Program records as a source for program implementation assessment and youth outcomes predictors during residential care

This study used point card information from a residential program to generate treatment fidelity metrics and determine if the metrics predicted youth outcomes after six months in care. Youth outcomes included staff (n = 52) and youth (n = 143) ratings, youth conduct records kept by the residential program's teaching-family homes and school records. Treatment fidelity metrics included the program components: (a) percentage of positive interactions, (b) number of privileges earned, and (c) a skills taught to interactions ratio. The percentage of positive interactions averaged 90% per youth; 76% of the point cards indicated that privileges were earned; and a variety of life skills were typically taught to the youth (skills ratio = .61). The data from the treatment fidelity metrics supported that the program was implemented consistent with program expectations. The range of implementation quality for each measured component was then used to predict youth outcomes. Increased percent of positive interactions predicted significantly decreased externalizing behaviors as reported by staff (β = − 0.31, p < .001) and youth (β = − 0.30, p < .001), and significantly fewer incidents of non-compliance (Exp(b) = 0.93, p < .001) and school problems (Exp(b) = 0.91, p < .001) as indicated on the program records. The skills ratio indicated similar trends across outcomes, although non-significant at the p < .01 level. Permanent products may be helpful to develop program treatment fidelity metrics, which may be useful for monitoring implementation and may be associated with improved youth outcomes.     

The Moderating Effects of Risk, Protection and Desistance on Violence in Female Adolescents

The major focus of this study was to test the theory driven conceptual model derived from the literature regarding risk, protective and desistance factors in relation to violent behavior of female adolescents. This study utilized The National Longitudinal Adolescent Health Study (Add Health) dataset and included 2,031 female participants. The conceptual model developed was based on life course perspective as it relates to violent behavior in adolescents. The tested SEM model suggested: (1) that each of the latent variables of risk (β = .06, t = .02, p < .001) and protective factors (β = −.07, t = .01, p < .001) were significantly directly associated with violent behavior, (2) the latent variable, desistance factors (β = .01, t = .06, p > .05), was not significantly directly associated with violent behavior, (3) there were mediating effects between risk factors, protective factors and violent behavior (β = −.12, t = .04, p < .05) and (4) there were no mediating effects between risk factors, desistance factors and violent behavior (β = −1.28, t = 2.99, p > .05).     

Differential Item Functioning of Pathological Gambling Criteria: An Examination of Gender, Race/Ethnicity, and Age

This study tested for the presence of differential item functioning (DIF) in DSM-IV Pathological Gambling Disorder (PGD) criteria based on gender, race/ethnicity and age. Using a nationally representative sample of adults from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), indicating current gambling (n = 10,899), Multiple Indicator-Multiple Cause (MIMIC) models tested for DIF, controlling for income, education, and marital status. Compared to the reference groups (i.e., Male, Caucasian, and ages 25–59 years), women (OR = 0.62; P < .001) and Asian Americans (OR = 0.33; P < .001) were less likely to endorse preoccupation (Criterion 1). Women were more likely to endorse gambling to escape (Criterion 5) (OR = 2.22; P < .001) but young adults (OR = 0.62; P < .05) were less likely to endorse it. African Americans (OR = 2.50; P < .001) and Hispanics were more likely to endorse trying to cut back (Criterion 3) (OR = 2.01; P < .01). African Americans were more likely to endorse the suffering losses (OR = 2.27; P < .01) criterion. Young adults were more likely to endorse chasing losses (Criterion 9) (OR = 1.81; P < .01) while older adults were less likely to endorse this criterion (OR = 0.76; P < .05). Further research is needed to identify factors contributing to DIF, address criteria level bias, and examine differential test functioning.     

The effects of organizational context on autonomy-enhancing policies in assisted living

This study examines the effects of facility size, ownership, chain membership, and residents' characteristics on autonomy-enhancing policies in assisted living. The theoretical framework for the study is based on the open systems perspective, which views organizations as being influenced by environmental context (e.g., ownership and chain membership). Data were collected from interviews with administrators of 60 facilities in Maryland. Autonomy-enhancing policies were assessed with the MEAP Policy Choice and Resident Control scales. Facility size and residents' disability were strong predictors of autonomy-enhancing policies (R² = .39, p < .001). Higher levels of policies that foster resident autonomy were associated with larger facility size (β = .54, p < .001) and lower residents' disability (β = .23, p < .05). Chain membership had an indirect influence on autonomy-enhancing via facility size and residents' disability. Chain-related facilities were larger, and their residents were less disabled. The study contributes to a better understanding of the mechanism through which organizational factors influence resident-oriented policies.     

