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Knight DK, Funk RR, Belenko S, Dennis M, Wiese AL, Bartkowski JP, Dembo R, Elkington KS, Flynn PM, Harris PW, Hogue A, Palinkas LA, Robertson AA, Scott CK. Results of a national survey of substance use treatment services for youth under community supervision. Health Justice 2023; 11:29. [PMID: 37515602 PMCID: PMC10385917 DOI: 10.1186/s40352-023-00233-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/17/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Despite the heightened risk for substance use (SU) among youth in the juvenile justice system, many do not receive the treatment that they need. OBJECTIVES The purpose of this study is to examine the extent to which youth under community supervision by juvenile justice agencies receive community-based SU services and the factors associated with access to such services. METHODS Data are from a nationally representative sample of Community Supervision (CS) agencies and their primary behavioral health (BH) partners. Surveys were completed by 192 CS and 271 BH agencies. RESULTS SU services are more often available through BH than CS for all treatment modalities. EBPs are more likely to be used by BH than by CS. Co-location of services occurs most often in communities with fewer treatment options and is associated with higher interagency collaboration. Youth are more likely to receive services in communities with higher EBP use, which mediates the relationship between the availability of SU treatment modalities and the proportion of youth served. CONCLUSION Findings identify opportunities to strengthen community systems and improve linkage to care.
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Affiliation(s)
- Danica K Knight
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Avenue, Fort Worth, TX, 76129, USA.
| | - Rod R Funk
- Chestnut Health Systems, 1003 Martin Luther King Jr. Drive, Bloomington, IL, 61701, USA
| | - Steven Belenko
- Temple University, 1801 N. Broad Street, Philadelphia, PA, 19122, USA
| | - Michael Dennis
- Chestnut Health Systems, 448 Wylie Drive, Normal, IL, 61761, USA
| | - Amanda L Wiese
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Avenue, Fort Worth, TX, 76129, USA
| | - John P Bartkowski
- University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX, 78248, USA
| | - Richard Dembo
- University of Southern Florida, 4202 E. Fowler Avenue, Tampa, FL, 33620, USA
| | - Katherine S Elkington
- Columbia University and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Patrick M Flynn
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Avenue, Fort Worth, TX, 76129, USA
| | - Philip W Harris
- Temple University, 1801 N. Broad Street, Philadelphia, PA, 19122, USA
| | - Aaron Hogue
- Partnership to End Addiction, Family and Adolescent Clinical Technology & Science (FACTS), 485 Lexington Avenue, 3rd Floor, New York, NY, 10017, USA
| | - Lawrence A Palinkas
- University of Southern California, 669 W. 34th Street, Los Angeles, CA, 90089, USA
| | - Angela A Robertson
- Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS, 39759, USA
| | - Christy K Scott
- Lighthouse Institute, Chestnut Health Systems, 221 W. Walton, Chicago, IL, 60610, USA
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Robertson AA, Gardner S, Dembo R, Dennis M, Pankow J, Wilson KJ. Impact of implementation interventions to improve substance use service delivery on recidivism among justice-involved youth. Health Justice 2023; 11:12. [PMID: 36853574 PMCID: PMC9972752 DOI: 10.1186/s40352-023-00210-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
Substance use disorders (SUD) are prevalent among justice-involved youth (JIY) and are a robust predictor of re-offending. Only a fraction of JIY with substance use problems receive treatment. This paper describes the impacts of system-level efforts to improve identification and referral to treatment on recidivism of JIY. A cluster randomized trial involving 20 county juvenile justice agency sites across 5 states was used to implement an organizational intervention (Core vs Enhanced) to juvenile justice staff and community-based treatment providers, working with 18,698 JIY from March 2014 to August 2017. Recidivism rates over four study time periods were examined. Logistic regression was used to predict recidivism as a function of site, need for SUD services, level of supervision, time, organizational intervention, and time x intervention interaction terms. Results indicated that Enhanced sites showed decreased levels of recidivism compared to Core-only sites, where it increased over time. Additionally, need for SU services, level of supervision, and site were significant predictors of reoffending. Findings suggest the potential value of facilitation of juvenile justice agency efforts to increasing identification of and referral to SUD services of JIY in need of such services for reducing further contact with the legal system.
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Affiliation(s)
- Angela A. Robertson
- Social Science Research Center, Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS 39759 USA
| | - Sheena Gardner
- Social Science Research Center, Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS 39759 USA
| | - Richard Dembo
- Department of Criminology, College of Behavioral & Criminal Sciences, University of South Florida, Tampa, FL USA
| | - Michael Dennis
- Lighthouse Institute, Chestnut Health Systems, Normal, IL USA
| | - Jennifer Pankow
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX USA
| | - Khirsten J. Wilson
- Social Science Research Center, Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS 39759 USA
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Knight DK, Belenko S, Dennis ML, Wasserman GA, Joe GW, Aarons GA, Bartkowski JP, Becan JE, Elkington KS, Hogue A, McReynolds LS, Robertson AA, Yang Y, Wiley TRA. The comparative effectiveness of Core versus Core+Enhanced implementation strategies in a randomized controlled trial to improve substance use treatment receipt among justice-involved youth. BMC Health Serv Res 2022; 22:1535. [PMID: 36527067 PMCID: PMC9758864 DOI: 10.1186/s12913-022-08902-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Most justice-involved youth are supervised in community settings, where assessment and linkage to substance use (SU) treatment services are inconsistent and fragmented. Only 1/3 of youth with an identified SU need receive a treatment referral and even fewer initiate services. Thus, improving identification and linkage to treatment requires coordination across juvenile justice (JJ) and behavioral health (BH) agencies. The current study examines the comparative effectiveness of two bundled implementation intervention strategies for improving SU treatment initiation, engagement, and continuing care among justice-involved youth supervised in community settings. Exploration, Preparation, Implementation, Sustainment (EPIS) served as the conceptual framework for study design and selection/timing of implementation intervention components, and the BH Services Cascade served as the conceptual and measurement framework for identifying and addressing gaps in service receipt. METHODS Part of a larger Juvenile-Justice Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) Cooperative, this study involved a multisite, cluster-randomized control trial where sites were paired then randomly assigned to receive Core (training teams on the BH Services Cascade and data-driven decision making; supporting goal selection) or Core+Enhanced (external facilitation of implementation teams) intervention components. Youth service records were collected from 20 JJ community supervision agencies (in five states) across five study phases (baseline, pre-randomization, early experiment, late experiment, maintenance). Implementation teams comprised of JJ and BH staff collaboratively identified goals along the BH Cascade and used data-driven decision-making to implement change. RESULTS Results suggest that Core intervention components were effective at increasing service receipt over time relative to baseline, but differences between Core and Core+Enhanced conditions were non-significant. Time to service initiation was shorter among Core+Enhanced sites, and deeper Cascade penetration occurred when external facilitation (of implementation teams) was provided. Wide variation existed in the degree and nature of change across service systems. CONCLUSIONS Findings demonstrate the criticality of early EPIS phases, demonstrating that strategies provided during the formative exploration and preparation phases produced some improvement in service receipt, whereas implementation-focused activities produced incremental improvement in moving youth farther along the Cascade.
