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National Research Initiative - Appendix D

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Appendix D: Examples of Successful Research-Policy or
Research-Services Linkages Submitted by Agencies

Bureau of the Census/Housing and Household Economic Statistics Division

  • Poverty: The Urban Institute's analysis of the effect of the welfare reform bill (Personal Responsibility and Work Opportunity Reconciliation Act of 1996) was based on the Census Bureau's March Income Supplement to the Current Population Survey (CPS). The official poverty statistics published annually by the Census Bureau, based on the March CPS, are among the Federal Government's most widely quoted indicators of children's well-being. These data have recently been supplemented with SIPP data (Survey of Income and Program Participation) showing that children make up a large percentage of the long-term poor (those who remain in poverty for every month of a two-year period).

  • Health Insurance Coverage: Health insurance coverage of children is a major concern. Recently, researchers at the RAND Corporation used the SIPP data to examine the effect of the Kassebaum-Kennedy Health Care Reform bill on health insurance premiums, which RAND found to be minor. This research was cited as one of the reasons behind the bill's final passage.

  • Child Support: Child support data collected in the CPS and SIPP are used by the Office of Child Support Enforcement in HHS to track the effectiveness of child support collection and enforcement efforts and to gauge whether proposed new child support enforcement efforts will be successful. This measure will continue to gain importance with the passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, which seeks to improve enforcement of child support from absent parents.

  • Disability: SIPP is one of few national databases with a comprehensive set of questions on children's disability status. This data is used to examine the economic resources of families with disabled children in order to evaluate SSI.

  • Child Care: HHS used SIPP data showing costs and distribution of types of child care of working mothers by income, poverty status, and marital status to form their recommendations to the White House of child care costs required by welfare reform.

Centers for Disease Control and Prevention/
Agency for Toxic Substances and Disease Registry

Research-Policy Linkages

  • Preventing Perinatal HIV Transmission: Over the past two decades, perinatal transmission of human immunodeficiency virus (HIV) has infected over 15,000 children and claimed over 3,000 lives. In February 1994, NIH announced the interim results of AIDS Clinical Trials Group Protocol 076 (ACTG 076) demonstrating that zidovudine (ZDV) administered to a group of HIV-infected women during pregnancy and labor and to their newborns reduced the risk for perinatal HIV transmission by two-thirds.

    As a result of NIH's 1994 findings on ZDV therapy on pregnant women, CDC led a multi-faceted campaign, along with public and private health organizations, community groups and individuals, to translate the ACTG 076 results into effective prevention measures. Although the concept of using a drug to prevent HIV transmission is simple, implementing an effective prevention program based on this intervention requires many steps. First, standard practice guidelines must be developed, institutional procedures must be established, and providers and staff must be trained about HIV counseling and testing and about using ZDV therapy for HIV-infected women and their children. Maximizing the use of this intervention by HIV-infected women requires that all pregnant women have access to prenatal care, and that they be offered HIV counseling and voluntary testing. In addition to ZDV therapy, pregnant women infected with HIV must also be provided access to other important medical, social, and psychological services needed for their own health. Finally, to maximize the benefit of these prevention programs, surveillance and evaluation studies are needed to assess their impact and determine how they can be improved.

    Many organizations have already begun steps toward developing, implementing, and evaluating perinatal HIV prevention programs. A U.S. Public Health Service (USPHS) task force led by NIH and CDC published guidelines for HIV counseling and voluntary testing for pregnant women and for the use of ZDV to prevent perinatal HIV transmission. Several professional medical organizations have adopted policies in support of these guidelines. The U.S. Congress and many State legislatures are considering or have passed laws promoting HIV counseling and testing of pregnant women, including legislation passed in several States requiring that HIV testing be offered to all pregnant women. The Health Care Financing Administration has required State Medicaid programs to cover the cost of ZDV to prevent perinatal transmission and has also encouraged States to cover the costs of HIV counseling, education, and voluntary testing for Medicaid-eligible pregnant women. The Health Resources and Services Administration has disseminated guidance to sites funded by the Ryan White CARE Act regarding implementation of strategies to reduce perinatal transmission. Conferences and other continuing medical education activities are training public and private health-care providers in the skills required to implement perinatal HIV prevention programs. Ongoing educational efforts are under way to encourage pregnant women to seek HIV testing and to provide information for HIV-infected pregnant women to make informed decisions about using ZDV.

    Even in the midst of these activities, findings from early evaluations are providing valuable feedback on the progress and impact of the strategies to implement perinatal HIV prevention recommendations in different populations. For example, in North Carolina, of the identified children who were born after the State adopted the ZDV guidelines in 1994, 75 percent of their mothers used ZDV during pregnancy or at delivery. They further estimated that the risk for perinatal HIV transmission declined statewide from 21 percent in 1993 to 9 percent in 1994.

  • Birth Defects Prevention: Each year, 2,500 to 3,000 infants are born with neural tube defects (NTD) caused by incomplete closing of the spine. A CDC study providing further evidence that folic acid (a B vitamin) prevents neural tube defects led to a USPHS recommendation that all women of reproductive age should consume 0.4 mg of folic acid daily. Recently, the FDA ruled that all enriched grain products include folic acid at the level of 140 mcg per 100 grams of grain.

