV services;
  2. Enhance the CCP program with research-based AODA/HIV curricula focused on engaging hard-to-reach women, their children, and their partners; and
  3. Increase the number of women and their partners who receive rapid HIV testing.

ISAP conducted the evaluation, which in­cluded process and outcome components to monitor the im­plementation of the intervention as well as measures of changes in participants from pre- to post-treatment in the following domains:

  • alcohol and drug use,
  • parenting behaviors and family functioning,
  • quality of life and social functioning,
  • criminal behavior and legal status,
  • mental health and physical health status,
  • HIV/AIDS risk reduction behaviors, and
  • treatment and services received.

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Project Team


Principal Investigator:
Christine E. Grella  (grella@ucla.edu)

Project Director:
Kira Jeter (kejeter@ucla.edu)


Funding Period


September 2006 to September 2011

Evaluation of the Community Bridges Project

The purpose of the Community Bridges Project was to strengthen and enhance the comprehensive treatment system in Santa Monica, CA, for chronically homeless persons who have co-occurring mental illness and substance use disorders.

The project developed a fully integrated system and treatment model for this population through collaboration among service providers that included substance abuse treatment, mental health treatment, health services, shelter and drop-in services, and transitional and permanent housing.

The integrated treatment model incorporated several evidence-based practices, including motivational interviewing and relapse prevention, with the aim of (1) increasing access to treatment, (2) increasing continuity of care and services integration, (3) improving quality of life and increasing self-determination, and (4) improving levels of functioning among participants. In addition, the project aimed to increase integration of services across the participating providers, to eliminate barriers to system entry, and to improve staff competency in treating homeless individuals with co-occurring disorders.

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Project Team


Principal Investigator:
Christine E. Grella  (grella@ucla.edu)

Project Director:
Kira Jeter (kejeter@ucla.edu)


Funding Period


April 2005 to September 2009

Evaluation of the Homeless Interventions Treatment Options Project (HI-TOP)

ISAP conducted the process and outcome evaluations of the Homeless Interventions Treatment Options Project (HI-TOP), which was an intervention project provided by Special Service for Groups, Inc. The project was funded by a 5-year grant from the Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. HI-TOP provided comprehensive substance abuse treatment and case management services to homeless individuals who had co-occurring substance abuse and mental health disorders. Treatment approaches included cognitive behavioral and motivational enhancement therapies within the context of residential treatment and aftercare services provided to participants. The evaluation study tracked the characteristics of project participants, and examined the delivery of project-specific services, adherence to the treatment models, barriers encountered in project implementation, and solutions devised to address those barriers. Focus groups with project participants and interviews with project staff were conducted in order to monitor their respective perceptions and experiences of the project; feedback was provided from the evaluation in order to refine the project implementation.

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Project Team


Principal Investigator:
Richard Rawson (rrawson@mednet.ucla.edu)

Project Director:
Anne Bellows (abellows@mednet.ucla.edu)


Funding Period


November 2006 to October 2011

Evaluation of New Elements Treatment Program, People in Progress

ISAP conducted the process and outcome evaluations of the New Elements Treatment program, which was an intervention project provided by People in Progress. The project was funded by a 5-year grant from the Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. New Elements provides comprehensive substance abuse treatment and case management services to homeless individuals. The evaluation study tracked the characteristics of project participants and examined the delivery of project-specific services, adherence to the treatment models, barriers encountered in project implementation, and solutions devised to address those barriers. Focus groups with project participants and interviews with project staff were conducted in order to monitor their respective perceptions and experiences of the project; feedback was provided from the evaluation in order to refine the project implementation.

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Project Team


Principal Investigator:
Christine E. Grella  (grella@ucla.edu)

Project Director:
Jeffrey Annon (jannon@ucla.edu)


Funding Period


October 2004 to September 2007

Evaluation of the Effective Adolescent Treatment (EAT) Project

ISAP conducted the site-level evaluation of the Effective Adolescent Treatment (EAT) Project at Tarzana Treatment Centers (TTC). The EAT projects were sponsored by the U.S. Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. TTC provided an evidence-based intervention, the Motivational Enhancement Therapy and Cognitive Behavioral Therapy for Adolescents – 5 sessions (MET/CBT 5), to adolescents who were in their outpatient substance abuse treatment program for youth. The goals of the MET/CBT 5 intervention were to increase motivation for and engagement in substance abuse treatment, and to provide behavioral skills training for relapse prevention and drug-use resistance. ISAP provided evaluation and data management services to the EAT project through a contract with its Data Management Center, monitored project implementation, and provided technical assistance for tracking and locating participants for follow-up.

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