The Efficacy of a Modified Theory of Reasoned Action to Explain Gambling Behavior in College Students

Recently, Thrasher et al. (College Student Affairs Journal 27(1): 57–75, 2007) explored the efficacy of the Theory of Reasoned Action (TRA; Ajzen and Fishbein, Attitudes, personality, and behavior, 1980) in explaining gambling behavior of college students. However, their study found the TRA only predicted small amounts of variance in gambling intentions. Heeding their call to enhance the efficacy of the TRA through the addition of explanatory variables to the model, the present study incorporated gambling motivations and locus of control as moderating variables within the TRA to test the potential of a modified TRA in explaining gambling behavior of college students. A total of 345 students at a major metropolitan research university in the Midwest volunteered to participate in the study. A series of hierarchical linear regressions indicated intrinsic motivation to accomplish (p = .002) significantly moderated the relationship between gambling attitudes and gambling intentions. Further, internal locus of control (p < .001), chance locus of control (p < .001), and powerful others locus of control (p < .001) also significantly moderated the relationship between gambling attitudes and gambling intentions. The significant impact of the moderating variables on the relationship between gambling attitudes and intentions suggests intrinsic motivation and locus of control can alter the impact of the relationship between gambling attitudes and gambling intentions.     

Bullied and Punished: Exploring the Links between Bullying and Discipline for Sexual and Gender Minority Youth

This study investigated connections between sexual and gender minority youths’ (SGMY) experiences with bullying victimization and their experiences with punishment. We interviewed 20 diverse adolescents (X = 18.45) about their experiences with bullying and school discipline. Using a qualitative mapping technique, we analyzed the pathways between victimization and punishment that emerged from our participants’ narratives. Our analyses revealed that among the adolescents who had experienced victimization related to their sexual orientation and/or gender identity (or expression) (n = 17), most of them (n = 15) had also experienced punishment connected to their victimization. We identified five pathways linking victimization and bullying. Further, we found that the majority of participants were navigating school contexts rife with pervasive and ongoing harassment and that adults ineffectively intervened and often compounded the harm experienced.     

Disparities in Persistent Victimization and Associated Internalizing Symptoms for Heterosexual Versus Sexual Minority Youth

This study investigated whether lesbian, gay, and bisexual (LGB) adolescents were at higher risk for persistent victimization of bullying compared to heterosexual adolescents, and how victimization trajectories were associated with internalizing symptom development across LGB and heterosexual adolescents. Data came from a five‐wave study (M_ageT1 = 11.1 to M_ageT5 = 22.3; n = 151 LGB; n = 1,275 heterosexual) and informants were adolescents and their parents. Adolescents were classified in three victimization trajectories: persistent (5.6%), decreasing (28.1%) or low (66.3%) victimization. LGB adolescents reported more persistent victimization, relative to no (OR = 6.79, 95% CI [3.52, 13.13]) or decreasing victimization (OR = 3.09, 95% CI [1.53, 6.24]), compared to heterosexual peers. Further, persistent victimization was more strongly associated with anxiety among LGB than among heterosexual adolescents.     

Beginning street life: Factors contributing to children working and living on the streets of Khartoum, Sudan

Understanding why some children work on the streets while others live there, and how causal factors differ by gender, is important in developing effective services for them. This study examined these questions in Sudan using participant observation, qualitative interviews, and surveys of working boys (n = 1025), working girls (n = 192), street boys (n = 397), and street girls (n = 35). Street children were less likely than working children to have local families (66% and 77%, p < 0.001), and more likely to have experienced some prior hardships, e.g. a mother's death (17% and 10%, p < 0.001), or coming from the war-torn south (30% and 10%, p < 0.001). 70% of street children and 10% of working children had abused (i.e. sniffed and sucked) glue (p < 0.001); initiating glue abuse often coincided with a transition from working to living on the streets. Within groups, conditions ‘pushing’ girls to street life were often harsher than for boys. For working girls, these included death of both parents (10% and 3%, p < 0.001), and/or insufficient food at home (59% and 43%, p < 0.001). For street girls, they included having a homeless family (23% and 9%, p = 0.019), and/or insufficient food at home (63% and 40%, p = 0.008), but street girls also more often reported boredom at home (80% and 48%, p < 0.001). Services should be tailored to the particular needs of each group by gender, including community-based prevention, street-based health and safety interventions, and street child counseling and re-integration programs.     