  • Injury Prevention: Head injuries are involved in 62 percent of bicycle-related deaths. CDC-funded research showed that bicycle helmets reduce the risk of head injury by 80 percent. Sixteen States now have statewide laws requiring use of helmets, and laws have been introduced or are pending in several others. In a joint Oregon-CDC evaluation it was shown that helmet use among children in Oregon went from 25 percent before the law to 49 percent afterward, and bicycle-related head injuries declined 47 percent for children under 10 years and 37 percent for children ages 10 to 15. In Georgia, the self-reported helmet use rate increased from 33 percent to 52 percent after the law took effect. This led to a new objective in Healthy Community 2000, urging all 50 States to pass such legislation.

    In another example, the potential for injuries associated with three-wheeled all-terrain vehicles (ATVs) was first identified by CDC researchers studying the problem in Alaska. Subsequently, the U.S. Consumer Product Safety Commission (in its role as a regulatory agency) reviewed the issue, determined that such vehicles were fundamentally unsafe, and banned their sale.

  • Lead Poisoning Prevention: In consultation with EPA and CDC, ATSDR conducted a study of the national extent of child lead poisoning. A Federal ad hoc panel was established and nationally recognized experts in toxicology and epidemiology were convened to conduct and oversee the study. States, Federal agencies, and other organizations contributed data on the extent of childhood lead poisoning, effects of lead on children, and sources of exposure.

    The report was transmitted to the Congress, through HHS, and to the Committee to Coordinate Environmental Health and Related Programs for the purpose of coordinating research and public health recommendations contained in the report. A substantial re-examination, and lowering to 10 ?g/dl, of the national standard for blood lead levels in children was conducted by CDC and implemented in a national public health initiative. ATSDR launched multiple studies to document lead exposure and adverse effects in children living near lead-contaminated sites.

    In addition, CDC established the National Childhood Lead Surveillance database. Data from these data surveillance systems are being used to estimate the number of children with elevated blood lead levels, target resources, direct screening activities and assess the effectiveness of intervention efforts. The National Health and Nutritional Examination Survey (NHANES), conducted by CDC, demonstrated that from 1976 through 1991, the number of children ages one to five years with blood lead levels higher than 10 micrograms per deciliter decreased from 88 percent to about 9 percent, due in part to the removal of lead from gasoline. NHANES III data indicate where the remaining blood lead poisoning problem continues to be of major public health concern among urban, minority, and low-income children and are being used to target prevention efforts.

  • Youth Risk Behavior: The Youth Risk Behavior Surveillance System (YRBSS) was developed to monitor priority health-risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems among youth and adults in the United States. The YRBSS monitors six categories of behaviors: (1) behaviors that contribute to unintentional and intentional injuries; (2) tobacco use; (3) alcohol and other drug use; (4) sexual behaviors that contribute to unintended pregnancy and sexually transmitted disease, including HIV infection; (5) dietary behaviors; and (6) physical activity.

    Data from the YRBSS are being used to (1) monitor progress in achieving 26 national health objectives for the year 2000, (2) monitor progress in achieving 28 Healthy Community 2000 model standards, (3) monitor progress in achieving National Education Goal 7 -- Safe, Disciplined, and Drug- Free Schools, (4) monitor progress in achieving measures of success for the American Cancer Society's comprehensive school health initiative, (5) focus school health education teacher training and instructional programs, and (6) support comprehensive school health programs nationwide.

  • Guidelines for Effective School Health Programs: CDC is developing guidelines to assist school-policy and decision- makers, school personnel, and others in planning, implementing, and evaluating programs that address specific health-risk behavior priority areas. Over the last two decades, there has been a growing body of controlled trials showing that well-designed school health programs can lead to improvement in a variety of health behaviors. Development of these guidelines includes an exhaustive review of published research and exemplary practice as well as collaboration with academic experts and national, Federal, and voluntary organizations with an interest in child and adolescent health. The guidelines include specific recommendations to help States, districts, and schools implement health promotion programs and policies that have been found to be most effective in promoting healthy behaviors. Recommendations cover topics such as policy development, curriculum development and selection, instructional strategies, staff training, family and community involvement, evaluation, and linkages between different components of the comprehensive school health program.

  • Tobacco Control - Implementation of the Synar Rule: The Synar rule, which implements Section 1926 of the Public Health Service Act, is putting research into practice, acting on the knowledge that about 3,000 young people under the age of 18 begin smoking every day and that 1,000 of them will eventually die of tobacco-related illnesses. The rule requires each State to have in place and to enforce state laws prohibiting the sale or distribution of tobacco products to individuals under the age of 18. Recent data from the Monitoring the Future Survey indicate significant increases in smoking among American youth. Limiting youth access to tobacco is one of many strategies necessary to reduce youth tobacco use.

    In addition, research has shown that, in the past, state enforcement efforts to prevent access to tobacco by minors were limited. The Inspector General determined that in 1992 only two of the 50 States reported having statewide enforcement strategies. Strong state enforcement of tobacco access laws is a major component of a comprehensive approach to preventing tobacco use among youth, and the Synar rule requires such enforcement. Ultimately, the Synar rule takes the knowledge of youth consumption trends and applies it to reducing the supply of tobacco products to young people.

  • Tobacco Control - Implementation of Goals 2000: The Pro- Children Act: Studies have shown that children exposed to secondhand smoke are more likely to have middle-ear disease, reduced lung function, and symptoms of respiratory irritation such as cough, phlegm, and wheeze. Exposures to secondhand smoke causes 150,000 to 300,000 lower respiratory tract infections in U.S. infants and children younger than 18 months, resulting in 7,500 to 15,000 hospitalizations a year. Exposure to secondhand smoke has also been directly linked to Sudden Infant Death Syndrome (SIDS), the major cause of death in infants between one month and one year of age. Such research helped educate the Congress about the health effects of secondhand smoke in infants, children, and youth and led to the Pro-Children Act, enacted in 1994.