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Affiliation(s)
- Danica K. Knight
- grid.264766.70000 0001 2289 1930Karyn Purvis Institute of Child Development, Texas Christian University, Fort Worth, USA
| | - Steven Belenko
- grid.264727.20000 0001 2248 3398Department of Criminal Justice, Temple University, Philadelphia, USA
| | | | - Gail A. Wasserman
- grid.21729.3f0000000419368729Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, USA
| | - George W. Joe
- grid.264766.70000 0001 2289 1930Institute of Behavioral Research, Texas Christian University, Fort Worth, USA
| | - Gregory A. Aarons
- grid.266100.30000 0001 2107 4242Child and Adolescent Services Research Center, University of California, San Diego, USA
| | - John P. Bartkowski
- grid.215352.20000000121845633Department of Sociology, University of Texas at San Antonio, San Antonio, USA
| | - Jennifer E. Becan
- grid.264766.70000 0001 2289 1930Institute of Behavioral Research, Texas Christian University, Fort Worth, USA
| | - Katherine S. Elkington
- grid.21729.3f0000000419368729Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, USA
| | - Aaron Hogue
- grid.475801.fPartnership to End Addiction, New York, USA
| | - Larkin S. McReynolds
- grid.239585.00000 0001 2285 2675Mailman School of Public Health, Columbia University, NYS Psychiatric Institute, New York, USA
| | - Angela A. Robertson
- grid.260120.70000 0001 0816 8287Social Science Research Center, Mississippi State University, Starkville, USA
| | - Yang Yang
- grid.264766.70000 0001 2289 1930Institute of Behavioral Research, Texas Christian University, Fort Worth, USA
| | - Tisha R. A. Wiley
- grid.420090.f0000 0004 0533 7147Service Research Branch, National Institute on Drug Abuse, Bethesda, USA
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Belenko S, Dembo R, Knight DK, Elkington KS, Wasserman GA, Robertson AA, Welsh WN, Schmeidler J, Joe GW, Wiley T. Using structured implementation interventions to improve referral to substance use treatment among justice-involved youth: Findings from a multisite cluster randomized trial. J Subst Abuse Treat 2022; 140:108829. [PMID: 35751945 PMCID: PMC9357202 DOI: 10.1016/j.jsat.2022.108829] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 03/25/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Youth involved in the justice system have high rates of alcohol and other drug use, but limited treatment engagement. JJ-TRIALS tested implementation activities with community supervision (CS) and behavioral health (BH) agencies to improve screening, identification of substance use service need, referral, and treatment initiation and engagement, guided by the BH Services Cascade and EPIS frameworks. This paper summarizes intervention impacts on referrals to treatment among youth on CS. METHODS This multisite cluster-randomized trial involved 18 matched pairs of sites in 36 counties in seven states randomly assigned to core or enhanced conditions after implementing the core intervention at all sites for six months. Enhanced sites received external facilitation for local change team activities to reduce unmet treatment needs; Core sites were encouraged to form interagency workgroups. The dependent variable was percentage referred to treatment among youth in need (N = 14,012). Two-level Bayesian regression assessed factors predicting referral across all sites and time periods. Generalized linear mixed models using logit transformation tested two hypotheses: (H1) referrals will increase from baseline to the experimental period, (H2) referral increases will be larger in enhanced sites than in core sites. RESULTS Although the intervention significantly increased referral, condition did not significantly predict referral across all time periods. Youth who tested drug positive, had an alcohol/other drug-related or felony charge, were placed in secure detention or assigned more intensive supervision, or who were White were more likely to be referred. H1 (p < .05) and H2 (p < .0001) were both significant in the hypothesized direction. Interaction analyses comparing site pair differences showed that findings were not consistent across sites. CONCLUSIONS The percentage of youth referred to treatment increased compared with baseline overall, and enhanced sites showed larger increases in referrals over time. However, variations in effects suggest that site-level differences were important. Researchers should carry out mixed methods studies to further understand reasons for the inconsistent findings within randomized site pairs, and how to further improve treatment referrals across CS and BH systems. Findings also highlight that even when CS agencies work collaboratively with BH providers to improve referrals, most justice-involved youth who need SU services are not referred.
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Affiliation(s)
| | - Richard Dembo
- University of South Florida, United States of America
| | | | - Katherine S Elkington
- Columbia University and New York State Psychiatric Institute, United States of America
| | - Gail A Wasserman
- Columbia University and New York State Psychiatric Institute, United States of America
| | | | | | - James Schmeidler
- Icahn School of Medicine at Mount Sinai, United States of America
| | - George W Joe
- Texas Christian University, United States of America
| | - Tisha Wiley
- National Institute on Drug Abuse, United States of America
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Wasserman GA, McReynolds LS, Taxman FS, Belenko S, Elkington KS, Robertson AA, Dennis ML, Knight DK, Knudsen HK, Dembo R, Ciarleglio A, Wiley TRA. The Missing Link(age): Multilevel Contributors to Service Uptake Failure Among Youths on Community Justice Supervision. Psychiatr Serv 2021; 72:546-554. [PMID: 33765861 PMCID: PMC8288447 DOI: 10.1176/appi.ps.202000163] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Youths in the juvenile justice system often do not access needed behavioral health services. The behavioral health services cascade model was used to examine rates of substance use screening, identification of substance use treatment needs, and referral to and initiation of treatment among youths undergoing juvenile justice system intake and to identify when treatment access is most challenged. Characteristics associated with identification of behavioral health needs and linkage to community services were also examined. METHODS Data were drawn from administrative records of 33 community justice agencies in seven states participating in Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System, funded by the National Institute on Drug Abuse (N=8,307 youths). Contributions of youth, staff, agency, and county characteristics to identification of behavioral health needs and linkage to community services were examined. RESULTS More than 70% (5,942 of 8,307) of youths were screened for substance use problems, and more than half needed treatment. Among those in need, only about one-fifth were referred to treatment, and among those referred, 67.5% initiated treatment. Overall, <10% of youths with identified needs initiated services. Multivariable multilevel regression analyses revealed several contributors to service-related outcomes, with youths' level of supervision being among the strongest predictors of treatment referral. CONCLUSIONS Community justice agencies appear to follow an approach that focuses identification and linkage practices on concerns other than youths' behavioral health needs, although such needs contribute to reoffending. Local agencies should coordinate efforts to support interagency communication in the referral and cross-system linkage process.
