Multi-site Project Research Articles

Commentary: Policy Priorities and Shifting Sands in the Supported Employment Evidence Base

Back to table of contents Previous article Next article ArticleFull AccessCommentary: Policy Priorities and Shifting Sands in the Supported Employment Evidence BaseDavid S. Salkever Ph.D.David S. Salkever Ph.D.Search for more papers by this authorPublished Online:1 Oct 2006AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail An evidence base is accumulating for supported employment for persons with severe and persistent mental disorders, particularly for supported employment based on the individual placement and support (IPS) model ( 1 ; see Original article: page 1391 ). This evidence base is the platform for codifying IPS with fidelity measures and for efforts to more widely disseminate supported employment based on IPS principles. In this group of articles on employment, several remind us that even when an intervention deserves the appellation "evidence-based," further questions about its comparative and overall efficacy and effectiveness are still worth asking. The multisite Employment Intervention Demonstration Project (EIDP) generated what is perhaps the most widely read evidence of supported employment success ( 2 ). However, studies in this issue by Macias and colleagues ( Original article: page 1406 ) and Schonebaum and coauthors ( Original article: page 1416 ) analyzing the same EIDP data from the site in Worcester, Massachusetts, contradict earlier findings and report that employment services provided to members of a clubhouse achieved outcomes similar to those of IPS supported employment programs. This finding is even more surprising because the clubhouse was compared with a supported employment program that was fully integrated into an assertive community treatment (ACT) program—and full integration with mental health treatment is believed to be most effective for supported employment. (Bond [1] has conjectured that the ACT model may take the idea of integration too far.) At a minimum, reconciling these findings requires recognition that "control" conditions in the EIDP varied widely by site. The same may be true for the experimental interventions; most sites were not described as IPS programs (3). Defining "treatment as usual" in our evidence base can be tricky, and generalizing from results from multiple sites with varying interventions may be hazardous. Other interesting issues are raised by these papers. One is the importance of job duration as an outcome measure ( Original article: page 1416 ). The IPS job duration results have been weak ( 1 ). A second is the ability of different program models to move clients into employment who are not strongly work oriented at intake, which Macias and colleagues ( Original article: page 1406 ) argue may be greater for clubhouse programs. We do not have evidence on the likely take-up rate of supported employment programs if they were more widely available. Similarly, we do not know whether the rate for clubhouse programs would in fact exceed rates for supported employment. If that turns out to be so, having both types of services available may be the best option. A third issue, raised by Casper and Carloni ( Original article: page 1430 ), is the extent to which take-up rates would increase if providers of psychiatric services were more aware of consumers' desires to work. The clear but qualified success of IPS-based supported employment invites further efforts to improve it and assess it against the most promising alternatives, which may include a clubhouse model. At least two directions for improvement are now under active investigation. One, highlighted by McGurk and Mueser ( Original article: page 1406 ), is combining IPS services with cognitive remediation strategies. A second is to offset problems in access to and provision of high-quality psychiatric care, including medication management, which Cook ( Original article: page 1391 ) notes may constitute barriers to employment. The Social Security Administration has recently funded a major trial, the Mental Health Treatment Study (www.ssa.gov/disabilityresearch/mentalhealth.htm), that will randomly assign SSDI recipients with mental disorders to IPS services combined with medication monitoring by using the protocols of the Texas Medication Algorithm Project. This study will also substantially expand financial coverage of behavioral health services for the experimental group. The results will be valuable in assessing the degree of synergy between improvement in access to and quality of care and IPS services. Among the many directions that might be taken in transforming the mental health system to remove barriers to employment, expanding access to and improving the effectiveness of supported employment and other promising models of employment services should surely rank very high on our policy priority list.Dr. Salkever is professor of public policy at the University of Maryland-Baltimore County (UMBC), Public Policy Building, Room 418, 1000 Hilltop Circle, Baltimore, MD 21250 (e-mail: [email protected]).