    HHS worked collaboratively with the Department of Education (ED) and the Department of Agriculture (USDA) to implement the Pro-Children Act, which prohibits smoking in facilities (in some cases portions of facilities) in which certain Federally funded children's services are provided on a routine or regular basis. The law applies to practically all elementary and secondary education and library facilities, day care centers, certain health care services to children, the WIC Program, and the Head Start program. Implementation of this law will prevent youth exposure to secondhand smoke outside the home in a variety of settings to help prevent the health effects of secondhand smoke that research has shown.

  • Preventing Youth Injuries from Paper Balers: Because of the risk for severe injury or death associated with loading cardboard boxes into paper balers, Federal child labor law prohibited 16- and 17-year-old workers from performing this task. Recently the grocery industry lobbied to change this law on the basis that new safety features have been added to paper balers since 1954 when this legislation was passed. But questions still remained as to whether these safety features are present in all balers, and whether allowing youths to load balers that meet specific safety requirements could lead to youths loading balers that are not properly equipped. To assist in this policy debate, CDC provided epidemiologic data on youth fatalities associated with paper balers; engineering evaluation data on machines in use; and hosted a meeting bringing together divergent perspectives. This information affected the paper baler legislation recently signed by President Clinton. The new law includes mandates that injuries or fatalities to minors resulting from contact with balers be reported to the Department of Labor (DOL). NIOSH is also providing technical assistance to the DOL in the development of materials for employers to help determine whether balers meet safety requirements mandated in the legislation, and in the collection of data on any resultant injuries.

Research-Services Linkages

  • School Health Education - Research to Classroom Project: In the Research to Classroom Project, the CDC identifies curricula that have credible evidence of reducing health -- risk behaviors among youth, and then ensures that the interventions, including training, are available nationwide for those interested in using them. However, CDC does not endorse curricula -- schools decide what curricula best meet their students' needs. Identified curricula must have undergone evaluation against a control or comparison group. Findings must have included reductions in risk behaviors (not merely knowledge or attitude changes) at a follow-up measurement at least four weeks after the intervention. To be selected, a report of the evaluation study must have been published in a peer reviewed journal, and a set of external evaluation experts and a set of program experts must have determined that the findings were solid and that the intervention could be generally applied.

    Since the project was initiated in 1992, at least one person from 51 of 57 States and territories has been trained as a master trainer on one or more of the identified curricula, and more than 3370 teachers have received training.

  • Occupational Injury Prevention - Hazard Alert on "Preventing Deaths and Injuries of Adolescent Workers": Every year, approximately 70 youths are killed and another 64,000 require treatment in emergency rooms for work-related injuries. CDC published a Hazard Alert and a one-page fact sheet to inform employers, teens, their parents, teachers and other decision-makers of the risk for job injuries among adolescents. The fact sheet has been distributed to every high school principal in the United States, and has been inserted in some high school report cards and signed work permits, incorporated into occupational safety and health training and education in schools, and used as a training reference by employers of adolescents.

  • Occupational Injury Prevention - "Work Safe This Summer" Campaign: In May 1996, Secretary of Labor Robert Reich launched a national campaign to promote safe employment of teenagers. This campaign features recommendations for reducing occupational injuries and NIOSH data describing the magnitude, patterns and risk of injuries to working children and adolescents.

  • Development of a Neurobehavioral Test Battery for Children: A series of consultations was held with nationally recognized experts in pediatrics, child psychology, neuropsychology, neurotoxicology, and early education. A battery of screening tests to assess neurobehavioral function in children as young as one year of age was field-tested and adopted. As a result, an operations manual, detailing ATSDR's Pediatric Environmental Neurobehavioral Test Battery was released in FY 1996 and made available for studies of children, ranging from one through 16 years of age, who may be exposed to neurotoxic substances in the environment.

Consumer Product Safety Commission

  • Preventing Infant Suffocation: In late 1990, several infant deaths were associated with the use of infant bean bag cushions. Most of the infants who died on the infant cushions had been diagnosed as having SIDS, although they were found with their faces buried straight down into a product that molded around their heads. Medical experts in SIDS at St. Louis University tested the cushions and concluded that the deaths were likely due to rebreathing of lethal levels of carbon dioxide (CO2) trapped in the infant cushions. The CPSC worked with manufacturers to recall infant bean bag cushions in early 1991 and banned them in June 1992. There were 35 infant deaths associated with these cushions.

    Further research into SIDS deaths by CPSC staff showed that rebreathing CO2 trapped in soft bedding may contribute to the deaths of as many as 30 percent of the infants initially diagnosed as having SIDS. Study results showed that infants who died with their nose and mouth covered by soft bedding were more likely to be sleeping on their stomachs on top of pillows, comforters, and other soft bedding. CPSC worked with the American Academy of Pediatrics, the National Institute of Child Health and Human Development, and the SIDS Alliance to promote side and back sleeping positions for infants, and to warn against the dangers of soft bedding.

