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Programs for Care System Transitions in Mental Health: A Systematic Review

June 3, 2022

Although transitions between health care systems are common when patients move between jobs or insurers, they are especially difficult to navigate when patients with mental health conditions leave an integrated system, such as the Military Health System (MHS). The authors synthesize evidence from studies of interventions that facilitate transitions between mental health care systems, such as the transition from the MHS to the Veterans Health Administration (VHA).The authors searched multiple research databases, reference-mined bibliographies of existing reviews, and consulted with experts to identify existing evaluations of transition support interventions. Key informants helped identify pertinent populations of interest who are transitioning between health care systems.Seventeen studies evaluating different approaches met inclusion criteria. Studies reported on different outcomes, and few could be combined in aggregated analyses. Analyses showed that care transition interventions can increase outpatient mental health service use, but the overall body of evidence is limited.

Use of Predictive Analytic Tools to Assess Technological Emergences and Acquisition Targets

June 2, 2022

The United States has been the international leader in science and technology of importance to national security for three-quarters of a century. However, the development by other nations of their own science and technology capabilities, in concert with and fueled by increasing globalization and connectivity of economic and technological development, has increased competition for technological leadership. The authors use patent filings to analyze the current relative positions of the United States and other countries in selected technology areas of interest to the Department of the Air Force: additive manufacturing, artificial intelligence, ceramics, quantum, sensors, and space.Areas of technological emergence were identified by detecting rapid growth in cumulative patent applications in specific technology areas and whether this occurred in the United States or China. The authors also describe and analyze the patent portfolios of U.S. companies that were early filers in these areas, focusing on small or medium-size companies that were not already owned or controlled by foreign entities; this, in turn, enabled identification of companies that had specific leading technological capabilities that could make them attractive for possible foreign acquisition. The authors propose a method to simultaneously identify connected areas of technological emergence and the companies with leading capabilities in these areas.

America's 5G Era: Balancing Big Data and Privacy

June 2, 2022

Fifth-generation (5G) wireless networking will increase the scale of wireless networks by an order of magnitude or more. Perhaps nothing exemplifies the future of the 5G era more than the ubiquitous surveillance that is gathering more and more-diverse data on people. Even before the 5G era, data were seen as a source of new economic value.The number of automated sensors and devices connected to wireless networks will grow in the next few years by an order of magnitude or more. Increasingly, these networks will inform artificial-intelligence algorithms, which will then autonomously make decisions and take actions — with humans directly involved only infrequently. In this report, researchers discuss how the United States should seek to balance the potential gains of the 5G era with the potential loss of privacy and of control of personal data.

Investing in Primary Care: Why It Matters for Californians with Commercial Coverage

April 19, 2022

Decades of research have shown that increased investments in primary care lead to higher-quality and more equitable care as well as lower costs. However, there were few data on the level of primary care investment specifically in the California health care market. This first-of-its-kind study, Investing in Primary Care: Why It Matters for Californians with Commercial Coverage, measures primary care spending, as a proportion of overall spending, among eight health plans and their product offerings, covering 80% of commercially insured adults in California (13.9 million). The study also took a deeper look at the primary care spending of 180 separate provider organizations, comprising 8.5 million adults enrolled in HMO plans, or nearly half of California's commercially insured adults.To measure the impact of primary care investment on care quality, researchers compared provider organizations on measures including the share of members who received recommended breast cancer, cervical cancer, and colorectal cancer screenings; received appropriate medications; and who had their diabetes care goals met. 

