Transcript NTTAC_TA 1595_Truancy Presentation revised

Truancy Programs
Richard Dembo, Ph.D.
Criminology Department
University of South Florida
4202 E. Fowler Avenue
Tampa, FL 33620
April 2010
The General State of Truancy Programs in the U.S.
• In many communities, truancy programs remain sanction and
procedure oriented.
• Resources are focused on identifying, locating and transitioning truant
youth back into their respective schools with appropriate sanctions
and/or citations.
• Often, these efforts include formal adjudication, police involvement,
and suspension or remedial programs, which have not been shown to
be effective in resolving the issues fostering truancy.
The General State of Truancy Programs in the U.S.
(Continued)
• Many communities lack screening/assessment and intervention services for
truant youth in spite of the psychosocial problems these youth often
present.
• A more effective response to truancy requires identifying and addressing
the problems that these youth and their families are experiencing through
effective truancy intervention programs.
• Review of the literature identified a relatively small number of studies of
interventions that have been put in place to decrease truancy rates by
remediating the problems causing this behavior.
~(Dembo & Gulledge, 2009).
Types of Truancy Programs
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School Based Programs
Community Based Programs
School & Community Based Programs
Court System Based Programs
Law Enforcement Based Programs
Essential Qualities of Effective Truancy Programs
• In its review of promising truancy reduction programs, the
Colorado Foundation for Families and Children noted several
critical elements that were necessary for effective programming:
1) parent/guardian involvement;
2) a continuum of services, to include meaningful incentives, consequences and
support;
3) collaboration with community resources—including law enforcement, mental
health services, mentoring and social services;
4) school administrative support and commitment to keeping youth in the
educational mainstream;
5) ongoing evaluation.
~Colorado Foundation for Families and Children(2007)
Essential Qualities of Effective Truancy Programs (Continued)
• Few of the many programs the Foundation
reviewed met these criteria
Of particular concern was the general lack of detailed
information on program implementation and system issues
experienced by truancy reduction programs, as well as a lack
of process and outcome evaluations, which could inform the
field.
Essential Qualities of Effective Truancy Programs (Continued)
• Most evaluations of truancy programs are:
– Based on aggregate data;
– Often lack meaningful comparison groups (Lehr, Sinclair
& Christenson, 2004);
– Focus on short-term benefits (e.g., reduction in unexcused
absences) which do not provide meaningful information on
changes in individual’s school attendance or academic
school performance (OJJDP, 2001 citing Mueller,
Giacomazzi, & Stoddard, 2006).
Challenges Presented by Truancy Programs
• Each of the various types of truancy programs have
experienced implementation challenges.
• As previously noted, a majority of the research published
from truancy studies is predominantly descriptive in
nature.
– Of these, a relatively small proportion of studies describe program
evaluation efforts.
– Even smaller still is the number of studies that discuss
implementation challenges or empirically validated results of
project effectiveness and short or long term outcomes.
Challenges Presented by Truancy Programs (Continued)
• The general lack of methodologically sound, empirical studies
conducted to determine truancy program effectiveness
continues to impede our understanding of how to best serve
the growing numbers of truant youth across the nation.
• Program evaluations in pilot studies conducted in the field are
frequently considered threatening; whereas, unevaluated
programs are perceived to be “safe.”
Challenges Presented by Truancy Programs (Continued)
• Reluctance for program evaluations may be because:
– “The facts, when made public, may set back a program and
the policy under which it operates, particularly if there are
some negative findings in the evaluation.” (Palumbo, 1987,
p. 22).
Challenges Presented by Truancy Programs (Continued)
• Additionally:
– If project staff members are fearful of negative evaluation results,
“avoiding political embarrassment rather than accomplishing
program goals may become the first priority” (Faux, 1971, p. 278).
– Descriptive and predictive studies are important to our
understanding events and issues preceding student truancy, chronic
absenteeism, and school dropout.
Challenges Presented by Truancy Programs (Continued)
• Studies that evaluate the effectiveness of truancy
interventions are needed to determine whether
these programs successfully serve their intended
populations and meet project goals by improving
truant youth psychosocial functioning, including
truant and related behavior.
Challenges Presented by Truancy Programs (Continued)
• A serious need exists to precisely document truancy
interventions, as well as to empirically evaluate their
effectiveness.
• Further, it is important to establish a continuum of
care for truant youth, inviting collaboration with
relevant community agencies.