  • Child-Resistant Packaging: For more than two decades, CPSC has enforced the Poison Prevention Packaging Act (PPPA) that requires child-resistant packaging for various drugs and household products. A CPSC economist recently published an article in JAMA that underlined the importance of child- resistant packaging. He calculated that the death rate from poisonings by drugs and household products dropped by 45 percent since 1974. This translates into 460 lives saved from 1974 to 1992.

    To address the poisonings that still occur, last year, CPSC revised the regulations to ensure that the packaging is both child-resistant and "adult-friendly." This is accomplished by testing the packaging with both children under age five and with adults ages 50 to 70. The new packaging is already on the market and will continue to be phased in over the next year-and-a-half. It is hoped that if packaging is easier to use, adults will not defeat the child resistant packaging, leave the packages open, or request non child- resistant packaging.

  • Baby Walkers: Baby walkers account for more injuries annually for young children than any other nursery product. About 25,500 children under 17 months of age are treated each year in hospital emergency rooms for walker-related injuries. A recent CPSC study indicated that 83 percent of the incidents involve children falling down stairs or between levels in baby walkers. CPSC worked with ASTM, a voluntary standards organization, to develop a voluntary performance requirement that would result in modified designs of baby walkers. These new baby walkers will have to stop on a top step or be too large to fit through a basement doorway. The final voluntary requirement, expected to be published by the end of 1996, could result in substantial reductions in the number of walker-related injuries.

  • Child-Resistant Cigarette Lighters: Each year, an estimated average of 150 deaths, 1,100 injuries, and 5,600 residential structure fires have resulted from children under age five playing with cigarette lighters. CPSC worked cooperatively with industry to develop a test method that evaluates the ability of children under five years old to operate disposable lighters. With industry support, CPSC passed a mandatory rule, effective in 1994, that required that most lighters be child resistant. This should result in fewer deaths, injuries and residential fires.

  • Lead in Miniblinds: Childhood poisoning from lead is still a problem. Approximately 0.9 million children between the ages of one and five continue to have blood lead levels that are of concern. In children, lead poisoning can cause irreversible brain damage, delay mental and physical growth, and cause behavior and learning problems.

    Because consumers cannot determine the amount of lead in the dust on their blinds, CPSC recently advised parents with young children to remove these vinyl miniblinds from their homes. CPSC also asked the Window Covering Safety Council, which represents the industry, to immediately change the way it produces vinyl miniblinds by removing the added lead. Manufacturers have agreed, and new miniblinds without added lead are now available in stores.

  • Window Pull-Cords and Strangulations: Since 1981, over 180 cases in which children have been strangled by window cords have been reported, or about one death per month. In about half these cases, children between eight months and four years old were found hanging in the loop of the cords. In other cases, children were found with pull cords wrapped around their necks. The younger children who died, usually between eight and 23 months old, were often in cribs that were placed near the window cords. The older children, typically between two-and-a-half and four years old, usually strangled in cords when they climbed on furniture near windows.

    CPSC met with the industry Window Covering Safety Council to find ways to remove this hazard. Manufacturers have now eliminated the loop on all new two-corded horizontal blinds. In addition, CPSC is working with industry to develop a voluntary standard for window covering pull cords that will address this hazard.

  • Drawstrings on Children's Clothing: Since 1985, CPSC has received reports of 17 deaths and 42 non-fatal incidents caused by drawstrings from the hoods and necks of children's jackets catching on such things as playground equipment and cribs. CPSC worked with children's clothing manufacturers to address this issue. Within months, the industry voluntarily agreed to redesign children's sweatshirts and jackets without the hazardous drawstrings at the hoods and necks. Today, most of this type of children's clothing in this country is sold without drawstrings.

  • Bike Helmets: Each year about 300 children are killed and 400,000 go to hospital emergency rooms because of bike- related incidents. Many of these injuries, and most of the serious ones, are to the head. Helmets can reduce the risk of head injury by up to 85 percent. CPSC is working on a new standard for bike helmets.

  • Playgrounds: Each year, about 200,000 children are injured seriously enough on playgrounds to go to hospital emergency rooms. About 20,000 children under age five go to hospital emergency rooms for home playground injuries. About another 35,000 children under age five go to hospital emergency rooms for public playground injuries. CPSC has worked with industry on voluntary safety standards for both home and public playground equipment.

    CPSC has also published a "Handbook for Public Playground Safety" that includes guidelines for safe playgrounds. Among other measures, CPSC emphasizes the need for protective surfaces for playgrounds. Such surfaces can break the falls that account for up to 75 percent of playground injuries to children.

National Highway Traffic Safety Administration

Motor vehicle crashes are the leading cause of death for every age 5-27. Below are several illustrations of how research conducted under the auspices of the National Highway Traffic Safety Administration (NHTSA) has influenced and directed policy decisions and service delivery.

Research-Policy Linkages

  • Federal Motor Vehicle Safety Standard for Child Safety Seats: NHTSA's child safety program is focused on protecting children under age five from injuries in motor vehicle crashes. Child safety seats are used to transport children in vehicles. Early laboratory research with dummies in sleds identified the characteristics of a safe child seat. The results of this research led to the implementation of Federal Motor Vehicle Safety Standard (FMVSS) 213 which sets forth the requirements manufacturers must follow for child restraint systems used in motor vehicles and aircraft. As a result, child safety seats have been effective in reducing injury to children.

