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Abstracts of Completed Studies

"Any views, opinions or conclusions presented in these abstracts are solely those of the author and do not necessarily represent those of the North Dakota Department of Human Services Institutional Review Board."

Proposal # 1

Author: Thomasine Heitkamp
Title of Study: Strengthening Communities Through Outreach to Parent's and Educators (SCOPE) Research Evaluation Study
Date Study Submitted: February 2003

The Purpose of this evaluation is to determine the degree that Strengthening Communities Through Outreach to Parent's and Educators (SCOPE) services are provided to the children and families it is designed to serve. Additionally, the study addressed if services were effective in improving children and families functioning and reducing residential stays. This study provided empirical evidence that the project served the youth it was designed to serve. Outcome data indicated that Strengthening Communities Through Outreach to Parent's and Educators (SCOPE) was effective in preserving and reuniting children in their home communities. Improvement in family functioning was also noted.

Proposal # 2

Author: Rebecca Salveson, Ed.D.
Title of Study: Kitchen Table Stories: A Qualitative Study of the Life Experiences of People Diagnosed with Chronic Mental Illness
Date Study Submitted: March 2006

This study examines the phenomenon of mental illness from the standpoint of those so labeled. Seven people diagnosed with chronic mental illness participated in ethnographic interviews covering the recalled time span of 1961 through 2001. These interviews were unique in that the participants experiences spanned two treatment paradigms - that of the large, custodial state hospitals and of deinstitutionalization - living and accessing services within the local community. Qualitative analysis of participant interview data uncovered several broad themes: assumption of the role of mental illness is a one-way and fairly lengthy process. Participants wanted others to be aware that their experiences (disordered thoughts, hallucinations, delusions) were very real to them. Treatment and support paradigms have improved over the past twenty years. Although people with chronic mental illness are more likely to live in relative independence in their home communities than at any other time in history, many still experience poverty and marginalization. Ethnographic research may have a transformative effect upon the researcher.

Proposal # 5

Author: Theresa Magelky
Title of Study: Risk Factors Associated with Child Abuse
Date Study Submitted: December 2001

The occurrence of child abuse has been widely associated with certain indicators or risk factors. It has been suggested that identifying and being aware of these factors can be important in recognizing, and possibly preventing, the occurrence of child abuse. Three variables frequently associated with child abuse were investigated in this study in order to determine if children with these risk factors were more likely to be victims of abuse than children without. Specifically, the variables examined were: age of the child's mother at the time of child's birth, a history of substance abuse in either biological parent, and a history of mental health issues in either biological parent. The research was of an archival design and involved examining the files of clients at West Central Human Service Center (WCHSC) who were 13 years of age or younger at the time of intake. Results indicated that the variables in question were no more likely to be present in the abused sample of children than in the nonabused sample. However, presence or absence of parental history of substance abuse came very close to being significant and further research pertaining to this is suggested.

Proposal # 7

Author: Trisha Kaelberer
Title of Study: Parents in Substance Abuse Treatment vs. Parents in Treatment for Depression and/or Anxiety: Their Perceptions of Emotional/Behavioral Adjustments in Their Children
Date Study Submitted: August 2001

Research has shown both parental substance abuse problems and parental depression and/or anxiety are related to a greater risk of behavioral and emotional problems in childhood and adolescence. This study seeks to discover how parents in treatment perceive the emotional and behavioral adjustment of their children. This study focuses on parents who are currently in substance abuse treatment and parents who are in treatment for substance abuse and/or anxiety at West Central Human Service Center. These parents also currently have a child between the ages of 5-18 living in the home. Results indicate that both groups of parents express concerns in regards to the adjustment of their children. The reported areas of greatest concern overall were self-esteem and academic achievement/school grades. Parents in treatment for both substance abuse and depression and/or anxiety were found to have concerns at a significantly greater level than parents in substance abuse treatment alone in the rated areas of academic achievement/school grades, aggressiveness and problems with substance use.