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Affiliation(s)
- Gail A Wasserman
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York City (Wasserman, McReynolds, Elkington); Schar School of Policy and Government, George Mason University, Fairfax, Virginia (Taxman); Department of Criminal Justice, Temple University, Philadelphia, (Belenko); Social Science Research Center, Mississippi State University, Starkville (Robertson); Lighthouse Institute, Chestnut Health Systems, Normal, Illinois (Dennis); Department of Psychology, Texas Christian University, Fort Worth (Knight); Department of Behavioral Science, University of Kentucky, Lexington (Knudsen); Department of Criminology, University of South Florida, Tampa (Dembo); Department of Biostatistics and Bioinformatics, George Washington University, Washington, D.C. (Ciarleglio); National Institute on Drug Abuse, Bethesda, Maryland (Wiley)
| | - Larkin S McReynolds
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York City (Wasserman, McReynolds, Elkington); Schar School of Policy and Government, George Mason University, Fairfax, Virginia (Taxman); Department of Criminal Justice, Temple University, Philadelphia, (Belenko); Social Science Research Center, Mississippi State University, Starkville (Robertson); Lighthouse Institute, Chestnut Health Systems, Normal, Illinois (Dennis); Department of Psychology, Texas Christian University, Fort Worth (Knight); Department of Behavioral Science, University of Kentucky, Lexington (Knudsen); Department of Criminology, University of South Florida, Tampa (Dembo); Department of Biostatistics and Bioinformatics, George Washington University, Washington, D.C. (Ciarleglio); National Institute on Drug Abuse, Bethesda, Maryland (Wiley)
| | - Faye S Taxman
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York City (Wasserman, McReynolds, Elkington); Schar School of Policy and Government, George Mason University, Fairfax, Virginia (Taxman); Department of Criminal Justice, Temple University, Philadelphia, (Belenko); Social Science Research Center, Mississippi State University, Starkville (Robertson); Lighthouse Institute, Chestnut Health Systems, Normal, Illinois (Dennis); Department of Psychology, Texas Christian University, Fort Worth (Knight); Department of Behavioral Science, University of Kentucky, Lexington (Knudsen); Department of Criminology, University of South Florida, Tampa (Dembo); Department of Biostatistics and Bioinformatics, George Washington University, Washington, D.C. (Ciarleglio); National Institute on Drug Abuse, Bethesda, Maryland (Wiley)
| | - Steven Belenko
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York City (Wasserman, McReynolds, Elkington); Schar School of Policy and Government, George Mason University, Fairfax, Virginia (Taxman); Department of Criminal Justice, Temple University, Philadelphia, (Belenko); Social Science Research Center, Mississippi State University, Starkville (Robertson); Lighthouse Institute, Chestnut Health Systems, Normal, Illinois (Dennis); Department of Psychology, Texas Christian University, Fort Worth (Knight); Department of Behavioral Science, University of Kentucky, Lexington (Knudsen); Department of Criminology, University of South Florida, Tampa (Dembo); Department of Biostatistics and Bioinformatics, George Washington University, Washington, D.C. (Ciarleglio); National Institute on Drug Abuse, Bethesda, Maryland (Wiley)
| | - Katherine S Elkington
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York City (Wasserman, McReynolds, Elkington); Schar School of Policy and Government, George Mason University, Fairfax, Virginia (Taxman); Department of Criminal Justice, Temple University, Philadelphia, (Belenko); Social Science Research Center, Mississippi State University, Starkville (Robertson); Lighthouse Institute, Chestnut Health Systems, Normal, Illinois (Dennis); Department of Psychology, Texas Christian University, Fort Worth (Knight); Department of Behavioral Science, University of Kentucky, Lexington (Knudsen); Department of Criminology, University of South Florida, Tampa (Dembo); Department of Biostatistics and Bioinformatics, George Washington University, Washington, D.C. (Ciarleglio); National Institute on Drug Abuse, Bethesda, Maryland (Wiley)
| | - Angela A Robertson
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York City (Wasserman, McReynolds, Elkington); Schar School of Policy and Government, George Mason University, Fairfax, Virginia (Taxman); Department of Criminal Justice, Temple University, Philadelphia, (Belenko); Social Science Research Center, Mississippi State University, Starkville (Robertson); Lighthouse Institute, Chestnut Health Systems, Normal, Illinois (Dennis); Department of Psychology, Texas Christian University, Fort Worth (Knight); Department of Behavioral Science, University of Kentucky, Lexington (Knudsen); Department of Criminology, University of South Florida, Tampa (Dembo); Department of Biostatistics and Bioinformatics, George Washington University, Washington, D.C. (Ciarleglio); National Institute on Drug Abuse, Bethesda, Maryland (Wiley)
| | - Michael L Dennis
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York City (Wasserman, McReynolds, Elkington); Schar School of Policy and Government, George Mason University, Fairfax, Virginia (Taxman); Department of Criminal Justice, Temple University, Philadelphia, (Belenko); Social Science Research Center, Mississippi State University, Starkville (Robertson); Lighthouse Institute, Chestnut Health Systems, Normal, Illinois (Dennis); Department of Psychology, Texas Christian University, Fort Worth (Knight); Department of Behavioral Science, University of Kentucky, Lexington (Knudsen); Department of Criminology, University of South Florida, Tampa (Dembo); Department of Biostatistics and Bioinformatics, George Washington University, Washington, D.C. (Ciarleglio); National Institute on Drug Abuse, Bethesda, Maryland (Wiley)
| | - Danica K Knight
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York City (Wasserman, McReynolds, Elkington); Schar School of Policy and Government, George Mason University, Fairfax, Virginia (Taxman); Department of Criminal Justice, Temple University, Philadelphia, (Belenko); Social Science Research Center, Mississippi State University, Starkville (Robertson); Lighthouse Institute, Chestnut Health Systems, Normal, Illinois (Dennis); Department of Psychology, Texas Christian University, Fort Worth (Knight); Department of Behavioral Science, University of Kentucky, Lexington (Knudsen); Department of Criminology, University of South Florida, Tampa (Dembo); Department of Biostatistics and Bioinformatics, George Washington University, Washington, D.C. (Ciarleglio); National Institute on Drug Abuse, Bethesda, Maryland (Wiley)
| | - Hannah K Knudsen
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York City (Wasserman, McReynolds, Elkington); Schar School of Policy and Government, George Mason University, Fairfax, Virginia (Taxman); Department of Criminal Justice, Temple University, Philadelphia, (Belenko); Social Science Research Center, Mississippi State University, Starkville (Robertson); Lighthouse Institute, Chestnut Health Systems, Normal, Illinois (Dennis); Department of Psychology, Texas Christian University, Fort Worth (Knight); Department of Behavioral Science, University of Kentucky, Lexington (Knudsen); Department of Criminology, University of South Florida, Tampa (Dembo); Department of Biostatistics and Bioinformatics, George Washington University, Washington, D.C. (Ciarleglio); National Institute on Drug Abuse, Bethesda, Maryland (Wiley)
