Epidemiology of Inhalant Abuse - Archives - National Institute on ...
Epidemiology of Inhalant Abuse - Archives - National Institute on ...
Epidemiology of Inhalant Abuse - Archives - National Institute on ...
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outcome evaluati<strong>on</strong>s. Ideally, such studies would be performed in<br />
tandem, although this is not strictly necessary.<br />
It may be very useful simply to perform process evaluati<strong>on</strong>s <str<strong>on</strong>g>of</str<strong>on</strong>g> whether<br />
and how particular policies are implemented. Such studies perform an<br />
important public accountability functi<strong>on</strong> even without data <strong>on</strong> outcomes.<br />
For example, if a policy (established as a law or a matter <str<strong>on</strong>g>of</str<strong>on</strong>g> system policy<br />
by a policy board) mandates that inhalant abuse curriculum units should<br />
be incorporated into and delivered as part <str<strong>on</strong>g>of</str<strong>on</strong>g> school-based drug abuse<br />
preventi<strong>on</strong> efforts, it would be useful and arguably important to examine<br />
whether and how this is accomplished. Process evaluati<strong>on</strong>s also should<br />
examine what is required to implement the policy in terms <str<strong>on</strong>g>of</str<strong>on</strong>g> resource,<br />
cost, time requirements, coordinati<strong>on</strong>, and other problems. All <str<strong>on</strong>g>of</str<strong>on</strong>g> these<br />
issues can and arguably should be addressed, even without examining<br />
whether the implementati<strong>on</strong> is effective.<br />
However, the objective <str<strong>on</strong>g>of</str<strong>on</strong>g> these initiatives is to reduce the incidence,<br />
prevalence, and c<strong>on</strong>sequences <str<strong>on</strong>g>of</str<strong>on</strong>g> inhalant abuse. Outcome studies should<br />
be performed to measure whether and how effective the respective<br />
policies are. The design and performance <str<strong>on</strong>g>of</str<strong>on</strong>g> inhalant abuse interventi<strong>on</strong><br />
outcome studies is not c<strong>on</strong>ceptually different from studies <str<strong>on</strong>g>of</str<strong>on</strong>g><br />
interventi<strong>on</strong>s directed at other substances, although the generally low<br />
rates <str<strong>on</strong>g>of</str<strong>on</strong>g> incidence and prevalence observed am<strong>on</strong>g many demographic<br />
groups must be accounted for in the study design.<br />
Furthermore, a process evaluati<strong>on</strong> for a policy should be a critical<br />
accompaniment to any outcome study. It significantly weakens an<br />
outcome analysis <str<strong>on</strong>g>of</str<strong>on</strong>g> changes in incidence and prevalence across time or<br />
communities unless it is known whether and how the policy is<br />
implemented.<br />
A perfect example is posed by the apparent lack <str<strong>on</strong>g>of</str<strong>on</strong>g> evaluati<strong>on</strong>s <str<strong>on</strong>g>of</str<strong>on</strong>g> schoolbased<br />
preventi<strong>on</strong> policies. As noted above, preventi<strong>on</strong> policies <str<strong>on</strong>g>of</str<strong>on</strong>g>ten are<br />
advocated by law enforcement and industry representatives who believe<br />
that the universal availability <str<strong>on</strong>g>of</str<strong>on</strong>g> products with inhalant abuse potential<br />
makes other strategies unworkable. Yet, there have not been studies <strong>on</strong><br />
preventi<strong>on</strong> and educati<strong>on</strong>. In fact, <strong>on</strong>ly half <str<strong>on</strong>g>of</str<strong>on</strong>g> the school preventi<strong>on</strong><br />
curricula reviewed in this study c<strong>on</strong>tained informati<strong>on</strong> about inhalants for<br />
students. No process evaluati<strong>on</strong>s were identified that examined whether<br />
or how instructors were delivering inhalant curriculum units, nor have<br />
preventi<strong>on</strong> evaluati<strong>on</strong>s such as Project STAR in Kansas City, KS, and<br />
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