Young Minds Matter Seminar on Transition-Age Youth (TAY) Attracts Hundreds

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On April 3, youth, families, mental health service providers, faith-based organizations, community groups, advocates, health care practitioners, peer specialists, foundation staff, and school teachers, counselors and administrators gathered in Houston, Texas to learn more about engaging youth who are transitioning into adulthood.

Dr. Fagan delivering his key note.
Dr. Fagan delivering his keynote.

Our keynote speaker Dr. Marc Fagan kicked off the conference with a stimulating presentation outlining why engaging young adults with mental health conditions is important and provided key strategies for doing so. While he hit on some of the current barriers that exist in the adult mental health system, he mainly focused his presentation on the Transition to Independence Process (TIP) model, an evidence-informed practice to help youth plan for their futures. He highlighted several TIP guidelines and how the process works. Learn more about TIP and his work here.

The conference also included three thought-provoking panels, featuring parents of TAY, TAY service providers and TAY themselves. Each panel introduced a unique perspective on the challenges faced during the transitional period from youth to adulthood for youth with mental health conditions. The parents of TAY shared the challenges and successes they have experienced during this important time in their children’s lives. While telling their personal stories, they helped the audience gain a better understanding on how parents and families can better support youth.

The service provider panel provided key insights on best practices for transitioning youth and highlighted programs that have been proven to work. The panel stressed the importance of the youth voice and their choices in decision-making.

Youth Panel
Youth Panel

The conference ended with the much anticipated youth panel that inspired the entire audience to think about systems change and effective solutions. The youth were passionate about their stories and helping their peers succeed. Audience members were encouraged by the youth’s courage and insights.

Overall the day was a huge success. The discussion, the people and the topic made it a great seminar. We hope all of the attendees felt the same.

For more info on the day, go to http://hogg.utexas.edu/initiatives/YMMTAY.html. To view pictures, go to https://www.facebook.com/media/set/?set=a.628680463825206.1073741826.199244320102158&type=1&l=301bbe6cc2.

A Mental Health Policy Update on the 83rd Legislative Session

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Since the commencement of the 83rd Legislative Session, the Hogg Foundation policy team has been extremely busy at the Texas Capitol. The foundation kicked off the session with our policy luncheon for legislators and their staff, which featured Hollywood producer Gary Foster and Representative Cindy Burkett. The luncheon also provided the opportunity for wide distribution of our new publication, “A Guide to Understanding Mental Health Systems and Services in Texas.”

Since then, the team has analyzed many mental health related bills for various Senate and House offices, was invited by Chairwoman Lois Kolkhorst to testify at a Public Health Committee hearing on mental health, and has provided testimony to various committees on mental health issues, including the Senate Finance, House Appropriations, House Human Services and Senate Health and Human Services committees.

The Hogg Foundation is serving as a valuable resource preparing talking points for committee hearings, visiting legislative offices to provide information and technical assistance, and attending weekly meetings of mental health advocates.

Here is an overview of what is happening at the Capitol that could have large implications for mental health:

  • State budget: Every biennium, the legislature is faced with the monumental task of developing a budget for our state. The House Appropriations and Senate Finance committees work hard to come up with innovative strategies for serving the people of Texas in the most fiscally responsible way. With more available revenue projected for the 2014/2015 biennium and the heightened attention to mental health as a result of national events, there are opportunities to secure greater funding for community mental health services. There have also been opportunities to work with legislators, state agencies and other advocates to help develop new, efficient ways of delivering the best mental health care to Texans.
  • Managed care and integrated health care: Managed care is an organized system for delivering comprehensive health services that allows the managed care organization to determine what services will be provided to an individual in return for their insurance premiums.   In an increasingly cost-conscious health care environment, moving behavioral health into the statewide managed care system is under consideration.  The move toward managed care has piqued the legislature’s interest in integrated health care because of the model’s potential to improve health outcomes while decreasing costs. Integrated health care—providing mental health care in primary care settings and vice versa—allows for earlier detection of mental and physical illnesses, earlier intervention, and therefore less acuity in health conditions.
  • Medicaid expansion: Federal health care reform allows states to opt out of the Affordable Care Act’s Medicaid expansion provision, leaving each state’s decision to participate in the hands of the governor and state leaders.  Many mental health advocates believe that the legislature has an extraordinary opportunity to maximize federal funding for uninsured Texans through Medicaid expansion and, in doing so, the state stands to transform Medicaid from a system that focuses on disability, which is extremely costly, into one that emphasizes prevention, health and wellness. They argue that, as more Texans have access to care, providers will be better able to meet mental health needs earlier, more effectively, and at a lesser cost.

