Abstract
| This project expands treatment services through expanded mobile sites to assess 2,700 patients. 120 of these will be provided day treatment and 32 will receive residential services.
The Navajo Nation/Dept. of Behavioral Health Services (DBHS) will implement the Dine Treatment Capacity Expansion Project (DTCEP). The DTCEP will expand treatment programs in the rural and unserved areas of the Navajo Nation. The DBHS will implement the expansion project in Crownpoint residential treatment center, in Shiprock and Crownpoint outpatient treatment centers, and in 6 mobile clinic sites in New Mexico, Arizona and Utah. Approximately 5,159 patients will directly benefit from this project. The funding of DCTEP will expand outreach treatment services in 6 unserved extremely rural communities covering about 9,000 population. During the 3-year project period, about @,027 patients will receive treatment services through the expanded mobile sites. About 2,700 patients will receive expanded treatment services in Crownpoint and Shiprock Outpatient treatment centers. The Crownpoint resident treatment center will also provide residential treatment to about 32 patients per year and day treatment to about 120 patients each year. Target Population/Geographic Service Area: The target population includes Navajo substance abusers and their families in underserved areas: Crownpoint, Shiprock, Utah strip, and the Hopi Partitioned Land area as well as mobile outreach to the communities of Pueblo Pintado, Torreon, Huerfano, and Counselor Chapters in the remote Eastern Agency of the Navajo Nation. |
Objectives
Purpose, Goals and Objectives?The purpose of the Dine Treatment Expansion (TCE) project (DTCEP) is to assist Navajo individuals and families to be healthy, productive, functional and self sufficient by reducing and/or eliminating the use, abuse, and addiction of AOD on the Navajo Nation through expanding alcohol treatment services to the underserved Navajo population at outreach, outpatient, and residential centers.
Objectives are: (1) establishment of a DTCEP office along with central and field offices, staffed, by the end of year one, (2) treatment will be provided to 227 patients from the underserved rural areas through outreach by the end of year one, (3) 700 will receive outpatient treatment in Crownpoint outpatient treatment centers, utilizing the Navajo Traditional Treatment Modality as well as Western Treatment, by the end of year one, (4) 24 residential treatment patients and 120 day treatment patients will be served in the Crownpoint service center by the end of year one, and (5) a Memorandum of Agreement between the project and other providers such as the Navajo Division of Social Services, Public Safety and hospitals will be implemented by the end of year one.
Indian Nation Served
Navajo Nation
Key Components
Service Providers: The DTCEP is under the auspices of the Department of Behavioral Health in the Division of Health, Navajo Nation. DTCEP will negotiate memoranda of agreements with a variety of Navajo area agencies, hospitals, and the New Mexico State Behavioral Health Services. The Navajo Nation has successfully operated several previous CSAT grants and operates a network of 12 service center alcohol treatment programs throughout the Navajo Nation.
Services Provided: Outreach outpatient treatment services will be provided through expanded mobile sites in Crownpoint and Shiprock and in 6 mobile clinic sites as well as expanded residential treatment in Crownpoint. Outreach and outpatient services include: substance abuse and individual/group/family counseling and therapy; AOD, HIV/AIDS and FAS/FAE prevention education to adults and youth; traditional healing ceremonies, intake, screening, and referrals, and drug court advocacy. Community based interventions will include a Community Response Team. There will also be intensive aftercare services, early intervention and prevention, and a Four World Intensive Aftercare Program that will address co-occurring disorders and will include psycho educational and support groups, healing ceremonies, and individual and family treatment as well as case management services. Day treatment also includes traditional ceremonies.
Evaluation Design
Theoretical Model: Schawanda?s community healing model will be utilized along with Navajo cultural norms to restore/reach cultural balance. A Navajo Continuum of Life Model will also be incorporated.
Strategy and Design?A process evaluation will be conducted as well as an outcome evaluation. Qualitative data is implied through the mention of examining the number of success stories but is not explicitly stated.
Evaluation Goals/Desired Results?Some of the evaluation goals are implied by the goals and objectives already listed. The overall goal is to examine the efficacy of treatment through the use of outcome measures and a process evaluation.
Evaluation Questions and Variables? Process evaluation elements will include examination of patient recruitment activities, intake, screening and assessment, diagnosis and treatment plans, selection of treatment modalities, outreach, linkages and coordination, support services and aftercare up to two years. The outcome evaluation will measure treatment impact and effectiveness through measures of physical and mental health, self-reliance and self-sufficiency, social or family support status, changes in AOD use, patient utilization, and cost benefit measurement as well as examining differences between measures for those completing versus those dropping out of treatment.
Instruments and Data Management?Some specific measures that are included in the evaluation will be a screening protocol to determine eligibility and suitability for treatment, a cultural and spiritual assessment instrument, an interview guide, baseline information, a client satisfaction survey, and a treatment follow up questionnaire. Experiential data can be collected through the ?Group Sweat Lodge Ceremony? in a way respectful of Navajo culture; implicitly, this appears to be qualitative data collection. There are also plans for a MIS database and previous data had been compiled and analyzed by Dr. Phil May, Professor at the University of New Mexico with expertise in AOD programs and research.
Evaluation Results
Theoretical Model: Schawanda?s community healing model will be utilized along with Navajo cultural norms to restore/reach cultural balance. A Navajo Continuum of Life Model will also be incorporated.
Strategy and Design?A process evaluation will be conducted as well as an outcome evaluation. Qualitative data is implied through the mention of examining the number of success stories but is not explicitly stated.
Evaluation Goals/Desired Results?Some of the evaluation goals are implied by the goals and objectives already listed. The overall goal is to examine the efficacy of treatment through the use of outcome measures and a process evaluation.
Evaluation Questions and Variables? Process evaluation elements will include examination of patient recruitment activities, intake, screening and assessment, diagnosis and treatment plans, selection of treatment modalities, outreach, linkages and coordination, support services and aftercare up to two years. The outcome evaluation will measure treatment impact and effectiveness through measures of physical and mental health, self-reliance and self-sufficiency, social or family support status, changes in AOD use, patient utilization, and cost benefit measurement as well as examining differences between measures for those completing versus those dropping out of treatment.
Instruments and Data Management?Some specific measures that are included in the evaluation will be a screening protocol to determine eligibility and suitability for treatment, a cultural and spiritual assessment instrument, an interview guide, baseline information, a client satisfaction survey, and a treatment follow up questionnaire. Experiential data can be collected through the ?Group Sweat Lodge Ceremony? in a way respectful of Navajo culture; implicitly, this appears to be qualitative data collection. There are also plans for a MIS database and previous data had been compiled and analyzed by Dr. Phil May, Professor at the University of New Mexico with expertise in AOD programs and research.
Products Developed