Proposal # 9

Author: Dr. Melissa Baartman Mork
Title of Study: Cognitive Self-Change in Repeat Offenders: An Evaluation of the North Dakota Department of Corrections Revocation Program
Date Study Submitted: April 2003

This clinical research project was an outcome study evaluating the effectiveness of the Cognitive Restructuring and Cognitive Self-Change program at the Tompkins Rehabilitation and Corrections Unit (TRCU) for the North Dakota Department of Corrections and Rehabilitation (DOCR) in Jamestown, North Dakota. Cognitive distortions were measured one by the "How I Think" (HIT) questionnaire at admission, twice more during treatment, and again at release. Results indicated that change was both statistically significant, with an alpha at <.01, as well as clinically significant as analyzed by Jacobson and Truax's Reliable Change Index (RCI). A grounded theory analysis of interviews conducted with program participants identified six themes of program impact: cognitive class content, addiction classes, staff, diversity, group cohesion, and authentic change in group members. Results of this study suggest this program is indeed effective in teaching participants new skills for cognitive self-change.

Proposal # 10

Author: Jennifer Alane Moldenhauer
Title of Study: Developing Community Networks: North Dakota State Hospital Social Workers' Suggestions for Successful Placement of Adult Individuals Diagnosed with Schizophrenia in the Community of Jamestown, North Dakota
Date Study Submitted: December 2001

This research aims to better understand what networks and programs may be helpful in developing an environment, within the community of Jamestown, North Dakota, which enables the greatest level of autonomy for adult individuals who have been diagnosed and treated for schizophrenia at North Dakota State Hospital (NDSH). This researcher conducted surveys of social workers employed at NDSH who work with this population. The survey asks the participants to rate categories of services within the community of Jamestown as 1 (poor) through 5 (excellent). The results of this research support that there are many programs and networks, which still need development, based on the ratings gathered through the survey process. Supportive data was gathered from professional journals. The data gathered may help advocates for autonomy and or community based treatment for individuals with schizophrenia to earmark areas most needed. Data may also be useful in determining the distribution of funds or need for grants to help develop programs within NDSH and Jamestown for individuals with this disorder.

Proposal # 14

Author: Jessica Guenther
Title of Study: Adolescent CAFAS Review Committee
Date Study Submitted: June 2002

The research design was summative evaluative research, as the research was used to supply valid and reliable evidence regarding the operation of a clinical program. Adolescent addiction counselors working in the adolescent substance use unit at West Central Human Service Center in Bismarck, North Dakota, collected the data used in this research. These counselors were trained Child and Adolescent Functional Assessment Scale (CAFAS) raters. They utilized the CAFAS systematically at the beginning of each adolescent's involvement in treatment and at discharge from treatment, from December 1, 1998 through December 26, 2001. This included 288 adolescents. The data was analyzed through a matched pair T-test, which can be utilized to determine if scores of the same participants in a study differ under different conditions. The different conditions in this study are pre-treatment and post-treatment. Results of this research indicate that adolescents with substance use issues who receive substance use treatment at West Central Human Service Center in Bismarck, North Dakota improve functioning in seven of the eight domain areas of the CAFAS: School/Work Performance, Home Performance, Community Performance, Behavior Toward Others, Emotions, Self-Harmful Behaviors, and Substance Use. Results indicate that adolescents with substance use issues receiving treatment at West Central Human Service Center in Bismarck, North Dakota, neither improve nor decline in functioning in the CAFAS domain of Thinking. The hypothesis was therefore partially supported.

Proposal # 15

Author: Julie A. Aberle
Title of Study: Outcomes of Intensive In-Home Services Utilizing the CAFAS
Date Study Submitted: April 2002

The purpose of the study is to determine if children or adolescents involved in Intensive In-Home Therapy improve from admission to discharge in any scales measured by the Child and Adolescent Functional Assessment Scale (CAFAS). The average age of the participants, average score upon admission and the average score upon discharge were determined. It was also determined which subscale of the CAFAS the children and adolescents had the highest and lowest scores on. This research attempted to identify if the children or adolescents CAFAS scores improve after receiving Intensive In-Home services. Intensive family preservation services are provided within the home of the client. The intensive family preservation service incorporates the entire family and the community in which the clients live. Workers provide families with information, support, counseling and referrals to other resources within their community. The workers develop a treatment plan with the ultimate goal being the preservation of the child in their own home safely.

Proposal # 17

Author: Amy Phillips
Title of Study: Intercultural Knowledge, Values, and Skills in Public Social Services: A Qualitative Study (Doctoral Dissertation)
Date Study Submitted: August 2004

This qualitative research study examined how social service providers and refugee recipients of public social services in a small city in an upper mid-western state described the intercultural knowledge and skills they felt were necessary for effective provision of services to refugees. The study sought to add to a body of knowledge related to the concept of "cultural competence," a concept that has received increasing attention in human service fields over the past twenty years. Lum (1999) describes cultural competence as an outcome goal "related to the master of cultural awareness, knowledge acquisition, skill development, and inductive learning" (p. 12). Fong (2004) has added to the cultural competence literature by emphasizing the importance of migration context in work with refugees. Culturally competent human services are seen as necessary to combat ethnocentrism and to ensure culturally relevant services (Weaver, 2005).