In addition to these major issues, other significant mental health subjects being addressed include the use of psychotropic medications in the foster care system, school-based behavioral health, developing the mental health workforce and revising the mental health code.

Stay tuned for more mental health policy updates as the session continues.

A Recap of the Central Texas African American Family Support Conference

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The Central Texas African American Family Support Conference (CTAAFSC), a densely-packed two days of informative workshops and stirring keynote speeches, achieved its goal of sharing quality information about African American behavioral health issues with consumers, services providers, faith community leaders and other key stakeholders. The event took place on Feb. 28 and Mar. 1 in Austin, Texas.

CTAAFSC, hosted by Austin Travis County Integral Care and sponsored by community partners from the public and private sectors, offered attendees a wealth of expert insight into the unique challenges confronting African Americans who utilize the behavioral health system in Texas. These challenges include stigma, the need for greater cultural competency among mental health workers, structural racism, substance use and the lack of mental health knowledge among clergy.

The Hogg Foundation, through its support of the Austin Area African American Behavioral Health Network (AAAABHN), has been supporting education and awareness about mental health in African American faith communities. In fact, the AAAABHN sponsored the specialized track for clergy leaders at the CTAAFSC. One result was the Thursday afternoon panel discussion titled “Creating a Compassionate Culture: Embracing the Mental Health Needs of the Congregation,” in which panelists candidly shared their personal experiences with mental illness and recovery. There was also a special session for preachers’ wives that focused on their unique challenges and offered advice on helping church members experiencing emotional distress. The AAAABHN also hosted a networking reception following the first day of the conference.

Hogg’s former executive director, Dr. King Davis, director of the Institute for Urban Policy Research and Analysis, moderated the opening session of the conference.

Outstanding individuals were honored with the Garnet F. Coleman “Eternal Flame” and Richard E. Hopkins “Torch” awards for their leadership in the area of behavioral health. This year’s Eternal Flame was Dr. Exalton Delco, husband of former state representative Wilhelmina Delco, who was honored for his commitment to individuals and families affected by behavioral health issues.

A full recap of the conference can be found here.

Are Professional Athletes Exempt From Having A Mental Illness?

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Athletes are often placed on a pedestal and viewed as role models and mentors. If you ask my son, or many young athletes what their dream job would be, many of them would tell you that they would love to play in the NBA, NFL or any other professional sports league.

Fans are often upset when their favorite player can’t play in a game due to physical injuries beyond his or her control. Teams are all about spending the money on the doctor, physical therapist and/or other treatment to get that player back on the field or court. But what about mental health? Do people think that professional athletes are exempt from mental illness or do they just not care because it is less likely to interfere with an athlete’s ability to perform (or so they think)? You don’t hear players announcing to the world that they have to sit out a game or two because his or her bipolar illness or anxiety is “acting up.” At least not until recently.

Over the past couple of months, Houston Rocket’s basketball player, Royce White, has joined his peer Metta World Peace, in sharing with the world that he is an individual who is living with a diagnosed mental health condition. I started thinking: if one in four adults has or will experience a mental health condition at some time in his or her lifetime, how do those numbers play out when it comes to a professional sports team?

So I did a little research just testing these numbers on my favorite sports league - the NBA. There are 30 teams in the NBA. Each team has anywhere from 12 to 15 players per team, making the number of players in the NBA range from 360 to 450 players each year. I’m sure by now you can guess where I’m going with this. That means that at any given time anywhere between 90 to 112 players in the NBA may be experiencing a mental illness.

Professional athletes (who are human by the way) are not exempt from a mental illness. As a society, we need to recognize that individuals who have been blessed with athletic abilities are just like the rest of us. One in four, remember? So what are professional leagues doing to make sure that they have qualified mental health professionals and adequate resources available to support the mental wellness of its players? What accommodations are being made to support these talented athletes in meeting their mental health needs?