| | - Richard Dembo
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York City (Wasserman, McReynolds, Elkington); Schar School of Policy and Government, George Mason University, Fairfax, Virginia (Taxman); Department of Criminal Justice, Temple University, Philadelphia, (Belenko); Social Science Research Center, Mississippi State University, Starkville (Robertson); Lighthouse Institute, Chestnut Health Systems, Normal, Illinois (Dennis); Department of Psychology, Texas Christian University, Fort Worth (Knight); Department of Behavioral Science, University of Kentucky, Lexington (Knudsen); Department of Criminology, University of South Florida, Tampa (Dembo); Department of Biostatistics and Bioinformatics, George Washington University, Washington, D.C. (Ciarleglio); National Institute on Drug Abuse, Bethesda, Maryland (Wiley)
| | - Adam Ciarleglio
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York City (Wasserman, McReynolds, Elkington); Schar School of Policy and Government, George Mason University, Fairfax, Virginia (Taxman); Department of Criminal Justice, Temple University, Philadelphia, (Belenko); Social Science Research Center, Mississippi State University, Starkville (Robertson); Lighthouse Institute, Chestnut Health Systems, Normal, Illinois (Dennis); Department of Psychology, Texas Christian University, Fort Worth (Knight); Department of Behavioral Science, University of Kentucky, Lexington (Knudsen); Department of Criminology, University of South Florida, Tampa (Dembo); Department of Biostatistics and Bioinformatics, George Washington University, Washington, D.C. (Ciarleglio); National Institute on Drug Abuse, Bethesda, Maryland (Wiley)
| | - Tisha R A Wiley
- Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York City (Wasserman, McReynolds, Elkington); Schar School of Policy and Government, George Mason University, Fairfax, Virginia (Taxman); Department of Criminal Justice, Temple University, Philadelphia, (Belenko); Social Science Research Center, Mississippi State University, Starkville (Robertson); Lighthouse Institute, Chestnut Health Systems, Normal, Illinois (Dennis); Department of Psychology, Texas Christian University, Fort Worth (Knight); Department of Behavioral Science, University of Kentucky, Lexington (Knudsen); Department of Criminology, University of South Florida, Tampa (Dembo); Department of Biostatistics and Bioinformatics, George Washington University, Washington, D.C. (Ciarleglio); National Institute on Drug Abuse, Bethesda, Maryland (Wiley)
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Huang S, Gardner S, Piper KN, Coleman AS, Becan JE, Robertson AA, Elkington KS. Bridging Systems to Implement HIV/STI Programming Within the Juvenile Justice System: Strengths and Challenges of a Local Change Team Approach. AIDS Educ Prev 2020; 32:432-453. [PMID: 33112673 DOI: 10.1521/aeap.2020.32.5.432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Justice-involved youth are at risk for HIV/STIs but do not access services. The complex challenges of improving the delivery of health-related services within juvenile justice (JJ) settings warrant exploration of strategies to close this service gap. This study describes the successes and challenges of utilizing a local change team (LCT) strategy comprising JJ and health agency staff to implement HIV/STI programming in JJ settings, across six counties in six states in the U.S. Five focus groups comprising n = 28 JJ and health agency staff who served as LCT members were conducted. Results demonstrated the structured nature of the collaborative process and strength of commitment among LCT members were necessary for successful implementation of HIV/STI programming. The use of LCTs comprising membership of JJ and (behavioral) health systems has broader applicability to other health and behavioral health issues faced by youth on probation that JJ staff may feel ill equipped to address.
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Affiliation(s)
- Sofia Huang
- Columbia University and New York State Psychiatric Institute, New York, New York
| | - Sheena Gardner
- Social Science Research Center, Mississippi State University, Starkville, Mississippi
| | - Kaitlin N Piper
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ashley S Coleman
- Social Science Research Center, Mississippi State University, Starkville, Mississippi
| | | | - Angela A Robertson
- Social Science Research Center, Mississippi State University, Starkville, Mississippi
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Robertson AA, Fang Z, Weiland D, Joe G, Gardner S, Dembo R, McReynolds L, Dickson M, Pankow J, Dennis M, Elkington K. Recidivism Among Justice-Involved Youth: Findings From JJ-TRIALS. Crim Justice Behav 2020; 47:1059-1078. [PMID: 35846112 PMCID: PMC9285988 DOI: 10.1177/0093854820922891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Recidivism, and the factors related to it, remains a highly significant concern among juvenile justice researchers, practitioners, and policy makers. Recent studies highlight the need to examine multiple measures of recidivism as well as conduct multilevel analyses of this phenomenon. Using data collected in a National Institute on Drug Abuse (NIDA)-funded Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) cooperative agreement, we examined individual- and site-level factors related to 1-year recidivism among probation youth in 20 sites in five states to answer research questions related to how recidivism rates differ across sites and the relationships between individual-level variables and a county-level concentrated disadvantage measure and recidivism. Our findings of large site differences in recidivism rates, and complex relationships between individual and county-level predictors of recidivism, highlight the need for more nuanced, contextually informed, multilevel approaches in studying recidivism among juveniles.
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Elkington KS, Spaulding A, Gardner S, Knight D, Belenko S, Becan JE, Robertson AA, Oser C, DiClemente R. A System-Level Intervention to Encourage Collaboration Between Juvenile Justice and Public Health Agencies to Promote HIV/STI Testing. AIDS Educ Prev 2020; 32:337-355. [PMID: 32897134 PMCID: PMC9426765 DOI: 10.1521/aeap.2020.32.4.337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Justice-involved youth are at high risk for HIV and STIs, and justice agencies are uniquely poised to offer HIV/STI testing. However, testing in these settings is not routine and represents a missed opportunity. This study describes a system-level implementation intervention designed to increase access to HIV/STI testing through juvenile justice (JJ) and public health agency collaboration across six counties in six states in the United States. Local change teams, active facilitation, and training were utilized to facilitate agency partnerships and development of HIV/STI practice change protocols. Five counties established health and JJ partnerships and four counties successfully implemented their protocols. Sites with HIV/STI education and testing protocols behaviorally screened 98.5% of youth and tested 41.2% of those youth; 0% were HIV+ and 43.2% had an STI. The intervention provides a feasible, scalable solution, through promoting partnerships between JJ and health agencies, to link youth to testing and treatment services.
