Special Populations and Topics Projects


Problem Gambling Prevention – Technical Assistance and Training Needs Assessment

Mary-Lynn Brecht, Ph.D., Principal Investigator
(lbrecht@ucla.edu)
Elizabeth Evans, M.A., Project Director

This needs assessment was designed to gather information to guide the specialization, modification, and expansion of technical assistance and training curricula and materials and other resources about problem gambling. It is part of a larger problem-gambling prevention project that provides technical assistance to meet the needs of a diverse target audience of service providers and community leaders to assist them in preventing problem gambling in their clients and communities. More specifically, the needs assessment addresses the following topics among service providers and community leaders: perception of participants of whether there are gambling problems among clients and in the community; level of awareness of existing resources on problem gambling; current use of existing resources on problem gambling; perceived utility of specific types of technical assistance and training resources directed at service providers as well as those directed at clients; and ways to increase utility of such resources. In order to describe the community context within which these service providers’ needs exist, the needs assessment also obtains relevant parallel information directly from clients and community members. The project uses multiple methods of data collection: phone surveys, in-person, semi-structured interviews, and focus groups. The sample size will be approximately 400 providers and 100 clients.

Problem Gambling Prevention – Technical Assistance and Training Needs Assessment was funded by the National Asian Pacific American Families Against Substance Abuse, through their contract with the California Office of Problem Gambling (05-00238; March 2006 through October 2006).

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Women, Methamphetamine, and Sex

Alison Hamilton Brown, Ph.D., Principal Investigator (alisonh@ucla.edu)

This 5-year project focuses on the relationship between methamphetamine (MA) and sex among women MA users. Two waves of in-depth qualitative interviews will be conducted with 30 women in residential treatment. Participants will be asked about their history of using MA and other substances, their life experiences (including any trauma or abuse they may have experienced), and their perspectives on how MA has affected their lives, specifically, their intimate relationships and sexual behaviors. As a career development award, the project also involves training for the principal investigator (PI) in public health and statistics, and subsequent secondary analysis of the “Methamphetamine Abuse: Natural History and Treatment Effects” study dataset (PI: Mary-Lynn Brecht). This analysis, along with analysis of the qualitative data, will add to the body of literature on the impact of substance abuse on life experiences. Considering that women who abuse substances such as MA typically have multiple factors placing them at risk for poor sexual decision-making (e.g., histories of violence and abuse), a more in-depth understanding of how women MA users conceptualize their sexual behaviors and experiences could assist in developing interventions for them. The PI’s co-mentors on the project are Drs. Richard Rawson (UCLA ISAP), Yih-Ing Hser (UCLA ISAP), and Vivian Brown (PROTOTYPES).

Women, Methamphetamine and Sex was funded by the National Institute on Drug Abuse, Grant 1 K01 DA017647 (April 2006 through March 2011).

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Alcohol Beverage Type,
Consumption Patterns, and
Outcomes among Older At-Risk Drinkers

Didra BrownTaylor, Ph.D., Principal Investigator
(xdidrax@aol.com)
Alison A. Moore, M.D., Co-Investigator

Given that measuring consumption patterns depends on accurate classification of beverage type in order to calculate ethanol intake, inaccurate classification of beverage type can result in overestimation or underestimation of ethanol consumption. In alcohol research, ethanol consumption is often determined by using quantity and frequency questionnaire items. These items assess beverage type usually consumed, frequency that the usual drink is consumed, and the usual container size. One potential weakness of determining ethanol consumption this way is that survey respondents may not accurately identify the beverage type they consume. Inaccurate classification of regular beer and malt liquor, and wine and fortified wine, can easily result in significant under- or overestimates of ethanol consumption, particularly for at-risk alcohol drinkers.

The aim of this study to better understand the specific types and amounts of alcoholic beverages consumed by drinkers who are in an ongoing randomized trial of screening and brief advice to reduce at-risk drinking among 800 older adults in primary care clinics. Data is collected using a calendar method, the Alcohol 7-day Timeline Follow-Back, and includes information on risks associated with alcohol use such as concomitant medical and psychiatric conditions, symptoms, medication use, smoking, and driving after drinking. The specific aims are to more accurately assess the types and amounts of alcoholic beverages consumed by older at-risk drinkers at baseline and 3- and 12-month follow-up and to determine if amount and type of beverages consumed are related to types of risks (e.g., risks due to alcohol use alone, alcohol and comorbidity, driving after drinking) and likelihood of reducing at-risk drinking.

