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.

Ensuring an Education for Confined Juveniles

Earlier this week, the heads of the U.S. Department of Justice and Department of Education appeared at the Northern Virginia Juvenile Detention Center School for the joint release of a guidance package aimed at improving the quality of education for youths in juvenile justice facilities.  The package lays out best practices for the provision of educational programming to confined juveniles, and includes

  • guiding principles for education in secure juvenile facilities,
  • a clarification letter on agency obligations around providing an appropriate education to youths with disabilities who are confined in juvenile justice facilities,
  • a clarification letter on how federal civil right laws apply to educational services in juvenile justice facilities, and
  • an explanation of federal student aid that may be available for eligible youth in the juvenile justice system.

Research supports the link between higher education and a reduced risk of recidivism, so ensuring that the right of an education extends to youths in the juvenile justice system (and with it the possibility of a post-secondary education) may result in lower criminal justice system costs in the future.  The 2014 report Just Learning: The Imperative to Transform Juvenile Justice Systems into Effective Educational Systems from the Southern Education Foundation suggests that juvenile justice initiatives that work to prevent youth from re-offending could save society at least $2 million – and as much as $3.8 million – per youth over a decade.

You can read more about the costs and outcomes of the juvenile justice system in a 2011 post on juvenile incarceration.

A Breakdown of Drug and Alcohol Usage in America

In 2013, 56% of adults in America classified themselves as "current drinkers", 24.6% reported that they were "binge drinkers".
In 2013, 56% of adults in America classified themselves as “current drinkers”, 24.6% reported that they were “binge drinkers”.

Alcohol consumption statistics have received much attention of late thanks to a Washington Post Wonkblog post citing material from the book Paying the Tab by Philip J. Cook and data from The National Institute on Alcohol Abuse and Alcoholism (NIAAA).  Those interested in alcohol consumption trends by adolescents and adults might also want to peruse the findings from the  National Survey on Drug Use and Health, an annual source of estimates on drug and alcohol use (although some categories are defined differently than those used by the NIAAA) and mental health in the United States.

According to a brief summarizing 2013 NSDUH data from the Substance Abuse and Health Services Administration (SAMHSA), last year more than half of Americans 12-years-and-over (52.2 percent) reported currently using alcohol, with approximately 23 percent classified as binge drinkers (defined as 5 or more drinks in one occasion).  Just over 6 percent self-reported as heavy drinkers – 16.2 million adults and 293,000 12-to-17 year-olds.  However, the use of alcohol within the past month and binge drinking both decreased among the 12-to-17-year-old group compared to 2012 data, from 12.9 percent to 11.6 percent and 7.2 percent to 6.2 percent, respectively.

Regarding drug use, 9.4 percent of adults used illicit drugs in 2013 with marijuana (7.6 percent), non-medical use of prescription drugs (1.7 percent)  and cocaine (0.6 percent) as the top three drugs currently used. Among adolescents, 8.8 percent reported currently using drugs. Again, marijuana (7.1 percent) and non-medical use of prescriptions (2.2 percent) were the most popular currently used illicit substances,  followed by hallucinogens (0.6) and inhalants (0.5).

Some of the reasons for not receiving drug and/or alcohol treatment by those who attempted to secure it (based on 2010-2013 data) include

  • lack of health care coverage or inability to afford the cost – 37.3 percent,
  • not ready to stop usage – 24.5 percent,
  • unsure of where to find treatment – 9 percent, and
  • health coverage that did not include rehabilitation – 8.2 percent.

The brief Substance Use and Mental Health Estimates from the 2013 National Survey in Drug Use and Health: Overview of Findings also contains data on the prevalence of mental and behavioral health issues among both adults and adolescents, including co-occurring mental health and substance abuse disorders.



Citation: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (September 4, 2014). The NSDUH Report: Substance Use and Mental Health Estimates from the
2013 National Survey on Drug Use and Health: Overview of Findings. Rockville, MD.

Photo Credit: M. Puzzanchera (Own Work) (CC By-NC-ND 3.0)

A Look at the Research on School Lunches and the Importance of Recess

Over the summer I came across a couple of briefs from Bridging the Gap that I thought might be appropriate to post once the yellow buses started rolling again. One report summarizes research on the changes in the federal lunch program, the other discusses policies on recess.

Although an initial government study found the much debated new nutritional regulations resulted in a decrease in participation in the school lunch program, waste of food, price increases and menu planning challenges between 2010-11 and 2012-13, student opinion of lunches may not be as negative as previously thought. According to the brief, Student Reactions During the First Year of Updated School Lunch Nutrition Standards, data on administrator perception of student opinion of the new meals concluded that while middle and high school students did voice their displeasure about the new lunches (44 and 53 percent, respectively), by the end of the year they were liked “to at least some extent” by students (70 and 63 percent).  Other findings,

  • Among elementary schools, more students complained about the meals in the spring of 2014 than at the beginning of the school year (56 percent versus 64 percent), but 70 percent of those surveyed reported that students generally liked the new lunches.
  • Rural schools reported more student complaints about school lunches than urban schools.
  • Rural schools reported increases in waste (students throwing away food) more than urban schools.

While school lunches are one way to attempt to impact student health and wellness, there has not been as much policy activity around the inclusion of recess time for elementary-school-age students.  Less than half of the school districts in the country have a recommended or required policy regarding daily recess, and just 13 states recommend or mandate recess as part of the daily schedule in elementary schools.  The CDC/Bridging the Gap brief, Strategies for Supporting Recess in Elementary Schools, discusses evidence-based approaches for encouraging physical activity such as recess, including

  • training and technical assistance from states to districts on student health and wellness,
  • upgrades to or maintenance of existing playground and sports equipment, and
  • daily recess as well as scheduled physical education class in elementary schools.

More information on the importance of recess in child development (including academic achievement)  is available at the website for the  US Play Coalition: A Partnership to promote the Value of Play throughout Life  at the Clemson University School of Health, Education and Human Development, including the white paper A Research-based Case for Recess.



Report Citations:

Terry-McElrath YM, Turner L, Colabianchi N, O’Malley PM, Chaloupka FJ, Johnston LD. Student Reactions during the First Year of Updated School Lunch Nutrition Standards— A BTG Research Brief. Ann Arbor, MI: Bridging the Gap Program, Institute for Social Research, University of Michigan; 2014.

Centers for Disease Control and Prevention and Bridging the Gap Research Program. Strategies For Supporting Quality Physical Education and Physical Activity in Schools.Atlanta, GA: U.S. Department of Health and Human Services; 2014.