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Program Description

Overview The Baltimore City Youth Bureaus’ experimental program was an early intervention strategy undertaken in a community-based clinic serving youth in Baltimore, Maryland. The intervention was designed to identify and reduce negative influences and experiences that place inner-city youth at high risk for drug use and other problem behavior.
Start Date September 1993
Scope local
Type after school, weekend, comprehensive services, mentoring
Location urban
Setting community-based organization
Participants elementary through high school students and school dropouts
Number of Sites/Grantees one experimental clinic and one control clinic
Number Served 235 youth over three years
Components Baltimore City Youth Bureaus are publicly funded clinics that offer individual counseling to youth considered at risk of developing a deviant lifestyle. Youth are referred to bureau services if they meet one or more of the following criteria: (1) known or admitted alcohol or drug experimentation; (2) a history of delinquency or other deviant behavior including criminal activity, incorrigibility, and precocious sexual behavior; and (3) expulsion from school or other indications of problematic school behavior.

Youth whose primary problem is substance abuse are treated in a separate division within the bureau. Counseling personnel use standard social work therapy practices to conduct individual counseling sessions, which last approximately 50 minutes. Counselor caseloads vary, but are usually in the 8–12 clients range. Counseling durations are typically brief, with continuous client involvement beyond three months occurring infrequently. One bureau served as the experimental (intervention) clinic in the study and the other as the control (treatment as usual) clinic.

In the experimental program, individual counseling was provided by existing bureau personnel who were trained in a case management approach involving needs assessment, planning and review of mutually agreed on treatment goals, and advocacy referral procedures. They were also provided assistance in locating and contacting community resources to facilitate referral for special client or family needs. Parenting sessions were designed to address issues in dealing with adolescent behavior. However, due to poor attendance, these sessions were eventually replaced by less formal parent discussions and program-sponsored parent/child social events.

Research staff also provided prevention services to youth in the experimental clinic that mainly included mentoring and remedial education. Mentoring was implemented through a “structured group approach,” in which representative role models from the community (African-American college students) were available to participants during group mentoring sessions conducted four or five days per week after school and occasionally on weekends.

Approximately 20 children participated per session, and staff/child ratios were generally 1:8 and never higher than 1:10. Sessions involved the provision of individual academic assistance, as well as regularly scheduled structured activities and presentations on diverse topics such as cultural heritage, social and life coping skills, conflict resolution, self-esteem, substance abuse prevention, HIV/AIDS awareness, and availability of community health and recreational resources. With the help of parent and community volunteers, the mentoring component sponsored educational and recreational holiday celebrations and field trips. After the first year, part-time teachers implemented more formal educational mentoring in order to attend to the children’s need for remedial education.
Funding Level approximately $350,000 per year for the program and evaluation
Funding Sources The National Institute of Drug Abuse funded the implementation and evaluation of the experimental program.
Other Components of the experimental program were implemented for the purposes of the evaluation. Both the evaluation and the intervention focus on the impact of risk and protective factors that have been found to be associated with deviant activity during adolescence.

Evaluation

Overview Components of the experimental program were implemented for the purposes of the evaluation. Both the evaluation and the intervention focus on the impact of risk and protective factors that have been found to be associated with deviant activity during adolescence..
Evaluator Social Research Center, Friends Research Institute, Inc.
Evaluations Profiled An Early Community-Based Intervention for the Prevention of Substance Abuse and Other Delinquent Behavior
Evaluations Planned none (this was a pilot program)
Report Availability Hanlon, T. E., Bateman, R. W., Simon, B. D., O’Grady, K. E., & Carswell, S. B. (2002). An early community-based intervention for the prevention of substance abuse and other delinquent behavior. Journal of Youth and Adolescence, 31(6), 459–471.

Hanlon, T. E., Bateman, R. W., Simon, B. D., O’Grady, K. E., & Carswell, S. B. (2004). Antecedents and correlates of deviant activity in urban youth manifesting behavioral problems. Journal of Primary Prevention, 24(3), 285–309.

Contacts

Evaluation Thomas E. Hanlon, Ph.D.
Associate Director
Social Research Center
Friends Research Institute, Inc.
1040 Park Avenue, Suite 103
Baltimore, MD 21201
Tel: 410-837-3977
Fax: 410-752-4218
Email: thanlon@frisrc.org
Program Betsy D. Simon, MS, CHES, CPS
Project Director
Social Research Center
Friends Research Institute, Inc.
1040 Park Avenue, Suite 103
Baltimore, MD 21201
Email: bsimon@frisrc.org
Profile Updated March 8, 2004

Evaluation: An Early Community-Based Intervention for the Prevention of Substance Abuse and Other Delinquent Behavior



Evaluation Description

Evaluation Purpose To examine the experimental program’s impact on: delinquent activity, substance abuse, sexual activity, and juvenile justice involvement.
Evaluation Design Quasi-Experimental: Two inner-city Baltimore neighborhoods with comparable demographic and socioeconomic characteristics were targeted for the study, based on earlier studies showing that these neighborhoods had exceptionally high rates of drug abuse, poverty, financial dependence, illegitimate births, and teen pregnancies, as well as severe health problems related to drug use. Two youth bureaus, one from each of these neighborhoods, were chosen for the study, one of which was randomly assigned as the experimental clinic, and the other as the control.