I commend Royce White, Metta World Peace and others who, in spite of the stigma associated with having a mental illness, are advocating for what is right. Thank you for using your time in the spotlight to shed light on a topic that will do more than win games. Your boldness will change and possibly save lives.

How many of you out there will stand bold with these role models and support their efforts to have mental health recognized as a key part of an athlete’s ability to perform?

Ima Hogg Children’s Mental Health Grants: Evaluating Programs and Building Sustainability

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Over 30 years ago Ms. Ima Hogg, being the visionary that she was, designated funding for services to address the mental health needs of children, youth and families in Houston and Harris County. In 2009 the Hogg Foundation funded eight agencies to support children, youth and families utilizing school and community-based resources and early childhood prevention and intervention.

In the final year of this grant initiative, grantees requested technical assistance around evaluation, outcomes and sustainability. Earlier this month the eight grantees met to network and participate in a training opportunity addressing these critical topics. (A special thanks to the DePelchin Children’s Center for hosting us!) The foundation’s own Dr. Michele Guzmán, assistant director of research and evaluation, provided guidance to the grantees around the importance of evaluation and reporting outcomes. The foundation’s National Advisory Council member, Domingo Barrios, facilitated a very interactive dialogue around strategies for maintaining quality community-based services and sustainability. The ongoing support of programs and how to continue services once a grant has ended is challenging for both funders and grantees. This meeting addressed this significant issue facing grantees and promoted an important discussion around the topic.

Funding for social services, including mental health, is limited. Yet, there are plenty of services and programs that need funding. Usually funders would like to fund grant programs for longer periods of time, yet we are faced with the challenges of more demand than supply. If we fund programs for longer periods of time it can limit our ability to assist in program development and new service delivery models.

Funders and service providers – how are you addressing this issue? I would love to hear your thoughts about this important topic in philanthropy.

Young People React to Eliminating Level Systems at Residential Treatment Centers

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In January of this year, Residential Treatment Centers (RTC) throughout Texas gathered in Houston and Austin to explore techniques for reducing their reliance on seclusion and restraint, and improving care for the young people they serve. Seclusion and restraint are dangerous behavioral management techniques that often exacerbate residents’ past traumatic experiences and prohibit the development of caring environments where young people thrive. The January gatherings were coordinated by Texas Network of Youth Services, the Hogg Foundation and national experts who supplied concrete resources and helped RTCs plan their initial implementation of trauma-informed care.

One of the most informative and compelling portions of the January training sessions was a panel of former RTC residents who talked about their experiences in these facilities and their transition into young adulthood. They talked about point and level systems, another behavior management technique often employed by RTCs that has been found to be “antithetical to individualized, culturally and developmentally appropriate treatment.”  Some residents said they liked the predictability of level systems, but many indicated that point and level systems pose an obstacle to treatment. A few of the RTCs decided to change or eliminate their point and level systems as a result of the panel’s feedback. Texas Network of Youth Services was able to interview five RTC residents about the elimination of point and level systems in their facility and wrote an article summarizing the discussion.

Here are some of the highlights from the summary:

  • Young people said “ it is more like it is at home and less like a placement” when point and level systems are eliminated.
  • Residents reported less envy among peers and a “more relaxed” environment.
  • There was a greater focus on treatment and communication.
  • Staff said they are better able to engage and empower residents by helping them set their own appropriate consequences for specific behavior.

Perhaps the best indicator of a successful transition from point and level systems is that the facility had 49 consecutive days without a restraint!

Peer Support, Peer Problems

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peer support, peer problems

As a grantmaking foundation, the Hogg Foundation is privy to a world of rich conversations about mental health, a world that we are often unable to do justice to in the course of everyday business. Sometimes, however, an opportunity presents itself for us to mine our relationships for the kind of storytelling that our usual communications — a blog post here, a press release there — only give a nod to. Such was the case with last December’s Alternatives conference, which inspired me to write an article about the growing field of certified peer specialists in mental health. The finished article, “Peer Support, Peer Problems,” was eventually published by Psych Central, one of the largest mental health resource sites on the web. An excerpt:

The therapeutic relationship is necessarily a test of the ability to maintain strict boundaries in an emotionally charged setting. But for peer specialists — individuals with lived experience of mental illness who have trained to use their recovery story to help others — the personal stakes can feel much higher.

