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Piper KN, Pankow J, Wood JD. Juvenile probation staff perceptions of engaging families in substance use services. FAMILY RELATIONS 2024; 73:2079-2102. [PMID: 38881821 PMCID: PMC11175584 DOI: 10.1111/fare.12974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 09/08/2023] [Indexed: 06/18/2024]
Abstract
Objectives Study objectives were to (a) understand juvenile justice staff members' experiences with engaging families in youth substance use services and (b) identify staff-perceived barriers to family engagement across steps of substance use service provision. Background Lack of family involvement in juvenile justice system substance use (SU) services is a key barrier to successful treatment of justice-involved youth. Method From June through November 2015, 33 focus groups were conducted at juvenile justice system probation sites across seven states. There were 263 participants, which included juvenile justice probation and behavioral health staff. Results Strategies to engage families in services were highly variable across the 33 juvenile justice sites. Juvenile justice staff members identified barriers to family engagement in SU services including family discomfort, distrust of juvenile justice staff, lack of family service compliance, difficulties accessing SU services, lack of transportation, insurance and cost barriers, low perceived need for treatment, lack of SU education, and SU treatment stigma. Conclusion and Implications Barriers to family engagement directly impact the success of SU service provision in juvenile justice settings. Implementation of strategies to engage families of justice-involved youth (e.g., providing tangible, informational, and emotional support to families, and involving families in juvenile justice policy and care decisions) are critical to improving SU outcomes among this vulnerable population.
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Affiliation(s)
- Kaitlin N Piper
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Jennifer Pankow
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX
| | - Jennifer D Wood
- Department of Criminal Justice, Temple University, Philadelphia, PA
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Welsh JW, Dopp AR, Durham RM, Sitar SI, Passetti LL, Hunter SB, Godley MD, Winters KC. Narrative review: Revised Principles and Practice Recommendations for Adolescent Substance Use Treatment and Policy. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00140-0. [PMID: 38537736 DOI: 10.1016/j.jaac.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/24/2024] [Accepted: 03/18/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE In 2014, the U.S. National Institute on Drug Abuse released the "Principles of Adolescent Substance Use Disorder Treatment," summarizing previously established evidence and outlining principles of effective assessment, treatment, and aftercare for substance use disorders (SUD). Winters et al. (2018) updated these principles to be developmentally appropriate for adolescents. This review builds on that formative work and recommends updated adolescent assessment, treatment, and aftercare principles and practices. METHOD The Cochrane, MEDLINE-PubMed, and PsychInfo databases were searched for relevant studies with new data about adolescent substance use services. This article updates the 13 original principles; condenses the 8 original modalities into 5 practices; and highlights implications for public policy approaches, future funding, and research. RESULTS Key recommendations from the principles include integrating care for co-occurring mental health disorders and SUDs, improving service accessibility including through the educational system, maintaining engagement, and addressing tension between agencies when collaborating with other youth service systems. Updates to the treatment practices include adoption of Screening, Brief Intervention and Referral to Treatment (SBIRT), investment in social programs and family involvement in treatment, expanding access to behavioral therapies and medications, increasing funding to harm reduction services, supporting reimbursement for continuing care services, and increasing investment in research. CONCLUSION These revised principles of adolescent assessment, treatment, and aftercare approaches and practices aim to establish guidance and evidence-based practices for treatment providers, while encouraging necessary support from policymakers and funding agencies to improve the standard of care for adolescent SUD services.
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Fix RL, Walsh CS, Sheidow AJ, McCart MR, Chapman JE, Drazdowski TK. Juvenile probation officers delivering an intervention for substance use significantly reduces adolescents' risky sexual behaviours. Sex Health 2024; 21:SH23181. [PMID: 38402850 PMCID: PMC11162195 DOI: 10.1071/sh23181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/05/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Risky sexual behaviour (RSB) is a serious public health problem for adolescents. We examined whether a contingency management intervention implemented by juvenile probation officers (JPOs) targeting substance use also impacted RSB. METHODS A total of 218 adolescents on probation were randomly assigned to contingency management or to probation as usual. RESULTS The substance use intervention delivered by JPOs reduced rates of RSB over time (β =-0.32, P =0.041 at 6months; β =-0.32, P =0.036 at 9months). CONCLUSIONS Adolescents receiving a substance use intervention from JPOs demonstrated reduced/prevented RSB. Interventions targeting single risk behaviours in juvenile probation populations should measure changes in other risk behaviours . Under-resourced communities lacking clinicians might consider JPOs delivering interventions.
