National Treatment Improvement Evaluation Study

Study Design

NTIES was conducted by the National Opinion Research Center at the University of Chicago, in conjunction with the Research Triangle Institute. They used a two-level study design with an administrative level and clinical outcomes level. The administrative level of data provided information on treatment orientation, size, budget, staffing distribution, [Page 624]and specific use of CSAT funds in all service delivery units (SDUs) eligible to receive support through a CSAT demonstration grant. The clinical outcomes level collected data from clients enrolled in eligible units during three waves: shortly after their first day in treatment, when they left treatment, and then at 12 months after the end of treatment. The sample for the administrative level consisted of all of the SDUs that receive direct support as part of the CSAT demonstration programs. The clinical outcome data were collected from clients who received treatment from SDUs in a subsample of the NTIES SDUs.

The unit of analysis for the administrative component was the SDU, which could be a stand-alone treatment provider or one component of a multitiered treatment organization. The unit of analysis for the clinical outcomes portion was individual client data. Clinical outcomes of treatment were measured primarily through a before and after, or pretreatment to posttreatment, design.

Instrument Development

The forms developed for the administrative data collection were a baseline administrative report, an administrative update, an exit log, and a clinician form. The SDU administrators completed the baseline and update forms, which asked about staffing, facilities, costs and revenues, admissions procedures, client composition, services offered, and treatment philosophy. The exit log was a monthly report on client admissions and discharges. The clinician form was filled out by the clinicians on staff at NTIES SDUs. It was a brief questionnaire about demographics, training, and treatment philosophy.

The intake form, discharge form, 1-year follow-up questionnaire for clients, and records abstraction forms were the instruments developed for the clinical outcomes portion of the study. The intake and 1-year follow-up questionnaire collected data on family background, education, drug and alcohol use, living arrangements and social support, mental health, criminal activity, sources of financial support, physical health, and sexual behavior. The discharge form and records abstraction collected data on treatment experience, such as admission characteristics, services received during treatment, and the conditions of discharge from treatment.

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