  • Children and Air Bags: While air bags are effective for adults and saved almost 500 lives in 1996 alone, the story is very different for children. To date, 32 children have suffered fatal injuries due to the activated passenger air bag. NHTSA required air bag warnings to be placed on the automobile visor; however, research showed that these warning labels were not noticed or understood. Focus group research provided information on effective warning labels (e.g., size, color, location, message) that parents would notice and read. This information was incorporated into a rule which will require manufacturers to install the new labels starting in May 1997. Other rulemaking is also under way to reduce airbags' power by 20 to 35 percent which will reduce the risk of airbag injury to children. These improvements are being made through changes to Federal airbag requirements (FMVSS 208).

  • Zero Tolerance: Research has shown that zero tolerance laws reduce single vehicle nighttime fatal crashes among drivers under the age of 21. A "zero tolerance" law sets a blood alcohol concentration (BAC) level of .02 or less for drivers under age 21. Such laws are called zero tolerance because a driver is likely to exceed a .02 BAC limit after only one beer or other alcoholic drink. These research results were influential in the passage of zero tolerance laws in 37 States and the District of Columbia. They also were influential in the enactment of a Federal zero tolerance requirement in the National Highway System Designation Act of 1995. Under this law, States without a zero tolerance law will lose highway construction funds.

  • Model Ice Cream Vendor Ordinance: In the early 1970s, NHTSA noticed that there was considerable casualties occurred around ice cream vending trucks. NHTSA conducted research to determine how best to address this problem. The research resulted in a model ice cream vendor ordinance which stipulated that those vehicles bear specific markings and signage and that they use certain routes. Subsequent testing showed these interventions to be highly effective.

Research-Services Linkages

  • Better Targeted Programs: Data show that young male pickup truck drivers have low safety belt usage. Recent research has provided information on effective messages and delivery mechanisms to reach this audience. Results from the research have been incorporated into public information and education materials targeted at young male pickup truck drivers.

  • Enforcement of Underage Impaired Driving Laws: Data indicated that the rates at which young drivers were being arrested for driving under the influence (DUI) of alcohol were far lower than the involvement of young drivers in alcohol-related crashes. Subsequent research then showed that DUI enforcement patrol tactics targeted adult drinking drivers, and overlooked young drivers, where drinking and driving patterns differed from those of adults. Training was initiated to inform police officers of the differences in youth drinking and driving behavior and to provide guidance on changing patrol tactics to apprehend youthful drinking drivers.

National Institutes of Health - National Institute of
Environmental Health Sciences (NIEHS)

  • Air Pollution: NIEHS funded long-term studies on effects of air pollution on human health that showed an association between chronic exposure to acid aerosols and respiratory symptoms in children. These findings have been pivotal in development of EPA guidelines for sulfur dioxide and particulate matter emissions.

  • PCBs: NIEHS research has shown that nursing infants are exposed to PCBs via their mother's milk and that children and mothers can be exposed to PCBs from eating fish that have accumulated PCBs in their tissues. Based on this research, California health laws have defined PCBs as a reproductive health hazard, and New York has issued health advisories for nursing mothers who consume contaminated fish.

  • Children's Environmental Health Network: NIEHS is one of several governmental agencies that supports the Children's Environmental Health Network. This effort has helped to establish an infrastructure to communicate environmental health policy, research and education among the network's governmental and non-governmental organizations.

National Institutes of Heath - National Institute
of Child Health and Human Development (NICHD)

  • The NICHD Family and Child Well-Being Research Network: NICHD established this multi-disciplinary network to enable researchers to do policy-relevant research and to collaborate directly with policy researchers. There are several examples of how the Network has empowered the university research community to act proactively and engage in a policy-relevant project.

    The Network has published a paper on new indicators of family and child well-being and co-sponsored a conference with the Institute for Research on Poverty (University of Wisconsin) to examine the state-of-the-art regarding welfare reform. This conference was held at NIH and led to the ASPE report on child well-being. The Network also budgeted resources to help the work of the Interagency Federal Forum on Child and Family Statistics, which has put together a short list of the most important indicators of child well- being that are under consideration for formal recognition as an authoritative series of government indicators.

    The Network also worked with the Census Bureau for three years to design the Survey of Program Dynamics (SPD). The Network enabled the scientific community to invest resources into the SPD design, which has enhanced the study's credibility. As a result, the new welfare legislation funds the SPD for six years, making it an important national source of data for evaluating welfare reform.

    The Network has enabled researchers to undertake other similar projects useful to the policy arms of Government and led to a good working relationship with ASPE and the Administration for Children and Families (ACF) of HHS to help address issues related to welfare reform. ASPE and ACF have now joined forces with the Network to develop better indicators of family and child well-being and to help design state-based evaluations of welfare reform that can work in harmony with the SPD.

  • Learning Disability: Children who do not learn to read constitute approximately 17 percent of the population and comprise over 50 percent of the special education population. Thirty-five percent of children with learning disabilities in reading drop out of school, a rate twice that of their classmates. Further, at least half of juvenile delinquents manifest some type of learning disability. In response to the significant deleterious impact that learning disabilities have on the development of the child, NICHD supported research to develop a diagnostic battery of assessment measures that predict children's reading performance. On the basis of these predictions, several NICHD prevention and early intervention sites are now under way and have demonstrated that reading disability can be prevented if intense and direct interventions take place in kindergarten and first grade. These findings were underscored by other NICHD research showing that 75 percent of learning disabled children who are not identified and provided with intervention by age nine will remain disabled through high school. These findings have been presented to the White House Interagency Committee on Learning Disabilities (an arm of the Domestic Policy Council).