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Stokes ML, Abram KM, Aaby DA, Welty LJ, Meyerson NS, Zawitz CJ, Teplin LA. Substance Use Disorders and HIV/AIDS Risk Behaviors in Youth After Juvenile Detention: A 16-Year Longitudinal Study. J Adolesc Health 2023; 73:640-649. [PMID: 37716716 PMCID: PMC10513729 DOI: 10.1016/j.jadohealth.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/27/2023] [Accepted: 05/10/2023] [Indexed: 09/18/2023]
Abstract
PURPOSE To examine the association between substance use disorders (SUDs) and HIV/AIDS risk behaviors in detained youth as they age. METHODS Prospective longitudinal study of a stratified random sample of 1,829 youth aged 10 to 18 years at baseline, sampled between November 1995 and June 1998 from the Cook County Juvenile Temporary Detention Center, Chicago, Illinois, and reinterviewed up to 13 times (to median age 32); 17,766 interviews overall. RESULTS Youth had greater odds of engaging in every risk behavior when they had an SUD compared with when they did not have an SUD. For example, SUD was associated with condomless vaginal sex with a high-risk partner (OR: 2.28, 95% CI: 1.84-2.82). SUD was also associated with multiple partners, although the strength varied by time and sex (e.g., 16 years after baseline, OR: 3.58, 95% CI: 2.46-5.23 females; OR: 2.07, 95% CI: 1.48-2.88 males). Types of SUD-alcohol, comorbid alcohol and marijuana, drugs other than marijuana-were also associated with HIV/AIDS risk behaviors. DISCUSSION SUDs and HIV/AIDS risk behaviors are linked among youth in the juvenile justice system and as they age. There is a longstanding need for targeted and integrated HIV and SUD services, but this need remains unmet.
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Affiliation(s)
- Marquita L Stokes
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Karen M Abram
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| | - David A Aaby
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Leah J Welty
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Nicholas S Meyerson
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Chad J Zawitz
- Cermak Health Services, Cook County Department of Corrections, Chicago, Illinois; Division of Infectious Diseases, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Linda A Teplin
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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5
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Quinn CR, Boyd DT, Menon SE, Mitchell M, Radney A, Coker EJ, Lloyd Allen J, Simmons-Horton S, Hughley A, DiClemente RJ, Voisin DR. Exploring Substance Misuse Behaviors Among Black Girls in Detention: Intersections of Trauma, Sex, and Age. Addict Behav 2023; 143:107693. [PMID: 37003109 DOI: 10.1016/j.addbeh.2023.107693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 01/30/2023] [Accepted: 03/09/2023] [Indexed: 03/17/2023]
Abstract
High risk substance misuse, trauma and gang involvement are prevalent in adolescents and often occur with youth involved with the youth punishment system. Evidence suggests that system involvement is related to trauma histories, substance misuse, as well as gang involvement. This study investigated the associations between individual and peer factors and their relationship to problem drug and alcohol use among Black girls involved with the youth punishment system. Data were collected from 188 Black girls in detention at baseline, as well as 3 and 6 month follow up periods. Measures assessed were abuse history, trauma history, sex while using drugs and alcohol, age, government assistance, and drug use. Significant findings from the multiple regression analyses indicated that younger girls were more likely to have a higher prevalence of having a drug problem than older girls at baseline. Having sex while on drugs and alcohol at the 3 month follow up period was correlated with drug use. These findings highlight how individual and peer factors can influence problem substance misuse, their behavior and peer relationships among Black girls in detention.
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Affiliation(s)
- Camille R Quinn
- University of Michigan, School of Social Work, Center for Equitable Family and Community Well-being, USA.
| | - Donte T Boyd
- The Ohio State University, College of Social Work, USA.
| | | | | | | | - Evelyn J Coker
- University of Wisconsin-Madison, Sandra Rosenbaum School of Social Work, USA.
| | | | - Sherri Simmons-Horton
- University of New Hampshire, College of Health and Human Services, Social Work, USA.
| | | | | | - Dexter R Voisin
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, USA.