Feasibility of a Primary Care Intervention to Decrease Oral Antibiotics for Acute Upper Respiratory Tract Infections: A Pilot Study

Antimicrobial resistance in common respiratory tract pathogens is a growing public health threat, especially in the southeastern United States. The excessive use of antibiotics for common infections is a major contributing factor in the emergence of antibiotic resistance. We report results from a multi-site outpatient pilot project in North Carolina to reduce antibiotic prescriptions for acute nonbacterial upper respiratory tract infections (URIs). Primary care practices were provided education and symptom therapy kits for patients with URIs, as an alternative to antibiotics, in a project to reduce the overuse of antimicrobial therapy The feasibility of this approach was evaluated with interviews and surveys. A methodology for claims-based evaluation of intervention efficacy in reduction of antibiotics use was developed as part of this project. Of eight contacted practices, four agreed to participate and three participated fully. Physicians reported that symptom therapy kits were useful for patients with URIs and resulted in a meaningful change in antibiotic prescribing behaviors. A claims-based approach is a feasible and promising method to evaluate efficacy in subsequent post-pilot large-scale implementations. Due to the small number of outpatient practices and the lack of controls in this pilot study, the efficacy of the intervention in reducing antibiotic use could not be determined. Education combined with symptom therapy kits as an alternative to oral antibiotics is a feasible intervention that warrants additional studies to evaluate the efficacy of this approach in the reduction of antibiotic use for URIs.

EIBT research after Lovaas (1987): A tale of two studies.

Abstract Since publication of Lovaas's (1987) seminal paper, serious questions have surfaced regarding design features that compromise validity of treatment efficacy data resulting from studies of early intensive behavioral treatment (EIBT) for children with autism. Lovaas and his colleagues have acknowledged legitimacy of some of these questions, and guidelines have emerged to improve validity of future efficacy studies: (1) use random assignment of participants; (2) use uniform assessment protocols; (3) document enough methodological detail to support replication. Two recent studies are examined in reference to their compliance with these guidelines (Howard, Sparkman, Cohen, Green, & Stanislaw, 2005; Sallows and Graupner, 2005). Findings indicate that different levels of compliance result in different degrees of threats to internal validity. Keywords: autism, autism spectrum disorders, early intensive behavioral treatment, Lovaas, random assignment, uniform assessment, replication. Introduction Since publication of Lovaas's (1987) seminal study, a growing body of research has been conducted to document treatment efficacy of early intensive behavioral treatment (EIBT) for children with autism spectrum disorders (e.g., Birnbrauer & Leach, 1993; Harris, Handleman, Gordon, Kristoff, & Fuentes, 1991; McEachin, Smith, & Lovaas, 1993; Scheinkopf & Siegal, 1998). However, serious questions have been raised about validity of much of this research. Lovaas's (1987) study in particular, which was designed to examine efficacy of treatment offered at UCLA Young Autism Project, has been subjected to considerable criticism (e.g., Gresham & MacMillan, 1997; Schopler, Short, & Mesibov, 1989). While much of this criticism was challenged by Lovaas and his colleagues, some of it was acknowledged by them to be valid. Moreover, these acknowledgements served as basis for emphasizing three research guidelines (among others) that could improve validity of follow-up treatment efficacy studies. Unfortunately, application of these guidelines has not always been consistent. The current paper summarizes those criticisms of Lovaas (1987) study that Lovaas and his colleagues have acknowledged as valid, and it summarizes research guidelines that evolved from these criticisms. Further, two recently published EIBT studies are reviewed and evaluated relative to their compliance with these guidelines. The first study was conducted by Howard, Sparkman, Cohen, Green, and Stanislaw (2005) and second was conducted by Sallows and Graupner (2005). Criticisms of Lovaas (1987) Research Criticisms of Lovaas (1987) research have been addressed by Tristram Smith, a colleague of Lovaas's and Research Director of Multi-Site Young Autism Project. Specifically, Smith (in Smith, Groen, & Wynn, 2000) noted two criticisms with which Lovaas and his associates reportedly concur: First, assignment to groups was based on whether or not therapists were available to provide intensive treatment rather than on a more arbitrary procedure, such as use of a random numbers table. Thus, assignment could have been biased [italics added]. Second, because children were referred to outside examiners, they received a variety of different tests rather than a uniform assessment protocol. Hence, assessment may have been unreliable [italics added]. (p. 270) While concurring with these criticisms, this concurrence was nonetheless qualified. For example, Lovaas and his colleagues have reportedly been dubious about importance of second criticism. Nevertheless, to address these (and other) criticisms relative to future research, they emphasized the need for replication to confirm results (Smith et al., 2000, p. 270). Also inherent in their responses are three guidelines to be addressed by follow-up treatment efficacy studies: (1) random assignment of participants to treatment conditions; (2) use of uniform assessment protocols across all participants; and (3) documentation of sufficient methodological detail to allow for independent replication. …

