AIDS and Behavior An Integrated Approach (1994) / Chapter Skim
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7 LINKAGES BETWEEN RESEARCH AND SERVICES
7 LINKAGES BETWEEN RESEARCH AND SERVICES
Pages 240-256
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From page 240... ...
The following discussion begins with a description of the SAMHSA AIDS programs, and then looks at how service programs in general and SAMHSA programs in particular are linked with the AIDS research programs of NIAAA, NIDA, and NIMH. Attention is also paid to the issue of collaboration and coordination beyond NIH and SAMHSA in the larger arena of PHS and HHS.
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From page 241... ...
The second CSAT AIDS program is the Treatment Improvement Demonstration Program, also known as the Comprehensive Community Treatment Program {CCTP)
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From page 243... ...
The- CMHS AIDS program includes Training and AIDS Training, which began at NIMH in FY 1990, and a new AIDS mental health services demonstration program, which was initiated in FY 1994. The Training Program, which was funded at $~.0 million in FY 1993, provides education ant!
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From page 244... ...
With the addition of the demonstrations, it rose again to $4.4 million in FY 1994. CSAP had no AIDS program until FY 1994, when it proposed providing supplements to the Prevention Demonstrations for High Risk Youth Program to fund outreach and risk reduction activities related to HIV/AIDS, including skills building, pre-post HIV test counseling, outreach to resistant populations, and services to people who have lost friends and family members to AIDS.
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From page 245... ...
3) As the Senate report notes, the problem of a lack of collaboration between the research and services communities exists beyond the federal agencies, and is based in great part on different professional cultures.
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From page 246... ...
At the same time, researchers often perceive service providers as unwilling to understand or appreciate the requirements of scientific research and the demand of their professional culture to get grants, teach, write, and publish. They encounter resistance to their efforts to refine or modify interventions in order to allow for rigorous scientific assessment, even though they explain to service providers the value of producing research results with scientific integrity.
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From page 247... ...
_ O NIAAA NIAAA identified only two AIDS research projects that it considers to have a direct relationship to the provision of services. The first is a longitudinal research program called The Native American Prevention Proj ect on AIDS and Substance Abuse iNAPPASAJ, which developed rural school-based and community research partnerships that have produced positive outcome effects among southwestern Native American and other youth at risk.
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From page 248... ...
The following is a representative sample of activities: NIDA/HRSA Program Linking Primary Health Care and Drug Abuse Treatment This program, which was one of those transferred to CSAT with the ADAMHA reorganization, is designed to demonstrate the feasibility of various models for linking substance abuse treatment with primary health care services for drug abusers at risk for acquiring or spreading HIV. Of the original 21 grantees, about one-third were community health centers, one-third were city or county health departments, and the remainder were other institutions such as hospitals or state agencies.
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From page 249... ...
During 1991, NIDA, the National Association of State Alcohol and Drug Abuse Directors (NASADAD) , and the NADR grantees entered into a partnership to structure, organize, and facilitate implementation of effective AIDS prevention models from the NADR projects into training workshops.
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From page 250... ...
The NIDA contractor was required to maintain a list of participants who successfully completed the training in order that these individuals could serve as technical resources to governments and other public and private agencies requesting technical assistance. Success of this program is attributed to the use of the contract mechanism, which allowed NIDA to adequately monitor performance progress and to select a contract firm with appropriate experience and expertise in HIV training and community outreach.
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From page 251... ...
The Columbia University AIDS Research Center also produced video and audio tapes in collaboration with an organization called The Meclia Group. Three of these videos: "AIDS, Me anti My Baby," "AIDS is About Secrets," and "AIDS, Not Us," have been used widely by community-based organizations, drug treatment programs, health departments, and other entities involved in HIV prevention efforts throughout the United States and in other countries.
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From page 252... ...
AIDS Health Care Worker Training Program Beginning in 1985, NIMH provided grants for training health care workers on different aspects of HIV/AIDS. Health care workers, including physicians, nurses, and social workers, were trained using the most current knowledge about AIDS, in particular HIVrelated neuropsychiatric anal cognitive problems.
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From page 253... ...
In addition to cultural differences' legal and regulatory barriers also hinder collaboration between the institutes now at NIH and the services entities at SAMHSA {as well as at HRSA and CDCJ. In particular, the ADAMHA reorganization legislation made it eminently clear that SAMHSA centers were not to engage in anything called "research," and that the NIH institutes were not to engage in providing anything that could qualify as "services." In the realms of substance abuse and mental health, the dichotomization of research and services is not always possible nor helpful, especially in the context of AIDS, which requires rapid information exchange between research and services.
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From page 254... ...
Coordination of PHS programs has resided for the past few years with the National AIDS Program Office INAPT, and cross-agency coordination has been the function of the Federal Coordinating Committee on AIDS, chaired by PHS. In 1993, however, the Clinton administration elevated the status of federal Attics conrdination to a White House position with the appointment of a National AIDS Policy Coordinator responsible for all federal AIDS policy and programs.
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From page 255... ...
RECOMMENDATIONS FOR LINKAGES BETWEEN RESEARCH AND SERVICES 7.1 The committee recommends that NIAAA, NIDA, and NIMH ensure adequate follow up time and money in their AIDS intervention research grants to accelerate information dissemination activities, including technical assistance. 7.2 The committee recommends that formal mechanisms be developed within the NIH institutes and other PHS agencies to foster linkages between AIDS research and services.
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From page 256... ...
256 / AIDS AND BEHAVIOR 7.4 The committee recommends that the Assistant Secretary for Health of HHS and the Director of the Office of National AIDS Policy continue to develop a specific strategic plan for interagency cooperation and coordination among PHS AIDS activities, including an implementation plan.
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