U.S. Department of Justice Office of Justice Programs, Innovation - Partnerships – Safer Neighborhoods Office of Juvenile Justice and Delinquency Prevention (OJJDP) Serving Children, Families and Communities OJJDP Deinstitutionalization of Status Offenders

I Mua Mau Ohana

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Intervention:
I Mua Mau Ohana (Moving Families Forward) is a long-term residential treatment program that uses culturally appropriate treatment for Hawaiian and Asian and Pacific Islander adolescents who suffer from substance abuse and co-occurring disorders. The ultimate goal of the substance abuse treatment intervention is to stop or reduce substance use by youth. Treatment services include nontraditional residential programming of adventure-based experiential therapy that employs culturally aligned land- and ocean-based experiences. An important aspect of the program is the improvement of a supportive family environment and family system, which is central to many Asian and Pacific Islander communities, and especially to Native Hawaiian identity and overall psychological health.

The program is a joint effort between two agencies in the state of Hawaii: Maui Youth and Family Services (MYFS) on the island of Maui and Marimed Foundation on the island of Oahu. Both agencies provide substance use disorder and psychiatric treatment for youth across the state.

The ongoing residential treatment program provides chemical dependency, psychological, medical, educational, adventure therapy, and vocational services for youth. Treatment consists of five basic components:
  1. An experiential learning/therapy component that includes a variety of activities design to foster and expand interest in personal growth and healing. Youths participate in culturally rotted activities, such as working in the lo’i kalo (taro field), canoe paddling, small boat sailing, and voyaging on a three-masted staysail schooner, the Makani Olu (Gracious Wind).
  2. An education component allows youths to return at age-appropriate grade levels after completing their treatment. Education is also provided on substance use and abuse, and addresses the importance of learning and expanding the skills needed for effective, independent living.
  3. A spiritual component is incorporated into the program. This component is designed to include cultural values and practices, to instill an awareness of well-being, and to facilitate individual recognition of personal mastery. Hawaiian cultural concepts of kuliana (responsibility) and pono (righteousness, or doing things rightly) are integrated through the treatment process.
  4. Counseling services are provided to address behavioral issues, as well as underlying feelings that may have led a youth to escape rather than cope with his or her problems.
  5. The program includes intensive family involvement inspired by traditional Hawaiian concepts of open communication and building trust. Family involvement includes biweekly family therapy sessions, monthly “family enrichment days,” and therapeutic home visits by staff shortly after youths are discharged from the program.
An aftercare component provides needed services to youths after they successfully complete the program. Successful completion is defined as a youth achieving at least 85 percent of target treatment goals outlined in his or her individual treatment plan.

Evaluation Methodology:
Study 1
Kim and Jackson (2009) used a single-group longitudinal design to evaluate the I Mua Mau Ohana program’s effectiveness in improving long-term outcomes for youth. An extensive outreach effort was conducted by disseminating program information and brochures to various youth-serving agencies, programs, schools, and other referral sources. During the research period (from September 2002 to October 2004), 250 program participants were admitted and completed an intake assessment. More than two thirds (68.4 percent) were male, 31.2 percent were female, and 0.4 percent were transgender. Participants were able to select more than one ethnicity; most reported being at least part Native Hawaiian (64.0 percent), followed by white (40.4 percent), other Pacific Islander (38.0 percent), Asian (36.8 percent), Hispanic (24.4 percent), Native American (8.8 percent), African American (8.0 percent), Alaskan Native (0.4 percent), or some other group (25.6 percent). Youths’ ages ranged from 13 to 18 years old, with the average age 15.8 years. The greatest substance use at intake was marijuana (63.2 percent), followed by alcohol (57.2 percent), and by methamphetamines and similar stimulants (30.8 percent).

The primary outcomes of interest are improvements on cessation of substance use, education and employment, physical and mental health, family and social functioning, and decreasing criminal justice involvement. The instruments used to collect data were the Government Performance and Results Act (GPRA) Tool and the Global Appraisal of Individual Needs. To measure substance use and substance problem severity, the Substance Problems Index was used along with items on GPRA. The Internal Mental Distress Index measured mental health. Change in psychological health was measured using the Emotional Problem Scale. The General Crime Index measured property crime, interpersonal crime, and drug crime. Finally, the Parent Activity Index was used as an indicator of family functioning.