Go read the entire article! Any feedback is appreciated.

 

 

 

No April Fools Here: Finding Common Ground and Building Community – Guest Post by Lara O’Toole

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This post was cross-posted from the Texas Network of Youth Services blog.

 

by Lara O’Toole, TNOYS meeting

The Harris County Transition-Age Youth and Families Initiative is an opportunity for youth, young adults, parents/caregivers, and service providers to come together to support mental health during the transition into adulthood.  A six-month planning phase is drawing to a close, but the initiative is one that will continue to grow and change over the next four years in order to build a stronger Houston.  TNOYS staff are excited to be coordinating the process and capturing its progress.

Some called April 1st the “best meeting yet!” and the energy that evening definitely supports that claim.  On Tuesday evening, April 1st, over 80 people – a diverse mix of youth, caregivers, and providers — gathered at DePelchin Children’s Center to review 8 plans that will be submitted to the Hogg Foundation for Mental Health in 2 weeks.  These plans came from teams at: Baylor College of Medicine’s Adolescent Department; Communities in Schools of Houston; Disability Rights Texas; Easter Seals of Greater Houston; Family Services of Greater Houston; Hay Center of Harris County Protective Services; Houston Department of Health and Human Services; and Star of Hope Mission.  During the planning phase, these teams conducted focus groups, interviews, and collaborated with youth and caregivers to design well-informed plans that complement one another.

TNOYS meeting The final planning meeting sparked connections and critical conversations.  It included: a review, discussion, and visual display of all plans; open dialogue; presentations by a team of youth and one caregiver; and a community dinner.  While not everyone in the conversation agreed on what is right for transition-age youth in Houston, the important thing is that they all have come to the table and are committed to developing plans that keep youth and caregivers at the center.  The efforts during this planning phase are only a first step; what follows will be the real work to change the system one organization at a time.

TNOYS is positioned to guide these eight organizations and their partners through a process of genuine youth and caregiver engagement that will result in stronger, more relevant services and supports.  Currently, the TNOYS team (Christine, Duncan, Lara, Elizabeth, Joyce, Sinclair, and LaQuentin) is building and strengthening a planning council, youth council, and caregiver council while also exploring participatory evaluation methods that will allow consumers to steer the initiative and promote continuous quality improvement.

TNOYS is looking forward to learning more about all of the plans, and hosting a community kickoff event in June in Houston.  We hope to have several more “best meetings yet.”

Lara O’Toole, LMSW, is Director of Professional & Program Development with the Texas Network of Youth Services.

Q&A with Yije Wang

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Yije Wang

Yije Wang, a doctoral student in the Human Development and Family Services Graduate Program at The University of Texas at Austin, was selected to receive the 2014 Frances Fowler Wallace Memorial for Mental Health Dissertation Award by the Hogg Foundation. The award will go to support research expenses for her dissertation on family and peer influence on the socialization of racial and ethnic minority adolescents.

Frances Fowler Wallace, the award’s namesake, was married to John Forsythe Wallace, who served as a member of the Texas House of Representatives and the State Board of Control. She died July 18, 1972, in Austin at the age of 80. The Wallace Award provides partial support for doctoral students’ dissertation research on “the cause, treatment, cure, and prevention of mental disease, mental illness, and mental disorders,” as directed in her will.  The award provides up to $1,500 for research-related expenses.

“One of the Hogg Foundation’s core values is supporting research that broadens our understanding of the psychological challenges faced by diverse populations and promotes interventions that further their well-being,” said Dr. Octavio N. Martinez, Jr., executive director of the Hogg Foundation. “With that in mind, awarding the Wallace Award to Ms. Wang was a straightforward decision.”

We spoke with Yije Wang about her research.

