Assessing state substance abuse prevention infrastructure through the lens of CSAP's Strategic Prevention Framework

Although the organizational structures and operating procedures of state substance abuse prevention systems vary substantially across states, there is scant empirical research regarding approaches for rigorous assessment of system attributes and which attributes are most conducive to overall effectiveness. As one component of the national cross-site evaluation of the SPF State Incentive Grant Program (SPF SIG), an instrument was developed to assess state substance abuse prevention system infrastructure in order to measure infrastructure change and examine the role of state infrastructure in achieving prevention-related outcomes. In this paper we describe the development of this instrument and summarize findings from its baseline administration. As expected, states and territories were found to vary substantially with respect seven key characteristics, or domains, of state prevention infrastructure. Across the six domains that were assessed using numeric ratings, states scored highest on data systems and lowest on strategic planning. Positive intercorrelations were observed among these domains, indicating that states with high capacity on one domain generally have relatively high capacity on other domains as well. The findings also suggest that state prevention infrastructure development is linked to both funding from state government and the presence of a state interagency coordinating body with decision-making authority. The methodology and baseline findings presented will be used to inform the ongoing national cross-site evaluation of the SPF SIG and may provide useful information to guide further research on state substance abuse prevention infrastructure.     

Organizational characteristics that foster early adoption of cultural and linguistic competence in outpatient substance abuse treatment in the United States

Recent years have seen an increased interest in developing culturally and linguistically responsive systems of care in substance abuse treatment in the United States. This study examines the extent to which external and internal organizational pressures contributed to the degree of adoption of culturally and linguistically responsive practices in the nation's outpatient substance abuse treatment system early in the period of development of this system of care. Findings show that a higher degree of adoption of culturally competent practices was most likely in treatment programs with high dependence on external funding and regulation. Internally, programs with a larger number of professionals were associated with the lowest degree of adoption, while managers’ cultural sensitivity contributed significantly to a high degree of adoption of these responsive practices. Considering the passage of recent legislation enforcing the use of cultural and linguistic competence in health care, implications of these baseline findings on early adoption patterns are discussed for future research and health care policy evaluation.     

Couple and family interventions in health problems

Intervention research for couples and families managing chronic health problems is in an early developmental stage. We reviewed randomized clinical trials of family interventions for common neurological diseases, cardiovascular diseases, cancer, and diabetes, which is similar to the content of previous reviews discussed later. One overriding theme of these studies is that patients with chronic illnesses and their families face a variety of challenges to which researchers have responded with an array of treatment modalities. Very few of the interventions reviewed, with the exception of treatment for adolescents with diabetes, tested family psychotherapy models. Most interventions were time-limited therapeutic interventions that trained families to improve their communication and problem-solving skills, individual and family coping skills, and medical management. Researchers more clearly described mechanisms of change in intervention studies with cancer and diabetes than with other diseases, and not surprisingly, they found greater empirical support for their interventions. Family interventions show promise to help patients and family members manage chronic illnesses. To develop an empirical base for family approaches to managing chronic illnesses, interventions must be based on theories that delineate mechanisms of change in family processes and skills in medical management necessary to maintain patients' and family members' health.     

The Effects of First Occupation on Long Term Health Status: Evidence from the Wisconsin Longitudinal Study

In this paper, we use a longitudinal survey that has collected information for 50 years on a large cohort of Wisconsin high school graduates and their siblings to examine the long term impact of early occupational choice on health status. We find evidence that beginning a career in a blue collar occupation is correlated with several measures of poor health outcomes at ages 50–65. Since our dataset includes usually unobserved pre-labor market characteristics, including IQ and childhood health status, we can show that controlling for these variables is important for many results and suggests a high level of selection into occupation based on health and ability. We also provide evidence of gender differentials in the association between first occupation and later health. Then, we replace our basic measure of occupational categories with summary measures of job characteristics and find that employment at “bad jobs” at the beginning of an individual’s career predicts later health outcomes. Finally, we use sibling information in the dataset to show that unmeasured family background factors explain a large share of the effects of occupation on later health. Overall, the evidence points to limited, though heterogeneous, long term effects of health from blue collar employment.     

