Many dimensions of disparity exist in the United States, both in health and in the social and economic aspects of well-being. If a health, social, or economic outcome is seen in a greater or lesser extent between populations, there is disparity. Race or ethnicity, sex, sexual identity, age, disability, socioeconomic status, and geographic location all contribute to an individual’s ability to achieve health and well-being. CDM projects address disparities related to underserved populations that often have multiple health and social/economic problems further aggravated by poverty, homelessness, and lack of health insurance. As a minority-owned business, CDM has a special commitment to this work.

Knowledge Application Program (KAP)

A large part of CDM’s work on SAMHSA’s Knowledge Application Program (KAP) has involved developing Treatment Improvement Protocols (TIPs) that aim to enhance the quality and cultural responsiveness of behavioral health services provided to special populations that have been historically underserved or that have particularly complex and multifaceted needs. Some of our most notable TIPs have focused on such special populations as individuals who are homeless (TIP 55), women (TIP 51), individuals who are suicidal (TIP 50), individuals involved with the criminal justice system (TIP 44), individuals with co-occurring disorders (TIP 42), individuals with HIV/AIDS (TIP 37), and individuals with child abuse and neglect issues (TIP 36).

Migrant and Seasonal Farmworkers

CDM led a team of multicultural researchers, dual language learner assessment and early childhood experts to provide ACF with a reliable and valid research plan to gather periodic information that describes the Migrant and Seasonal Head Start programs and participating families. The result of this project is a comprehensive, multi-method research design that describes variations in program services, identifies strengths and gaps in Head Start services, and describes disparity issues experienced by migrant and seasonal farmworker families and children served by Head Start, including lack of insurance coverage, access to care, health literacy, and language barriers.

As an integral part of our work, CDM continues to support gender initiatives, racial/ethnic initiatives, and other programs that reach underserved populations that often have multiple and overlapping health problems exacerbated by poverty, homelessness, and lack of health insurance.
Discrimination Focus Groups

While racial and ethnic discrimination has been related to potential risk factors for disease, less is known about the impact of discrimination because of weight, sexual orientation, or chronic disabilities on health outcomes. CDM conducts focus groups for the Eunice Kennedy Shriver National Institute on Child Health and Human Development to gain a better understanding of the link between these forms of discrimination, health outcomes, and health risk behaviors among youth, and to inform the development of survey measures.

Co-Occurring Disorders

SAMHSA has identified as one of its highest priorities the improvement of treatment and services for individuals with co-occurring mental and substance abuse disorders, and created the Co-Occurring Center for Excellence (COCE) as a vital link between the agency and states, communities, and providers. CDM and its partners managed SAMHSA’s Co-Occurring Center for Excellence (COCE).

In addition to operating the Co-Occurring Center for Excellence (COCE), CDM developed and produced the Treatment Improvement Protocol (TIP), Substance Abuse Treatment for Persons With Co-Occurring Disorders. This TIP revises TIP 9, Assessment and Treatment of Patients With Coexisting Mental Illness and Alcohol and Other Drug Abuse. The revised TIP provides information about developments in the rapidly growing field of co-occurring substance use and mental disorders and captures the state-of-the-art in the treatment of people with co-occurring disorders. The TIP focuses on practical realities of clinical cases and real situations so the reader will acquire increased knowledge, encouragement, and resourcefulness in working with clients with co-occurring disorders.  


CDM continues to work to improve services for people who are homeless, one of the most vulnerable groups in our Nation. Projects include the National Resource and Training Center on Homelessness and Mental Illness and the National Technical Assistance Center on Chronic Homelessness. An earlier project included the Model Programs for Homeless Individuals, which supported the evaluation of model demonstration projects addressing the needs of homeless people with both mental and substance use disorders.  CDM provided qualitative and quantitative research support services and technical assistance to help grantees evaluate the effectiveness of their programs.  CDM also produced a compendium of promising models for national replication.

Alcohol Research Mentoring

To assist new investigators in the alcohol research field, CDM supported the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in designing and pilot testing an Alcohol Research Mentoring System (ARMS).  Using distance learning and information technology, promising new investigators were guided through the process of developing and submitting grants and, where appropriate, preparing resubmissions. NIAAA initiated this effort to encourage and mentor new investigators, especially those who are members of racial/ethnic minorities.

Cluster Groups

CDM supported CSAP’s cluster group initiative to improve prevention programs for traditionally underserved populations.  Individual clusters disseminated knowledge about specific cultural issues and appropriate intervention strategies for African American, Asian/Pacific Islander, and Hispanic populations; rural communities; and women and children.

Minority Recruitment Materials

For the National Institute on Deafness and Other Communication Disorders (NIDCD), CDM prepared written and multimedia materials to support outreach, recruitment, and training to encourage an increase in minority participation in research on deafness and other communication disorders. 

Focus Group Research on Highway Safety Issues Among Hispanic Populations

CDM conducted telephone surveys and focus groups for the National Highway Traffic Safety Administration (NHTSA) in a qualitative study to identify the impact of highway safety messages on subgroups of the Hispanic population in the United States.  CDM staff collected and analyzed data to determine how NHTSA should tailor its communications to best promote safety in those communities.

Nursing Workforce Research

CDM examined the development and implementation of successful approaches to recruiting and retaining Hispanic Americans in baccalaureate nursing education programs.  CDM identified key factors and synthesized these into a working model that other baccalaureate programs could use to improve the representation of Hispanics in nursing.  This model, in the form of a monograph, targeted institutions that sought to enhance diversity in the nursing workforce.