Interviews were conducted with youths at intake and at the 3-, 6-, and 12-month follow-ups. The data was analyzed with a sequence of three (1 X 2) MANOVAS assessing the significance of change from intake to each of the 3 follow-up periods. Multivariate significance tests were also conducted for the major categories of analyses, including the substance use domain, the criminal justice domain, the physical and mental health domain, and the family functioning domain, and these included multiple F tests comparisons for individual varies and scales. Contingency table analyses were used to analyze change in percentage distributions for arrests variables.

The study had some limitations. First, there was no control or comparison group with which to compare the results of youth who participated in the program. Another major issue was the successful completion rate of youths in the program. A little more than half (51.3 percent) of all youth participants prematurely dropped out of the program.

Evaluation Outcome:
Study 1
Alcohol Use
From intake through the 3-, 6-, and 12-month follow-ups, youths in the I Mua Mau Ohana program reported significant decreases in the number of days they used alcohol in the past 90 days. During all 3 follow-up periods, youth participants also reported significant decreases in the number of days they used alcohol until they were drunk in the past 90 days.

Marijuana Use
Youth participants also reported significant decreases in the number of days they used marijuana in the past 90 days at all 3 follow-up periods.

Other Drug Use
There was a significant decrease in the number of days youths reported using stimulants in the past 90 days at all 3 follow-up periods. Youths also reported significant decreases in use of crack and hallucinogens at the 3- and 6-month follow-up periods, but the impact wore off by the 12-month follow-up. For all other drugs asked about (including inhalants, heroin, nonprescription drugs, PCP/angel dust, and analgesics), there was no significant impact on drug use in the past 90 days at any of the follow-up periods.

Mental Health
There were significant decreases on the Emotional Problem Scale at the 3-, 6- and 12-month follow-up periods, suggesting improvement in youths’ mental health status.

Family Functioning
There was significant increase in the Parent Activity Index (which was used as an indicator of family functioning) from intake to the 3-month follow-up. However, there was no significant change at the 6-month follow-up, and there was a significant decrease at the 12-month follow-up. The results suggest the program did not make a consistent impact on family functioning.

General Crime
There were significant reductions in the General Crime Index across all 3 follow-up periods. There were also significant reductions in the number of days that youths reported being held in juvenile detention during all 3 follow-up periods.

References:
Kim, Richard J., and David S. Jackson. 2009. “Outcome Evaluation Findings of a Hawaiian Culture-Based Adolescent Substance Abuse Treatment Program.” Psychological Services 6(1):43–55.

 
Program Specification:
Program Type:
Academic Skills Enhancement
Alcohol and Drug Therapy / Education
Cognitive Behavioral Treatment
Conflict Resolution / Interpersonal Skills
Family Therapy
Residential Treatment Centers
Ethnicity:
American Indian or Alaska Native
Asian
African American
Native Hawaiian or Other Pacific Islander
Hispanic or Latino (of any race)
White
Other Ethnicity
Gender:
Both
Age: Middle School: 11 to 13 years
High School/Young Adult: 14 to 21 years
Target Settings:
Rural
Suburban
Problem Behaviors:
ATOD/Underage Drinking
Family Functioning
DSO Strategies:
Direct Services
DSO Intervention Types:
Residential Care
Core Requirements:
Deinstitutionalization of Status Offenders (DSO)
Disproportionate Minority Contact (DMC)
 
Additional Information:
Endorsements:

Status:

Program is in operation at this time.

Performance Measures:
Suggested OJJDP Performance Measures for the Program Types(s):
Contact Information:

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OJJDP Deinstitutionalization of Status Offenders Best Practices Database
The OJJDP Deinstitutionalization of Status Offenders Best Practices Database  was created and developed by Development Services Group
under Cooperative Agreement #2008-JF-FX-0072.