Substance Use & Misuse
ISSN: 1082-6084 (Print) 1532-2491 (Online) Journal homepage: http://www.tandfonline.com/loi/isum20
The Need to Restructure the Substance Misuse Behavioral Science Research Enterprise Richard Dembo To cite this article: Richard Dembo (2015) The Need to Restructure the Substance Misuse Behavioral Science Research Enterprise, Substance Use & Misuse, 50:8-9, 1103-1105, DOI: 10.3109/10826084.2015.1007670 To link to this article: http://dx.doi.org/10.3109/10826084.2015.1007670
Published online: 11 Sep 2015.
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Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=isum20 Download by: [Universite Laval]
Date: 05 November 2015, At: 19:01
Substance Use & Misuse, 50:1103–1105, 2015 C Taylor & Francis Group, LLC Copyright ISSN: 1082-6084 print / 1532-2491 online DOI: 10.3109/10826084.2015.1007670
ORIGINAL ARTICLE
The Need to Restructure the Substance Misuse Behavioral Science Research Enterprise Richard Dembo
Downloaded by [Universite Laval] at 19:01 05 November 2015
Department of Criminology, University of South Florida, Tampa, Florida, USA to reverse this situation, which has been exacerbated by increasingly limited funds for program evaluation at the national and state levels. 2. Increasing research use of secondary, often dated, data in research studies. The growing challenges in funding to support the conduct of new research studies has led to an increased analysis of secondary data. A recent article in the field of criminology indicated that over 60% of articles published in the top three journals in the field between 2000 and 2010 relied on secondary data for their analyses (Nelson, Wooditch & Gabbidon, 2014). While such data analyses may provide a rich opportunity to study specific critical issues in the field, they present a risk that the results of such studies will have a dated policy relevance. The benefits and costs of the use of such data analyses need to be weighed. The increased use of secondary data is fueled by the publication expectations of many researchers’ academic departments. There is a need to revise the publish or perish syndrome, so that more attention is devoted to acquiring secure knowledge, resulting in quality publications relating to the development of more informed and effective services to drug-involved persons. 3. Focus on short-term outcome studies of intervention effects. Limited funding resources at the national and state levels have led to an encouragement of researchers to design shorter term projects, rather than longer term longitudinal studies. Such a trend reduces the opportunity to obtain a more nuanced understanding of developmental processes, and reduces the chances of identifying delayed effects, and the range of associated necessary conditions, levels, and qualities of endogenous as well as exogenous ones, in the impact of interventions on drug use in prevention and intervention clinical trials (Prado et al., 2007; Wolchik et al., 2002; Dembo et al., in press,). 4. The continued search for new screening, assessment, prevention, and treatment tools, models, and programs in a field now quite rich in these resources, reduces
Two major dynamics characterize the field of substance misuse behavioral science research in recent decades. First, assessments of the outcomes of prevention and treatment services have shown increasing conceptual and methodological sophistication, but, in general, have not kept pace with new developments in biostatistics and multivariate analyses. Second, funding for richer, more informed evaluation efforts to assess the efficacy, cost benefits, and longer term outcomes of these services has declined significantly. These two processes are creating a growing crisis in the field. Researchers, program administrators, and legislative bodies at the state and federal levels have each contributed to this crisis. A significant restructuring of what we do and when (appropriate timing), their underpinnings (theoretical, empirical, stakeholder agendas and goals, etc.) and how we do it, and the ongoing availability and accessibility of relevant human and non-human resources, amongst other considerations, is needed. Although this Op-Ed piece prevents full discussion of these issues, as someone who has been involved in this field for many years, I feel several key issues need to be addressed: 1. Narrow focused and unrealistic program and policy maker/stakeholder expectations. Behavioral health care and policy makers are often concerned with program outcomes in narrowly defined ways. For example, a concern about recidivism remains a dominant interest, although the field had long been aware that program success is optimally achieved when clients’ emotional/psychological functioning, employment/vocational, and sociocultural skills are improved given his/her available and accessible inner as well as external resources. A narrow focus on outcomes has hindered the maturity of the drug use(r) intervention field, and led to an oversimplification of the goals of treatment—with its negative effects on service delivery and community wellbeing. Serious efforts are needed
Address correspondence to Richard Dembo, Department of Criminology, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620; E-mail: [email protected]