  1. Tell us about yourself. At what point did you decide to pursue a career in mental health research, and what influenced that decision? I decided to pursue a career in children’s mental health in college. I assisted in a research project on parent-adolescent conflict, interviewing more than 60 adolescents about their perspectives and feelings. Getting to know so many different life stories fascinated me, and I wanted to keep conducting research to better understand adolescents’ psychological well-being.
  1.  Your dissertation is titled, “Family-Peer Incongruence in Cultural Socialization and Adolescent Adjustment.” What questions are you trying to answer with this work? I’m particularly interested in the phenomenon that race/ethnic minority adolescents live at the conjunction of various cultures (e.g., their heritage culture, the mainstream American culture). In this work, I examined how two primary socialization agents, parents and peers, convey a variety of cultural messages (e.g., talking to the child about the importance to know one’s heritage vs. mainstream culture, involving the child in activities specific to one’s heritage vs. mainstream culture). When parents and peers convey incongruent messages (e.g., parents being more oriented towards the heritage culture and peers being more oriented towards the mainstream culture), I wanted to know how adolescents make meanings of the incongruence and how their well-being is affected.
  1.  What led to your taking a professional interest in this particular topic? Racial and ethnic minority youth are often portrait as being “caught between two worlds,” namely their heritage culture and the mainstream American culture. Although it has been theorized as an important predictor for adolescent psychological well-being and there is extensive literature about adolescents’ ability to navigate across cultural contexts, little empirical work has examined the cultural contexts across multiple developmental settings that eventually lead to the cultural challenges that youth are faced with.
  1.  How do you think your research methods and approach will help you to answer the questions that you’re posing? My research collected adolescents’ reports on their parents’ and peers’ practices of socializing adolescents towards their heritage culture or the mainstream culture. I used a statistical technique called latent profiles analysis to explore subpopulations of adolescents experiencing different patterns of family and peer socialization. I also looked at mean differences between family and peer socialization and linked the difference scores to adolescents’ psychological well-being.
  1.  Are there any suggested readings you can recommend for those who might be interested in learning more about this topic? I really liked two qualitative studies on this topic. They provided vivid and rich descriptions of the cultural incongruence racial and ethnic minority adolescents experience and the struggles they undergo as a result. One of them is Desiree Baolian Qin’s article in Journal of Adolescent Research on gender and ethnic identity negotiations of Chinese immigrant adolescents; another is a 1991 study by Patricia Phelan et. al. on how students negotiate family, peer and school cultures that was published in Anthropology & Education Quarterly.

The Hogg Foundation for Mental Health is currently accepting applications for this award; proposals are reviewed on a rolling basis and may be submitted at any time. http://www.hogg.utexas.edu/initiatives/FFW.html

On the Tragedy at Fort Hood

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As a nation we’ll spend the next weeks and months trying to piece together the details of the shootings this week at Fort Hood. One thing we know right now, which is the most important thing, is that four people are dead (one of them the shooter), 16 are wounded, and the lives of the victims and their friends and family have been irrevocably changed.

On behalf of the staff of the Hogg Foundation for Mental Health, I’d like to extend our condolences to the families of those who died, and our thoughts and prayers to everyone who has been affected. This would have been a tragic event no matter where it occurred. That it happened at Fort Hood, a community still recovering from the shootings of 2009, is heartbreaking.

My father was in the Air Force. I grew up on military bases. One thing I remember very distinctly was the feeling of safety we had. Outside the borders of the base, the world might be a dangerous place, but on base we felt protected.

That sense of safety was already ripped apart, at Fort Hood, by what happened in 2009. I can’t imagine how violated it feels now.

Our thoughts go out to the victims, their families and the community. We wish them all the love, compassion, support and understanding they deserve.

Sincerely,

Dr. Octavio N. Martinez, Jr.
Executive Director, Hogg Foundation for Mental Health

Local Clergy Get Trained in Mental Health First Aid

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mental health first aid

“Maybe your faith isn’t strong enough.” “You should just pray a little harder.” “Girl, the devil is just trying to steal your joy!” Sound familiar? Chances are you’ve said something similar to someone you know who is “going through” a mental health challenge, or someone has said something similar to you.

The truth is, mental health conditions are real! The National Institute of Mental Health estimates that 1 in 4 individuals live with a mental health condition. Mental illness does not discriminate and it does not spare individuals of strong faith or people of color! In fact, it is estimated that 75 percent of African Americans do not use traditional mental health services or providers and rely on pastors or clergy for support.