The IMAGE project: methodological issues for the molecular genetic analysis of ADHD

The genetic mechanisms involved in attention deficit hyperactivity disorder (ADHD) are being studied with considerable success by several centres worldwide. These studies confirm prior hypotheses about the role of genetic variation within genes involved in the regulation of dopamine, norepinephrine and serotonin neurotransmission in susceptibility to ADHD. Despite the importance of these findings, uncertainties remain due to the very small effects sizes that are observed. We discuss possible reasons for why the true strength of the associations may have been underestimated in research to date, considering the effects of linkage disequilibrium, allelic heterogeneity, population differences and gene by environment interactions.With the identification of genes associated with ADHD, the goal of ADHD genetics is now shifting from gene discovery towards gene functionality – the study of intermediate phenotypes ('endophenotypes'). We discuss methodological issues relating to quantitative genetic data from twin and family studies on candidate endophenotypes and how such data can inform attempts to link molecular genetic data to cognitive, affective and motivational processes in ADHD.The International Multi-centre ADHD Gene (IMAGE) project exemplifies current collaborative research efforts on the genetics of ADHD. This European multi-site project is well placed to take advantage of the resources that are emerging following the sequencing of the human genome and the development of international resources for whole genome association analysis. As a result of IMAGE and other molecular genetic investigations of ADHD, we envisage a rapid increase in the number of identified genetic variants and the promise of identifying novel gene systems that we are not currently investigating, opening further doors in the study of gene functionality.

Validity of teacher ratings in selecting influential aggressive adolescents for a targeted preventive intervention.

This study describes a method for using teacher nominations and ratings to identify socially influential, aggressive middle school students for participation in a targeted violence prevention intervention. The teacher nomination method is compared with peer nominations of aggression and influence to obtain validity evidence. Participants were urban, predominantly African American and Latino sixth-grade students who were involved in a pilot study for a large multi-site violence prevention project. Convergent validity was suggested by the high correlation of teacher ratings of peer influence and peer nominations of social influence. The teacher ratings of influence demonstrated acceptable sensitivity and specificity when predicting peer nominations of influence among the most aggressive children. Results are discussed in terms of the application of teacher nominations and ratings in large trials and full implementation of targeted prevention programs.

Use of Complementary Therapies Among Breast and Prostate Cancer Patients During Treatment: A Multisite Study

The purpose of this study was to compare the use of complementary therapies (CT) among breast and prostate cancer patients during active cancer treatment. The authors compared use and beliefs about the role of CT in cancer recovery. A self-report survey was completed by 126 breast cancer patients and 82 prostate cancer patients as part of a multisite research project. The self-report questionnaire inquired about the use of various CTs, sources of information about CT, reasons for using CT, beliefs about the benefits and risks of CT, demographic characteristics, and cancer treatment history. Most of the respondents were older than 50 years, Caucasian, married, had attended or completed college, and were less than 1 year post-diagnosis. Prostate cancer patients were significantly older than the breast cancer patients (P < .001). Several differences emerged between the groups. Compared to the prostate cancer patients, significantly more of the breast cancer patients reported using CT because they wanted to reduce the risk of recurrence (P < .01), play a more active role in recovery (P < .01), help manage stress (P < .01), take a more holistic approach (P < .01), or boost the immune system (P < .01). More of the prostate cancer patients reported using CT to have more control of their recovery (P < .05). The 2 groups also differed significantly (P < .01) on several beliefs about the potential benefits and risks of using CT. Most of the patients in this study had used some form of CT since the time of their diagnosis. Differences among breast and prostate cancer patients with regard to their use of CT during cancer treatment should be considered by oncology professionals who are discussing this topic with their patients.

Coping and self-efficacy in marijuana treatment: Results from the Marijuana Treatment Project.

This study examined whether a coping-skills-based treatment for marijuana dependence operated by encouraging the use of coping skills or via other mechanisms. Participants were 450 men and women treated in the multisite Marijuana Treatment Project who were randomly assigned to motivational enhancement therapy plus cognitive-behavioral (MET-CB) treatment, motivational enhancement therapy (MET), or a delayed treatment control group. Marijuana use and coping skills were measured at baseline and at follow-ups through 15 months. Results showed that marijuana outcomes were predicted by treatment type and by coping skills use, but that the coping-skills-oriented MET-CB treatment did not result in greater use of coping skills than did the MET treatment. The results suggest that mechanisms of coping skills treatment may need to be reconceptualized.