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attention to other important issues, such as health disparities, institutional barriers as well as “bridges”–enablers to needed and viable changes. In this vein, there is a need to form long-term partnerships with groups experiencing serious health disparities, such as Native Americans and inner-city African Americans, and conduct research leading to an improvement in their quality of their lives. OJJDP, the Blueprints Violence Prevention Initiative at the University of Colorado, NREPP, and CrimeSolutions.gov have identified many highly effective and promising intervention programs for substance misusers. In addition, there are now many publications documenting the psychometric properties of highly regarded screening and assessment tools (Grisso, Vincent, & Seagrave, 2005). Given this situation, a judicious refocus of our attention on topic areas about which we know much less, such implementation science issues in the fields of drug misuse prevention and treatment, is warranted. 5. Continued use of overly simplistic outcome models to evaluate programs. There is persistent practice in conducting outcome analyses in the complex, multidimensional and interdisciplinary drug use(r) intervention field involving one major outcome variable, such as recidivism or return to drug use. Binary conceptualizations continue to be an ongoing flaw. Regression analysis is a predominant mode of such analyses. However, developments in the fields of biostatistics and multivariate modeling, as well as the area of artificial neural network analysis, has led to a revolution in statistical thinking and modes of analyses involving multiple predictors and outcomes, which provide results more reflective of the real world complexities we live in and try to understand. That which is hidden has become more visible and measurable. Such modes of analyses should occupy a more valued place in our work. The encouragement of editors of journals in the field would go a long way toward correcting this imbalance. 6. Loss of a generation of talented researchers. The challenges of funding, and the issue of our field’s future relevance to policy, run the risk of a loss of a generation of talented researchers moving to other disciplines. Serious efforts are needed to ensure the richness of talent in our field is retained as new researchers and practitioners enter it. 7. Suggested strategies to improve our field There are several things that can be done to improve our field now and in the future. These include: 1. Funding of longer term, expanded domain outcome studies. 2. Revision of graduate student curricula to incorporate new conceptual models and advanced statistical procedures. 3. Establish special funding streams for new researchers
4. Require involvement of nonagency evaluation researchers in the agencies they study, perhaps by embedding them in these agencies for the duration of their studies. This will help reduce the gulf between academia and the world of service delivery. Promise of a new direction I view the challenges noted above as opportunities for our field to move to a place of more robust conceptual and technical quality, and stronger relevance to public policy. We have learned and achieved much to date. We need to continue to work together to actualize the potential of our field to enrich the lives of the troubled lives we touch, directly or indirectly, in our work. Declaration of interest
The author reports no conflict of interest. The author alone is responsible for the content and writing of the article.
THE AUTHOR Richard Dembo, PhD, USA, has a long history, beginning in the mid-1980s, collaborating with juvenile justice and community service agencies in the states of Florida and Kansas, which resulted in numerous publications and two books. His projects include screening and assessment, and a longitudinal study, of detained youth; evaluation of diversion programs; developing, implementing, and evaluating a Family Empowerment Intervention; developing, implementing and evaluating an intensive case management service for diversion youth; implementing and evaluating a Brief Intervention for drug using youth involved in drug court and among truant youth. Dr. Dembo has been instrumental in obtaining millions of dollars in federal, state and local funds for the University of South Florida and the Tampa Bay area for various research and service delivery projects addressing the needs of high risk youth, their families, and their surrounding communities.
REFERENCES Dembo, R., Briones-Robinson, R., Schmeidler, J., Wareham, J., Ungaro, R., Winters, K. C., . . .Belenko, S. (in press). Brief intervention impact on truant youths’ marijuana use: 18month follow-up. Journal of Child and Adolescent Substance Abuse. Grisso, T., Vincent, G., & Seagrave, D. (2005). Mental Health Screening and Assessment in Juvenile Justice. New York: Guilford Press. Nelson, M. S., Wooditch, A., & Gabbidon, S. L. (2014). Is criminology out-of-date? A research note on the use of common types of data. Journal of Criminal Justice Education, 25(1), 16–33.
THE NEED TO RESTRUCTURE THE SUBSTANCE MISUSE BEHAVIORAL SCIENCE RESEARCH ENTERPRISE
Downloaded by [Universite Laval] at 19:01 05 November 2015
Prado, G., Pantin, H., Briones, E., Schwartz, S. J., Feaster, D., Huang, S., . . .Szapocznik, Jos´e. (2007). A randomized controlled trial of a parent- centered intervention in preventing substance use and HIV risk behaviors in Hispanic adolescents. Journal of Consulting and Clinical Psychology, 75(6), 914–926.
1105
Wolchik, S. A., Sandler, I. N., Millsap, R. E., Plummer, B. A., Greene, S. M., Anderson, E. R., . . .Haine, R. (2002). Six-year follow-up of preventive interventions for children of divorce: Randomized controlled trial. Journal of American Medical Association, 288(15), 1874–1881.
