Project Findings: Low Cost, Low Key Changes can Improve Outcomes

Work in behavioral science suggests that small changes can move people to act on personal goals. To test this approach in the realm of human services, MRDC along with sponsoring federal agencies, launched the Behavioral Interventions to Advance Self Sufficiency (BIAS) program with a goal of improving both the efficiency and outcomes of programming. Small changes or “nudges” to a program that facilitate the experience for clients, for example, the simplification of an application process, personalization of correspondence, or prominently highlighting a deadline, have an influence on decisions made by current or potential program participants. These adjustments are not major design changes, rather they are low cost, easily implemented ways to change the complexities many lower income families face .

Randomized trials at participating state and local human service agencies introduced specific behavioral interventions based on a period of review and identification of “bottlenecks.” Results indicate that these small changes had a statistically significant impact on outcomes in childcare and work support (including increased attendance at meetings or appointments) and child support (including increased rate of payment).

If small changes make a difference, why are larger-scale programmatic changes (that could result in increased benefits) so difficult to negotiate and implement? Perhaps examining program design through the lens of behavioral economics, where both staff and participant benefit from improved outcomes, is the path toward innovation in the provision of human services. The full report on the BIAS project and additional information on the MRDC’s work with behavioral interventions is available on their website.

 

Report citation: Richburg-Hayes, Lashawn, Caitlin Anzelone, and Nadine Dechausay with Patrick Landers (2017). Nudging Change in Human Services: Final Report of the Behavioral Interventions to Advance Self-Sufficiency (BIAS) Project. OPRE Report 2017-23. Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.

SAMHSA’s 2015 Behavioral Health Barometer: Pennsylvania Offers Look at Substance Use, Mental Health Treatment

Earlier this year The Substance Abuse and Mental Health Services Administration (SAMHSA) published the third edition of their Behavioral Health Barometer: Pennsylvaniapart of series of reports at both the national and the state level that provides a “snapshot of behavioral health.”  The Barometer pulls data on youth and adult behavioral health markers from the National Survey on Drug Use and Health, the National Survey of Substance Abuse Treatment Services, the Youth Risk Behavior Survey, the Monitoring the Future survey, and services used by Medicare enrollees. This free report is a great source of data for needs assessments and grant proposals, be sure to download the national and state (of your choice) report at the SAMHSA website.

Below are data from the report on aspects of youth and adolescent behavioral health and substance use. Overall, the state percentages are comparable to national percentages, with higher proportions in reported cigarette use and binge drinking.

For Pennsylvania in 2013/2013-14:

  • approximately 84,000 adolescents (12 to 17 years old), just under 9 percent of all adolescents, used illegal drugs during the month prior.
  • 6.6 percent of adolescents used cigarettes within the last month – this is higher than the national data point  of 5.2 percent.
  • 16.5 percent of adolescents binged on alcohol within the last month – again, higher than the national percentage of 14 percent.
  • 198,088 youth (under 18 years of age) received services from the public mental health system, with 63.5 percent reporting improvement post-treatment, lower than the national data point of 69.5 percent.

 

 

 

Report Citation:  Substance Abuse and Mental Health Services Administration. Behavioral Health Barometer: Pennsylvania, 2015. HHS Publication No. SMA–16–Baro–2015–PA. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.

 

Child Maltreatment and Abuse – A Predictor Agencies are Using Prediction to Prevent

According to 2011 data,  12.5 percent of children under the age of 18 are abused or neglected in the United States each year.  A Facts on Youth brief from the Center for Health and Justice at TASC cites a study published in JAMA Pediatrics that found confirmed maltreatment for 1 in 8 youth, with nearly 6 percent of cases  (just less than half of confirmed reports) involving children ages 5 and under.  The brief also notes that studies of child abuse and maltreatment that rely on self-reports rather than substantiated reports indicate a rate of up to 40 percent.

The Child Trends brief Preventing Violence: Understanding and addressing determinants of youth violence in the United States reviewed relevant research on interventions and policy approaches to reducing youth violence, with an emphasis on individual, family and school/community factors.  This review identified several predictors of violence, including domestic violence, dysfunctional parenting, gun availability, low self-control, and lack of connectedness to school.  Child maltreatment, however, was a strong predictor of nearly every type of violence.  The prevention of child abuse and provision of interventions to address the impact of such trauma appear to be critical actions in reducing the potential of future violence.  That said, although child maltreatment is a risk factor for criminal behavior, the longer term negative effects of that experience may be offset or amplified by other life events. Completing high school/getting a GED and getting married were two factors identified by a research team at the Social Development Research Group at the University of Washington as having a positive impact on a person’s life, thus reducing the power of the relationship between the maltreatment and future high risk behaviors.  A history of maltreatment combined with additional risk factors, such as poverty, increases the likelihood of criminal behavior.

As safety and health are essential factors in optimal child development, and may affect a multitude of life outcomes, new strategies have emerged to better identify and “triage” high-risk situations.  States are turning to the big data playbook to assist in investigations of abuse and maltreatment, using predictive analysis to help prioritize reports and better provide preventive services. Information such as family history, school reports and other administrative data, plus case officer knowledge, gives child welfare decision-makers more (if not necessarily better) data to guide the use of resources for the protection of children. Along with Connecticut, Florida, and Los Angeles County, Allegheny County here in western Pennsylvania is utilizing predictive analytics in an effort to reduce child maltreatment, abuse, and fatalities.  For more information on how predictive analysis is being used in child welfare, see Who will Seize the Child Abuse Prediction Market by Darian Woods and Checklists, Big Data and the Virtues of Human Judgement by Holden Slattery, both in The Chronicle of Social Change.

 

Study Finds Overseas Tobacco Advertising Reaches Very Young Children

Tobacco marketing reaches children as young as 5 years old influencing their attitudes about smoking and smokers, according to a study of children in Brazil, China, India, Nigeria, Pakistan, and Russia recently published in the journal Child: Care, Health & Development. The research study, led by Dr. Dina Borzekowski, research professor in the Department of Behavioral and Community Health at the University of Maryland adds to her body of work on the impact of media on children’s health.

The research team assessed the children’s level of familiarity with tobacco branding, their intention to smoke in the future, and their overall exposure to media.  Among 5-and-6-year-old children in the six counties, nearly 68 percent were able to identify one tobacco logo and more than 25 percent could identify two or more. Higher levels of media exposure were not necessarily associated with better knowledge of tobacco brands. However, in three of the sample countries the presence of an adult in the home was also not a significant factor in brand knowledge, suggesting that advertising plays a role in the exposure of very young children to tobacco brands and smoking behavior.

Although tobacco companies face weaker regulations overseas, they spent $9.6 billion on advertising in the United States in 2012.  A U.S. Surgeon General’s report suggests that these companies continue to target marketing to American adolescents, portraying smoking or smokeless tobacco use as a desirable behavior. Considering the approximately 3.5 middle and high school students who used tobacco in 2012, it’s working.

Extensive information about tobacco marketing and promotion is available at the Stanford Research Into the Impact of Advertising (SRITA) webpage.

 

 

Study Citation: Pires, P. P., Ribas, R. C.,  Borzekowski, D. L. G. (2015).  Attitudes and intentions to smoke: a study of young Brazilian children. Child: Care, Health and Development.1365-2214 http://dx.doi.org/10.1111/cch.12240