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Affiliation(s)
- Katherine S. Elkington
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY
| | - Anne Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Sheena Gardner
- Social Science Research Center, Mississippi State University, Starkville, MS
| | - Danica Knight
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX
| | - Steven Belenko
- Department of Criminal Justice, Temple University, Philadelphia, PA
| | - Jennifer E. Becan
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX
| | - Angela A. Robertson
- Social Science Research Center, Mississippi State University, Starkville, MS
| | - Carrie Oser
- Department of Sociology, University of Kentucky, Lexington, KY
| | - Ralph DiClemente
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
- Department of Social and Behavioral Sciences, New York University (NYU) College of Global Public Health, New York, NY
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Elkington KS, Robertson AA, Knight DK, Gardner SK, Funk RR, Dennis ML, Oser C, DiClemente R. HIV/STI Service Delivery Within Juvenile Community Supervision Agencies: A National Survey of Practices and Approaches to Moving High-Risk Youth Through the HIV Care Cascade. AIDS Patient Care STDS 2020; 34:72-80. [PMID: 32049557 PMCID: PMC7044763 DOI: 10.1089/apc.2019.0157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Justice-involved youth (JIY) are at considerable risk for human immunodeficiency virus (HIV), but are disconnected from treatment and prevention. Juvenile justice agencies providing community supervision (CS) are well positioned to provide HIV prevention, testing, and prompt referral to treatment for JIY. However, we lack an understanding of juvenile CS agency responses to HIV/sexually transmitted infection (STI) needs among JIY. We conducted a nationwide systematic assessment of how juvenile CS agencies identify, refer, and move youth through the HIV care cascade using a nationally representative sample of 195 juvenile CS agencies across 20 states. Two-thirds of CS agencies did not offer any HIV-/STI-related services, and 82% reported no collaboration with health agencies. Screening or referral for HIV risk behaviors was reported by 32% of the CS agencies and 12% for any intervention or prevention for HIV/STI risk behaviors. Between 21% and 30% of agencies were unaware of the location of local HIV/STI services. HIV/STI prevention training was not a priority for directors and was ranked second to last out of 16 training topics. Agencies where staff expressed need for HIV risk training and where specific court programming was available were more likely to provide or refer for HIV/STI screening and/or testing. Agencies were more likely to provide or refer for services if they provided pre-trial/pre-adjudication supervision, parole, or court programming. Considering the low provision of HIV/STI-related services and limited collaboration between health and justice agencies, interventions that promote cross-system collaboration designed to minimize barriers and facilitate identification, referral, and linkage to HIV services for JIY are necessary.
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Affiliation(s)
- Katherine S. Elkington
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, New York
| | - Angela A. Robertson
- Social Science Research Center, Mississippi State University, Starkville, Mississippi
| | - Danica K. Knight
- Institute of Behavioral Research, Texas Christian University, Fort Worth, Texas
| | - Sheena K. Gardner
- Social Science Research Center, Mississippi State University, Starkville, Mississippi
| | | | | | - Carrie Oser
- Department of Sociology and Center on Drug and Alcohol Research, College of Medicine, University of Kentucky, Lexington, Kentucky
- Department of Behavioral Science, Center on Drug and Alcohol Research, College of Medicine, University of Kentucky, Lexington, Kentucky
| | - Ralph DiClemente
- Department of Social and Behavioral Sciences, New York University, New York, New York
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10
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Affiliation(s)
- Angela A. Robertson
- Mississippi State University, Social Science Research Center, Starkville, Mississippi
| | - Qian M. Zhou
- Department of Mathematics and Statistics, Mississippi State University, Mississippi State, Mississippi
| | - Andrew Tatch
- Mississippi State University, Social Science Research Center, Starkville, Mississippi
| | - Melanie Walsh
- Mississippi State University, Social Science Research Center, Starkville, Mississippi
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11
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Robertson AA, Hiller M, Dembo R, Dennis M, Scott C, Henry BF, Elkington KS. National Survey of Juvenile Community Supervision Agency Practices and Caregiver Involvement in Behavioral Health Treatment. J Child Fam Stud 2019; 28:3110-3120. [PMID: 31749598 PMCID: PMC6865812 DOI: 10.1007/s10826-019-01488-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVES This study sought to expand the sparse literature examining the extent to which family engagement interventions and the structural characteristics of juvenile community supervision agencies influence caregiver participation in youths' behavioral health (i.e., mental health and substance use) treatment. METHODS We analyzed data from a national survey of juvenile community supervision agencies, conducted as a part of a Juvenile Justice Translational Research on Interventions for Adolescents in the Legal System (JJTRIALS) Cooperative Agreement funded by NIH/NIDA. RESULTS Findings indicated agencies employ a variety of family engagement strategies, with passive strategies like services referrals and flexible schedules being more common than active strategies like provision of family therapy. Multivariate prediction of caregiver involvement in behavioral health care showed the most consistent effects for rural-urban location of the agency; rural agencies more successfully engaged families in their youth's behavioral healthcare. Relatedly, the more family engagement services, the greater the involvement of families in behavioral health treatment. Agencies with a juvenile drug treatment court also showed greater involvement. CONCLUSIONS Our findings that juvenile justice agencies are using multiple techniques to engage families, and that there is a relationship between use of these techniques and actual family engagement, would benefit from replication over time and in other jurisdictions. Analysis of data from a second wave of the national survey, recently completed, is expected to test the reliability of our findings over time, as well as identify whether and what kind of changes occurred in the two years following the first survey.