The Hillsborough County, Truancy Intake Center
• Intake and Processing Youths at the TIC
• Involvement in Intervention Services
Issues Relating to Truancy
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Truancy in American schools
Midpoint along a continuum (Nat'l School Safety Center, 1996)
Truants represent an at-risk population (Dembo & Turner, 1994)
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Stressful, troubled family situations
Educational difficulties
Emotional and other psychosocial difficulties
Alcohol and/or other drug use
Identification and response
A Significant and Innovative Approach
•
Drug involvement exists among a sizable proportion of truant youth

Truant youth are unlikely to receive drug intervention services under
current procedures

Affordable and transportable interventions for drug-using truant youth
are rare, yet greatly needed
 Truant youth consist of a heterogeneous group of younger, mild-tomoderate drug using youth
 Very few low-intensive services are available to them
A Significant and Innovative Approach (Continued)
•
Current treatment technologies for juvenile drug abuse are incorporated
into the curriculum
– Cognitive-behavioral, problem solving, and family strategies
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Truancy centers - opportunistic settings for BI
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Inclusion criteria are targeted for non-serious justice involved, mild-tomoderate drug using youths in order to test the intervention as a secondary
prevention curriculum
– A form of service that has been generally understudied and underutilized in juvenile drug treatment systems
Specific Goals

To test the efficacy of Brief Intervention-Youth (BI-Y) and
Brief Intervention-Parent (BI-P) on post-program drug use
and related behaviors for truant youth
•
To test the relative effects of parental involvement in the BI
on post-treatment drug use and related behaviors
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To identify youth and parent factors that are associated with
significant post-program improvement
– Reductions in drug use and delinquent behavior and
improvement in school behavior and attitudes
Continuity of Care
Efforts to address truant behavior are all too often
sanction and procedure oriented
•
Truant youth: disciplinary and management problems
Without a continuum-of-care across service areas (i.e.
school, community, court, law enforcement agencies),
truancy initiatives are ill-equipped to address issues
directly associated with truancy
•
Academic problems, troubled family situations, and
other psychosocial difficulties - including drug use
Continuity of Care (continued)
• Current intervention services in Hillsborough County
are addressing truancy by crossing agency
boundaries. The following agencies work together:
• The Hillsborough County Juvenile Assessment
Center, Hillsborough County Sheriff’s Office, the
City of Tampa Police Department, Hillsborough
County School Board, and the University of
South Florida [with NIDA funding]
Continuity of Care (continued)
The benefits of interagency collaboration includes:
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Common objective of all collaborative agencies in
addressing the service needs and risk factors of truant
youth in an effort to prevent their school failure and
movement into the juvenile justice system
Holistic, systems oriented, in-home intervention
Extended follow-up and community referral services
Selection of Study Subjects
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Study Setting
Hillsborough County Truancy Intake Center (TIC)
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Study Eligibility
Youth processed at the TIC are eligible for inclusion if:
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They are between 11-15 years of age,
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They indicate past year alcohol/drug use on the Personal Experience Screening Questionnaire
(PESQ; Winters, 1992) or TIC Social Worker indicates youth has an alcohol/drug use issue,
•
They have no official record of delinquency, or a delinquency record with no more than two
misdemeanors
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*Social Worker / Guidance Counselor Referral System*
Students may also be referred to the BI-Project by their on-site school Social Worker or Guidance
Counselor
The social worker/guidance counselor may present the BI project to the youth/family and encourage them
to contact the TIC staff
After a referred family makes contact, project staff will check the youth for eligibility (i.e., arrest history)
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*Diversion Program Referral System*
We also accept referrals of youths meeting study eligibility criteria from a community diversion program
•
Family Enrollment
• Invitation to Participate
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Overview of project; Schedule first in-home assessment
• Research Interviews
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A research staff member meets with youth & parent for
the consent/assent process and an initial in-home
interview
Follow-up in-home interviews conducted at 3, 6, 12, &
18-months following last participation
Youth and parents interviews conducted separately
Intervention Groups
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Random Assignment
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1/3 of the participants do not meet with an interventionist; receive Standard Truancy Services + project referral assistance
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1/3 of the participants have two (youth) in-home sessions with an interventionist
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1/3 of the participants have three in-home sessions with an interventionist (two youth sessions + one parent/guardian session)
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Session ONE (Youth)
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Substance use and related consequences
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Willingness to change
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Causes and benefits of change
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Goals for change the youth would like to pursue
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Abstinence or reduce substance use goals
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Session TWO (Youth)
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Reviews progress with the agreed upon goals
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Identifies risk situations associated with the youth’s difficulty in goal attainment
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Strategies to address barriers toward goal attainment
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Negotiates a continuation in goals or advancement to more ambitious goals
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Session THREE (Parent/Guardian)
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Integrated behavioral and family therapy approach
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Topics addressed with parent/guardian:
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Child’s substance use problems
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Parent attitudes/behaviors regarding their child’s substance use
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Parent monitoring/supervision to promote progress toward their child’s intervention goals
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Parent communication skills to enhance youth-parent connectedness
Youth and parent/guardian given $5 for each session they attend.
