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Comprehensive Community Mental Health Services for Children and Their Families Program: Data Sources

1: Data source—the longitudinal outcome study conducted in communities funded between 1997 and 2000. Findings based on 3,563 caregivers with complete data at entry and 12 months on their child’s living situation in the previous 6 months. Data were collected using the Restrictiveness of Living Environments Scale (ROLES). Caregivers were asked at intake and after 12 months to report the number of days their child received inpatient hospital care during the previous 6 months. The number of days per child was calculated, which was used to calculate the average number of days of inpatient hospitalization per child at baseline and 12 months. These figures were multiplied by the national daily cost estimate, resulting in the calculation of a difference in costs from baseline to 12 months. According to the Agency for Healthcare Research and Quality (AHRQ), the national estimate of the average daily cost of inpatient hospital care in 2002 was $1,501 per day (AHRQ, 2004).

2: Data source—the longitudinal outcome study conducted in communities funded between 1997 and 2000. Findings based on 2,602 caregivers with complete data at entry and 18 months on their child’s living situation in the previous 6 months. The Restrictiveness of Living Environments Scale (ROLES) was used to collect information on types of living arrangements and amount of time a child spent in each type during the previous 6 months. From these data, children who spent any time in an inpatient hospital were identified and the amount of time they spent there was calculated (in days). Because the data was significantly skewed, the number of days was split so that one or more days equaled 1. A generalized estimating equation (GEE) for assessing change in this dichotomous longitudinal outcome was computed, and a statistically significant change over the two time points (i.e., from baseline to 18 months) was obtained (p<.0001).

3: Data source—the longitudinal outcome study conducted in communities funded between 1997 and 2000. Findings based on 2,239 youth with complete data at entry and 12 months on the Delinquency Survey (DS) for the relevant question. The DS collected information from youth on engagement in behaviors that could result in law enforcement involvement and on actual contacts with law enforcement. One DS question asks youth how many times s/he was arrested in the previous 6 months. The average number of arrests was calculated per child at baseline and 12 months were calculated. These figures were multiplied by the national cost estimate, and a difference in costs from baseline to 12 months was calculated. According to data from the Bureau of Justice Statistics, the average cost per juvenile arrest was $4,149 in 2000 (The National Center on Addiction and Substance Abuse, 2004).

4: Data source—the longitudinal outcome study conducted in communities funded between 1997 and 2000. Findings based on 2,782 caregivers with complete data at entry into services and at the 18-month follow up on the Child Behavior Checklist (CBCL), which assesses a child’s behavioral and emotional problems. Analysis involved calculation of the Reliable Change Index (RCI) for the Total Problems scale of the CBCL, which compares a child’s scores at two different points in time (in this case, at baseline and at the 18-month follow up) while adjusting for the reliability of the measure. The RCI indicates whether a change in scores shows clinically significant improvement, stability, or deterioration. Improvement and deterioration are defined as a difference in outcome scores, adjusted for measurement error of the outcome, so that a difference of this size would not be due to the unreliability of the measure.

5: Data source—the longitudinal outcome study conducted in communities funded between 1997 and 2000. Findings based on 1,887 caregivers with complete data at entry and 12 months on item 18 on the Child Behavior Checklist, which asks respondents if their child had deliberately harmed himself/herself or attempted suicide in the previous 6 months. Responses of “very true or often true” and “somewhat or sometimes true” were combined. Analysis involved the use of a generalized estimating equation (GEE) for assessing change in this dichotomous longitudinal outcome; change over the two time points was statistically significant (p < .0001).

6: Data source—the longitudinal outcome study conducted in communities funded between 1997 and 2000. Findings based on 2,433 caregivers whose children attended school in the previous 6 months and who provided complete data at entry and 18 months on their child’s school-related outcomes. Data were collected using the Educational Questionnaire developed specifically for the national evaluation. The attendance item was split so that 75 percent of the time or more equaled 1 and less than 75 percent of the time equaled 0. Analysis involved the use of a generalized estimating equation (GEE) for assessing change in these dichotomous longitudinal outcomes. Change over the two time points (i.e., from baseline to 18 months) was statistically significant (p < .0001).

7: Data source—the longitudinal outcome study conducted in communities funded between 1997 and 2000. Findings based on 2,433 caregivers whose children attended school in the previous 6 months and who provided complete data at entry and 18 months on their child’s school-related outcomes. Data were collected using the Educational Questionnaire developed specifically for the national evaluation, including a series of items about the child’s grades (if the school attended used grades). Grades were split so that A, B, or C equaled 1 and D or F equaled 0. Analysis involved the use of a generalized estimating equation (GEE) for assessing change in these dichotomous longitudinal outcomes. Change over the two time points (i.e., from baseline to 18 months) was statistically significant (p < .0001).

8: Data source—the longitudinal outcome study conducted in communities funded between 1997 and 2000. Findings based on 1,115 youth with complete data at entry, 6 months, 12 months, and 18 months on the Delinquency Survey (DS) for the relevant question. The DS collects information from youth on engagement in behaviors that could result in law enforcement involvement and on actual contacts with law enforcement. One DS question asks the youth whether s/he had been in juvenile detention or other secure facilities in the previous 6 months. Positive and negative responses were coded as 1 and 0, respectively. Analysis involved the use of a generalized estimating equation (GEE) for assessing change in this dichotomous longitudinal outcome. Change over the four time points (i.e., baseline, 6, 12, and 18 months) was statistically significant (p < .0001).

References

Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project. (2004). The HCUP Nationwide Inpatient Sample (NIS), 2002. Rockville, MD.

The National Center on Addiction and Substance Abuse. (2004). Criminal neglect: Substance abuse, juvenile justice and the children left behind. New York: The National Center on Addiction and Substance Abuse (CASA) at Columbia University.

Zeger, S.L. & Liang, K.Y. (1986). Longitudinal data analysis for discrete and continuous outcomes. Biometrics, 42, 121-30.

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