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Affiliation(s)
- Angela A Robertson
- Social Science Research Center, Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS 39759
| | - Matthew Hiller
- Department of Criminal Justice, Temple University, Philadelphia, PA
| | - Richard Dembo
- Department of Criminology, University of South Florida, Tampa, FL
| | | | | | - Brandy F Henry
- The Heller School for Social Policy and Management, Brandeis University, Waltham, MA
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12
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Robertson AA, Zhou QM, Tatch A, Walsh M. Gender-Specific Predictors of Recidivism Among DUI Offenders. J Stud Alcohol Drugs 2019; 80:641-650. [PMID: 31790354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVE Women are less likely than men to be arrested for driving under the influence (DUI) of alcohol or another drug, yet their proportion of DUI offenders is growing. Understanding how DUI recidivism risk varies for men and women is of practical utility for DUI assessment and intervention programs. The goals of the current study are to determine if there are different sets of predictors for men and women and whether gender-specific DUI recidivism risk scales perform better than a single recidivism scale for both men and women. METHOD We rely on statistically driven techniques to develop gender-specific and total sample recidivism risk scales. We then test the ability of the scales to predict recidivism within 12 months among a large sample (N = 10,827, 22.3% female) of DUI offenders court mandated to a DUI intervention in Mississippi. RESULTS Predictors of recidivism were drawn from measures of criminal history, substance use disorders, driving behaviors, and accidents. Gender-specific models yielded different sets of recidivism risk factors for men and women, with minimal overlap between the two. Male risk factors were criminal history and heavy alcohol consumption. For women, evidence of a substance use disorder was a unique predictor. Having a prior DUI arrest, driving behaviors, and a physical health consequence of alcohol or drug use (i.e., weight loss) were shared predictors for both sexes. CONCLUSIONS Findings suggest that within broad categories of risk factors, the predictive validity of specific assessment items may vary by sex. Our methods represent progression toward more efficient prediction of DUI recidivists.
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Affiliation(s)
- Angela A Robertson
- Mississippi State University, Social Science Research Center, Starkville, Mississippi
| | - Qian M Zhou
- Department of Mathematics and Statistics, Mississippi State University, Mississippi State, Mississippi
| | - Andrew Tatch
- Mississippi State University, Social Science Research Center, Starkville, Mississippi
| | - Melanie Walsh
- Mississippi State University, Social Science Research Center, Starkville, Mississippi
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Gardner SK, Elkington KS, Knight DK, Huang S, DiClemente RJ, Spaulding AC, Oser CB, Robertson AA, Baird-Thomas C. Juvenile justice staff endorsement of HIV/STI prevention, testing, and treatment linkage. Health Justice 2019; 7:15. [PMID: 31485779 PMCID: PMC6724232 DOI: 10.1186/s40352-019-0096-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 08/22/2019] [Indexed: 05/11/2023]
Abstract
BACKGROUND While involvement in the legal system offers an opportunity to educate, screen, and treat high-risk youth, research shows that staff attitudes toward these practices can serve as barriers to implementation. The current study investigates the degree to which JJ staff endorse HIV prevention, testing, and treatment linkage practices with youth under community supervision and examines differences between individuals who supervise youth (e.g., juvenile probation officer) and those working in non-supervisory roles (e.g., case manager, assessment specialist). METHODS Juvenile justice staff consenting to participation in JJ-TRIALS completed an initial staff survey (N = 501). Survey items measured perceived importance of HIV/STI prevention (4 items); perceived importance of HIV/STI testing (7 items); and perceived importance of HIV/STI treatment linkage (8 items). RESULTS Confirmatory Factor Analysis (CFA) was computed (SAS CALIS procedure) for each of the three domains. Findings suggest that while staff recognize that youth are at risk for HIV/STIs and require provision of HIV/STI prevention and treatment linkage, attitudes concerning the importance of procuring or providing testing services for youth is substantially lower. Furthermore, analytic models comparing staff with and without supervision responsibilities (computed using SAS PROC MIXED) indicated that attitudes differed by site and staff responsible for supervision rated HIV treatment linkage practices as less important compared to non-supervising staff. CONCLUSIONS Establishing partnerships with health agencies equipped with resources and skillsets to provide HIV/STI testing and related services may be an effective model to promote greater awareness and use of best practices among JJ staff and more effectively address the unmet needs of this high-risk population of youth.
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Affiliation(s)
- Sheena K. Gardner
- Social Science Research Center, Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS 39759 USA
| | - Katherine S. Elkington
- Department of Psychiatry, Division of Child & Adolescent Psychiatry, Columbia University, 1051 Riverside Drive, #15, New York, NY 10032 USA
| | - Danica K. Knight
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Avenue, Fort Worth, TX 76109 USA
| | - Sofia Huang
- Department of Psychiatry, Division of Child & Adolescent Psychiatry, Columbia University, 1051 Riverside Drive, #15, New York, NY 10032 USA
| | - Ralph J. DiClemente
- College of Global Public Health, New York University, 715 #719, Broadway, New York, NY 10003 USA
| | - Anne C. Spaulding
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322 USA
| | - Carrie B. Oser
- Department of Sociology, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY 40506 USA
| | - Angela A. Robertson
- Social Science Research Center, Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS 39759 USA
| | - Connie Baird-Thomas
- Social Science Research Center, Mississippi State University, 153 Mississippi Parkway, Canton, MS 39046 USA
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14
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Abstract
Racial differences in drinking motives, protective behavioral strategies (PBSs), alcohol consumption, and alcohol-related problems were examined among college student drinkers (N = 443: 296 [66.8%] White, 147 [33.3%] Black). Survey participants were recruited from large undergraduate sociology classes and residence halls at the university. Key differences between Black and White college students in drinking behaviors, reasons for drinking (i.e., motives), and the use of PBSs were observed. These racial differences have implications for the implementation of prevention/intervention programs intending to reduce alcohol consumption and alcohol-related problems among college students.
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Affiliation(s)
| | | | - Andrew Tatch
- Mississippi State University, Starkville, Mississippi
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15
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Robertson AA, Walker CS. Predictors of justice system involvement: Maltreatment and education. Child Abuse Negl 2018; 76:408-415. [PMID: 29241115 DOI: 10.1016/j.chiabu.2017.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 10/23/2017] [Accepted: 12/01/2017] [Indexed: 06/07/2023]
Abstract
Decades of research have established that experience of abuse and/or neglect in childhood is related to negative outcomes, such as juvenile delinquency. Existing research has shown that involvement in child welfare services is also related to juvenile delinquency, particularly for children who are victims of neglect. Research has also identified educational factors such as chronic absenteeism as significant predictors of involvement in the juvenile justice system. However, little research has investigated the combined influence of educational factors, child abuse, and involvement in child protective services on justice system involvement. The current study examined the influence of educational factors and involvement in child protective services on justice system involvement. The study utilized records from an educational database of children who attended a school within a county of Mississippi in any year from 2003 through 2013. Cases were then matched with records from the county Youth Court, Law Enforcement agencies, and Child Protection Services. A multivariate logistic regression controlling for gender, race, current age, and time at risk was conducted to involvement in the justice system. In general, educational factors were stronger predictors of justice system involvement than allegations of maltreatment.
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Affiliation(s)
- Angela A Robertson
- Social Science Research Center, Mississippi State University, 1 Research Boulevard, Suite 103, Starkville, MS 39759, United States
| | - Courtney S Walker
- Mississippi State University, Department of Psychology, 110 Magruder Hall, 255 Lee Blvd. 39762, United States.