Data Collection in a Multisite Project: Teleform™

Data collection, entry, validation, and management are salient time- and resource-consuming dimensions of all research projects. This is especially true for multisite studies, which pose unique, additional challenges because of their research design requirements. To save time and reduce the number of manual data entry errors, automated processing systems are becoming more widely used. Our research team chose Teleform for data entry and collection for the Smoking Cessation or Reduction in Pregnancy Trial study. This article presents our experience with this new technology.

Learning about assessment for learning: a framework for discourse about classroom practice1

‘Learning how to Learn – in classrooms, schools and networks’ is a four-year, multi-site project funded under the Economic and Social Research Council Teaching and Learning Research Programme and concerned with the development of formative assessment practice. This article describes how analysis of a large double-scale questionnaire administered across project schools provided not only information about trends in teacher values and practices, but also a basis for observation, analysis and discourse about classroom practice. A group of secondary Postgraduate Certificate of Education trainees were provided with a semi-structured observational framework derived from factor analysis of questionnaire responses in order to guide their observation of classroom video and analysis of teacher interviews. While all trainees were able to identify effective practice and to relate it to their own evolving craft knowledge, for a minority the framework also provided a focus for enquiry and dialogue about the relationships and tensions between the values and practices of the featured teachers and of the participating trainees themselves.

Older New Zealand Women Doing the Work of Christmas: A Recipe for Identity Formation

‘Christmas, because it is rather a sentimental time you tend to look for the familiar and go back into what you remember in your childhood.’ In the process of preparing family favourites or trying exciting new foods at Christmas, older New Zealand women construct self and family identities. This paper presents the New Zealand findings from an interpretive, multi-site research project exploring older women's experiences of food occupations at Christmas in Auckland, New Zealand, and Kentucky, USA and Songkran (the tradition Thai New Year) in Chiang Mai, Thailand. Narrative data were collected through focus group interviews with 16 New Zealand women, aged 65 years or over. Talk about recipes and kitchen things used, and how the foods are prepared and served revealed layers of identity work. While recipes from, and stories about, mothers’ and grandmothers’ homemade cooking are kept alive through doing the food work at Christmas, being a women in contemporary New Zealand allowed new identities to emerge. Identity as a family unit is formed and reformed over time by blending cultural and family traditions and remaking new ones through Christmas foods and family rituals. Significantly, the women's skilled preparation and customising of recipes for Christmas foods creates a rich opportunity for self-affirmation and public recognition. For these older women, the gift of Christmas food was like giving something of themselves.

Internet pharmacies and online prescription drug sales: a cross-sectional study

Psychonaut2002 is a European Union, multi-site research project to investigate the developing relationship between the Internet and drugs with abuse potential. This paper describes the findings of the Scotland research site, which investigated the online availability of prescription drugs. The project used a cross-sectional study to investigate 275 English-language websites, found by searching Google.com and AltaVista.com for ‘prescription drugs’. We found that online pharmacies selling prescription drugs can be classified into four types: (1) legitimate pharmacies; (2) subscription pharmacies; (3) lifestyle pharmacies; and (4) no-prescription pharmacies. The paper considers these findings in relation to what is already known about Internet access. We specifically consider the issues of literacy, Internet access, and credit-card ownership in relation to online pharmacies. We suggest that those from higher socioeconomic groups would be most able to access online pharmacies. However, drug abuse within this population may not be so readily recognized. Efforts to bridge the digital divide may increase access to Internet-sourced drugs amongst those in lower socioeconomic groups. We conclude that stereotypical notions of drug abuse being limited to lower socioeconomic groups may need to change. Increased Internet access may increase the role of the Internet in drug abuse.

Institutional Review Boards and Multisite Studies in Health Services Research: Is There a Better Way?

