Suchergebnisse

Human recovery is the process of rebuilding social and daily routines and support networks that foster physical and mental health and well-being. RAND researchers conducted a facilitated discussion with Louisiana NGO leaders to capture lessons learned and challenges faced by these organizations in the aftermath of Hurricane Katrina. The subsequent lessons also serve to inform potential policy changes and future research directions

Abstract. Background: Although communication is a key component of US strategies to prevent suicide and there are a number of marketing campaigns promoting messages that suicide is a preventable public health problem, there has been little evaluation of these campaigns. Aims: The study describes the development of a checklist of best practices for suicide prevention communication campaigns and the use of the checklist to evaluate California's investment in "Know the Signs" (KTS-M), a suicide prevention mass media campaign. Method: We conducted a literature review and solicited expert feedback to identify best practices and then used the RAND/UCLA appropriateness method to assess whether KTS-M was consistent with the identified best practices. Results: Overall, experts agreed that KTS-M adhered to most of the 46 checklist items and suggested that the campaign was among the best suicide prevention media campaigns they had observed. Limitations: The checklist was developed through expert input and literature review and focuses only on media campaigns. Conclusion: Given the nascent state of the evidence about what makes an effective suicide prevention message and the growing number of campaigns, the checklist of best practices reflects one way of promoting quality in this evolving field. The consistency between the experts' comments and their ratings of KTS-M suggests that the checklist may provide important guidance to inform the development of future campaigns and the evaluation of ongoing campaigns.

In 2009, individuals heavily affected by Hurricanes Katrina and Rita were still in need of social services. The Federal Emergency Management Agency (FEMA) provided funding to the Louisiana Recovery Authority to implement the Disaster Case Management Pilot (DCMP) in order to help people still living in FEMA temporary housing units in April 2009 move to permanent and secure housing and access services. Despite concerted effort by participating agencies, the implementation of the DCMP was fraught with challenges. As a result, the pilot could not be implemented as intended, leaving the needs of many clients not fully met. This article shares details of a study that documents some of the key challenges in coordination, communication, and financing of the program and offers recommendations for future state and FEMA implementation of disaster case management. In light of these challenges, the authors recommend that federal and state governments review the systems used to identify and locate residents in need of disaster case management; these systems performed poorly in the DCMP, making it difficult to appropriately plan services. The stop and start of recovery initiatives led to serious discontinuities in client recovery, so the authors also recommend that federal and state governments consider a single, longer-term recovery initiative that seamlessly acknowledges the stages of human recovery. Improvements in how federal and state governments identify and locate affected residents, consider needs and vulnerabilities in planning, and ensure continuity of services are critical to ensure high-quality disaster case management.

The RAND Suicide Prevention Program Evaluation Toolkit draws from the scientific literature to guide evaluations of suicide prevention programs. This study is a companion to the toolkit and provides background on its development and testing.

Despite the efforts of both the U.S. Department of Defense and the Veterans Health Administration to enhance mental health services, many service members are not regularly seeking needed care when they have mental health problems. Without appropriate treatment, these mental health problems can have wide-ranging and negative impacts on the quality of life and the social, emotional, and cognitive functioning of affected service members. The services have been actively engaged in developing policies, programs, and campaigns designed to reduce stigma and increase service members' help-seeking behavior. However, there has been no comprehensive assessment of these efforts' effectiveness and the extent to which they align with service members' needs or evidence-based practices. The goal of this research was to assess DoD's approach to stigma reduction, how well it is working and how it might be improved. To address these questions, RAND researchers used five complementary methods: (1) literature review, (2) a microsimulation modeling of costs, (3) interviews with program staff, (4) prospective policy analysis, and (5) an expert panel. The priorities outlined in this report identify ways in which program and policy development and research and evaluation can improve understanding of how best to efficiently and effectively provide needed treatment to service members with mental illness

In the immediate aftermath of disaster, governments usually act quickly to reduce risk and to recover their communities' socio-economic functioning. Policy makers in these situations need—but may not have the capacity or time for—substantial analysis and public debate about how to balance short- and long-term societal needs. Inadequate attention to this challenge may result in a deepening of the inequities that increase vulnerability to disaster impacts. We review case examples to illustrate how post-disaster policies may influence the nature, pace, and inclusiveness of community recovery. We then apply a vulnerability/inequity framework to conceptualize how to enhance disaster recovery and avoid perpetuating inequities when weighing the diverse needs of communities across long time horizons.

Community resilience, or the sustained ability of a community to withstand and recover from adversity, has become a key policy issue. This report provides a roadmap for federal, state, and local leaders who are developing plans to enhance community resilience for health security threats and describes options for building community resilience in key areas

The increase in suicides among military personnel has raised concern. This book reviews the current evidence on suicide epidemiology in the military, identifies state-of-the-art suicide-prevention programs, describes and catalogs suicide-prevention activities in the U.S. Department of Defense (DoD) and across each service, and recommends ways to ensure that the activities in DoD and across each service reflect state-of-the-art prevention science

Since late 2001, U.S. military forces have been engaged in conflicts around the globe, most notably in Iraq and Afghanistan. These conflicts have exacted a substantial toll on soldiers, marines, sailors, and airmen, and this toll goes beyond the well-publicized casualty figures. It extends to the stress that repetitive deployments can have on the individual servicemember and his or her family. This stress can manifest itself in different ways—increased divorce rates, spouse and child abuse, mental distress, substance abuse—but one of the most troubling manifestations is suicide, which is increasing across the U.S. Department of Defense (DoD). The increase in suicides among members of the military has raised concern among policymakers, military leaders, and the population at large. While DoD and the military services have had a number of efforts under way to deal with the increase in suicides among their members, the Assistant Secretary of Defense for Health Affairs asked RAND to review the current evidence detailing suicide epidemiology in the military, identify "state-of-the-art" suicide-prevention programs, describe and catalog suicide-prevention activities in DoD and across each service, and recommend ways to ensure that the activities in DoD and across each service reflect state-of-the-art prevention science.

The RAND Program Classification Tool is an instrument containing questions and response options across eight core domains that allows managers of a portfolio of programs to quickly, easily, and consistently describe and compare their programs.

The RAND Online Measure Repository is an online searchable database of 171 measures of psychological health and traumatic brain injury, including measure domains, uses, psychometrics, and costs, that can be used to support program evaluation.

Sexual violence affects millions of Americans, and approximately one out of every three women and one out of every four men have experienced sexual violence during their lifetime. While prevention efforts have focused on implementing specific programmatic approaches, there has been relatively little focus on developing comprehensive and effective approaches to reduce sexual assault prevention across an organization. This study describes the development of the Prevention Evaluation Framework, an assessment targeting organizational best practices for comprehensive sexual assault prevention across multiple domains including human resources, collaborative relationships and infrastructure, use of evidence-informed approaches, quality implementation and continuous evaluation of programs/policies. Using the structured RAND/University of California, Los Angeles appropriateness method to develop the assessment, we conducted a literature review and solicited expert feedback about what a comprehensive organizational approach to sexual assault prevention should entail. We then pilot tested the assessment with 3 United States military service academies; and continued to improve and adapt the assessment to a range of organizations with input from 6 Department of Defense headquarters organizations, and 9 universities across the country. Given the nascent state of the evidence about what makes an effective organizational approach to sexual assault prevention, the assessment reflects one way of promoting quality in this evolving field. The consistency between the experts' ratings and the literature, and the relevance of the items across organizations suggest that the assessment provides important guidance to inform the development of comprehensive organizational approaches to sexual assault prevention and to the evaluation of ongoing efforts.