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Childs K, Viglione J, Chapman JE, Drazdowski TK, McCart MR, Sheidow AJ. Delinquency, Substance Use, and Risky Sexual Behaviors among Youth who are involved in the Justice System and Predominantly Reside in Rural Communities: Patterns and Associated Risk Factors. JOURNAL OF CRIME AND JUSTICE 2022; 46:211-230. [PMID: 36970184 PMCID: PMC10035540 DOI: 10.1080/0735648x.2022.2103014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 07/05/2022] [Indexed: 10/15/2022]
Abstract
There is a significant gap in research examining the prevalence of problem behaviors among youth involved in the juvenile justice system in rural areas. The current study sought to address this gap by exploring the behavioral patterns of 210 youth who were on juvenile probation in predominantly rural counties and who were identified as having a substance use disorder. First, we examined the correlation among 7 problem behaviors representing different forms of substance use, delinquency, and sexual risk-taking and 8 risk factors related to recent service utilization, internalizing and externalizing difficulties, and social support networks. Then, we used latent class analysis (LCA) to identify distinct behavioral profiles based on the observed problem behaviors. LCA identified a 3-class model representing distinct groups labeled Experimenting (70%), Polysubstance Use + Delinquent Behaviors (24%), and Diverse Delinquent Behaviors (6%). Finally, we assessed differences (i.e., ANOVA, χ2) in each risk factor across the behavioral profiles. Important similarities and differences in the association among the problem behaviors, behavioral profiles, and the risk factors were revealed. These findings underscore the need for an interconnected behavioral health model within rural juvenile justice systems that is able to address youths' multidimensional needs including criminogenic, behavioral, and physical health needs.
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Affiliation(s)
- Kristina Childs
- University of Central Florida, Department of Criminal Justice
| | - Jill Viglione
- University of Central Florida, Department of Criminal Justice
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Porche MV, Fortuna LR, Tolou-Shams M. Unpacking the Layers: Dismantling Inequities in Substance Use Services and Outcomes for Racially Minoritized Adolescents. Child Adolesc Psychiatr Clin N Am 2022; 31:223-236. [PMID: 35361361 PMCID: PMC10662943 DOI: 10.1016/j.chc.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Minoritized youth have lower prevalence rates of substance use disorders (SUD) compared with White peers, but proportionally those that are diagnosed are less likely to engage in specialized care and there are few culturally responsive treatments or programs available. We examine social determinants of SUD, with emphasis on the impact of trauma, including racial trauma, and include an intersectional approach incorporating race, ethnicity, and gender. This review of the literature highlights evidence-based effective clinical practice as examples for the field in developing therapeutic approaches to SUD for this population.
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Affiliation(s)
- Michelle V Porche
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco (UCSF), 1001 Potrero Avenue, Building 5, Room 7M, San Francisco, CA, USA.
| | - Lisa R Fortuna
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, 1001 Potrero Avenue, Building 5, Room 7M16, San Francisco, CA, USA
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, 1001 Potrero Avenue, Building 5, Room 7M18, San Francisco, CA 94110, USA
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Modrowski CA, Sheerin KM, Owens T, Pine SM, Shea LM, Frazier E, Lowenhaupt E. Piloting an Evidence-Based Assessment Protocol for Incarcerated Adolescents. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2022; 8:525-540. [PMID: 38144516 PMCID: PMC10745203 DOI: 10.1080/23794925.2022.2051216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
Although evidence-based assessment is considered an essential component of evidence-based practice, few adolescents have access to evidence-based assessment. Despite experiencing high rates of mental health disorders, incarcerated justice-involved adolescents are rarely able to access evidence-based psychiatric care. In this article, we discuss the components of an evidence-based assessment protocol designed and piloted with incarcerated adolescents involved in Rhode Island's juvenile justice system. In particular, we describe the components of our evidence-based protocol, ways in which evidence-based assessment may need to be modified when working with this population, and discuss policy and clinical implications relevant to increasing access to evidence-based assessment among incarcerated adolescents.
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Randomized Controlled Trial of an Alcohol-related Sexual Risk Reduction Intervention with Adolescents: The Role of Neurocognitive Activation During Risky Decision-Making. AIDS Behav 2021; 25:265-275. [PMID: 33712986 DOI: 10.1007/s10461-021-03190-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2021] [Indexed: 10/21/2022]
Abstract
Justice-involved youth are at a higher risk of negative outcomes from sexual activity and alcohol use relative to their non-justice involved peers. In the current study, we tested the extent to which variability in neurocognitive response (i.e., activation in the right superior parietal lobule; rSPL) during a risky decision-making task moderated the success of a sexual risk reduction intervention. In a cluster randomized trial blocked by gender, justice-involved adolescents (N = 269) first completed a risky decision-making task during a magnetic resonance imaging (MRI) session, then were assigned to an information-only control (GINFO) or sexual risk reduction intervention incorporating alcohol risk reduction content (GPI + GMET) and then re-contacted every three months for one year. Youth in the GPI + GMET intervention reported less sexual risk behavior 12 months after intervention than those in the control. Although neurocognitive activation was associated with sexual risk behavior, it did not moderate intervention outcomes. This risk-reduction intervention appears to work equally well across a range of neurocognitive responses.