While human service fields such as social work, counseling psychology, and nursing have extensively examined cultural competence in relation to their practitioners, very little has been written about the intercultural interactions of eligibility, or economic assistance, workers in the public social services. These individuals are frequently the gatekeepers for programs on which refugees heavily rely in their first months, or years, of resettlement. This study used grounded theory methodology to gather, analyze, and compare data from semi-structured interviews with county eligibility workers, county social workers, former refugees, and providers from other human service fields (called "stakeholders" in the study.)

The study found that county providers, both eligibility and social workers, relied on program policies and rules, their personal value systems, and a generic set of helping attitudes to guide their work with refugees. In contrast, stakeholders discussed an interplay of self awareness and relationship-building as primary skills in their intercultural work and refugee interviewees articulated a need for "human connection" in interactions with county workers. The findings indicated that county providers relied minimally on the professionally-defined knowledge and skills of cultural competence and that, in the absence of these skills, county programs and workers serve primarily to indoctrinate refugees into dominant American cultural norms and practices.

Proposal #18

Author: Randy Telander
Title of Study: Offender Treatment: An Evaluation of a Cognitive Restructuring Program
Date Study Submitted: May 2007

The United States is first among industrialized nations in the rate at which we imprison offenders. With ever-increasing numbers of incarcerated offenders and continued high recidivism rates, many institutions have begun implementing treatment programs in attempts to combat crime and reduce recidivism rates. Currently, the most widely used treatment programs are based on changing cognition related to general criminal thinking/behavior (Andrews, Hoge, Bonta, Gendreau, & Cullen, 1990). With high costs to all of society (including victim losses and costs to prevent, convict, and imprison offenders), it is important for correctional officials to know the extent to which programs are facilitating offender change. However, despite many reported program evaluations being published in the literature, many have identifiable flaws and few, if any researchers have been able to solve random sampling problems owing to low scientific rigor and results that are not robust. The present study utilized recently developed scales in which to measure criminal thinking change and randomized participants into treatment and control groups in an attempt to evaluate a widely used cognitive change program implemented by the North Dakota Department of Corrections and Rehabilitation. Analyses reviewed change in seven criminal thinking scales from two different measures, the relationship between criminality and change in criminal thinking, whether external attributions of blame related to criminal thinking change, and the extent to which IQ was a mediating factor. Results revealed no significant change and/or relationship for the aforementioned analyses. Additional and post hoc analyses provide modest support for some hypotheses. Suggestions for future research are provided including the need for adequate sample size and on site research personnel.

Proposal # 19

Author:Jody K. Larson
Title of Study:Comparison of Scores on the Allen Cognitive Level Screen and the Global Assessment of Functioning for Persons Admitted to a State Psychiatric Facility
Date Study Submitted: February 2004

This quantitative study examined the potential correlation between the scores on the Allen Cognitive Level Screen (ACLS) and the Global Assessment of Functioning (GAF) as measures of predicting an individual's ability to attend to safety in an unfamiliar, institutional setting. The purpose of this study was to provide information useful to caregivers regarding the impact that a cognitive disability has on an individual's ability to perform occupations in safe manner. A record review was completed of individuals admitted to a state psychiatric facility during a 3-year period (n=26). Trained professional staff had completed the ACLS and the GAF within 10 days of admission. Factors identified as having a potential impact on the score obtained on the GAF an/or the ACLS included age, gender, race, level of education, and DSM-IV diagnostic categories. The ACLS is designed to assess one's ability to perform routine and novel tasks. It is also used to predict the amount of assistance that will be needed to perform tasks safely. The GAF is used to report the individual's psychological, social, and occupational functioning. Both assessments are designed to measure current level of functioning as well as predict adaptive functioning. A forward linear regression model was used to determine that the DMS-IV diagnostic category, specifically Axis II, was the strongest predictor of the scores obtained on both ACLS and GAF. A stronger correlation existed with the scores on the ACLS (F[1,25]=6.201; p=0.02) than with the scores on the GAF (F[1,25]=4.713; p=0.04). No statistically significant correlation existed between scores on the GAF and the ACLS. Results suggested that the ACLS and the GAF contribute information about different, but important components of adaptive functioning. However, the ACLS more accurately measured an individual's ability to perform occupations in a safe manner when a cognitive disability was present. The ACLS can be used as a valuable part of an interdisciplinary assessment of the individual with a cognitive disability, especially in the area of safety.