Alcohol Beverage Type, Consumption Patterns, and Outcomes among Older At-Risk Drinkers was funded by the University of California Research Centers for Minority Aging Research, Grant P30 AG021684 (July 2005 through June 2006).

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Evaluation of Cost Avoidance and
Child Welfare Outcomes of
Dependency Drug Court Participants

Christine E. Grella, Ph.D., Principal Investigator
(grella@ucla.edu)
Elizabeth Hall, Ph.D., Co-Investigator

The goal of this study was to evaluate the effects of Dependency Drug Court (DDC) participation on child welfare outcomes and costs. DDCs provide treatment for parents with substance abuse problems under court monitoring (following the drug court model) as well as monitor the dependency cases of their children who have been put into out-of-home placement, pending the parent(s)’ treatment participation. A case-control method was used in the evaluation study, in which child welfare cases of DDC participants in 3 counties in California were sampled in a 12-month period and then matched to child welfare cases in 3 comparison counties (without DDC’s) that opened in the same time frame. Outcomes included rates of family reunification and re-entries into foster care following case closure. The overall rates of reunification at 36 months following placement were slightly higher in the DDC counties than in their respective comparison counties; the rate of reunification for children in kin home placements was significantly higher among the DDC cases than cases in their respective comparison counties. Further, parents who successfully graduated from the DDC were significantly more likely to reunify with their children, compared to parents who were dismissed from the DDC, and their children spent less time in out-of-home placement.  Lastly, rates of re-entry into a new placement episode following case closure were significantly lower among cases in the DDC counties, compared with their respective comparison counties. Cost analyses estimated offsets due to the higher rates of reunification and lower rates of foster care re-entry in the DDC vs. comparison counties.

Evaluation of Cost Avoidance and Child Welfare Outcomes of Dependency Drug Court Participants was funded by the State of California, Department of Social Services, Contract 05-2035 (July 2005 through June 2006).

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Evaluation of the Effective
Adolescent Treatment (EAT) Project

Christine E. Grella, Ph.D., Principal Investigator
(grella@ucla.edu)
Jeffrey Annon, M.A., Project Director

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

Evaluation of the Effective Adolescent Treatment (EAT) Project was funded by Tarzana Treatment Center, Subcontract HR-096 (October 2004 through September 2007).

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

Christine E. Grella, Ph.D., Principal Investigator
(grella@ucla.edu)
Kira Jeter, Project Director

ISAP is conducting the process and outcome evaluations of the Homeless Interventions Treatment Options Project (HI-TOP), which is an intervention project provided by Special Service for Groups, Inc. The project is funded by a 5-year grant from the Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. HI-TOP provides comprehensive substance abuse treatment and case management services to homeless individuals who have co-occurring substance abuse and mental health disorders. Treatment approaches include cognitive behavioral and motivational enhancement therapies within the context of residential treatment and aftercare services provided to participants. The evaluation study is tracking the characteristics of project participants, and examining 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 are being conducted in order to monitor their respective perceptions and experiences of the project; feedback is provided from the evaluation in order to refine the project implementation. 

Evaluation of Homeless Interventions Treatment Options Project was funded by Special Service for Groups, Inc., Subcontract 243 (April 2005 through September 2009).

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Linking Substance Abuse Treatment and Child Welfare Outcomes:
Secondary Analyses of Data from
Two Service Delivery Systems

Christine E. Grella, Ph.D., Principal Investigator
(grella@ucla.edu)

This study  is conducting secondary analyses of data linked from two existing databases: the California Treatment Outcome Project (CalTOP), which contains information on participants in a statewide substance abuse treatment outcome monitoring project; and the Child Welfare Services/Case Management System, which is the statewide data system containing information on all child welfare events in California. Bivariate analyses and multivariate logistic regression were conducted comparing mothers in CalTOP who were (N = 1,939) and were not (N = 2,217) involved with child welfare (Grella, Hser, & Huang, 2006). Mothers who were involved with child welfare were younger (31.6 vs. 34.4), had more children (2.9 vs. 2.1), and had more employment problems (as measured by ASI severity scores). They were more likely than others to be referred to treatment by the criminal justice system (OR = 1.31, P < .01), to have a history of physical abuse (OR = 1.39, P < .0001), and to be treated in outpatient programs (OR = 1.55, P < .0001). They had lower levels of alcohol severity, but did not differ in regard to psychiatric severity or criminal involvement. Primary users of methamphetamine were disproportionately represented among the child-welfare involved group (47% vs. 37%). We are currently conducting longitudinal analyses of child welfare outcomes using pretreatment characteristics, treatment services received, and status at a 9-month follow-up as predictors. Study findings will have application to policies that aim to improve the outcomes of child-welfare involved mothers in substance abuse treatment.