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Hirschtritt ME, Folk JB, Marshall BDL, Li Y, Tolou-Shams M. Cannabis Use Among Court-Involved Minority Sexual Orientation and Gender Identity Adolescents. THE JOURNAL OF THE AMERICAN ACADEMY OF PSYCHIATRY AND THE LAW 2021; 49:350-360. [PMID: 34001670 PMCID: PMC8429183 DOI: 10.29158/jaapl.200104-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We examined the effects of family functioning and beliefs regarding peers' cannabis use among minority (n = 112) and non-minority (n = 275) sexual orientation and gender identity (SOGI), first-time court-involved adolescents. We examined longitudinally the effects of baseline general family functioning and peer cannabis use beliefs on self-reported cannabis use and cannabis-related consequences after 12 months. At baseline, 39.2 percent of adolescents reported using cannabis. Minority SOGI adolescents reported worse family functioning (p = .017) and higher peer cannabis use beliefs (p = .047). Higher peer cannabis use beliefs at baseline predicted recent cannabis use at the 12-month assessment for both minority and non-minority SOGI adolescents. Better family functioning predicted a lower likelihood of recent cannabis use at 12 months for non-minority SOGI adolescents, but not for minority SOGI adolescents. Baseline peer cannabis use beliefs and family functioning predicted cannabis-related consequences for both cohorts at 12 months when accounting for intermediate (i.e., four-month and eight-month) data. Among all first-time court-involved adolescents, those who believed greater cannabis use among their peers reported more subsequent cannabis use themselves. Conversely, higher general family functioning may be less of a protective factor for minority SOGI adolescents. These results suggest the utility of feedback interventions to modify peer norm beliefs among first-time court-involved adolescents.
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Affiliation(s)
- Matthew E Hirschtritt
- Dr. Hirschtritt is Clinical Professor, Dr. Folk is Assistant Professor, and Dr. Tolou-Shams is Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA. Dr. Marshall is Associate Professor and Dr. Li is Biostatistician, Department of Epidemiology, Brown University School of Public Health, Providence, RI. Dr. Tolou-Shams is Director, Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, CA.
| | - Johanna B Folk
- Dr. Hirschtritt is Clinical Professor, Dr. Folk is Assistant Professor, and Dr. Tolou-Shams is Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA. Dr. Marshall is Associate Professor and Dr. Li is Biostatistician, Department of Epidemiology, Brown University School of Public Health, Providence, RI. Dr. Tolou-Shams is Director, Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, CA
| | - Brandon D L Marshall
- Dr. Hirschtritt is Clinical Professor, Dr. Folk is Assistant Professor, and Dr. Tolou-Shams is Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA. Dr. Marshall is Associate Professor and Dr. Li is Biostatistician, Department of Epidemiology, Brown University School of Public Health, Providence, RI. Dr. Tolou-Shams is Director, Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, CA
| | - Yu Li
- Dr. Hirschtritt is Clinical Professor, Dr. Folk is Assistant Professor, and Dr. Tolou-Shams is Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA. Dr. Marshall is Associate Professor and Dr. Li is Biostatistician, Department of Epidemiology, Brown University School of Public Health, Providence, RI. Dr. Tolou-Shams is Director, Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, CA
| | - Marina Tolou-Shams
- Dr. Hirschtritt is Clinical Professor, Dr. Folk is Assistant Professor, and Dr. Tolou-Shams is Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA. Dr. Marshall is Associate Professor and Dr. Li is Biostatistician, Department of Epidemiology, Brown University School of Public Health, Providence, RI. Dr. Tolou-Shams is Director, Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, CA
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Tolou-Shams M, Folk JB, Marshall BD, Dauria EF, Kemp K, Li Y, Koinis-Mitchell D, Brown LK. Predictors of cannabis use among first-time justice-involved youth: A cohort study. Drug Alcohol Depend 2021; 225:108754. [PMID: 34051549 PMCID: PMC8282753 DOI: 10.1016/j.drugalcdep.2021.108754] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/04/2021] [Accepted: 04/09/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Justice-involved youth use cannabis at higher rates than their same-aged peers increasing likelihood of adverse behavioral health consequences and continued legal involvement. This study examined individual level predictors of early onset use cannabis use (<13 years of age) and cannabis use initiation in the 12 months following first court contact. METHODS Participants were 391 first-time justice-involved youth (56.9 % male; Mage = 14.6 years; 32.1 % White, 11.1 % Black, 14.7 % Other/Multi-racial, 42.2 % Latinx) and an involved caregiver (87.2 % female; Mage = 41.0 years). Baseline assessments captured individual level factors; cannabis use was assessed every four months post-baseline for 