Proposal # 20

Author:Angela Sailer
Title of Study:Evaluation of the Social Support Component of a Weight Loss Treatment Program for Individuals with Mild Mental Retardation
Date Study Submitted: March 2004

Obesity is a major problem for people in the United States. The most successful programs for treating obesity in individuals with mental retardation are typically treatment packages consisting of multiple behavioral components. These behavioral components include self-monitoring, stimulus control, energy expenditure, and reinforcement. Although behavioral treatment packages have successfully produced weight loss with individuals with mental retardation in a variety of settings (e.g., institution, group home, school, workplace) no research had been conducted with mildly mentally retarded individuals living independently in community settings (e.g., their own apartments). The present study examined the effectiveness of a 10-week behavioral weight loss treatment program with mildly mentally retarded individuals living independently in the community. The components of the weight loss program included a) teaching the participants to monitor their daily food intake and to identify what types of food they should and should not be eating, b) increasing awareness of environmental events related to eating, c) reducing the rate of eating and serving sizes, d) teaching the use of self reward, e) increasing energy expenditure through exercise and increasing everyday activities, and f) reducing snacking behavior by delaying the snack, eating a low-calorie snack, or by engaging in an alternative behavior. Six adults diagnosed with mild mental retardation were referred for participation in the study by case managers at a local human service center. The treatment program was evaluated in a multiple baseline across participants design. The results of the treatment program were mixed, with some participants losing a moderate amount of weight and some not losing any weight at all. Across all 6 participants, the mean weight loss at the end of 10 weeks of treatment was 5.5 lbs (with a range of +1 lb to -18 lbs). The mean weight loss from baseline to the end of the 1 month follow-up, for the 5 participants who were assessed at follow-up, was 3.4 lbs (with a range of +5 lbs to -13 lbs). Three individuals lost a mean of 13 pounds (range of 8 to 18 lbs) or 4.4% of their body weight (range of 3.4% to 5.6%) in the program. Suggestions for future research evaluating the factors that contribute to successful weight loss by individuals with mild mental retardation are provided.

Proposal # 22

Author:Mandy J. Clemenson
Title of Study:National Family Caregiver Support Program
Date Study Submitted: May 2004

This thesis examined the relationship between the factors that significantly contribute to the perceived costs of providing informal care. Specifically, I explained whether the social capital explains the perceived amount of difficulties as well as the level of concern and intensity of effort confronting caregivers. The factors that were examined in this study included services for the informal care recipient, services for the informal caregiver, and community support. Multiple regression procedures were employed to test the association between social capital and perceived difficulties of providing informal care. Findings from this research indicate that there appears to be a moderate level of association between social capital and perceived difficulties in providing informal care (overall). The most important predictors of perceived difficulties in providing elderly informal care were: community support, level of informal care recipient services, caregiver status (spouse), hours per week spent caregiving, and gender. However, the single most important indicator predicting the perceived costs of providing informal care is community support.

Proposal # 26

Author:Linda Olson
Title of Study: BORDERS: Biochemical Organic Radioactive Disaster Response System
Date Study Submitted: March 2005

A needs assessment was conducted as part of the BORDERS evaluation plan, to determine bioterrorism preparedness training needs for various front-line healthcare workers. Five groups of North Dakota healthcare professionals were targeted. Data from 499 respondents, within six different survey groups, yielded a response rate of 26%. The findings support the development of a web-based learning system to train healthcare professionals in bioterrorism preparedness. Eight of ten respondents expressed a lack of confidence in the ability to perform tasks related to bioterrorism preparedness, thus it is clear that considerable room for improvement in knowledge and skills exists. There were some substantial differences among the various groups in regard to their confidence in this area, so the notion to develop several levels of learning, segmented by healthcare discipline, received strong support based on these data. Finally, respondents indicated considerable willingness to utilize web-based learning as a means of acquiring additional knowledge and skills.