Factors predicting student intervention when witnessing anti-LGBTQ harassment: The influence of peers,teachers, and climate

Bullying and harassment are systemic problems in schools, especially for sexual minority youth. Previous research suggests the importance of addressing student intervention in cases of bullying, but little is known about how to encourage this kind of intervention, particularly in response to anti-LGBTQ bullying. The present study used data collected through a participatory action research project to examine three factors' impact on students' intentions to intervene: hearing homophobic language, seeing teachers intervene, and seeing other students intervene. In the final model, seeing other students intervene (β = .19, p < .001) had a more significant positive effect on a students' own likelihood to intervene than seeing teachers intervene (β = .07, p < .05). In multivariate analysis, frequency of hearing homophobic language did not impact student's likelihood to intervene. Findings suggest the importance of youth leadership in multi-level anti-bullying programs.     

A randomized,double-blind,placebo-controlled trial of testosterone gel on body composition and health-related quality-of-life in men with hypogonadal to low-normal levels of serum testosterone and symptoms of androgen deficiency over 6 months with 12 months open-label follow-up

Introduction: The clinical significance of low to low-normal testosterone (T) levels in men remains debated. Aim: To analyze the effects of raising serum T on lean body mass (LBM), fat mass (FM), total body mass, and health-related quality-of-life (HRQoL). Methods: Randomized, double-blind, placebo-controlled study. Men, aged 50–80 years, with serum total T<15 nmol/L and bioavailable T < 6.68 nmol/L, and a Aging Males’ Symptoms (AMS) total score >36, received 6 months treatment with transdermal 1% T gel (5–7.5?mg/day; n =183) or placebo gel (n =179), followed by 12 months open-label with T in all. Results: After 6 months, LBM increased in T- treated patients by 1.28?±?0.15?kg (mean ± SE) and FM decreased by 1.16?±?0.16?kg, with minor changes with placebo (LBM +0.02?±?0.10?kg and FM ?0.14?±?0.12?kg; all p < 0.001, T group vs. placebo). Changes were largely similar across subgroups of age, baseline total testosterone, and baseline BMI. Total HRQoL improved compared with placebo (p < 0.05, T group vs. placebo). Conclusions: Six months 1% T gel improved body composition and HRQoL in symptomatic men with low to low-normal T, with further improvements over the following 12 months.     

Risky Business: Is There an Association between Casual Sex and Mental Health among Emerging Adults?

A multiethnic sample of single, heterosexual, emerging-adult college students (N = 3,907) ages 18 to 25, from 30 institutions across the United States, participated in a study about identity, culture, psychological well-being, and risky behaviors. Given ongoing debates about the connection between casual sex and psychological adjustment, in the current study we assessed the cross-sectional association of participation in casual sex with psychological well-being and distress. A greater proportion of men (18.6%) compared to women (7.4%) reported having had casual sex in the month prior to assessment. Structural equation modeling indicated that casual sex was negatively associated with well-being (ß = .20, p < .001) and positively associated with psychological distress (ß = .16, p < .001). Gender did not moderate these associations. For emerging-adult college students, engaging in casual sex may elevate risk for negative psychological outcomes.     

Quality indicator survey versus traditional survey in New York State: a comparison of results from annual nursing home surveys

Despite the passage of OBRA’87 for nursing home reform, concerns about care in facilities continue. The Centers for Medicare and Medicaid developed new regulations and the Traditional Survey (TS) process for annual nursing home survey. The survey is conducted by state regional offices to determine facility compliance with federal regulations. Despite the regulations and new survey process, the TS inconsistently identified problems. A computerized process called the Quality Indicator Survey (QIS) was subsequently developed. This study was designed to compare results from TS and QIS on overall deficiencies, select quality indicators, high-severity deficiencies, and severity differences of seven quality indicators in New York State over a 6-year period from 2010 through 2015. Results of t-tests determined a significant difference in the overall mean number of deficiencies (p < .001), and on four indicators: choices (p < .001), nursing staff (p < .001), dental (p < .001), and dignity (p < .05). Facilities using the TS showed a higher mean number of harm level or higher deficiencies (p < .001). Chi-square tests for severity levels showed significantly more higher severity deficiencies on two quality indicators: nutrition (p < 0.001) and hydration (p < 0.05). Thus, the QIS produced a greater mean number of deficiencies, while TS produced more higher severity deficiencies in New York State.     

