The operation of Glen Canyon Dam on the Colorado River affects several downstream resources and water uses including water supply for consumptive uses in Arizona, California, and Nevada, hydroelectric power production, endangered species of native fish, recreational angling for non-native fish, and recreational boating in the Grand Canyon. Decisions about the magnitude and timing of water releases through the dam involve trade-offs between these resources and uses. The numerous laws affecting dam operations create a hierarchy of legal priorities that should govern these decisions. At the top of the hierarchy are mandatory requirements for water storage and delivery and for conservation of endangered species. Other resources and water uses have lower legal priorities. The Glen Canyon Dam Adaptive Management Program ("AMP") has substituted collaborative decision making among stakeholders for the hierarchy of priorities created by law. The AMP has thereby facilitated non-compliance with the Endangered Species Act by the Bureau of Reclamation, which operates the dam, and has effectively given hydroelectric power production and non-native fisheries higher priorities than they are legally entitled to. Adaptive management is consistent with the laws governing operation of Glen Canyon Dam, but collaborative decision making is not. Nor is collaborative decision making an essential, or even logical, component of adaptive management. As implemented in the case of Glen Canyon Dam, collaborative decision making has actually stifled adaptive management by making agreement among stakeholders a prerequisite to changes in the operation of the dam. This Article proposes a program for adaptive, but not collaborative, management of Glen Canyon Dam that would better conform to the law and would be more amenable to adaptation and experimentation than would the current, stakeholder-centered program.

This brief article, written for a symposium on "Collaboration and the Colorado River," evaluates the U.S. Department of the Interior's Glen Canyon Dam Adaptive Management Program ("AMP"). The AMP has been advanced as a pioneering collaborative and adaptive approach for both decreasing scientific uncertainty in support of regulatory decision-making and helping manage contentious resource disputes -- in this case, the increasingly thorny conflict over the Colorado River's finite natural resources. Though encouraging in some respects, the AMP serves as a valuable illustration of the flaws of existing regulatory processes purporting to incorporate collaboration and regulatory adaptation into the decision-making process. Born in the shadow of the law and improvised with too little thought as to its structure, the AMP demonstrates the need to attend to the design of the regulatory process and integrate mechanisms that compel systematic program evaluation and adaptation. As such, the AMP provides vital information on how future collaborative experiments might be modified to enhance their prospects of success.

With a focus on resources of the Colorado River ecosystem below Glen Canyon Dam, the Glen Canyon Dam Adaptive Management Program has included a variety of experimental policy tests, ranging from manipulation of water releases from the dam to removal of non-native fish within Grand Canyon National Park. None of these field-scale experiments has yet produced unambiguous results in terms of management prescriptions. But there has been adaptive learning, mostly from unanticipated or surprising resource responses relative to predictions from ecosystem modeling. Surprise learning opportunities may often be viewed with dismay by some stakeholders who might not be clear about the purpose of science and modeling in adaptive management. However, the experimental results from the Glen Canyon Dam program actually represent scientific successes in terms of revealing new opportunities for developing better river management policies. A new long-term experimental management planning process for Glen Canyon Dam operations, started in 2011 by the U.S. Department of the Interior, provides an opportunity to refocus management objectives, identify and evaluate key uncertainties about the influence of dam releases, and refine monitoring for learning over the next several decades. Adaptive learning since 1995 is critical input to this long-term planning effort. Embracing uncertainty and surprise outcomes revealed by monitoring and ecosystem modeling will likely continue the advancement of resource objectives below the dam, and may also promote efficient learning in other complex programs.