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16
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Morse DT, Robertson AA. Psychometric properties of the Short Inventory of Problems (SIP) with adjudicated DUI intervention participants. Psychology of Addictive Behaviors 2017; 31:110-116. [DOI: 10.1037/adb0000249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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17
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Leukefeld CG, Cawood M, Wiley T, Robertson AA, Fisher JH, Arrigona N, Donohue P, Staples-Horne M, Harris PW, Dembo R, Roysden J, Marks KR. The Benefits of Community and Juvenile Justice Involvement in Organizational Research. J Juv Justice 2017; 6:112-124. [PMID: 28828202 PMCID: PMC5562037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The Juvenile Justice (JJ) system has a number of local behavioral health service community linkages for substance abuse, mental health, and HIV services. However, there have only been a few systemic studies that examine and seek to improve these community behavioral health linkages for justice-involved youth. Implementation research is a way of identifying, testing, and understanding effective strategies for translating evidence-based treatment and prevention approaches into service delivery. This article explores benefits and challenges of participatory research within the context of the National Institute on Drug Abuse (NIDA)'s Juvenile Justice Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) implementation behavioral health study. The JJ-TRIALS study has involved JJ partners (representatives from state-level JJ agencies) throughout the study development, design, and implementation. Proponents of participatory research argue that such participation strengthens relations between the community and academia; ensures the relevancy of research questions; increases the capacity of data collection; and enhances program recruitment, sustainability, and extension. The extent of the impact that JJ partners have had on the JJ-TRIALS study will be discussed, as well as the benefits local JJ agencies can derive from both short- and long-term participation. Issues associated with the site selection, participation, and implementation of evidence-based practices also will be discussed.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Richard Dembo
- Department of Criminology, University of South Florida
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18
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Belenko S, Knight D, Wasserman GA, Dennis ML, Wiley T, Taxman FS, Oser C, Dembo R, Robertson AA, Sales J. The Juvenile Justice Behavioral Health Services Cascade: A new framework for measuring unmet substance use treatment services needs among adolescent offenders. J Subst Abuse Treat 2016; 74:80-91. [PMID: 28132705 DOI: 10.1016/j.jsat.2016.12.012] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 12/15/2016] [Accepted: 12/28/2016] [Indexed: 11/26/2022]
Abstract
OVERVIEW Substance use and substance use disorders are highly prevalent among youth under juvenile justice (JJ) supervision, and related to delinquency, psychopathology, social problems, risky sex and sexually transmitted infections, and health problems. However, numerous gaps exist in the identification of behavioral health (BH) problems and in the subsequent referral, initiation and retention in treatment for youth in community justice settings. This reflects both organizational and systems factors, including coordination between justice and BH agencies. METHODS AND RESULTS This paper presents a new framework, the Juvenile Justice Behavioral Health Services Cascade ("Cascade"), for measuring unmet substance use treatment needs to illustrate how the cascade approach can be useful in understanding service delivery issues and identifying strategies to improve treatment engagement and outcomes for youth under community JJ supervision. We discuss the organizational and systems barriers for linking delinquent youth to BH services, and explain how the Cascade can help understand and address these barriers. We provide a detailed description of the sequential steps and measures of the Cascade, and then offer an example of its application from the Juvenile Justice - Translational Research on Interventions for Adolescents in the Legal System project (JJ-TRIALS), a multi-site research cooperative funded by the National Institute on Drug Abuse. CONCLUSION As illustrated with substance abuse treatment, the Cascade has potential for informing and guiding efforts to improve behavioral health service linkages for adolescent offenders, developing and testing interventions and policies to improve interagency and cross-systems coordination, and informing the development of measures and interventions for improving the implementation of treatment in complex multisystem service settings. Clinical Trials Registration number - NCT02672150.
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Affiliation(s)
- Steven Belenko
- Temple University, 1115 Polett Walk, Philadelphia, PA 19122, United States.
| | - Danica Knight
- Texas Christian University, 3034 Sandage Avenue, Fort Worth, TX 76129, United States.
| | - Gail A Wasserman
- Columbia University, 1051 Riverside Drive, Unit 78, New York City, NY 10032, United States.
| | - Michael L Dennis
- Chestnut Health Systems, 448 Wylie Drive, Normal, IL 61701, United States.
| | - Tisha Wiley
- National Institute on Drug Abuse, 6001 Executive Boulevard, Room 5191, Bethesda, MD 20892, United States.
| | - Faye S Taxman
- George Mason University, 4087 University Drive, 4100, MSN 6D3, Fairfax, VA 22030, United States.
| | - Carrie Oser
- University of Kentucky, 1531 Patterson Office Tower, Lexington, KY 40506, United States.
| | - Richard Dembo
- University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, United States.
| | - Angela A Robertson
- Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS 39759, United States.
| | - Jessica Sales
- Emory University, Rollins School of Public Health, 1518 Clifton Road, Room 570, Atlanta, GA 30322, United States.
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Knight DK, Belenko S, Wiley T, Robertson AA, Arrigona N, Dennis M, Bartkowski JP, McReynolds LS, Becan JE, Knudsen HK, Wasserman GA, Rose E, DiClemente R, Leukefeld C. Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS): a cluster randomized trial targeting system-wide improvement in substance use services. Implement Sci 2016; 11:57. [PMID: 27130175 PMCID: PMC4850663 DOI: 10.1186/s13012-016-0423-5] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 04/20/2016] [Indexed: 01/11/2024] Open
Abstract
Background The purpose of this paper is to describe the Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) study, a cooperative implementation science initiative involving the National Institute on Drug Abuse, six research centers, a coordinating center, and Juvenile Justice Partners representing seven US states. While the pooling of resources across centers enables a robust implementation study design involving 36 juvenile justice agencies and their behavioral health partner agencies, co-producing a study protocol that has potential to advance implementation science, meets the needs of all constituencies (funding agency, researchers, partners, study sites), and can be implemented with fidelity across the cooperative can be challenging. This paper describes (a) the study background and rationale, including the juvenile justice context and best practices for substance use disorders, (b) the selection and use of an implementation science framework to guide study design and inform selection of implementation components, and (c) the specific study design elements, including research questions, implementation interventions, measurement, and analytic plan. Methods/design The JJ-TRIALS primary study uses a head-to-head cluster randomized trial with a phased rollout to evaluate the differential effectiveness of two conditions (Core and Enhanced) in 36 sites located in seven states. A Core strategy for promoting change is compared to an Enhanced strategy that incorporates all core strategies plus active facilitation. Target outcomes include improvements in evidence-based screening, assessment, and linkage to substance use treatment. Discussion Contributions to implementation science are discussed as well as challenges associated with designing and deploying a complex, collaborative project. Trial registration NCT02672150.