Proposal # 27

Author:Steve Saum
Title of Study: A Comparison of Actuarial Risk Prediction Measures and a Stable Dynamic Risk Measure in a Group of Sex Offenders
Date Study Submitted: July 2006

Child sexual abuse is an alarming social problem. High profile cases of child abductions, sexual assaults, and murders have led to changes in public policy and changes in how the mental health profession evaluates and treats sexual offenders. As such, there is increasing pressure on mental health professionals to improve their ability to predict who is more likely to sexually reoffend. Past research has focused primarily on static, or unchanging, risk factors, such as age at time of offense, age of victim, etc., whereas current research has begun to examine dynamic, or changing, risk factors in sexual recidivism. This study aims to determine if it is possible to improve predictive accuracy over static actuarial risk measures by considering stable dynamic factors as described in the Stable-2000 and proposes the following research questions: Is it possible to improve predictive accuracy of static, actuarial risk measures by considering stable dynamic factors as described in the Stable-2000? Two-sided, two-sample analyses were conducted and indicate that there was a significant relationship between sexual recidivism and Static-99 scores and sexual recidivism and Stable-2000 scores. Areas under the curve (AUC's) indicated that the Static-99 was the better instrument at predicting sexual recidivism. Cox proportional hazard analysis indicated that although the Stable-2000 did not significantly improve the predictive ability of the Static-99, the two instruments combined did significantly predict sexual recidivism. In addition, results indicated that individuals who completed treatment were significantly less likely to sexually reoffend than those individuals who did not complete treatment.

Proposal # 28

Author:Linda Keup, Ph.D.
Title of Study: Recruitment and Retention of the Older Worker
Date Study Submitted: September 2005

The rapidly changing demographics of the U.S. workforce pose a serious challenge for today's human resource managers. Faced with an aging workforce that may begin retiring en masse in just a few years and a shrinking entry labor pool to replace them, they expect recruiting, staffing, and retention to become increasingly difficult. A number of personal and policy reasons may make working longer in their lives more attractive to Baby Boomers, thus easing the employment shortage somewhat. This study sought to determine at what age employees plan to retire, whether they will continue to work during their "retirement" years and, if so, what type of work they may seek. Job, organizational, and personal characteristics that attract individuals to positions were rated and then ranked by respondents.
Although older workers in the sample (46+) indicated later retirement ages, the majority of all respondents planned to retirement at the "traditional" ages of 60-65. Factors that were correlated with later retirement were uncertain or poor financial health, and perceived organizational support for their work.
The majority of respondents indicate a desire to work part-time in their retirement, both at the same type of work and doing something different. A small number want to start their own businesses.
Factors that are critically important to this sample are economic ones-health insurance, competitive wages, a retirement plan, and job security.

Proposal # 29

Author:Carol B. Massanari, Ph.D.
Title of Study: ND Department of Public Instruction Sensory Impairment Study
Date Study Submitted: August 2005

The North Dakota Department of Public Instruction (NDPI) in its commitment to improving education for all students identified a need to learn more about services for students with sensory impairments. While recognizing that services have continued to improve throughout the state, NDPI also recognized that declining enrollment in a rural state along with the increased emphasis on accountability brought new challenges to the provision of services for students with sensory impairment. To gather additional information, NDPI decided to contract with an external party to conduct a study.

This study used surveys and focus groups to collect information to get a better picture of general satisfaction with services and results, to identify areas in need of improvement, and to gather suggestions for improvement. Participants included local education agency directors of special education, teachers, relates service providers, parents, students and adults with sensory impairment, and North Dakota Department of Human Services (NDDHS) employees.

Generally speaking the respondents in this study expressed an overall sense of satisfaction with services that are available and provided to individuals with sensory impairment in North Dakota (ND). At the same time, more information is needed to fully understand some of the concerns and needs identified. Some of the areas that warrant further exploration include the following:

  • Outcomes – Those who rated employment and ability to attend higher education indicated a general satisfaction that options are available. At the same time, patterns within the data reveal a need to learn more specific information about the level of academic achievement students with sensory impairment demonstrate when they leave school, the types of jobs available, where individuals live, how many individuals leave the state, and how many individuals with sensory impairment are unemployed.
  • Professional development – Generally survey responses indicated that professional development opportunities are available. At the same time, comments in focus groups indicated a need for professional development. More information is needed to discern the specific type of professional development needed and for whom professional development is needed.
  • Certified staff – Survey respondents indicated that they have qualified staff currently employed. However, focus group respondents indicated that one of the greatest challenges, especially for rural or smaller communities, was finding certified teachers and certified interpreters. Further exploration is needed to explore the specific barriers and needs for certified staff and to find creative ways to address these needs, both in terms of training and employment.
  • Parent training and information – Most indicated that there was sufficient parent training and information. A few indicated a need to improve in this area, but more information will be needed to determine the specific needs or areas for improvement.

