RAND Resource Guide Can Help Students Recover from Traumatic Experiences

Following Hurricanes Katrina and Rita, hundreds of thousands of schoolchildren in the Gulf States were displaced. The trauma that accompanies the loss of home, familiar surroundings, and sometimes even family members and friends may have serious long-term consequences for children. The schools that absorbed displaced children were usually equipped to provide mental health support. However, many had limited information for determining individual children's needs and providing appropriate help. To assist schools and students, RAND researchers developed a resource guide that describes school-based mental health programs for students exposed to trauma. The guide provides information on programs and other resources, including guidance on assessing treatment needs and selecting children for trauma programs, descriptions of 24 trauma-focused programs that have been used worldwide, funding options to obtain program materials and train staff, and ways to identify new sources of funding. The researchers also interviewed school personnel in Louisiana, Mississippi, Texas, and Alabama to understand what helped them implement mental health programs for their students, and what got in the way. According to many school personnel the team interviewed, the main barriers to helping students following the hurricanes were a lack of knowledge about what programs they should use and a lack of staff trained to implement mental health programs. The RAND resource guide—How Schools Can Help Students Recover From Traumatic Experiences: A Tool Kit for Supporting Long-Term Recovery—puts this information in the hands of schools before a disaster happens. The kit is also available as a Web-based decision tool to help schools focus on those programs that best match their needs.

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Neighborhood Parks Improve Physical Activity Among Adolescent Girls

Increased rates of obesity and other health problems related to diet and sedentary lifestyles among children are a growing problem, and Congress has sought legislative solutions. Adolescent girls in particular pose concern because their level of physical activity is known to decrease as they progress through adolescence. Many studies have shown that proximity to parks and other recreational facilities can influence physical activity. A team of researchers led by RAND's Deborah Cohen examined the relationship between neighborhood parks and physical activity among adolescent girls. Using baseline data from the Trial of Activity for Adolescent Girls—a national research study focusing on middle-school girls—the study examined the physical activity of 1,556 sixth-grade girls in six U.S. cities. It also counted the average number of public parks within a one-mile radius of the girls' homes. The study found that adolescent girls who live within one-half mile of a public park are significantly more physically active than other girls. The most dramatic effects on physical activity were seen among girls living near miniparks, playgrounds, walking paths, and running tracks. The findings suggest that communities should make parks a higher priority, particularly ones with amenities like running tracks or walking paths, which also are relatively inexpensive to create.

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People with Asthma and Other Obstructive Lung Diseases Get About Half of Recommended Care

Obstructive lung disease affects approximately 9 percent of all Americans and is a leading cause of death in the United States. Specific forms of the disease include asthma and chronic obstructive pulmonary disease (COPD), the most common form of which is emphysema. Although many studies have identified proper care for those with these illnesses, little is known about how often patients receive proper care. A team of researchers from RAND and other institutions assessed the quality of care received by patients with obstructive lung disease. The researchers examined a nationally representative sample from 12 communities around the United States. The results showed that people with asthma and COPD receive only 57 percent of recommended care. The pattern of care varied by condition. Patients with asthma received about 67 percent of the care recommended for routine management of their illness, but only 48 percent of the care recommended when their condition worsened. The opposite pattern held among patients with COPD. Patients received just 46 percent of the routine care recommended for COPD, compared with about 60 percent of recommended care when their symptoms were worse. Improving care for both conditions could save lives and improve health for large numbers of Americans. For example, the study estimates that increasing the number of COPD patients in the United States who receive oxygen treatment at home could prevent 27,000 to 57,000 deaths annually. In addition, increasing the number of hospitalized asthmatic patients who receive systematic steroid treatments could prevent an estimated 2,000 deaths each year.

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