Linking Substance Abuse Treatment and Child Welfare Outcomes: Secondary Analyses of Data from Two Service Delivery Systems was funded by the Robert Wood Johnson Foundation, Grant 52673 (April 2005 through December 2006).

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Alcohol and Homeless Women’s
Use of Health Services

Lillian Gelberg, M.D., Principal Investigator
(lgelberg@mednet.ucla.edu)
Douglas Longshore, Ph.D., Co-Investigator
(deceased Dec. 30, 2005)

This secondary analysis project examined correlates of health care utilization and unmet need for care among homeless alcohol-using women in Los Angeles.

Alcohol and Homeless Women’s Use of Health Services was funded by the National Institute on Alcohol Abuse and Alcoholism to the UCLA Department of Family Services, Grant 5 R21 AA13398, with collaboration by UCLA ISAP (March 2002 through February 2006).

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Children Exposed to
Methamphetamine Use and Manufacture

Nena Messina, Ph.D., Principal Investigator
(nmessina@ucla.edu)
Patricia Marinelli-Casey, Ph.D., & Richard Rawson, Ph.D., Co-Investigators
Florentina Marcu, M.S., Project Director

With the cooperation of the existing Drug Endangered Children (DEC) program in Los Angeles County and the Los Angeles County Department of Children and Family Services (DCFS), UCLA ISAP is conducting a 2-year pilot study to analyze existing Los Angeles DEC case data to enhance our understanding of the extent, epidemiology, and medical (e.g., respiratory, dental, dermatological, etc.) and developmental (e.g., cautions or delays) problems of drug-exposed children, as well as child-welfare case management services, treatment, and placement for these children. The study will further provide the basis for ongoing and expanded research applications on drug-endangered children state- and nationwide. 
Study Aims: UCLA ISAP proposes to assist the DEC initiative by achieving the following aims:

  1. To document and describe the epidemiology (e.g., number, age-range, gender, race/ethnicity, rates of neglect, abuse, or MA-related accidental or purposeful deaths) of children removed from home-based MA labs in Los Angeles County;
  2. To explore the nature and extent of the medical problems (e.g., respiratory, dental, dermatological, burns) associated with children removed from home-based MA labs in Los Angeles County;
  3. To explore the nature and extent of the developmental problems (e.g., cautions or delays) associated with children removed from home-based MA labs in Los Angeles County;
  4. To describe the child welfare placement outcomes (e.g., termination of parental rights, kinship care, foster care, adoption) of children removed from home-based MA labs in Los Angeles County.

Children Exposed to Methamphetamine Use and Manufacture was funded by the National Institute on Mental Health, Contract 1 R21 DA019566 (August 2005 through May 2007).

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Drug Treatment and Mental Health Services: Ethnic Differences in
Access and Outcomes

Noosha Niv, Ph.D., Principal Investigator
(noosha23@yahoo.com)
Yih-Ing Hser, Ph.D., Co-Investigator

The goal of this study was to provide an analysis of ethnic differences in utilization of mental health services and psychiatric outcomes among drug-abusing patients with mental health problems. The study addressed the following objectives: 1) to examine the mental health service histories and needs among patients in substance abuse treatment by ethnicity (African American, Hispanic, White); 2) to explore if ethnicity and patients’ mental health severity are related to how mental health services and drug treatment were structured (Integrated, Partnership, No Mental Health); 3) to compare ethnic groups by the type, frequency, and sources of mental health services received; 4) to examine treatment satisfaction and rates of treatment completion; and 5) to investigate the relationship between ethnicity and outcomes (e.g., mental health, drug and alcohol, recidivism), controlling for patient characteristics.

