Addictions Programs and Projects
Basic Olicognograph: Addiction's Social Services
Design of programs, projects, whatever the subject use the product of investigation. What have worked may work again and what is not ... is not so sure. With complexity in mind we think that lot of waste came from trying to force what seemed to have worked (especially by those involved in power struggle) against flexibility of common sense. Memory of complex things that worked does not last long you have to recreate (re-produce). Hide bad memories is not a so useless mean. For most common sort of studies of situation, you have: 1) Case Studies: a method for learning about a complex phenomenon based upon selection and comprehensive understanding derived from extensive description and analysis of the phenomenon and the context in which it occurs. Case studies may compile a variety of information about the phenomenon of interest, using both qualitative and quantitative data sources and a variety of sampling strategies. They are characterized by in-depth analyses of social relationships or processes as they unfold within a particular setting or across several settings selected on the basis of characteristics relevant to the study question. 2) Environmental Analyses: which consider associations using grouped or aggregated data for both exposure and outcomes. For example, ecological analyses can be used to consider the association between female literacy and urbanicity or urbanization and childhood malnutrition. Such simple correlations can suggest country features that co-vary with measures of country-level health for further consideration. 3) Ethnographic methods which basic contains: - Formal interview; - Informal interview; - Conversations; - Observations; - Participant observation. 5) Multilevel Methods Multilevel analyses integrate individual-level variables with group-and macro-level variables so that multiple levels of influence can be assessed simultaneously.
Addiction can be studied as a social environment problem and assessed as a health hazard risks which basic: Uses and limitations of hazard data, exposure data are: 1) Hazard data: Regulatory compliance (not representative of individual exposures); Standard setting (gaps in geographic coverage of monitors); Policymaking (high percentage of nondetected values in data); Characterization of (sampling and measurement errors are often unknown - reflect current levels of risks - insufficient data quantity for trend analysis - objectives for monitoring vary across environmental media). 2) Exposure data: Indicator of individual exposure to a hazard (data availability at proper care level); Required to link hazard with health outcome (misclassification of exposure - difficult to account for multiple exposure links - exposure models based on assumptions and uncertainties not included in statistical analysis - lack of data amount, frequency, and duration of exposure - variability within populations impedes generalizing exposure - difficult to reconstruct past). 3) Health outcome data: Describes health status of populations (data completeness); Describes distribution and frequency of disease: (misclassification of disease - generalizability to population - confidentiality). 4) All three types of data: (completeness of records - timeliness of reporting - availability of access to data - social vs space geographic resolution - frequency of data collection - lack of data collection standards)
Emerging health issues: notional variation with urban development |
||||
problem type |
varies with urban growth |
changes with spread in city growth |
presents risk for the poor |
varies with age and gender |
communicable diseases |
high |
somewhat |
high |
somewhat |
traffic injuries |
high |
somewhat |
high |
high |
violence |
somewhat |
somewhat |
high |
high |
obesity |
somewhat |
low |
high |
high |
unsafe settlements |
high |
high |
high |
somewhat |
source: nfm |
||||
There is also economics concern which can point to assessment of existing structures and care also new processes, projects or programs. We may dyslike the sort of primary correspondance often used to reduce functional relations to dialogues that look like arena of filty words, but with some sense of empathy there are many ressources for useful translations from one kind of specialists registiers to others if any could mind that much opposition and "bad words" come more from lack of goodwill linguistic flexibility rather than from incompetence of any register to develop a convenient set of soft concepts. Some traditional reasons why economics can help in something as in addictions programs are: 1) Competition for limited substance abuse program funds, combined with increased scrutiny of program costs and outcomes, creating a need for better understanding of how costs and outcomes are related in substance abuse treatment. 2) Programs increasingly called on to show that treatment of substance-abusing patients is a good investment of public and private funds. 3) Program costs must be justified relative to program outcomes.
Methods for assessing programs, services, activities start with concepts like: 1) Cost Analysis A thorough description of the type and amount of all resources used to produce substance abuse treatment services. Cost analyses are critically important for deciding how to allocate funds within a program and for understanding the relationships between costs and outcomes. Examining cost figures for the program as awhole (or for parts of it) is a basic form of cost analysis; 2) Cost-Effectiveness Analysis the relationship between program costs and program effectiveness, that is, patient outcome. Costs are measured as money spent, whereas effectiveness or outcome is measured as changes in patients’ behaviors, thoughts, feelings, or biology. For example, the cost-effectiveness of an opiate treatment program might be measured as the cost of generating an opiate-free month for the average patient. There is no single standard for “cost-effective.” Generally, the term is used loosely as a way of saying that something probably costs less, or is more effective, than something else; 3) Cost-Benefit Analysis: The measurement of both costs and outcomes in monetary terms. Costs and benefits can be compared between programs or contrasted within a single program. Cost-benefit analysis can also discover whether program expenditures are less than, similar to, or greater than program benefits. The time it takes for program benefits to exceed program costs is also measured in some cost-benefit analyses. Cost-benefit findings can often stand alone.
Analyses of cost, cost-effectiveness, and cost-benefit relationships can provide valuable insights into how a program operates and how its operations could be improved to serve more people better for less. They can also show funders that program managers are aware of the importance of accountability—accountability for how funds are used and what they are used to achieve. A sort of frame for outcomes, activities and cost post could be the following one.
Matrix of Outcomes and Accounts |
|||||
costs |
program procedures |
psychosocial processes |
other processes |
interim outcomes |
long-term out-comes |
temporal: direct services (paid, volunteered) administrative, other indirect means |
individual therapy with therapist, medical |
skill acquisition: social, job- seeking voca -tional, relapse prevention |
client characteristics age, gender, race, |
relations with peers, children, spouse/mate, relatives employer, others |
continuation of interim outcome |
material: equipments, direct service indirect |
group therapy women's men's prevocacional relaspe prevention |
expectancies self efficacity outcome compliance difficulty of treatment |
prior treatment employment |
employment,teaching, training |
cost savings in health and mental services |
supplies: medicines, psychometric tests office supplies |
education drug abuse, health & nutrition |
relationships & social support: therapist, family, peers employers spouse/mate others |
physically challenged medical complications psychological complications |
independent living |
welfare employee and assistance program operation training of new employees |
spatial direct services administrative other indirects |
referrals: health, social services legal aid, vocational |
|
therapist characteristics: training, experience, history, age, gender, race |
cessation of substance abuse, preferred drug other drugs |
benefits acrued tax revenues, positive modeling for others |
transportation |
extra program |
|
|
HIV transmission behaviors |
prevention |
communications |
|
|
addiction physiology |
physical health |
improved family and social climate |
|
|
|
|
|
|
source: nfm |
|||||
There is the patient too and as weel as it exists an psychological and anthropological of project, more properly in the medium of life's term, the sort of methods developped in projects techniques can inspire tools, see in desintoxication page for more individually applied introduction.