  • Child support: NICHD has used USDA data to create family equivalence scales that, in turn, result in child support schedules. NICHD researchers have explored which types of people pay child support, how custody affects child support, and the role child support plays in children's well-being.

  • Adolescent Health: NICHD, with funding from 10 NIH program offices and components and other Public Health Services agencies, is conducting the National Longitudinal Study of Adolescent Health. The goal of the study is to better understand the factors that promote good health among young people and to explore those factors that place youth at risk. Data is being shared with researchers, program planners, parents, educators, and health care providers across the country.

Office of National Drug Control Policy (ONDCP)

  • Alcohol and Drug Use: Survey and other research by Federal agencies and private organizations provides convincing evidence that early first use of alcohol or tobacco is strongly correlated with later use of illegal substances. Children who smoke cigarettes are 12 times more likely to use marijuana and 19 times more likely to use cocaine.

    Such knowledge has been instrumental in shaping numerous Federal policies and programs. Many substance abuse prevention strategies are now oriented toward elementary and middle school youth. The research has been cited in testimony, budget justifications, and public information and educational initiatives.

  • Link Between Drugs and Violence: Understanding of the strong link between drugs and violence was a major impetus for modifying the Drug Free Schools and Communities Act to the Safe and Drug-Free Schools and Communities Act (Title IV).

  • Drug Data Evaluation and Interagency Coordination Working Group: ONDCP is also part of a Drug Data Evaluation and Interagency Coordination Working Group that includes representatives from about 20 Federal departments and agencies involved with drug issues. During its first year, the Subcommittee developed an inventory of drug-related information systems and data sets; produced a report, Federal Drug-Related Data Needs Assessment; and consulted with public- and private-sector drug research experts concerning drug data and policy issues.

U.S. Department of Agriculture

USDA is the Federal Government's lead agency for human nutrition research, and is responsible for assuring and monitoring the nutritional health of all Americans through nutrition research. The Agricultural Research Service (ARS) in the Research, Education, and Economics (REE) mission area of USDA conducts an integrated program of human nutrition research that provides a vital link to the interdisciplinary food and agricultural sciences programs of REE agencies. The ARS has six Human Nutrition Research Centers nationwide, staffed by a cadre of renowned scientists with expertise in nutrition, in areas that cover the spectrum of the human life cycle. Two of these centers are targeted to research on the specific needs of children: the Children's Nutrition Research Center in Houston, Texas, and the Arkansas Children's Nutrition Research Center in Little Rock.

The ARS also serves as the USDA leader and liaison for the mandatory review every five years of the Dietary Guidelines for Americans, the Federal policy document for all nutrition information and education materials produced by the Federal Government. ARS research is critical to the development of these guidelines. ARS also conducts nationwide surveys of food consumption by Americans, the data from which are used to support development of food and nutrition policies within USDA. Food consumption data is also used by other Federal agencies that form policy. These agencies include EPA and HHS.

USDA relies heavily on scientific research to formulate policy related to providing Americans with a healthful and abundant food supply; in other words, research affects USDA's food and nutrition policies. In December 1994, the Center for Nutrition Policy and Promotion (CNPP) was created to facilitate the link between research and the dietary and socioeconomic needs of the consumer. CNPP has used research in the following ways:

  • Research on food and nutrient consumption helped determine which foods must be fortified with folate to prevent birth defects. It published the Dietary Guidelines for Americans every five years to promote healthful diet for individuals over the age of two years.

  • Research on the cost of raising children is used to publish an annual report, "Expenditure on Children by Families," that estimates food and other expenditures incurred by parents of different economic levels. States use this report to help establish child support guidelines and foster care payments. These guidelines affect millions of youngsters involved in child custody and support cases.

  • Research on how maternal nutrition affects the health of infants can have a direct impact on nutritional policies for pregnant women in economically vulnerable groups.

Research related to food assistance and other nutrition programs also results in policy evaluation, often leading to much-needed improvements. For example, CNPP is responsible for the development of USDA food plans, including the Thrifty Food Plan (TFP), which serves as the nutritional basis for Food Stamp benefit level. TFP specifies quantities of different types of food that households may use to provide nutritious meals and snacks at relatively low cost. State-of-the-art nutrition and economic modeling is used periodically to revise the TFP, which affects millions of American adults and their children.

U.S. Department of Education

Research-Services Linkages

  • Success for All: Building on Research to Improve Learning: One of the best known programs for whole school reform is Success for All, a comprehensive school-wide restructuring program designed to ensure that all children are successful in basic skills, particularly reading, the first time they are taught. Success for All draws from research to determine effective ways of improving reading and writing instruction, building family support for education, and helping teachers and other staff members implement the program. Components of the instructional program include one-on-one tutoring by certified teachers; regular assessments to determine whether students are making adequate progress and to suggest alternative teaching strategies; and an early reading program that uses regular storybooks supported by careful instruction that focuses on phonetic awareness, auditory discrimination, and sound- blending.

    Success for All programs are being implemented in 28 States across the Nation. In Houston, Texas, the program is being "scaled up" to 74 elementary schools. Implementation funds come from the Texas Education Agency, with the district and participating schools providing continuing support primarily through reallocation of Title I and special education resources.