12 months. Primary analyses involved multivariable modified Poisson regressions and survival analysis. RESULTS In multivariable models, youth who reported lifetime cannabis use (n = 188, 48.1 %) were older, reported alcohol use and positive cannabis use expectancies. Greater self-control and self-concept were associated with lower likelihood of lifetime cannabis use. Youth who initiated cannabis during the 12-month follow-up (n = 30, 14.8 %) tended to be older, White/non-Latinx, and to report more psychiatric symptoms (posttraumatic stress, externalizing, internalizing, and affect dysregulation), delinquent behavior, lower levels of self-control, poorer self-concept, greater drug use intentions and positive cannabis expectancies. In the multivariable survival analysis, affect dysregulation, internalizing symptoms, and more positive cannabis expectancies remained independently and positively associated with cannabis initiation. CONCLUSIONS There is a critical and unique window of opportunity to prevent cannabis use initiation among first-time justice-involved youth. Research is needed to determine whether brief interventions that aim to modify expectancies about cannabis use reduce rates of cannabis initiation in this underserved population.
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Affiliation(s)
- Marina Tolou-Shams
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA, 94110, USA.
| | - Johanna B. Folk
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA, 94110, USA
| | - Brandon D.L. Marshall
- Brown University School of Public Health, Department of Epidemiology, 121 South Main Street, Providence, RI, 02903, USA
| | - Emily F. Dauria
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA, 94110, USA
| | - Kathleen Kemp
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St, Providence, RI, 02903, USA.
| | - Yu Li
- Brown University School of Public Health, Department of Epidemiology, 121 South Main Street, Providence, RI, 02903, USA.
| | - Daphne Koinis-Mitchell
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St, Providence, RI, 02903, USA; The Warren Alpert Medical School of Brown University, Department of Pediatrics, 222 Richmond St, Providence, RI, 02903, USA; Rhode Island Hospital, Division of Child and Adolescent Psychiatry, Coro West, 1 Hoppin Street, Providence, RI 02903.
| | - Larry K. Brown
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St, Providence, RI, 02903, USA,Rhode Island Hospital, Division of Child and Adolescent Psychiatry, Coro West, 1 Hoppin Street, Providence, RI 02903
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Pro G, Montgomery BEE, Zaller N. Tailoring services in opioid treatment programs for patients involved in America's criminal justice system: national associations and variation by state and Medicaid expansion status. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2021; 16:50. [PMID: 34147098 PMCID: PMC8214376 DOI: 10.1186/s13011-021-00388-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/08/2021] [Indexed: 11/18/2022]
Abstract
Background Opioid treatment programs (OTPs) are the primary source of medication-assisted treatment (MAT) for many individuals with opioid use disorder, including poor and uninsured patients and those involved in the criminal justice (CJ) system. Substance use treatment services that are tailored to the unique needs of patients often produce better outcomes, but little national research has addressed characteristics associated with whether OTPs offer services specifically tailored to community members involved in the CJ system. Medicaid expansion under the Affordable Care Act has broadly strengthened MAT services, but the role of expansion in supporting MAT services that are specifically tailored towards CJ-involved populations remains unknown. Moreover, it is unknown whether the availability of tailored services varies between Medicaid expansion states. Methods We used the 2019 National Survey of Substance Abuse Treatment Services to identify OTPs in the US (n = 1679) and whether they offered services specifically tailored for CJ-involved patients. We used logistic regression to model the association between OTPs offering tailored services and state Medicaid expansion status, adjusted for state-level opioid overdose and community supervision rates. Results Nationally, only a quarter of OTPs offered services tailored to CJ populations, and the majority of OTPs (73%) were located in Medicaid expansion states. Compared to OTPs in non-expansion states, OTPs in expansion states demonstrated nearly double the odds of offering tailored services (adjusted odds ratio = 1.90, 95% confidence interval = 1.41–2.57, p < 0.0001). The predicted probability of offering tailored services varied by state; probability estimates for all expansion states were above the national mean, and estimates for all non-expansion states were below the national mean. Conclusion Our findings reiterate the role of Medicaid in promoting the adoption of comprehensive OTP services for CJ-involved populations. However, the proportion of OTPs that offered tailored services was relatively low, pointing to the need to continually strengthen Medicaid services and coverage.