This year, the Austin Area African American Behavioral Health Network partnered with Austin Travis County Integral Care to offer Mental Health First Aid (MHFA) at the 14th Annual Central Texas African American Family Support Conference. Nearly 40 local faith leaders became certified in MHFA by participating in an 8-hour training program that introduced them to risk factors and warning signs of mental illnesses and to recognize when and how to refer an individual for additional support.

Faith communities have to begin to understand that some of the consequences of untreated mental illness include incarceration, homelessness, unemployment and substance use. It is my hope that with increased awareness and education in African American communities, we can decrease the stigma associated with seeking support for mental health conditions and get the help we need and deserve. I would love to hear from you about how your church or faith-based organization provides love and support (or if it is a challenge) to individuals living with mental health conditions and their families.

 

Introducing Hogg News

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Hogg News

If you do a search for “Hogg Foundation newsletter” at The University of Texas Digital Repository, you will find examples dating back to 1955. Since at least that time, the Hogg Foundation has recognized the importance of timely and regular communication with the public about the foundation’s activities and current priorities. As the foundation has evolved to keep pace with the most cutting-edge understandings of mental health, it only makes sense that our communication tools and approaches do likewise.

With that in mind, I’m excited to introduce our new electronic newsletter, the Hogg News. For those who grew accustomed to the Hogg Dialogue, or even our old print newsletter, the Hogg News should seem like quite a departure in terms of style and content. The major shift is that we’ve moved the traditional types of newsletter content to the bottom. You can still learn about recent Hogg news, read posts from Hogg Blog, and view recent Hogg publications. You just have to scroll down a bit.

At the top, in the “featured” space, we now highlight projects, issues, resources, and conversations that are of interest not just to readers who have a close relationship with the Hogg Foundation, but to anyone who cares about the future of mental health in America.

In this first issue we’re featuring the posters, sounds and stories that emerged from 4 Plus 4 Equals, a unique visual arts project in Austin designed to explore questions and raise awareness about mental health. This project, which was co-produced by Hogg grantee Via Hope, is an example of the kind of next-level thinking and conversation about mental health that the foundation loves to promote.

We would like to give special thanks to Stephen Callender of Stellar Impeller, a design and marketing agency in Austin, for the visually arresting design of the Hogg News.

Any and all feedback is welcome. To become a subscriber, visit this page and select “Email newsletter” from the list of options.

Thanks!

My Ah Ha! Moment: Beyond Evidence-Based Practice

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Remember the last time you had an Ah Ha! moment?

Mine was last Thursday morning, at work during a staff meeting.

In reviewing one of the agenda items, there was dialogue about the values and strategies of the Hogg Foundation for Mental Health. One of my colleagues pointed out that over the years the foundation has shifted their grant making efforts to a competitive and strategic process in order to achieve greater results, such as having a more significant impact with measurable outcomes.

The foundation has also shifted in a few other areas:

  • Five years ago, the foundation hired two full time individuals with lived mental health experience (consumers) as program officers.
  • We have incorporated the involvement of consumers, youth and family members in the design, development and implementation of the initiatives we fund.
  • We have appointed two individuals with lived mental health experience to the foundation’s National Advisory Council. The appointees provide guidance and expertise on matters related to strategic planning, major grant initiatives and other projects and activities.
  • We have funded consumer, youth and family centered recovery education initiatives

All of this has never been done before in the 74 year history of the foundation.

For years, the foundation has based much of its decisions on “Evidence Based Practice” (EBP). In layman’s terms EBP is:[1]

  • Based on a theory of change that is documented in a clear logic or conceptual mode.
  • Similar in content and structure to interventions that appear in registries and/or the peer-reviewed literature.
  • Supported by documentation that it has been effectively implemented in the past, and multiple times, in a manner attentive to scientific standards of evidence and with results that show a consistent pattern of credible and positive effects.
  • Reviewed and deemed appropriate by a panel of informed prevention experts that includes well-qualified prevention researchers who are experienced in evaluating prevention interventions similar to those under review; local prevention practitioners; and key community leaders as appropriate, e.g., officials from law enforcement and education

Then it hit me! Ah Ha! The Hogg Foundation has made some intentional decisions based on great ideas, not EBP! With this shift we are indeed having a more significant impact with measurable outcomes.