The following paper examines the issue of whether the current system for ethics review of multisite health services research protocols is adequate, or whether there exist alternative methods that should be considered. (1) Investigators at different sites in a multisite project often have very different experiences with respect to the requirements and requests of the review board. Other problems include the waste of time and resources spent on document preparation for review boards, and delays in the commencement of research activities. (2) There are several possible reasons why there is variability in ethics review. These include the absence of standardized forms, differences in the background and experiences of board members, the influence of institutional or professional culture, and regional thinking. (3) Given the limited benefits derived from the variability in recommendations of multiple boards and the numerous problems encountered in seeking ethics approval from multiple boards suggest that some sort of reform is in order. The increasing number of multisite, health services research studies calls for a centralized system of ethics review. The local review model is simply not conducive to multisite studies, and jeopardizes the integrity of the research process. Centralized multisite review boards, together with standardized documents and procedure, electronic access to documentation, and training for board members are all possible solutions. Changes to the current system are necessary not only to facilitate the conduct of multisite research, but also to preserve the integrity of the ethics approval process in general.

Evaluation of native and introduced grasses for low-input pastures in temperate Australia: rationale and scope

The historical approach to pasture improvement in the high rainfall zone of temperate Australia has been to add introduced herbaceous legumes and to replace perennial native grasses with introduced species requiring high inputs of fertiliser for maintenance. The application of this high-input approach on land with low capability has lead to the loss of perennial grasses, erosion, soil acidification and increasing salinity on the lower slopes. This model of pasture improvement has not been successful on the margins of the wheat belt and in semi-arid regions. The Native and Low-input Grasses Network (NLIGN) was established in 1996 to coordinate research on grasses suitable for land with low capability and for semi-arid regions. The NLIGN multi-site evaluation project was initiated to test promising lines (accessions) of native and introduced grasses for low-input pastures at eight sites across southern Australia. The broad objective of the project was to identify native and/or introduced perennial grass lines that had possible commercial potential for low-input pastures. This objective was achieved in an initial 3-year evaluation phase, which began in 1998 and tested lines for persistence, production and palatability.

HIV Testing and Awareness of Care-related Services among a Group of HIV-positive Asian Americans and Pacific Islanders in the United States: Findings from a Supplemental HIV/AIDS Surveillance Project

Compared with other racial/ethnic groups in the United States, Asian Americans and Pacific Islanders (AAPIs) are more likely to be at an advanced stage of AIDS disease and have opportunistic infections at the time of diagnosis. However, it is not clear how these two findings are related to issues such as HIV testing and access to HIV care-related services. We examined HIV testing and awareness of care-related services among a group of HIV-positive AAPIs in the United States. Data are from a multisite supplemental surveillance project, 1990-1999. Compared with Whites, a higher percentage of AAPIs cited "illness" as the main reason for HIV testing and had their tests done as a hospital inpatients--although these differences were not statistically significant. A significantly lower percentage of AAPIs than Whites were aware of their current CD4 count; AAPIs also had significantly lower awareness about a number of care-related services. Among AAPIs, educational level was positively associated with awareness of these services. Efforts are needed to promote service availability among HIV-positive AAPIs.

My Place, Your Place, or a Safer Place

Supervised injection facilities (SIF), a harm reduction intervention, may reduce several risks of public injection drug use. The prospect of conducting a scientific, multi-site pilot project of these facilities is being explored at federal and local levels in Canada. Experiences with SIF in Europe and Australia indicate that successful outcomes for the community ultimately hinge upon the responsiveness and relevance of the facilities to the needs of their primary target group: people who inject drugs in public places. Consideration of the factors and conditions found to influence a potential user’s uptake of SIF, therefore, is imperative. This study sought to assess the acceptability of SIF and to determine factors associated with willingness of injecting drug users (IDU) to use SIF in a city considering their establishment. From April 2001 to February 2002, following key informant interviews, a crosssectional study was conducted among publicly injecting IDU participating in an ongoing HIV surveillance study in Montreal. Univariate and bivariate analyses preceded logistic regression. Participants were 11 key informants and 251 publicly injecting IDU. Key informants generated the Montreal-specific SIF model subsequently presented to IDU. 76% of IDU were willing to use at least one of three proposed SIF sites. Exploratory multivariable models indicated drug-use characteristics and SIF attributes as determinants of outcome: predominant cocaine injection, history of overdose, knowing about SIF, relieving and empowering feelings toward using SIF, and comfort with disclosure of one’s injecting drug use. User consultations are essential to assess relevance and plan SIF acceptable to IDU.