Proposal # 32

Author:Donald N. Olson
Title of Study: Comparison of Interface Pressures Using Supplements in a Custom-Molded Seating System: A Single-Subject Study
Date Study Submitted: May 2005

Objective: To study the relative effectiveness of 3 seating surface materials when used in the recess of a custom molded seat of one subject to reduce average peak pressure and to distribute overall applied forces favorably. Design: This study used a single subject design where sitting pressure data was averaged over time and the results of each material tested compared directly. As closely as possible, the testing protocol established by Apatsidis was followed in order to compare the results of the two studies. Participants: A single subject, who has a diagnosis of spastic quadriplegia and multiple orthopedic deformities, was recruited for this study. He is a typical custom molded seating user. Interventions: The subject was provided with a new custom molded seating system where a large recess was designed into his seat for the placement of the 3 test materials: Sunmate® foam, Akton® gel, and the control material Dynaflex® foam. Outcome Measures: Pressure recordings using the Force Sensitive Applications® (FSA) pressure mapping system were taken at timed intervals. The average peak pressure and 2 pressure distribution ratios were calculated and compared. Results: Consistent with the findings of Apatsidis, Sunmate® foam performed better than the other materials at reducing average peak pressure. Pressure distribution ratios defined by Apatsidis were also calculated, however the validity of those results were questionable. Conclusions: Sunmate® foam may be the material of choice when used in the recess of a custom molded seat. In addition to supplement material choice, proper depth of bony prominence contour is an important factor in reducing peak pressures typically seen in these areas. Pressure mapping technology, a useful clinical decision making tool, has limitations that must be understood by the seating team before conclusions can be made regarding any data obtained from the system.

Proposal #33

Author: Ruth G. McRoy, Ph.D.
Title of Study: The Collaboration to AdoptUSKids
Date Study Submitted: March 2008

This report outlines the findings of two legislatively mandated adoption-research studies conducted as part of The Collaboration to AdoptUsKids. In the first study, a nationwide purposive sample of 300 families seeking to adopt children with special needs from the public child welfare system was selected, interviewed, and surveyed to determine actual and potential barriers to the completion of the adoption process. In addition, a nationwide sample of 382 private- and public-agency adoption staff members were surveyed to assess their opinions regarding barriers to the adoption process. this first study is referred to as the "Barriers" study in this report. In the second study, a four-year prospective examination of a nationwide sample of 161 families who had adopted children with special needs was conducted in order to determine factors that contributed to successful adoption outcomes. When all represented states are counted in both studies, family and staff participants came from all ten standard federal regions, forty-seven states and the District of Columbia. This research study is referred to as the "Success Factors" study in this report.

Proposal # 34

Author:Christina Neurohr
Title of Study: Social and Economic Impact of the RCS Rural Services Initiative
Date Study Submitted: May 2006

The purpose of the study was to fill a void in information concerning out migration in the rural communities. By conducting this study we hoped to prove that the services Rehabilitation Consulting and Services (RCS) provides to farmers and ranchers with disabilities, are effective and do help them maintain their business. The primary hypothesis, rural communities are adversely affected financially and socially when a farm family 'leaves the farm.' A secondary hypothesis, the RCS Rural Services Initiative is effective in assisting farm operators in staying in business when they are adversely affected by a vocational handicap.

The majority of individual that participated in this study were elderly farmers or ranchers. If vocational rehabilitation would not have assisted them they would have remained in business, but it would have been difficult. Most people attended their local church and participated in church activities. Only 18.75% of people did their personal shopping in their local community, while 68.75% did most of their shopping in the Bismarck/Mandan area. The same percents account for receiving medical services. Sixty percent of farmers and ranchers owned their own place.

My second hypothesis was supported. Vocational Rehabilitation Rural Services is very effective in keeping the farm family on the farm. By assisting farmers and ranchers with assistive technology devices, these devises make working conditions easier. Farm families are able to be productive, and stay on the farm. The farming productivity helps the community strive economically.