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Affiliation(s)
- George Pro
- Southern Public Health and Criminal Justice Research Center and the Department of Health Behavior and Health Education in the Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, USA.
| | - Brooke E E Montgomery
- Southern Public Health and Criminal Justice Research Center and the Department of Health Behavior and Health Education in the Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Nickolas Zaller
- Southern Public Health and Criminal Justice Research Center and the Department of Health Behavior and Health Education in the Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, USA
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Abstract
Justice-involved youth have a number of risk factors for HIV infection, including high rates of substance use, psychiatric comorbidities, and risky sexual behaviors. Although detained youth are likely to receive health care-which may include HIV testing-court-involved, non-incarcerated (CINI) youth may be unlikely to receive HIV testing services either before or during their justice involvement. However, the relationship between risk factors and HIV testing among CINI youth is largely unknown. We explored the association between HIV testing and factors commonly associated with both HIV testing and HIV risk among 173 CINI youth with identified behaviors that put them at risk for HIV acquisition. Only 15.6% of participants reported a lifetime history of HIV testing, despite high rates of sexual and substance use risk behaviors. Age (older), gender (female), sexual orientation (non-heterosexual), recent marijuana use, lifetime use of other drugs, history of a sexually transmitted infection, pap smear in the past year and history of mental health/substance use treatment were all significantly associated with lifetime HIV testing. The extremely low testing rates in this sample emphasize that the juvenile justice system outside of detention is not adequately addressing youths' needs related to HIV testing or ensuring access to testing services for youth at risk of contracting HIV. Results suggest that additional efforts are needed to connect justice-involved youth to healthcare more broadly and HIV testing in particular.
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Affiliation(s)
- Emily Haney-Caron
- Department of Psychology, John Jay College of Criminal Justice and the Graduate Center, City University of New York, 524 West 59th Street, New York, NY, 10019, USA.
| | - Larry K Brown
- Department of Psychiatry and Human Behavior, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Marina Tolou-Shams
- UCSF Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
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Boyd DT, Waller B, Quinn CR. Understanding of personal agency among youth to curtail HIV rates. CHILDREN AND YOUTH SERVICES REVIEW 2020; 116:105179. [PMID: 36778097 PMCID: PMC9912712 DOI: 10.1016/j.childyouth.2020.105179] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
We aimed to discover which social factors influence protective health behaviors among Black youth. We measured study variables based on data from the National Survey of Teens and Young Adults on HIV/AIDS. Participants include youth aged 15 to 24 who completed a 40-question, web-based survey. The analytical sample of participants (n = 270) only comprised African American youth, mean age 20 years (SD: 0.28). Using multiple regression analysis, study findings suggest that focusing on protective health behaviors, such as personal agency among youth, with variables like personal perception and concern and HIV testing could be one way to reduce their risk of HIV transmission. Enhancing the role and influence of personal agency given their testing behaviors can inform HIV prevention and intervention programs that are specific to Black youth. Our findings identify targets for intervention to enhance personal agency in this population, including enhancing HIV risk prevention.
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Elkington KS, O'Grady MA, Tross S, Wilson P, Watkins J, Lebron L, Cohall R, Cohall A. A study protocol for a randomized controlled trial of a cross-systems service delivery model to improve identification and care for HIV, STIs and substance use among justice-involved young adults. HEALTH & JUSTICE 2020; 8:20. [PMID: 32797292 PMCID: PMC7427909 DOI: 10.1186/s40352-020-00121-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Justice-involved young adults (JIYA) aged 18-24 are at significant risk for HIV and problematic substance use (SU) but are unlikely to know their HIV status or be linked to HIV or SU treatment and care. Intensive efforts to increase screening and improve linkage to HIV and SU services for JIYA are needed that address youth as well as justice and health/behavioral health system-level barriers. METHODS MoveUp is a four-session intervention that integrates evidence-based protocols to promote HIV and STI testing, HIV and SU behavioral risk reduction and engagement in treatment for JIYA. MoveUp is delivered onsite at an alternative sentencing program (ASP) by HIV testing outreach workers from a youth-focused medical and HIV treatment program. N = 450 youth are randomized following baseline assessment into two groups: MoveUp or standard of care. Youth are followed for 12 months following the intervention; unprotected sexual behavior, substance use, HIV and STI testing as well as treatment linkage will be assessed at 3, 6, 9 and 12-months. DISCUSSION This study is one of the first to systematically test an integrated screen/testing, prevention intervention and linkage-to-care services program (MoveUp), using evidence-based approaches to address the overlapping HIV/STI and substance use epidemics in JIYA by providing on-site services to identify HIV/STI and SU risk and treatment need within justice-settings as well as linkage to services in the community. This approach, capitalizing on health and justice partnerships, represents an innovation that can capitalize on missed opportunities for engaging JIYA in health care.