Deterrence and Escalation in Competition with Russia (Executive Summary)

January 20, 2022

The deterrence of armed conflict has been studied intensively for decades, as have escalation dynamics along the path to such conflicts. The deterrence of forms of aggression below the level of armed conflict -- such hostile measures as economic coercion, political subversion, and military intimidation -- has received much less attention.In this report, the authors investigate how the United States might use its military posture in Europe (specifically, ground forces) as part of a strategy to deter these Russian malign activities.The authors identify how forward posture could deter hostile measures through signaling the United States' commitment to its allies and partners, providing irregular capabilities for those partners and allies threatened with political subversion, providing conventional capabilities to neutralize hostile powers' coercion attempts, and providing support for other instruments of U.S. power, such as sanctions. However, forward posture can also lead to an escalation in competitor activities, increasing their sense of threat, incentivizing partners to undertake aggression at levels below armed conflict, and incentivizing third parties to act in ways that increase the likelihood of confrontation. The authors propose ways to calibrate U.S. forward posture to minimize such risks while enhancing deterrence.

Establishing Feeder-Designation Relationships with Colleges and Universities to Increase Racial and Ethnic Diversity in Air Force Officer Accessions

December 27, 2021

The U.S. Air Force's Diversity and Inclusion Task Force was established to specifically assess ways of improving diversity, equity, and inclusion within the Department of the Air Force (DAF). The task force asked the RAND Corporation to explore several topics that resulted in deep-dive projects. One of the topics was assessing the efficacy of making Tuskegee University in Alabama a "feeder for the Air Force" to assist with increasing racial and ethnic diversity in officer accessions. Our first order of business was to explore, codify, and define the use of the term "feeder" in the Air Force context. The results of the exploration revealed that there is no official regulatory definition for the use of the term. Even if used as a term of art, it is still necessary to define and codify the term for the purposes of increasing diversity in accessions in a meaningful way.

Social and Emotional Learning Is the Cornerstone

December 16, 2021

This report provides an illustration of two Opportunity by Design (ObD) high schools in which practices for supporting students' SEL were implemented schoolwide and integrated into teachers' academic instruction. The ObD initiative was launched by the Carnegie Corporation of New York to support the design and creation of a network of small, innovative high schools of choice in large, urban districts in the United States. These schools provide a unique perspective on what implementation of schoolwide, integrated, explicit SEL instruction can look like when it is a core design feature from school inception. The findings may provide valuable insight for leaders of other small high schools seeking to strengthen their own focus on SEL.

Job-Related Stress Threatens the Teacher Supply: Key Findings from the 2021 State of the U.S. Teacher Survey

June 15, 2021

Teaching was a stressful occupation long before the coronavirus disease 2019 (COVID-19) pandemic occurred; during the pandemic, it might have become even more stressful. Teachers are navigating unfamiliar technology, are balancing multiple modes of teaching, and have concerns about returning to in-person instruction. In addition, many teachers are caring for their own children while teaching.To explore the issue of job-related stress among teachers, the authors fielded a survey in January and February 2021 through RAND's American Teacher Panel. The results suggest that teachers have experienced many job-related stressors during the 2020–2021 academic year. Perhaps as a result, one in four teachers were considering leaving their job by the end of the school year — more than in a typical prepandemic year and a higher rate than employed adults nationally. Black or African American teachers were particularly likely to plan to leave. Also, teachers were more likely to report experiencing frequent job-related stress and symptoms of depression than the general population.Stressful working conditions and increased personal responsibilities were more common among likely pandemic leavers (i.e., teachers who were unlikely to leave their jobs before the pandemic but who were likely to leave at the time of the survey). The experiences of these likely pandemic leavers were similar in many ways to those of teachers who left the profession after the start of the pandemic. These similarities suggest that likely pandemic leavers might decide to quit their jobs absent efforts to address challenging working conditions and support teacher well-being.