Mortality among a national population sentenced to compulsory care for substance use disorders in Sweden: Descriptive study

Sweden's compulsory addiction system treats individuals with severe alcohol and narcotics use disorders. Merging data from three national level register databases of those sentenced to compulsory care from 2001 to 2009 (n = 4515), the aims of this study were to: (1) compute mortality rates to compare to the general Swedish population; (2) identify leading cause of mortality by alcohol or narcotics use; and (3) identify individual level characteristics associated with mortality among alcohol and narcotics users. In this population, 24% were deceased by 2011. The most common cause of death for alcohol users was physical ailments linked to alcohol use, while narcotics users commonly died of drug poisoning or suicide. Average age of death differed significantly between alcohol users (55.0) and narcotics users (32.5). Multivariable logistic regression analysis identified the same three factors predicting mortality: older age (alcohol users OR = 1.28, narcotic users OR = 1.16), gender [males were nearly 3 times more likely to die among narcotics users (p < .000) and 1.6 times more likely to die among alcohol users (p < .01)] and reporting serious health problems (for alcohol users p < .000, for narcotics users p < .05). Enhanced program and government efforts are needed to implement overdose-prevention efforts and different treatment modalities for both narcotic and alcohol users.     

Campus Walkability,Pedometer-Determined Steps,and Moderate-to-Vigorous Physical Activity: A Comparison of 2 University Campuses

Objective and Participants: At 2 Arizona State University (ASU) campuses, the authors measured student activity and distance walked on campus, as well as student-reported walkability around the student union. Methods: Students from ASU-Polytechnic (n = 20, 33% male) and ASU-Tempe (n = 20, 60% male) recorded distance walked on campus and wore physical activity monitors for 5 days. Results: Polytechnic students spent an average of 36.9 minutes in moderate-to-vigorous physical activity each week; Tempe students spent 69.5 minutes (p < .001). At Polytechnic, students walked an average of 7,674 steps per weekday; at Tempe, 11,294 steps (p = .003). Female students at Polytechnic walked an average of 1.3 km/d; at Tempe, 4.3 km/d (p < .001). At Polytechnic, men walked an average of 1.4 km/d; at Tempe, 3.1 km/d (p = .03). Tempe students rated campus walk-ability as very good, whereas Polytechnic students rated it fair (p < .001). Conclusions: Students at both campuses met activity recommendations; noted differences may be attributed to the built environment's contribution to walkability.     

Child protection and out-of-home placement experiences of preschool children born to mothers enrolled in methadone maintenance treatment during pregnancy

Children born to opiate-dependent women engaged in methadone maintenance treatment are at high risk of child welfare concern. However, few studies have examined the early child protection service (CPS) contacts of this group or the risk factors that place some but not other mother–infant dyads at increased risk of serious concern resulting in the removal of the child from the family home. As part of a prospective longitudinal study based in New Zealand, 73 women enrolled in methadone maintenance treatment during pregnancy and 54 non-methadone maintained comparison mothers were recruited during pregnancy and interviewed close to delivery, 18-months and 4.5-years. At each follow-up evaluation, detailed life history methods were used to describe children's family circumstances and all CPS contacts. By 4.5-years postdelivery, methadone maintained mothers were ten-times more likely to have been investigated by child protection services than comparison mothers (59% v. 6%, p < .001). Of these contacts, almost half (44%) resulted in the removal of the child from the family home compared to no comparison children (p < .001). These children were most frequently placed before age 1, with an average of 1–2 caregiver changes (range: 0–7). In addition to maternal methadone maintenance treatment during pregnancy (p < .001), significant independent predictors of child out-of-home placement included maternal depression (p = .01), maternal history of child custody loss (p = .02), and to some extent, high levels of family socioeconomic adversity (p = .06). Findings highlight the complex psychosocial needs of this high-risk group, as well as the need for careful monitoring and parenting support following hospital discharge.     