  • Family Connections-A Tool for Parent Involvement in the Education of Young Children: Research has repeatedly shown that parent involvement is critical to children's learning. The Appalachia Educational Laboratory built on the research base to develop practical ways of increasing parental involvement to support young children's reading. A series of 30 four-page weekly guides for home use includes messages to parents on reading aloud, effective discipline strategies, learning through play, and appropriate learning activities for parents and other family members to do with young children. The series was first tested in Kentucky in 1992 and subsequently used in Virginia, West Virginia, Mississippi, Oklahoma, New York, and Tennessee.

  • Teaching Cases: New Approaches to the Pedagogy of Teacher Education and Staff Development: The Far West Laboratory for Educational Research and Development has drawn on the work of Bruner, Resnick, Sprio, Shone and others to develop case-based approaches for teacher preparation and staff development that connect general principles with the demands of real-world educational situations. Approaches include case analysis, case writing, and case discussion that help teachers develop new skills, deepen their knowledge of subject matter, and acquire needed sensitivities to children of diverse backgrounds and cultures.

  • Center for Research on Teacher Learning: Research findings resulting from work at the Center for Research on Teacher Learning are providing a framework for Kentucky's school reform (KERA) relating to teacher development. In order for the goals of KERA to be realized, it became obvious that teachers must be supported as they learn new teaching practices and assume new roles in school governance. The research of the Center is being applied to the policy and budgetary decisions about what teachers need in order to help students meet the State's new learning goals. Understanding of what is required in making significant change go as far beyond surface and trivial teacher workshops for new strategies. Researchers are partners with policymakers and practitioners in identifying and, it is hoped, implementing the conditions for successful reform.


Over time, researchers have demonstrated not only how to assess the progress of individual students, but also how to analyze each student's learning environment (e.g., factors at school, in the home, and in the community) that can significantly influence educational outcomes. These and other advances in research have contributed to development and validation of innovative approaches to education that result in improved learning and increased independence among infants, toddlers, children, and youth with disabilities.

Research-Policy Linkages

  • Pre-referral Services Projects: Projects such as those conducted by OSEP researcher Tanis Bryan (University of Illinois-Chicago) have helped schools reduce the number of children referred to special education programs and services. Local schools using pre-referral services form collaborative teams of special educators and general educators. Team members identify, observe, and assess children who are experiencing difficulty learning in their general education classrooms. The team then develops and implements alternative instructional strategies that seek to address each child's individual academic and social problems. Teachers employ these strategies with the child in general education classrooms -- before (not after) referral to special education becomes necessary. Pilot pre-referral services projects have reduced rates of special education referrals by 30-50 percent in three States (California, Kansas, and North Carolina). Based on these positive results, pre-referral services are now required in 27 States.

  • Transition Services Projects: Projects such as those conducted by OSEP researcher Philip Ferguson (University of Oregon), help prepare youths with disabilities for employment after high school. In the 1980s, OSEP transition projects provided States and localities with information about effective transition programs. For example, OSEP researchers have shown that the key features of successful programs include (a) involving the students themselves in making choices about their own post-school jobs, (b) providing opportunities for work and "on-the-job" experience while the students are in high school, and c creating local networks of families, peers, and employers who can provide ongoing support after the students finish high school. States and localities are currently using these proven practices to plan for successful transitions for all youth with disabilities. Transition plans for students with disabilities, many of which are modeled after proven practices, are now required in each of the 50 States.

  • Early Identification Projects: Projects such as those conducted by OSEP researcher Keith Scott (University of Miami), have demonstrated proven techniques to determine which children need early intervention. Early identification is a continuous process that involves (a) screening children to identify who to refer for additional evaluation and (b) clinically assessing referred children to identify their individual needs for services. OSEP research shows that these procedures are effective in identifying not only infants and toddlers with severe disabilities but also young children at risk for developmental delays. These techniques are widely used, as shown by the fact that "child find" systems for early identification are now required in each of the 50 States.

  • Family-Based Services Projects: Projects such as those conducted by OSEP researchers Carl Dunst (Allegheny-Singer Research Institute, Pittsburgh, Pennsylvania), demonstrate proven strategies to empower parents to actively support their child's growth and development. OSEP-funded research suggests not only the importance of family involvement but also effective strategies for working with families of young children with disabilities. For example, when a young child needs services from different local agencies, it is often necessary to help families learn how to assess and effectively coordinate the delivery of these services. Individual Family Service Plans, many of which reflect these proven practices, are now required for all young children with disabilities who receive Federally supported early-intervention programs and services.

Research-Services Linkages

  • Curriculum-Based Measurement (CBM) Projects: Projects such as those conducted by OSEP researchers Lynn and Douglas Fuchs (Vanderbilt University), help teachers learn how to adjust their instruction to improve educational outcomes for students with learning disabilities. Teachers using CBM ask their students to answer questions that assess their comprehension of a short passage in reading or their skill at solving word problems in mathematics; the tests are administered on a weekly or semi-monthly basis throughout the school year. OSEP-funded research demonstrates how teachers can use CBM results to identify students who would benefit from more time to complete their assignments or from cooperative reviews of their lessons with peers. These proven practices are changing how children with disabilities are assessed all across the country. Title I programs in Nashville Public Schools have adopted this practice. SEAs are using CBM practices in Colorado, Iowa, Kansas, and Nebraska. In addition, LEAs are using this practice in California, Illinois, Kansas, Iowa, Minnesota, Nebraska, Oregon, and Tennessee.