Data for this study were collected in the California Treatment Outcome Project, a statewide outcome monitoring system, which included all adult patients admitted to 43 substance abuse programs in 13 counties. All patients completed the Addiction Severity Index (ASI) at intake. Three-month and 9-month follow-up interviews were conducted with a subset of the intake sample. This subset completed the Treatment Service Review (TSR) and a treatment satisfaction questionnaire at the 3-month follow-up. The TSR was used to collect information regarding services received in each of the seven domains of the ASI. A subset also completed the ASI at the 9-month follow-up. Pretreatment and posttreatment administrative records regarding mental health treatment, substance abuse treatment, and criminal justice involvement were obtained as well. (Additional information is available at www.rwjf.org).

Drug Treatment and Mental Health Services: Ethnic Differences in Access and Outcomes was funded by the Robert Wood Johnson Foundation, Grant 053085 (June 2005 through November 2006).

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Prenatal Methamphetamine Exposure
and Child Development

Barry Lester, M.D., Brown University, Principal Investigator
Richard A. Rawson, Ph.D., Co-Investigator
(rrawson@mednet.ucla.edu)
Jeffrey Annon, M.A., Project Director

Despite the fact that methamphetamine (MA) use is very high in some regions, little is known about the potential neurotoxic effects of prenatal MA exposure on the development of children. The IDEAL (Infant Development, Environment and Lifestyle) study was initiated to study these effects. The investigators enrolled 1,618 mothers at four clinical centers in cities where MA use was known to be a problem, Los Angeles, Des Moines, Tulsa, and Honolulu, and identified 84 newborns who were exposed to MA in utero, and 1,534 who were not exposed. The investigators looked at neonatal birth weight and gestational ages in weeks. They also looked at the relationship between MA exposure and the rate of small-for-gestational-age births. The study found that the children who were exposed in utero to MA were 3.5 times more likely than unexposed children to be small for their gestational age. MA-exposed infants were also more likely to be born pre-term (less than 37 weeks gestation). In all, 12.5% of the drug-exposed infants were born pre-term, compared with 6.5% of those who were not exposed (P = 0.036). Mothers who used MA were more likely to have a lower socioeconomic status, live in a household earning less than $10,000 per year, be on Medicaid, live without a partner, and were more likely not to have finished high school. They also tended to be younger, to seek prenatal care later in pregnancy, have fewer visits for prenatal care, and, somewhat surprisingly, to gain more weight during pregnancy relative to non-users. The latter finding reflects the fact that those who quit MA use earlier in gestation gained 10 pounds more than those who continued to use MA throughout their pregnancy, suggesting that the anorexic effects of MA are limited to continuous use. For more information, see Smith, L.M., et al. (2006). The Infant Development, Environment, and Lifestyle Study: Effects of prenatal methamphetamine exposure, polydrug exposure, and poverty on intrauterine growth. Pediatrics, 118(3),1149-1156.

Prenatal Methamphetamine Exposure and Child Development was funded by the National Institute on Drug Abuse to the Emma Pendleton Bradley Hospital with collaboration by UCLA ISAP, Subcontract 712-7605-8985 (September 2001 through August 2007).

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UCLA Access to Care Project

Richard A. Rawson, Ph.D. (rrawson@mednet.ucla.edu), Vivian B. Brown, Ph.D. (protoceo@aol.com), & Elizabeth Gong-Guy, Ph.D. (egongguy@sps.ucla.edu),
Principal Investigators
Suzanne Spear, M.S., Project Director

The project will develop and implement screening and brief intervention services for students engaging in high-risk use of alcohol and other drugs (AOD). These services will take place at the UCLA Student Psychological Services. Over the course of the 3-year project, Student Psychological Services will screen a minimum of 3,000 students per year and conduct brief interventions with 300 students per year. Staff at Student Psychological Services will use evidence-based tools developed specifically for college students, refined through collaboration with student representatives, campus groups, researchers, and community service providers. Central to the screening and brief intervention activity to be refined, implemented, and tested is the Alcohol, Smoking, and Substance Use Involvement Screening Test (ASSIST) developed by the World Health Organization. The Access to Care Project will harness the energy and activism of students and will build upon existing partnerships between campus and community organizations in an effort to reduce substance abuse and related consequences among students and their communities.

UCLA Access to Care Project was funded by the Substance Abuse & Mental Health Services Administration/Center for Substance Abuse Treatment, Grant 1 H79 TL17244 (July 2005 through June 2008).

Last Updated: 12/17/2008

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2016 ISAP Publications
2015 ISAP Publications