Strengths of Brief Intervention
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BI coordinates therapy components
• Rational-Emotive Therapy (RET)
• Promotes adaptive beliefs
• Problem Solving Therapy (PST)
• Promotes coping skills
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BI promotes self-efficacy
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BI is individually tailored
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BI is flexible
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BI focuses on real-life applications
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BI promotes parent monitoring and support
Gender Breakdown (n=137)
Ethnic Breakdown (n=137)
Age and Living Arrangement
Age: Mean= 14.71, SD=1.22
 Lives With:
Biological mom and dad:
Biological mom alone:
Biological mom & stepdad/boyfriend:
Biological mom & other relative/friend:
Biological dad:
Biological dad & stepmother/girlfriend:
Biological dad & other relative/friend:
Other living arrangement:
13.9%
28.5%
22.6%
16.8%
2.2%
2.9%
0.7%
12.3%
Alcohol/Other Drug Use (n=137)
 Alcohol
Ever drank alcohol to point of feeling buzzed or intoxicated (64%)
Ever drank alcohol 5+ times in lifetime to the point of feeling buzzed or
intoxicated (36%)
 Marijuana
 Ever used marijuana (93%)
 Ever used marijuana 5+ times in lifetime (66%)
 Other Drugs Ever Used by 10% of Youths
 Barbiturates (12%)
 Ever used other drug 5+ times (9%)
Alcohol/Other Drug Use
•Urine test results (n=125)
Positive for Amphetamines*
6%
Positive for Cocaine
<1%
Positive for Opiates
-Positive for Marijuana
47%
* Many of these youths were on amphetamine based ADHD
medication.
Alcohol/Other Drug Use/Abuse Diagnosis
• Substance Use/Abuse Diagnosis(%)
None
Alcohol
80
Marijuana
42
Other drugs (e.g., barbs) 92
Combined/Ov. Diagnosis 39
Abuse
15
36
7
39
Dependence
5
21
2
23
Parent/Guardian Report of Youth or Their Family Experiencing
Stressful/Traumatic Events in Lifetime (n=137)
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Unemployment of parent
Divorce of parents
Death of loved one
Serious illness
Victim of violent crime
Eviction from house or apartment
Legal problem resulting in jail time or detention
Accidental injury requiring hospitalization
Other traumatic event not listed
52.6%
42.3%
62.8%
34.3%
20.4%
18.2%
27.0%
9.5%
46.7%
(e.g., youth being placed in foster care, not having a relationship with father)
Mean=3.14, SD=1.73
Self-Reported Sexual Risk Behaviors: Baseline and 3 Mos. Follow-Up
Baseline (Ever)
(n=135-137)(%)
3 Mos. Follow Up
(n=101)(%)
81
72
85
76
68
66
35
29
12
9
26
15
7. Have you been or gotten someone pregnant?
4
4
8. Have you been tested for HIV?
15
20
9. Have you had sex with two or more people?
32
33
10. Have you had anal intercourse (sex in the butt)?
8
5
11. Have you had a sexually transmitted disease (STD)?
2
1
1. Have any of your close friends had sex?
2. Have you had any kind of sexual contact with another person?
3.Have you had sexual intercourse?