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Affiliation(s)
- Katherine S Elkington
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, NY, USA.
- Clinical Medical Psychology, HIV Center of Clinical and Behavioral Studies, 1051 Riverside Drive, #15, New York, NY, 10032, USA.
| | - Megan A O'Grady
- University of Connecticut, School of Medicine Department of Public Health Sciences, 263 Farmington Avenue, Farmington, CT, 06030-6325, USA
| | - Susan Tross
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, NY, USA
| | - Patrick Wilson
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jillian Watkins
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, NY, USA
| | | | - Renee Cohall
- Mailman School of Public Health, Columbia University, New York, NY, USA
- New York Presbyterian Hospital, New York, NY, USA
| | - Alwyn Cohall
- Mailman School of Public Health, Columbia University, New York, NY, USA
- New York Presbyterian Hospital, New York, NY, USA
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Selitsky L, Markowitz N, Baxa DM, Kaljee L, Miree CA, Islam N, Burse C, Newaz R, Dankerlui D, Jacobsen G, Joseph C. Self-report of domestic violence and forced sex are related to sexual risk behaviors in a sample of juvenile detainees. HEALTH & JUSTICE 2020; 8:15. [PMID: 32577955 PMCID: PMC7313184 DOI: 10.1186/s40352-020-00116-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 06/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Justice-involved youth have higher rates of sexually transmitted infections (STIs), and a higher prevalence of the associated sexual risk behaviors. Sexual risk behaviors are also associated with alcohol and drug use. Research suggests that a history of trauma is an important predictor of alcohol and drug use in youth offenders, and therefore is a likely contributor to sexual risk behavior in this population. The objective of this analysis is to determine the association of trauma, specifically, domestic violence and forced sex, to six sexual risk behaviors and a history of chlamydia among detained youth. METHODS The analysis uses data from a convenience sample of detainees assenting to HIV testing conducted December 2016 - August 2017 using the state-certified Voluntary Counseling Testing and Referral (VCTR) process. RESULTS Of the 379 youth that received VCTR at the facility, 308 (81.3%) were used in this analysis. Report of domestic violence was significantly associated with sex under the influence of alcohol and was also significantly associated with sex under the influence of marijuana. Forced sex was associated with a sexual partner of unknown HIV status. CONCLUSIONS Traumatic experiences were related to sexual risk behaviors in this analysis, and substance use was strongly implicated in the association. Trauma is known to be a catalyst to sexual risk behaviors, substance use, and delinquency in adolescence. Results support the findings of other investigators and re-iterate the need for trauma-informed interventions that can improve the life trajectories of detained youth.
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Affiliation(s)
- Lea Selitsky
- Internal Medicine, Johns Hopkins Hospital, Baltimore, USA
| | - Norman Markowitz
- Division of Infectious Diseases, Henry Ford Health System and School of Medicine, Wayne State University, Detroit, USA
| | - Dwayne M. Baxa
- William Beaumont School of Medicine, Oakland University, Rochester, USA
- Division of Infectious Diseases, Henry Ford Health System, Detroit, USA
| | - Linda Kaljee
- Global Health Initiative, Henry Ford Health System, Detroit, USA
| | - Cheryl A. Miree
- Department of Public Health Sciences, Henry Ford Health System, 1 Ford Place, Detroit, Michigan USA
| | - Nishat Islam
- Department of Public Health Sciences, Henry Ford Health System, 1 Ford Place, Detroit, Michigan USA
| | - Chez Burse
- Global Health Initiative, Henry Ford Health System, Detroit, USA
| | - Rehnuma Newaz
- Department of Public Health Sciences, Henry Ford Health System, 1 Ford Place, Detroit, Michigan USA
| | - Doreen Dankerlui
- Global Health Initiative, Henry Ford Health System, Detroit, USA
| | - Gordon Jacobsen
- Department of Public Health Sciences, Henry Ford Health System, 1 Ford Place, Detroit, Michigan USA
| | - Christine Joseph
- Department of Public Health Sciences, Henry Ford Health System, 1 Ford Place, Detroit, Michigan USA
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17
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Tolou-Shams M, Brown LK, Marshall BDL, Dauria E, Koinis-Mitchell D, Kemp K, Poindexter B. The Behavioral Health Needs of First-Time Offending Justice-Involved Youth: Substance Use, Sexual Risk and Mental Health. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2020; 28:291-303. [PMID: 34220180 DOI: 10.1080/1067828x.2020.1774023] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study examines substance use, emotional/behavioral symptoms and sexual risk among first-time offending, court-involved, non-incarcerated (FTO-CINI) youth. Youth and caregivers (N=423) completed tablet-based assessments. By time of first justice contact (average 14.5 years old), 49% used substances, 40% were sexually active and 33% reported both. Youth with co-occurring substance use and sexual risk had more emotional/behavioral symptoms; youth with delinquent offenses and females had greater co-occurring risk. Time of first offense is a critical period to intervene upon high rates of mental health need for those with co-occurring substance use and sexual risk to prevent poor health and legal outcomes.