One limitation to the study was the majority of participants were older farmers or ranchers. I was unable to contact individuals who were younger. They may have had a different perspective on their community and the services they received. The agency might only receive data from participants in the western part of North Dakota. The rural service program is very strong in this area. The rural service program in the eastern part of the state is still new to some of the counselors. This might be a disadvantage to the study West Central Human Services is conducting.

Proposal # 35

Author:Sara D. Quam
Title of Study: Parent Attitudes Upon Completing a Brief Parent Training Program
Date Study Submitted: May 2006

A brief parenting program was reviewed and subsequently offered in a community mental health agency in order to assess change in parental attitudes and satisfaction upon completion of the course. A sample of 18 parents served as participants with a mean age of 36.9. The course consisted of a blended format involving the use of a video program and group discussion. Parent questionnaire data were obtained pre and post treatment. The parent training outcome data were analyzed with a series of t tests for paired samples to compare the means for the pretest and posttest total scores. The data analysis revealed attitude changes in the desired direction. More specifically, parents reported increased levels of satisfaction in their spouse or ex-spouse's parenting performance, the parent-child relationship, and their own parenting performance. The results of this study provide support for the value of a brief parent training course as a powerful educational technique for changing attitudes and behavior.

Proposal # 36

Author:Ellen L. Csikai, Ph.D.
Title of Study: Examination of Adult Protective Service Workers' Educational Needs Re: End-of-Life Issues
Date Study Submitted: May 2006

The purpose of adult protection in the U.S. is to ensure the safety and protection of older adults from abuse and exploitation. In this endeavor, adult protective services (APS) workers face a variety of situations involving injury, serious illness, death, grief, and bereavement when working with older adults and their families. The purpose of this study was to identify end-of-life care situations encountered by APS workers and their perceived educational needs for effective practice with end-of-life issues in this setting.

While one can easily understand that social workers and other helping professionals working in health care settings need to understand end-of-life issues, this study demonstrated that adult protective services workers also face a range of end-of-life issues for which they may be unprepared in terms of education and experience to handle effectively. Targeted educational resources should be developed and utilized in state APS agency training programs to assist APS workers intervene with end-of-life issues in practice. In addition, social work education programs need to include end-of-life content in social work courses to inform future practice in any setting.

Proposal # 39

Author:Kevin M. Thompson, Ph.D.
Title of Study: An Outcome Evaluation of Juvenile Drug Court Using the Child and Adolescent Functional Assessment Scale
Date Study Submitted: October 2006

This study sought to determine the effectiveness of treatment for substance abusing juveniles. More specifically, this study assessed whether there existed treatment progress differences between juvenile drug court participants and substance abusing juveniles not exposed to drug court. Juvenile drug courts should theoretically improve treatment outcomes for juveniles through more intensive supervision and higher level accountability. One hundred ninety juveniles were included in the study. Subjects included juvenile drug court graduates, terminated drug court participants, and a comparison group. Licensed addiction counselors (LAC's) employed by substance abuse treatment facilities completed a Child and Adolescent Functional Assessment (CAFAS) on each juvenile participating in treatment. The CAFAS is used to assess the effect of symptoms in children and adolescents with emotional, behavioral, or substance use disorders. Seven of the nine subscales were employed in this study: (1) School Performance, (2) Home Functioning, (3) Delinquency, (4) Behavior toward others, (5) Moods/emotion, (6) Substance Use, and (7) Family/Social Support.

Data show that all three groups make substantial progress on all of the subscale domains during the first 90 days of treatment. Following 90 days, drug court graduates continue to make substantial treatment gains. Comparison group subjects exhibit modest gains and terminated participants tend to either stall in treatment progress or regress. Explanations for the lack of progress exhibited by terminated participants are offered in the report. Being dual diagnosed had only a weak impact on course of treatment outcome.

Several recommendations emerge from this study:

  1. Think about some different treatment strategies for juveniles who, upon intake demonstrate little family support and exhibit widespread family conflict. These juveniles tend to make little treatment progress. This could include extending the range of services to the family unit and extending intensive treatment for this group.
  2. Find a vehicle for providing juveniles with additional academic support after 90 days of treatment. Some juveniles in treatment exhibit school surrender behaviors following 90 days of treatment. Perhaps additional school resources like tutoring help or structured study time would prevent some of this academic relapse.
  3. Think about extending intensive treatment beyond 90 days for juveniles who score high at intake on the home impairment and family support subscale and exhibit higher than average mood scores.
  4. Continue to fund juvenile drug courts. For those who complete the program, treatment is clearly effective. The additional accountability, supervision, and additional programming options in drug court facilitate treatment outcomes for these juveniles.