4. Have you had sexual intercourse without using a condom?
5. Do you find it difficult to use condoms every time you have sex?
6. Have you thought you or your partner might be pregnant?
Past Year Self-Reported Delinquency (%)(N=137)
Offense Type
0
1-4
5-29
30-54
55-99
100-199
200+
Index
52
31
12
5
--
2
--
Person crimes
23
33
30
4
5
4
2
General Theft
25
36
30
5
2
<1
2
Drug Sales
66
19
9
2
2
2
<1
Total Delinquency
7
17
42
15
7
7
5
Psychosocial Description of the Youths’ Families and the Youths
(n=136 or 137) (% Ever)
 Family Problems
Family member ever had an alcohol/other drug abuse problem
58
Family member ever received alcohol/other drug use treatment
24
Family history of mental health problems
36
 Youth Problems
Ever had an alcohol/other drug abuse problem
19
Ever received treatment for alcohol/other drug abuse problem
11
Ever received services for emotional/behavioral problems
51
The Longitudinal Model
Figure 1
Conceptual/Research Foundation for the Model
• The sexual risky behavior model is based on the literature
indicating:
– Relationships between youth’s psychosocial problems and
drug use (Dembo & Schmeidler, 2002; Dembo, Wareham et
al., 2007);
– Relationships between these constructs and youths’ engaging
in sexual risky behavior (Elkington, Teplin et al., 2008;
Rowe, Wang et al., 2008; Cook, Comer et al., 2006; TolouShams, Brown et al., 2008; Dembo, Belenko et al., 2009);
– Continuity of sexual risky behavior over time (Romero,
Teplin et al., 2007; DiClemente, Wingood et al., 2002).
Key Measures
1. Self-Reported Delinquency (Elliott et al., 1976), log transformed
2. Stressful/traumatic events of youth/family member (Parent reports) (from parent/guardian
(Adolescent Diagnostic Interview [ADI] [Winters & Henly, 1993])
3. Reported family alcohol/drug problems & mental health problems(ADI)
4. Youth reported emotional/psychological problems (ADI)
5. Lifetime alcohol, marijuana other drug use (baseline ADI)
6. UA marijuana (baseline)
7. Sexual Risky Behavior (POSIT HIV/STD Risk Behavior Questions baseline and 3 month followup). Good psychometric properties (e.g., internal consistency = 0.80, one-week test-retest
reliability = 0.90; concurrent validity with the Sexual Risk Questionnaire scores: r = 0.80)
•
Variable Measurement Level:
– Continuous: SRD total score, caretaker report of stressful/traumatic events
(measures 1 & 2)
– Categorical: All other variables in the model were binary or ordinal
Preliminary Analyses
 Confirmatory factor analysis of the psychosocial and drug use
variables found them to be significantly related to separate, but
correlated, latent variables (Mplus; Muthen & Muthen [version 5],
2007) (chi-square=14.64[15], p=.48) (CFI=1.000, TLI=1.000,
RMSEA=0.000, WRMR=0.591).
 Exploratory factor analysis (SPSS, Version 17) at each time point,
found the sex risk behavior items 2 (sexual contact), 3 (intercourse),
4 (sex w/o condom) & 9 (2+ sex partners) to form a separate factor.
Hence, these items were used as our measures of sex risk.
Preliminary Analyses (Continued)
• At each time point, confirmatory factor analysis found the
sex risk behavior items to measure one latent variable
reflecting sexual risk (baseline: chi-square=0.14[1],
p=0.71) )(CFI=1.000, TLI=1.014, RMSEA=0.000,
WRMR=0.142); 3 mos. follow-up: chi-square=1.79[2],
p=0.41) (CFI=1.000, TLI=1.002, RMSEA=0.000,
WRMR=0.348)
 For the baseline and 3 month follow-up sexual risk
items/factors, measurement invariance (equal factor
loadings and thresholds) was supported by additional
analyses (Nested chi-square test=7.48[5],p=0.19)
(Widaman & Reise, 1997).
Results of Model Test
Figure 2
Covariate Effects on Latent Variables in the Sexual Risky
Behavioral Model
Psychosocial
Factors
Estimate
Age
S.E.
Drug
Use
Estimate
Baseline
Sex Risk
S.E.
Estimate
S.E.
3 mos.
Sex Risk
Estimate
S.E.
-0.045
0.042 0.150*
0.055
0.267*
0.080 -0.120
0.133
0.131
0.108 -0.014
0.113
0.307
0.214 -0.043
0.269
AAmer
-0.352*
0.145 -0.147
0.143
0.459
0.246 -0.587
0.487
Hispanic
-0.262
0.126 0.098
0.120
0.237
0.237 -0.183
0.345
Gender
(Female)
Future Directions
• Repeat analyses with a larger number of cases
• Examine for intervention effects
• Pursue latent growth modeling analyses
involving more time points
• Pursue mediation analyses