Changes in Firm Pension Policy: Trends Away from Traditional Defined Benefit Plans

In light of the recent concerns regarding the solvency of Social Security’s Old-Age, Survivors and Disability Insurance (OASDI), private pensions may play an increasingly important role in retirement welfare of US retirees. However, the private pension landscape has evolved in ways that may result in lower private pension wealth for retirees. One recent such phenomenon involves the conversion of traditional defined benefit pension plans to cash balance plans, which results in lower pension benefits for many workers. In this study, I investigated how characteristics of the firm’s workforce influenced whether the firm converted their traditional pension plan to a cash balance plan and how these characteristics related to the firm’s pension plan policy more generally. Using the Longitudinal Employer-Household Data and pension plan data from the Department of Labor/Internal Revenue Service and the Pension Benefit Guaranty Corporation, I found little evidence of workforce age distribution effects on the likelihood of DB plan conversion to a cash balance plan in the 1990s. More generally, I consistently found positive associations between firms with older and more female workforces and defined contribution plans during the same time.     

Explaining the move toward the market in US academic science: how institutional logics can change without institutional entrepreneurs

Organizational institutionalism has shown how institutional entrepreneurs can introduce new logics into fields and push for their broader acceptance. In academic science in the United States, however, market logic gained strength without such an entrepreneurial project. This article proposes an alternative “practice selection” model to explain how a new institutional logic can gain strength when local innovations interact with changes outside the field. Actors within a field are always experimenting with practices grounded in a variety of logics. When one logic is dominant, innovations based on alternative logics may have trouble gaining the resources they need to become more broadly institutionalized. But if a changing environment starts systematically to favor practices based on an alternative logic, that logic can become stronger even in the absence of a coherent project to promote it. This is what happened in US academic science, as growing political concern with the economic impact of innovation changed the field’s environment in ways that encouraged the spread of local market-logic practices.     

Carceral politics as gender justice? The “traffic in women” and neoliberal circuits of crime,sex, and rights

This article draws upon recent works in sociology, jurisprudence, and feminist theory in order to assess the ways in which feminism, and sex and gender more generally, have become intricately interwoven with punitive agendas in contemporary US politics. Melding existing theoretical discussions of penal trends with insights drawn from my own ethnographic research on the contemporary anti-trafficking movement in the United States—the most recent domain of feminist activism in which a crime frame has prevailed against competing models of social justice—I elaborate upon the ways that neoliberalism and the politics of sex and gender have intertwined to produce a carceral turn in feminist advocacy movements previously organized around struggles for economic justice and liberation. Taking the anti-trafficking movement as a case study, I further demonstrate how human rights discourse has become a key vehicle both for the transnationalization of carceral politics and for the reincorporation of these policies into the domestic terrain in a benevolent, feminist guise. I conclude by urging greater and more nuanced attention to the operations of gender and sexual politics within mainstream analyses of contemporary modes of punishment, as well as a careful consideration of the neoliberal carceral state within feminist discussions of gender, sexuality, and the law.     

Marital Status,Spousal Characteristics,and the Use of Preventive Care

In this article, we investigated the effects of marriage and spousal characteristics on the use of preventive care. We accounted for the endogeneity of marriage by combining propensity score estimation techniques with marriage transitions observed in longitudinal data. Results indicated that marriage increases the probability of dental check-ups and physical examinations for both sexes and mammograms and Pap smears for women. Next, we examined whether spousal characteristics affect the use of preventive care. Spousal education, income, health conditions, and preferences for risk and health care all affected use of preventive care in expected directions. Taken together, we conclude that marriage increases the use of preventive care; however, the net marital effect masks a heterogeneity that results from the characteristics of the spouse an individual marries.     

Grandparental Involvement and South African Adolescents’ Psychological Well-Being

This study was designed to explore the grandparent-grandchild relationship from the perspective of South African adolescents, and to investigate whether grandparental involvement is independently associated with adolescents’ psychological well-being. Data were collected from 204 adolescents (mean age = 13.69) using a school-based survey. Results revealed high levels of contact between grandparents and grandchildren, although involvement varied depending on grandparent, grandchild, and family characteristics. Grandparental involvement was significantly associated with more adolescent prosocial behavior, independent of parental involvement. The findings suggest a unique association between grandparental involvement and prosocial behavior that is robust across different cultural contexts.