Proposal #40

Author: Edward Larson
Title of Study: Exploring the Relationship Between Employment and Quality of Life in Individuals with Schizophrenia
Date Study Submitted: July 2007

This study explored the relationship between employment and quality of life in individuals with schizophrenia. Thirty-five participants were asked to complete the Quality of Life Inventory (QOLI) as well as disclose general information. The participants' Global Assessment of Functioning (GAF) was measured by the principal researcher and by the participants' case manager. It was hypothesized that the participants who are employed would have a better quality of life and a higher Global Assessment of Functioning than the participants who are not employed. The results showed that individuals employed had a higher quality of life and higher GAF scores but not to the degree expected. These results may be used to provide people with schizophrenia programming for employment and reduce the risk of their using other public assistance.

Proposal # 43

Author:Garth J. Kruger, M. A.
Title of Study: Government Rural Outreach Initiative (Videoconferencing Evaluation Project)
Date Study Submitted: January 2007

The purpose of the Northwood Video Conferencing Evaluation Project was to evaluate clinical counseling services and addiction services to patients at the Valley Community Health Centers in Northwood, ND through video conferencing with the North Dakota Department of Human Services' Northeast Human Service Center in Grand Forks, ND. This evaluation examined: 1) whether video conferencing was effective in treating depression and anxiety in a clinical population, and 2) consumers' satisfaction with video conferencing mental health services. Findings suggested that those who received services benefited from participation as evidenced by a decrease in depression and anxiety scores. Statistically significant increases in individuals' overall daily functioning from the pre to post test were found as well. Finally, this study revealed that nearly all participants were satisfied with their video conferencing experience and found it more convenient than traveling long distances to see a counselor.

Proposal #44

Authors: Vicki Michels, Ph.D., and Deb Olson, Ph.D.
Title of Study: Assessing Levels of Foster Care Placement
Date Study Submitted: February 2008

The purpose of the study was to determine the prevalence rate of children being kept at higher or lower levels of care than necessary given their treatment/care needs. A second goal was to determine obstacles to moving children within the foster care system placements when a change in treatment placement is needed. The results indicate that children's symptom severity did not seem to be related to level of placement. Most of the children surveyed exhibited typical and stable behaviors for the duration of data collection indicating that some of the children may be in too restrictive placements. The most common problems encountered when children were perceived as needing a different level of care were either unavailability of appropriate placement, most often foster homes, or concerns about the potential disruption of the current progress or services that the child was receiving.

Proposal #47

Author: Jenny Steinhaus
Title of Study: North Dakota State University Family Nutrition Program, Participation Rates and Barriers to Program Participation
Date Study Submitted: June 2007

This study identified the main barriers to participating in nutrition education from any source as: being unaware of training offered, lack of transportation and child care, lack of privacy, inconvenient timing of the education, and lack of interest. Those who participate in FNP [Family Nutrition Program] nutrition education identified their main barriers as: training is offered on an inconvenient day, training is offered in an inconvenient location, and lack of transportation.
In addition, clients who participated in this study identified their preferred nutrition education delivery methods as: recipes or cookbooks, watching videos, written materials or brochures, practicing cooking, group training, meeting with friends to learn about nutrition, and training in their home.  They also indicated that they preferred afternoon and weekday education opportunities.

When education levels were analyzed, those who have never completed High School or a GED indicated they are less comfortable in a group and were less comfortable using an internet website as a delivery method than those with a higher education.

When the employment status of respondents was analyzed, it was found that Native Americans were more likely to be unemployed than Whites. In addition Native Americans indicated the barrier of transportation more often than Whites.  Whites indicated that they are not comfortable in a group and were more likely to receive nutrition information from a doctor. Native Americans indicated the barrier of, “I have difficulty understanding spoken English” more often than Whites. 

Males and females also had differing survey responses; females indicated that they participated in WIC, would like to receive recipes as a delivery method, would like training in their home, and they are not comfortable in a group more than men.  When marital status was compared, those who were unemployed, had a lower income, and were under 30 years old, were more likely to have been never married.

Increasing attention to reducing client barriers can help to alleviate the barriers experienced by this audience and increase attendance at nutrition education. This study determined barriers to participation so more effective strategies can be developed and implemented to overcome the barriers of attending nutrition education.



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