RAND Corporation

About: RAND Corporation is a nonprofit organization based out in Santa Monica, California, United States. It is known for research contribution in the topics: Health care & Population. The organization has 9602 authors who have published 18570 publications receiving 744658 citations.

Drug prevention in junior high: A multi-site longitudinal test

Abstract: Results from a longitudinal experiment to curb drug use during junior high indicate that education programs based on a social-influence model can prevent or reduce young adolescents' use of cigarettes and marijuana. This multi-site experiment involved the entire seventh-grade cohort of 30 junior high schools drawn from eight urban, suburban, and rural communities in California and Oregon. Implemented between 1984 and 1986, the curriculum's impact was assessed at 3-, 12-, and 15-month follow-ups. The program, which had positive results for both low- and high-risk students, was equally successful in schools with high and low minority enrollment. However, the program did not help previously confirmed smokers and its effects on adolescent drinking were short-lived.

A School-Based Mental Health Program for Traumatized Latino Immigrant Children

Abstract: Objective To pilot-test a school mental health program for Latino immigrant students who have been exposed to community violence. Method In this quasi-experimental study conducted from January through June 2000, 198 students in third through eighth grade with trauma-related depression and/or posttraumatic stress disorder symptoms were compared after receiving an intervention or being on a waitlist. The intervention consisted of a manual-based, eight-session, group cognitive-behavioral therapy (CBT) delivered in Spanish by bilingual, bicultural school social workers. Parents and teachers were eligible to receive psychoeducation and support services. Results Students in the intervention group ( n = 152) had significantly greater improvement in posttraumatic stress disorder and depressive symptoms compared with those on the waitlist ( n = 47) at 3-month follow-up, adjusting for relevant covariates. Conclusions A collaborative research team of school clinicians, educators, and researchers developed this trauma-focused CBT program for Latino immigrant students and their families. This pilot test demonstrated that this program for traumatized youths, designed for delivery on school campuses by school clinicians, can be implemented and evaluated in the school setting and is associated with a modest decline in trauma-related mental health problems.

A New Analytic Method for Finding Policy-Relevant Scenarios:

Abstract: Scenarios play a prominent role in policy debates over climate change, but questions continue about how best to use them. We describe a new analytic method, based on robust decision making, for suggesting narrative scenarios that emerge naturally from a decision analytic framework. We identify key scenarios as those most important to the choices facing decision makers and find such cases with statistical analysis of datasets created by multiple runs of computer simulation models. The resulting scenarios can communicate quantitative judgments about uncertainty as well as support a well-defined decision process without many drawbacks of current approaches. We describe an application to long-term water planning in California.

Can patient self-management help explain the SES health gradient?

Abstract: There are large differences in health outcomes by socioeconomic status (SES) that cannot be explained fully by traditional arguments, such as access to care or poor health behaviors. We consider a different explanation—better self-management of disease by the more educated. We examine differences by education in treatment adherence among patients with two illnesses, diabetes and HIV, and then assess the subsequent impact of differential adherence on health status. One unique component of this research is that for diabetes we combine two different surveys—one cohort study and one randomized clinical trial—that are usually used exclusively by either biomedical or/and social scientists separately. For both illnesses, we find significant effects of adherence that are much stronger among patients with high SES. After controlling for other factors, more educated HIV+ patients are more likely to adhere to therapy, and this adherence made them experience improvements in their self-reported general health. Similarly, among diabetics, the less educated were much more likely to switch treatment, which led to worsening general health. In the randomized trial setting, intensive treatment regimens that compensated for poor adherence led to better improvements in glycemic control for the less educated. Among two distinct chronic illnesses, the ability to maintain a better health regimen is an important independent determinant of subsequent health outcomes. This finding is robust across clinical trial and population-based settings. Because this ability varies by schooling, self-maintenance is an important reason for the steep SES gradient in health outcomes.