My place, your place, or a safer place: The intention among montréal injecting drug users to use supervised injecting facilities

Supervised injection facilities (SIF), a harm reduction intervention, may reduce several risks of public injection drug use. The prospect of conducting a scientific, multi-site pilot project of these facilities is being explored at federal and local levels in Canada. Experiences with SIF in Europe and Australia indicate that successful outcomes for the community ultimately hinge upon the responsiveness and relevance of the facilities to the needs of their primary target group: people who inject drugs in public places. Consideration of the factors and conditions found to influence a potential user's uptake of SIF, therefore, is imperative. This study sought to assess the acceptability of SIF and to determine factors associated with willingness of injecting drug users (IDU) to use SIF in a city considering their establishment. From April 2001 to February 2002, following key informant interviews, a cross-sectional study was conducted among publicly injecting IDU participating in an ongoing HIV surveillance study in Montréal. Univariate and bivariate analyses preceded logistic regression. Participants were 11 key informants and 251 publicly injecting IDU. Key informants generated the Montréal-specific SIF model subsequently presented to IDU. 76% of IDU were willing to use at least one of three proposed SIF sites. Exploratory multivariable models indicated drug-use characteristics and SIF attributes as determinants of outcome: predominant cocaine injection, history of overdose, knowing about SIF, relieving and empowering feelings toward using SIF, and comfort with disclosure of one's injecting drug use. User consultations are essential to assess relevance and plan SIF acceptable to IDU.

Science education as/for participation in the community

AbstractIn this paper, we take up and advance the project of rethinking “scientific literacy” by Eisenhart, Finkel, and Marion (American Educational Research Journal, 1996, 33, 261–295). As part of a project of rethinking science education, we advance three propositions. First, because society is built on division of labor, not everybody needs to know the same basic sets of concepts; it is more important to allow the emergence of scientific literacy as a collective property. Second, scientific knowledge ought not to be privileged in democratic collective decision making but ought to be one of many resources. Third, rethinking science education as and for participation in community life sets up the potential for lifelong participation in and learning of science‐related issues. To show the viability of these propositions, we provide a case study based on a 3‐year, multisite ethnographic research project as part of which we investigated science in the community. Framing our work in terms of activity theory, we provide descriptions of science in a local middle school, where students learn science while participating in a community effort to contribute to the knowledge base about a local creek. The children's activities are continuous with those of adults concerned about environmental health. In this way, rather than preparing for life after school, science education allows students to participate in legitimate ways in community life and therefore provides a starting point for uninterrupted lifelong learning across the presently existing boundary separating formal schooling from everyday life outside schools. © 2004 Wiley Periodicals, Inc. Sci Ed 88:263–291, 2004; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/sce.10113

A ‘partnership model’ for ethical Indigenous research

This paper describes the methodological challenges and innovative outcomes of a multi-site South Australian project investigating the use of medicines by Aboriginal people with mental health disorders (the full report of the research including outcomes of its various components appears elsewhere). Participatory action research using multiple methods and the epistimology of critical social science, enabled Indigenous research ethics to underpin the project-ensuring cultural relevance and respect throughout. Particular challenges encountered involved navigating mainstream and Indigenous bureaucratic structures, recruitment and training of Aboriginal research assistants from local communities, issues of confidentiality of individuals and families, time management that did not encroach on already stressed communities and workers, and leadership and internal research team issues. Meeting these challenges within the dynamics of a multi cultural project spanning urban, rural and remote Indigenous settings led to the development, implementation and articulation of a ‘partnership model' for conducting Indigenous research. This model, together with its four key features-Respect, Collaboration, Active Participation, Meeting Needsis presented for consideration and potential use by other researchers and Aboriginal groups. As no previous research had investigated medication use by Aboriginal people to the depth and extent of this project, the model was necessarily innovative and developmental.

The multisite violence prevention project: Background and overview

Abstract This paper provides an overview of the Multisite Violence Prevention Project, a 5-year project to compare the effects of a universal intervention (all students and teachers) and a targeted intervention (family program for high-risk children) on reducing aggression and violence among sixth graders. First, the paper describes the role of the Centers for Disease Control and Prevention in developing the project. Second, it details the background of researchers at the four participating universities (Duke University, The University of Georgia, University of Illinois at Chicago, and Virginia Commonwealth University) and examines the characteristics of the selected schools ( n=37). Finally, the paper summarizes the theoretical perspectives guiding the work, the development of interventions based on promising strategies, the decision to intervene at the school level, the research questions guiding the project, the research design, and the measurement process for evaluating the results of the program.

The multisite violence prevention project: A commentary from academic research

The multisite violence prevention project: A commentary from academic research