ISSN: 1082-6084 (Print) 1532-2491 (Online) Journal homepage: http://www.tandfonline.com/loi/isum20
The Need to Restructure the Substance Misuse Behavioral Science Research Enterprise Richard Dembo To cite this article: Richard Dembo (2015) The Need to Restructure the Substance Misuse Behavioral Science Research Enterprise, Substance Use & Misuse, 50:8-9, 1103-1105, DOI: 10.3109/10826084.2015.1007670 To link to this article: http://dx.doi.org/10.3109/10826084.2015.1007670
Published online: 11 Sep 2015.
Submit your article to this journal
Article views: 5
View related articles
View Crossmark data
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=isum20 Download by: [Universite Laval]
Date: 05 November 2015, At: 19:01
Substance Use & Misuse, 50:1103–1105, 2015 C Taylor & Francis Group, LLC Copyright ISSN: 1082-6084 print / 1532-2491 online DOI: 10.3109/10826084.2015.1007670
ORIGINAL ARTICLE
The Need to Restructure the Substance Misuse Behavioral Science Research Enterprise Richard Dembo
Downloaded by [Universite Laval] at 19:01 05 November 2015
Department of Criminology, University of South Florida, Tampa, Florida, USA to reverse this situation, which has been exacerbated by increasingly limited funds for program evaluation at the national and state levels. 2. Increasing research use of secondary, often dated, data in research studies. The growing challenges in funding to support the conduct of new research studies has led to an increased analysis of secondary data. A recent article in the field of criminology indicated that over 60% of articles published in the top three journals in the field between 2000 and 2010 relied on secondary data for their analyses (Nelson, Wooditch & Gabbidon, 2014). While such data analyses may provide a rich opportunity to study specific critical issues in the field, they present a risk that the results of such studies will have a dated policy relevance. The benefits and costs of the use of such data analyses need to be weighed. The increased use of secondary data is fueled by the publication expectations of many researchers’ academic departments. There is a need to revise the publish or perish syndrome, so that more attention is devoted to acquiring secure knowledge, resulting in quality publications relating to the development of more informed and effective services to drug-involved persons. 3. Focus on short-term outcome studies of intervention effects. Limited funding resources at the national and state levels have led to an encouragement of researchers to design shorter term projects, rather than longer term longitudinal studies. Such a trend reduces the opportunity to obtain a more nuanced understanding of developmental processes, and reduces the chances of identifying delayed effects, and the range of associated necessary conditions, levels, and qualities of endogenous as well as exogenous ones, in the impact of interventions on drug use in prevention and intervention clinical trials (Prado et al., 2007; Wolchik et al., 2002; Dembo et al., in press,). 4. The continued search for new screening, assessment, prevention, and treatment tools, models, and programs in a field now quite rich in these resources, reduces
Two major dynamics characterize the field of substance misuse behavioral science research in recent decades. First, assessments of the outcomes of prevention and treatment services have shown increasing conceptual and methodological sophistication, but, in general, have not kept pace with new developments in biostatistics and multivariate analyses. Second, funding for richer, more informed evaluation efforts to assess the efficacy, cost benefits, and longer term outcomes of these services has declined significantly. These two processes are creating a growing crisis in the field. Researchers, program administrators, and legislative bodies at the state and federal levels have each contributed to this crisis. A significant restructuring of what we do and when (appropriate timing), their underpinnings (theoretical, empirical, stakeholder agendas and goals, etc.) and how we do it, and the ongoing availability and accessibility of relevant human and non-human resources, amongst other considerations, is needed. Although this Op-Ed piece prevents full discussion of these issues, as someone who has been involved in this field for many years, I feel several key issues need to be addressed: 1. Narrow focused and unrealistic program and policy maker/stakeholder expectations. Behavioral health care and policy makers are often concerned with program outcomes in narrowly defined ways. For example, a concern about recidivism remains a dominant interest, although the field had long been aware that program success is optimally achieved when clients’ emotional/psychological functioning, employment/vocational, and sociocultural skills are improved given his/her available and accessible inner as well as external resources. A narrow focus on outcomes has hindered the maturity of the drug use(r) intervention field, and led to an oversimplification of the goals of treatment—with its negative effects on service delivery and community wellbeing. Serious efforts are needed
Address correspondence to Richard Dembo, Department of Criminology, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620; E-mail: [email protected]
1103
Downloaded by [Universite Laval] at 19:01 05 November 2015
1104
R. DEMBO