Over the course of the study, Bureau counselors at the experimental clinic site were requested to refer eligible clients to the experimental program (no records were kept of the number and characteristics of non-referrals). Recruitment of experimental and control participants was undertaken at the time of bureau referral and involved obtaining informed assent of the child and informed consent of the caretaker.

Over the three-year intake period, 428 youth were admitted into the study, of which 235 were in the experimental clinic and 193 were in the control clinic. Of the 428 youth, 97.4% were African American and 2.6% were white; 59% were boys and 41% were girls. The average age at interview was 13.3 years. Referrals to both clinics came from the family (50%), school (26%), a community or social service agency (17%), or the Maryland Department of Juvenile Justice (6%). School learning and behavioral problems were the principal reasons for referral (44%), followed by family conflict (29%), and Juvenile Justice involvement (10%). Fewer than 10% of the youth had ever used drugs, and marijuana was the only drug used in all but one case.

There were significant differences (p< 0.01) in the baseline characteristics of the two clinic samples. Control youth were: slightly older; yielded higher baseline risk factor scores for family dysfunction, school problem behavior, and peer deviance; were more likely to have engaged in sexual activity, including intercourse; reported greater substance abuse and delinquent activity, including violent activity, both over their lifetime and the preceding six months; and reported more encounters with juvenile justice authorities, including a greater incidence of arrest and incarceration. These baseline differences were statistically controlled in the analysis.
Data Collection Methods Secondary Source/Data Review: Arrest records on youth in the sample were obtained from the Department of Juvenile Services.

Surveys/Questionnaires: Youth at the two clinics were administered questionnaires that examined risk and protective factors (based on research regarding self-reported characteristics, circumstances, and experiences during adolescence found to predict adult drug use and criminal activity). In addition to demographic information, the principle areas covered were family stability and functioning, school interest and performance, deviance of peer associates, and extent of delinquent behavior. At baseline (at program entrance), the time periods covered by the questionnaire were their lifetimes and the past six months. At follow up (one year after entrance), only information from the past six months was obtained.
Data Collection Timeframe Data were collected from September 1993 through December 1997.


Findings:
Summative/Outcome Findings

Prevention With regard to alcohol abuse (number of times “high”), there was a significant treatment effect favoring the experimental clinic (p<.03), with a significantly more beneficial treatment effect for younger experimental clinic participants (p<.02) than for older participants.

No significant differences were found between the treatment and comparison group outcomes in terms of marijuana use (number of times used).

No differential treatment effect with regard to sexual activity was noted.

Experimental clinic participants demonstrated significantly less frequent delinquent activity than control participants (p<.001, with an average of 3.05 instances of delinquent activity for the experimental clinic vs. 11.06 for the control clinic, and with 7 experimental clinic participants and 27 controls having engaged in daily delinquent activity at follow-up). There was also a significantly more beneficial treatment effect for younger experimental clinic participants (p=.0023) than for older participants.

Analysis of the occurrence of delinquent activity over the last six months revealed significant treatment effects in both violent and nonviolent delinquent activity (p<0.0001 for each). There was also a significantly more beneficial treatment effect in instances of both violent and nonviolent activity for younger experimental clinic participants than for older participants (p<.01 for each).

Participation in the experimental clinic was associated with fewer numbers of different types of delinquent activities (e.g., shoplifting, forgery, selling drugs, physical assault, etc.) at follow-up than was participation in the control clinic program (p<.01). This treatment effect on types of acts committed was significantly stronger for younger participants than for older participants (p<.05).

During the six months preceding the one-year follow-up assessment, 17% of experimental clinic participants versus 27% of control clinic participants reported that they had been arrested, on parole or probation, convicted of a crime, or incarcerated. With respect to officially recorded involvement with legal authorities at follow-up, the principle predictors of arrests were prior recorded arrests and age (the older, the more likelihood of arrest). There was also a tendency for experimental clinic involvement to be associated with a decreased likelihood of arrest at follow-up (p=.05). This treatment effect was significantly stronger for younger participants than for older participants (p=.02).

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