  • Critical Thinking Skills Projects: Projects such as those conducted by OSEP researcher Donald Deshler (University of Kansas), have helped middle school and high school students with learning disabilities develop the complex learning strategies needed for tomorrow's jobs. For example, one set of proven strategies has helped students improve their writing skills. The strategies provide "helpful hints" and other guidelines for identifying a stimulating theme for a composition, writing clearly worded sentences that elaborate upon the theme, organizing these sentences into coherent paragraphs, and systematically checking the composition for errors. OSEP researchers found that not only did the performance of students increase dramatically after they learned these strategies, but also that outside reviewers rated the students' written products more highly, on average, than those of their non-disabled peers. Today, these proven practices are widely used, having been disseminated through a national network of teachers and teacher-trainers. This network, which is based at the universities in four States (Arizona, Alabama, Kansas, and Pennsylvania), has provided information to more than 75,000 teachers in 1,200 school districts in 26 States across the country.

  • Anchored Instruction Techniques1: Techniques such as those demonstrated by OSEP researchers Ted Hasselbring (Vanderbilt University), Ralph Ferretti (University of Delaware), and John Woodward (University of Puget Sound). Teachers using anchored instruction techniques ask their students to view video and animated adventures on CD-ROM discs. The teachers then use these adventures to organize a series of interrelated lessons around a common topic. The lessons help students learn to select a challenging topic, discover what it means, and then communicate this information to their peers, other teachers, and their families. As a result, students with learning disabilities are excelling in math, reading, and social studies. OSEP-funded research shows that teachers' use of this proven practice can help thousands of students with disabilities, at all skill levels, to access new information and excel in reading, mathematics, and social science. These CD-ROM discs are commercially distributed through state distribution centers.

U.S. Department of Health and Human Services,
Administration for Children and Families

  • SIME/DIME Negative Income Tax Experiments: Results of these experiments suggested that provision of cash assistance to two-parent families had destabilizing family impacts, and helped lead to the downfall of welfare reform legislation in the late 1970s.

  • Welfare-to-Work Demonstration Projects: Projects, evaluated by the Manpower Demonstration Research Corporation, were very influential in the development of the Family Support Act of 1988, particularly the JOBS program.

  • The Ohio Learning, Earning and Parenting (LEAP) Program: Positive findings on school attendance and enrollment from the LEAP program led to President Clinton's recent executive action on school requirements for teen parents.

    Other research has also been influential, but in different ways the Bane and Ellwood studies of welfare dynamics in the 1980s, for instance, provided a much greater understanding of the welfare caseload. This research was used to develop targeting strategies.

    One of the best examples of research-services linkages is the Families and Schools Together (FAST) project. FAST is a collaborative prevention project for elementary school children who are at-risk for school failure, juvenile delinquency, and substance abuse in adolescence. The collaboration involves schools, nonprofit mental health services, education and assessment agencies for substance abuse, and families. The following convey a sense of how FAST research and development results are facilitating more effective service delivery and informing public policy decision-making:

    • FAST is being taken to scale in Madison, Wisconsin. Over the next three years, FAST will be expanded to every school in the city. A broadly representative group of public and private organizations and businesses will provide funding.

    • Both Head Start-FAST and middle school-FAST have been replicated in three other States. FAST sites include Racine and Kenosha, Wisconsin, Des Moines, Iowa, and Baltimore, Maryland.

    • The FAST elementary school program has been replicated in 26 States and Canada, with funding from the DeWitt Wallace Reader's Digest Fund. There are now almost 200 certified FAST trainers. FAST has achieved substantial cross-cultural and cross-language success.

    • Both California (under a Juvenile Crime Prevention Initiative) and Wisconsin (under the Anti-Drug bill) have included FAST in their state budgets for $1 million a year for five years or more.

    • The National Institute of Drug Abuse is reportedly on the verge of approving a request for a $3 million intensive, long-term evaluation of FAST.

    • CNN recently reported on FAST programs in Florida and Georgia. FAST has received awards from the United Way of America, Harvard/Ford Foundation, and the Family Resource Coalition.

U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation (ASPE)

  • Institute for Research on Poverty: For almost 30 years, ASPE has supported the Institute for Research on Poverty, a national, university-based center for research on the nature, causes, and consequences of poverty and social inequity in the United States. The Institute sponsors the original research of its members and dissemination of their findings. Its work has consistently been multidisciplinary, pooling research interest and knowledge across the major fields of social science. The Institute's research has advanced the link between science and policy related to welfare reform proposals, assessment of training and employment programs for young people, investigations of groups at high risk of poverty (e.g., the homeless, the disabled, and single parent families), and monitoring of demographic behavior.

    Here are just two examples of how the Institute is helping to bridge the gap between the research, policy, and services realms:

    • The economically vulnerable state of many single-parent families led Institute researchers to propose, in 1982, the Wisconsin Child Support Assurance System, an alternative to Aid to Families with Dependent Children (AFDC) for custodial parents with child support orders. Three components of this recommendation became law with the passage of the national Family Support Act of 1988.

    • In February 1996, the Institute presented a conference on "The New Federalism: Monitoring Consequences" to enable researchers and other analysts to share information about what they were doing in response to the emergence of new programs and policies affecting children and families and to discuss the coordination of efforts to monitor, evaluate, and respond to those changes.

    1 See also: Fox, J. (March 1990). The Impact of Research on Education Policy, Office of Research, Office of Educational Research and Improvement, U.S. Department of Education, Working Paper OR 90-522.

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National Research Initiative - Report

National Research Initiative - Appendix A

National Research Initiative - Appendix B

National Research Initiative - Appendix C

National Research Initiative - Appendix D