Using State-level Policy Levers to Promote Principal Quality

November 17, 2020

In this report, we examine how seven states use state policy levers to advance policy change to improve the quality of school principals. These states are all actively engaging in a collaborative initiative focused on principal preparation program redesign. We consider the following questions, drawing on data about the use of various policy levers in the states:How does a state's context shape its use of policy levers to improve principal quality? What  policy  levers  are  states  using,  how  are  the  levers  used,  and  what  policy changes have states made that affect the way levers are used? What supports the effective use of policy levers?What are the barriers to and facilitators of policy change?All seven states in the study were part of The Wallace Foundation's University Principal Preparation Initiative (UPPI). Launched in 2016, UPPI is supporting seven university-based principal preparation programs to work in collaboration with their district and state partners to redesign and improve the programs to better support the development of effective principals.  The programs were chosen for the initiative, in part, because they were located in states that had favorable conditions for supporting principal quality. In addition, the programs had expressed interest in and already conducted some initial work toward redesigning their principal preparation programs. The UPPI programs and their respective states are Albany State University (Georgia), Florida Atlantic University (Florida), North Carolina State University (North Carolina), San Diego State University (California), the University of Connecticut (Connecticut), Virginia State University (Virginia), and Western Kentucky University (Kentucky).We drew on three data sources for this analysis: (1)  biannual interviews with UPPI participants, (2) interviews with state-level stakeholders across the seven UPPI states, and (3) relevant secondary data, such as state plans, state licensure requirements, state legislation, reports from state departments of education, and research literature on school leadership. In this report, we focus on seven policy levers that states can use to improve school leadership. The first six of these were drawn from research as described by Manna (2015), and the seventh was derived from Grissom, Mitani, and Woo (2019): setting principal standardsrecruiting aspiring principals into the professionlicensing new and veteran principals approving and overseeing principal preparation programssupporting principals' growth with professional development evaluating principalsusing leader tracking systems to support analysis of aspiring and established school leaders' experiences and outcomes.

High School Teachers' Perceptions and Use of Personalized Learning Findings from the American Teacher Panel

August 12, 2020

Technology-facilitated personalized learning (PL) approaches have become increasingly common in K–12 schools across the United States, and as distance learning becomes more common during the coronavirus disease 2019 (COVID-19) pandemic, they are poised to become even more widely used. PL aims to create individual learning experiences and pathways for students. PL takes a wide variety of forms and typically involves changes to instructional materials and practices as well as school and system-level organizational conditions. These changes are often facilitated by technology. Despite the popularity of PL, little data exists on the prevalence of PL practices, and there is only limited understanding of the conditions needed to support high-quality PL implementation, particularly in high schools. This report presents findings from RAND's 2018 American Teacher Panel. As part of the survey, a nationally representative sample of high school teachers responded to questions about their use of instructional practices consistent with PL and access to necessary supports. The findings should be useful to practitioners, professional development and support providers, researchers, and policymakers who are interested in understanding how high school teachers are using PL practices and which supports and resources they need to use them effectively.

Gun Policy In America: An Overview (Updated April, 2020)

April 22, 2020

This report is an overview of the key findings from RAND's Gun Policy in America initiative, which aimed to provide objective information on what is and isn't known about the effects of different gun laws, to create tools and resources to improve the quality of research on gun policy, and improve the national debate on developing fair and effective gun policies.

A Consensus Proposal for a Revised Regional Order in Post-Soviet Europe and Eurasia

December 19, 2019

At the core of the heightened tensions between Russia and the West is the contest for influence over the countries physically located between them (referred to here as the in-between states): first and foremost Ukraine, but also Belarus, Moldova, Georgia, Armenia, and Azerbaijan. While the relationship between Russia and the West was far from ideal before 2014, it was the Ukraine crisis that fundamentally changed that relationship, ruling out any remaining hopes for partnership and effectively institutionalizing a confrontational dynamic. The contest over the in-between states has taken a significant toll on these countries. The most extreme case is the war in Ukraine, in which over 13,000 people have died; other regional conflicts have occurred in Moldova, Georgia, and Azerbaijan, and the competition has also disrupted regional trade patterns and set back the process of reform and domestic transformation in these states. In short, all of the states involved—Russia, the countries of the West, and the in-between states—are less secure and prosperous as a result.