The Glen Canyon Dam Adaptive Management Program (AMP) has been identified as a model for natural resource management. We challenge that assertion, citing the lack of progress toward a long-term management plan for the dam, sustained extra-programmatic conflict, and a downriver ecology that is still in jeopardy, despite over ten years of meetings and an expensive research program. We have examined the primary and secondary sources available on the AMP’s design and operation in light of best practices identified in the literature on adaptive management and collaborative decision-making. We have identified six shortcomings: (1) an inadequate approach to identifying stakeholders; (2) a failure to provide clear goals and involve stakeholders in establishing the operating procedures that guide the collaborative process; (3) inappropriate use of professional neutrals and a failure to cultivate consensus; (4) a failure to establish and follow clear joint fact-finding procedures; (5) a failure to produce functional written agreements; and (6) a failure to manage the AMP adaptively and cultivate long-term problem-solving capacity.

Adaptive management can be an effective approach for addressing complex ecosystem-related processes like the operation of the Glen Canyon Dam, particularly in the face of substantial complexity, uncertainty, and political contentiousness. However, the Glen Canyon Dam AMP shows that a stated commitment to collaboration and adaptive management is insufficient. Effective management of natural resources can only be realized through careful attention to the collaborative design and implementation of appropriate problem-solving and adaptive-management procedures. It also requires the development of an appropriate organizational infrastructure that promotes stakeholder dialogue and agency learning. Though the experimental Glen Canyon Dam AMP is far from a success of collaborative adaptive management, the lessons from its shortcomings can foster more effective collaborative adaptive management in the future by Congress, federal agencies, and local and state authorities.

Purpose: Implementation of a postpartum depression (PPD) screening while using evidence-based interventions to improve depressive symptoms, enhance breastfeeding (BF) self-efficacy, and strengthen the mother-infant dyad (MID).

Background and Significance: PPD is highly prevalent among women living in the United States and threatens the physical and psychological health of MIDs. Many of these women go undiagnosed and without treatment, further worsening symptoms and outcomes. This has inspired world healthcare leaders and organizations to address maternal mental health among postpartum women.

Methods: A 12-week evidenced-based project consisted of two-sets of participants including mothers and staff. A comprehensive maternal support program guided by an informational pamphlet (IP) and implementation of PPD screening using the Edinburgh Postnatal Depression Scale served as the two-part intervention for this project. Goals were to decrease PPD, enhance BF satisfaction, and strengthen the MID. Comprehensive maternal support encompasses interventions proven to meet the project goals and includes tailored BF education and care to maternal needs, social support by peer/family involvement, skin-to-skin contact during BF, emotion-regulation strategies, and availability of community resources.

Outcomes: The BSES-SF scores did result in statistical significance based on an alpha value of 0.10, t(3) = -2.98, p = .059, proving a positive effect was seen in breastfeeding self-efficacy post intervention. The results did not show statistical significance (t(3) = 0.60, p = .591) in regard to pre and post-depression scores. However, the mean pre-score (M =3.50, SD 3.11) did decrease post-intervention (M =2.75, SD 1.26) and exemplifies clinical significance.

Conclusion: The outcomes of this Quality-Improvement project showed improved scores for depression and BF self-efficacy post-intervention. This demonstrates the value in screening for PPD using a validated screening tool and instituting comprehensive maternal support guided by evidence-based practice in a community setting.

Routine cervical cancer screening has significantly decreased the mortality rate of cervical cancer. Today, cervical cancer predominantly affects those who are rarely or never screened. Government programs are in place to provide cervical cancer screening at little to no cost, yet screening rates remain suboptimal.

This project evaluated an evidence-based intervention to increase cervical cancer screening among underserved women in a federally qualified health center (FQHC). Female patients ages 21 to 65 years without history of hysterectomy (n=1,710) were sent reminders to their phones through the electronic health record (EHR). The message included educational material about the screening process and an announcement regarding government aid for free or reduced cost screening.

The number of patients who made an appointment after receiving the message was assessed two months later. In total, 156 responses were collected, and 28 patients made an appointment for screening. The most frequently observed category of Ethnicity was Hispanic/Latina (n = 24, 86%). The most frequently observed category of Insurance was Title X (n = 13, 46%). The observations for Age had an average of 41.04 (SD = 9.93). Using an EHR communication function to send motivational reminders has shown some promise for increasing cervical cancer screening, thereby reducing cervical cancer mortality among the underserved.