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Affiliation(s)
- Marina Tolou-Shams
- University of California, San Francisco, Department of Psychiatry, Weill Institute for Neurosciences; 1001 Potrero Ave, San Francisco, CA, 94110, USA.,Zuckerberg San Francisco General Hospital, Division of Infant Child and Adolescent Psychiatry; 1001 Potrero Ave, San Francisco, CA, 94110, USA
| | - Larry K Brown
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University; 222 Richmond St, Providence, RI 02903, USA.,Department of Psychiatry, Rhode Island Hospital; 593 Eddy St, Providence, RI 02903, USA
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health; 121 S Main St, Providence, RI 02903, USA
| | - Emily Dauria
- University of California, San Francisco, Department of Psychiatry, Weill Institute for Neurosciences; 1001 Potrero Ave, San Francisco, CA, 94110, USA.,Zuckerberg San Francisco General Hospital, Division of Infant Child and Adolescent Psychiatry; 1001 Potrero Ave, San Francisco, CA, 94110, USA
| | - Daphne Koinis-Mitchell
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University; 222 Richmond St, Providence, RI 02903, USA.,Department of Psychiatry, Rhode Island Hospital; 593 Eddy St, Providence, RI 02903, USA
| | - Kathleen Kemp
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University; 222 Richmond St, Providence, RI 02903, USA.,Department of Psychiatry, Rhode Island Hospital; 593 Eddy St, Providence, RI 02903, USA
| | - Brittney Poindexter
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University; 222 Richmond St, Providence, RI 02903, USA.,Department of Psychiatry, Rhode Island Hospital; 593 Eddy St, Providence, RI 02903, USA
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Sheidow AJ, McCart MR, Chapman JE, Drazdowski TK. Capacity of juvenile probation officers in low-resourced, rural settings to deliver an evidence-based substance use intervention to adolescents. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2019; 34:76-88. [PMID: 31393146 DOI: 10.1037/adb0000497] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Substance use is a major public health problem with a host of negative outcomes. Justice-involved youth have even higher risks and lack access to evidence-based interventions, particularly in rural communities. Task-shifting, or redistribution of tasks downstream to an existing workforce with less training, may be an innovative strategy to increase access to evidence-based interventions. Initial findings are presented from a services research trial conducted primarily in rural communities in which an existing workforce, juvenile probation/parole officers (JPOs), were randomized either to learn and deliver contingency management (CM) or to continue delivering probation services as usual (PAU). This study used the prevailing version of CM for adolescents, that is, family-based with behavior modification and cognitive behavioral components. Data included JPOs' self-reports, as well as audio-recorded youth/family sessions with JPOs rated by expert and trained observational coders. Data also included ratings from a comparison study in which therapists were trained and supervised by experts to deliver CM to justice-involved youth/families. Results showed JPOs can feasibly incorporate CM into their services. When adherence of CM JPOs was compared against CM therapists, JPOs delivered significantly more cognitive behavioral components of CM and similar levels of behavior modification components of CM. These findings suggest that JPOs can be leveraged to provide evidence-based substance use interventions like CM in similar, or even greater, capacities to clinically trained therapists. This task-shifting approach could dramatically expand service access for these high-risk youth, particularly in rural areas where substance use services are limited or nonexistent. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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