attention to other important issues, such as health disparities, institutional barriers as well as “bridges”–enablers to needed and viable changes. In this vein, there is a need to form long-term partnerships with groups experiencing serious health disparities, such as Native Americans and inner-city African Americans, and conduct research leading to an improvement in their quality of their lives. OJJDP, the Blueprints Violence Prevention Initiative at the University of Colorado, NREPP, and CrimeSolutions.gov have identified many highly effective and promising intervention programs for substance misusers. In addition, there are now many publications documenting the psychometric properties of highly regarded screening and assessment tools (Grisso, Vincent, & Seagrave, 2005). Given this situation, a judicious refocus of our attention on topic areas about which we know much less, such implementation science issues in the fields of drug misuse prevention and treatment, is warranted. 5. Continued use of overly simplistic outcome models to evaluate programs. There is persistent practice in conducting outcome analyses in the complex, multidimensional and interdisciplinary drug use(r) intervention field involving one major outcome variable, such as recidivism or return to drug use. Binary conceptualizations continue to be an ongoing flaw. Regression analysis is a predominant mode of such analyses. However, developments in the fields of biostatistics and multivariate modeling, as well as the area of artificial neural network analysis, has led to a revolution in statistical thinking and modes of analyses involving multiple predictors and outcomes, which provide results more reflective of the real world complexities we live in and try to understand. That which is hidden has become more visible and measurable. Such modes of analyses should occupy a more valued place in our work. The encouragement of editors of journals in the field would go a long way toward correcting this imbalance. 6. Loss of a generation of talented researchers. The challenges of funding, and the issue of our field’s future relevance to policy, run the risk of a loss of a generation of talented researchers moving to other disciplines. Serious efforts are needed to ensure the richness of talent in our field is retained as new researchers and practitioners enter it. 7. Suggested strategies to improve our field There are several things that can be done to improve our field now and in the future. These include: 1. Funding of longer term, expanded domain outcome studies. 2. Revision of graduate student curricula to incorporate new conceptual models and advanced statistical procedures. 3. Establish special funding streams for new researchers
4. Require involvement of nonagency evaluation researchers in the agencies they study, perhaps by embedding them in these agencies for the duration of their studies. This will help reduce the gulf between academia and the world of service delivery. Promise of a new direction I view the challenges noted above as opportunities for our field to move to a place of more robust conceptual and technical quality, and stronger relevance to public policy. We have learned and achieved much to date. We need to continue to work together to actualize the potential of our field to enrich the lives of the troubled lives we touch, directly or indirectly, in our work. Declaration of interest
The author reports no conflict of interest. The author alone is responsible for the content and writing of the article.
THE AUTHOR Richard Dembo, PhD, USA, has a long history, beginning in the mid-1980s, collaborating with juvenile justice and community service agencies in the states of Florida and Kansas, which resulted in numerous publications and two books. His projects include screening and assessment, and a longitudinal study, of detained youth; evaluation of diversion programs; developing, implementing, and evaluating a Family Empowerment Intervention; developing, implementing and evaluating an intensive case management service for diversion youth; implementing and evaluating a Brief Intervention for drug using youth involved in drug court and among truant youth. Dr. Dembo has been instrumental in obtaining millions of dollars in federal, state and local funds for the University of South Florida and the Tampa Bay area for various research and service delivery projects addressing the needs of high risk youth, their families, and their surrounding communities.
REFERENCES Dembo, R., Briones-Robinson, R., Schmeidler, J., Wareham, J., Ungaro, R., Winters, K. C., . . .Belenko, S. (in press). Brief intervention impact on truant youths’ marijuana use: 18month follow-up. Journal of Child and Adolescent Substance Abuse. Grisso, T., Vincent, G., & Seagrave, D. (2005). Mental Health Screening and Assessment in Juvenile Justice. New York: Guilford Press. Nelson, M. S., Wooditch, A., & Gabbidon, S. L. (2014). Is criminology out-of-date? A research note on the use of common types of data. Journal of Criminal Justice Education, 25(1), 16–33.
THE NEED TO RESTRUCTURE THE SUBSTANCE MISUSE BEHAVIORAL SCIENCE RESEARCH ENTERPRISE
Downloaded by [Universite Laval] at 19:01 05 November 2015
Prado, G., Pantin, H., Briones, E., Schwartz, S. J., Feaster, D., Huang, S., . . .Szapocznik, Jos´e. (2007). A randomized controlled trial of a parent- centered intervention in preventing substance use and HIV risk behaviors in Hispanic adolescents. Journal of Consulting and Clinical Psychology, 75(6), 914–926.
1105
Wolchik, S. A., Sandler, I. N., Millsap, R. E., Plummer, B. A., Greene, S. M., Anderson, E. R., . . .Haine, R. (2002). Six-year follow-up of preventive interventions for children of divorce: Randomized controlled trial. Journal of American Medical Association, 288(15), 1874–1881.