Family-of-origin and service-member resilience

ABSTRACT

Military research on family resilience has not examined the contribution of family-of-origin to resilience of service-members. In this study, researchers investigated the extent to which predeployed service-members’ perception of resilience was related to characteristics of family-of-origin. The sample consisted of 344 U.S. Army soldiers within 6 months of deployment to Afghanistan, contacted through their units and invited to participate. Soldiers completed a survey of perceived resilience, family-of-origin and immediate family variables, and social support. Data were also collected on age, income, ethnicity, number of deployments, and relationship status. Regression analyses were conducted to explain variation in service-member resilience scores. Sample demographics were compared with the active duty soldier population and correlations among the key family-of-origin and social support variables were reported. Family-of-origin satisfaction was moderately related to service-member resilience for the full sample (β = .176, p = .001) and married sample (β = .260, p = .000). It was weakly related in the unmarried sample (β = .147, p = .226). Family social support explained the most variation in resilience across all samples. Study limitations and guidelines and resources for social work practice, education, and research to strengthen family-of-origin and service-member resilience are provided.     

The Influence of Consent on College Students’ Perceptions of the Quality of Sexual Intercourse at Last Event

ABSTRACT. The current study assessed consent's relation to quality of sexual intercourse. College students (n = 640) participated in a survey assessing their most recent intercourse. Hierarchical regression was conducted: alcohol consumption, relationship status, and age were entered in Step 1; the Internal and External Consent Scale factors were entered in Step 2. For women, three internal consent factors explained a significant proportion of variance in quality of intercourse beyond Step 1 (ΔR² = .17, p < .001). For men, one internal and two external consent factors were significant predictors beyond Step 1 (ΔR² = .24, p < .001). Preliminary findings suggest consent is associated with quality of intercourse.     

Associations Between Sexual Abuse and Negative Health Consequences Among High-Risk Men Who Have Sex with Men

This study evaluated whether a history of sexual abuse could differentiate negative health consequences among men who have sex with men (MSM; N = 148) enrolled in a risk counseling program. More than half (51.4%) reported an experience of sexual abuse. A history of sexual abuse was associated with increased psychological distress, increased rates of alcohol (AOR = 2.91; p <.01) and/or drug abuse (AOR = 2; p <.01) treatment, increased risk of housing instability (AOR = 2.13; p <.05), and increased risk for suicidality (AOR = 4.3; p <.001). Findings demonstrate that screening for sexual abuse may be useful in determining the service needs of high-risk MSM.     

‘Reach Out,Rise Up’: The efficacy of text messaging in an intervention package for anxiety and depression severity in young people

BackgroundDepression and anxiety are among the most commonly experienced mental health issues faced by young people in Aotearoa, New Zealand. Considerable barriers exist that prevent young people from engaging with face-to-face mental health services. Young people's preference for technology-based counselling mediums such as text messaging opens up new pathways for intervention.ObjectiveA pilot text message-based intervention package was trialled for use by young people to evaluate the potential efficacy of the text package as an intervention for depression and anxiety symptoms.MethodThe text package was piloted using a 10-week longitudinal cohort pilot with 21 young participants (12–24 years) who demonstrated mild to moderate anxiety and/or depression symptoms.ResultsParticipants' post-package scores were significantly lower than their pre-package scores for both anxiety (Z = − 2.83, p = .005, r = − 0.65) and depression (Z = − 2.49, p = .013, r = −.056). ‘Feeling encouraged and supported’ increased as a result of receiving support from a trained supporter (Z = − 2.06, p = .039, r = − 0.45), but not from friends/family (Z = − 1.72, p = .130, r = − 0.37). Anxiety and depression scores did not change as a result of support from either trained supporters or friends/family.ConclusionsFindings support the potential efficacy of the text package, justify wider trials of the text package, and support the use of text message-based interventions as potentially effective therapies for young people.     

The relationship between binge drinking and prosocial bystander behavior among college men

Abstract

Objectives: This study prospectively examined binge drinking’s effect on prosocial bystander behavior and indicators of bystander behavior: intentions to intervene, self-efficacy to intervene, and positive outcome expectancies for intervening. Participants: College men were recruited from February to April 2010. Methods: Pre- and posttest surveys were administered as part of a randomized controlled trial (n?=?743). Potential confounders were identified using Pearson product-moment correlations. Controlling for covariates, multiple linear regression was used to examine whether binge drinking was predictive of prosocial bystander behavior and indicators of bystander behavior. Results: Binge drinking was related to lower bystander behavior (p<.05), lower intentions to intervene (p<.001), and less positive outcome expectancies for intervening (p<.05). Conclusions: Binge drinking may reduce the ability to notice a risk situation and intervene as a prosocial bystander. Results highlight the need for bystander programs to address alcohol use within the context of bystander behavior.