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Affiliation(s)
- Danica K Knight
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA.
| | - Steven Belenko
- Department of Criminal Justice, Temple University, Philadelphia, PA, USA
| | - Tisha Wiley
- National Institute on Drug Abuse, Bethseda, MD, USA
| | - Angela A Robertson
- Social Science Research Center, Mississippi State University, Starkville, MS, USA
| | - Nancy Arrigona
- Council of State Governments Justice Center, Austin, TX, USA
| | | | - John P Bartkowski
- Department of Sociology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Larkin S McReynolds
- Center for the Promotion of Mental Health in Juvenile Justice, Columbia University/NYSPI, New York, NY, USA
| | - Jennifer E Becan
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA
| | | | - Gail A Wasserman
- Center for the Promotion of Mental Health in Juvenile Justice, Columbia University/NYSPI, New York, NY, USA
| | - Eve Rose
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ralph DiClemente
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Carl Leukefeld
- Behavioral Science, University of Kentucky, Lexington, KY, USA
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Abstract
This study examines the impact of abuse trauma (physical and sexual) on alcohol and drug use of high-risk girls (12-18 years of age) who were surveyed within the first two weeks of their incarceration. One-way ANOVA analyses and Tukey post-hoc tests indicate physical abuse with a weapon was associated with higher marijuana use and number of drugs used. Sexual abuse, especially within the past year increased marijuana use, alcohol use, number of drugs used, and alcohol and other drug (AOD) problems. Policy implications reflect the need for treatment protocols within substance abuse programs to address abuse trauma, particularly, forced sex which has occurred within the last year.
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21
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Hood KB, Robertson AA, Baird-Thomas C. Implementing solutions to barriers to on-site HIV testing in substance abuse treatment: a tale of three facilities. Eval Program Plann 2015; 49:1-9. [PMID: 25462936 DOI: 10.1016/j.evalprogplan.2014.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 09/08/2014] [Accepted: 11/01/2014] [Indexed: 06/04/2023]
Abstract
Due to the scarcity of resources for implementing rapid on-site HIV testing, many substance abuse treatment programs do not offer these services. This study sought to determine whether addressing previously identified implementation barriers to integrating on-site rapid HIV testing into the treatment admissions process would increase offer and acceptance rates. Results indicate that it is feasible to integrate rapid HIV testing into existing treatment programs for substance abusers when resources are provided. Addressing barriers such as providing start-up costs for HIV testing, staff training, addressing staffing needs to reduce competing job responsibilities, and helping treatment staff members overcome their concerns about clients' reactions to positive test results is paramount for the integration and maintenance of such programs.
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Affiliation(s)
- Kristina B Hood
- Mississippi State University, Department of Psychology PO Box 6161 Mississippi State, MS 39762, USA.
| | - Angela A Robertson
- Mississippi State University, Social Science Research Center, 1 Research Blvd., Suite 103, Starkville, MS 39759, USA.
| | - Connie Baird-Thomas
- Mississippi State University, Social Science Research Center, 1 Research Blvd., Suite 103, Starkville, MS 39759, USA.
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Rich SL, Robertson AA, Wilson JK. Having "The Talk": Individual, Family, and Partner Factors on Unprotected Sex among Female Adolescent Offenders. Deviant Behav 2013; 35:311-322. [PMID: 31511754 PMCID: PMC6738972 DOI: 10.1080/01639625.2013.848117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 07/10/2013] [Indexed: 06/10/2023]
Abstract
This study assessed the influence of individual age and substance use, family support and communication, and partner support and communication on the frequency of unprotected sex among incarcerated adolescent females. Subjects (n = 273) completed a survey on psychosocial correlates and risk behaviors for sexually transmitted infections (STI). Communication with male partners and sex while under the influence have a significant impact on condom use. Findings highlight the necessity of providing assertive communication skills training and increasing self-efficacy as STI/HIV prevention components for adolescent females thus empowering their decision-making processes.
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Affiliation(s)
- S Lynne Rich
- University of Central Arkansas, Conway, Arkansas, USA
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Abstract
Drug abusing offenders have high rates of HIV and other sexually transmitted infections (STI). To date, the HIV/STI prevention needs of offenders in drug court programs have been ignored. This multi-method study employed interviews to assess drug court professionals' perceptions of the need for an HIV risk reduction intervention to be integrated into the services provided to drug court participants. Then, surveys were completed by 235 drug court participants to assess whether their sexual risk behaviors affirmed the need for such an intervention. The survey also assessed demographic characteristics, drug use prior to program entry, HIV knowledge, and condom attitudes. The relationship between duration in the drug court program and sexual risk behavior was also examined. Implications for the development and delivery of HIV risk reduction interventions within drug court programs are discussed.
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Affiliation(s)
- Angela A Robertson
- Social Science Research Center, Mississippi State University, Starkville, Mississippi, USA
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Robertson AA, Liew H, Gardner S. An evaluation of the narrowing gender gap in DUI arrests. Accid Anal Prev 2011; 43:1414-1420. [PMID: 21545874 DOI: 10.1016/j.aap.2011.02.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 01/26/2011] [Accepted: 02/11/2011] [Indexed: 05/30/2023]
Abstract
Although males account for the vast majority of those convicted of driving under the influence of alcohol and/or other drugs (DUI), female DUI convictions have increased over the past two decades. In this study, we examined the ratio of males-to-females who were court-mandated between the years 1992 and 2008 to attend the Mississippi Alcohol Safety Education Program (MASEP), a DUI intervention program in Mississippi. The data for this study came from MASEP records; the Behavioral Risk Factor Surveillance System (BRFSS); the Uniform Crime Reports (UCR); the Treatment Episode Data Set (TEDS); the National Household Travel Survey (NHTS); and National Highway Traffic Safety Administration (NHTSA), an agency within the US Department of Transportation. Augmented Dickey-Fuller (ADF) tests were used to assess the nature (i.e., convergence, divergence, or stability) of this trend and to identify predictors. The results showed that, over the 17-year period, the gender gap in DUI convictions, self-reported history of prior arrest, official drug arrests, and substance abuse treatment admissions has narrowed considerably. Results from the autoregressive integrated moving average (ARIMA) models show that three factors account for increases in the proportion of women mandated to attend MASEP: self-reported arrest prior to the DUI conviction, female admissions to substance abuse treatment, and annual miles driven. Changes in both women's behavior and law enforcement practices have increased female exposure to DUI arrests and narrowed the gender gap in DUI convictions.
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Affiliation(s)
- Angela A Robertson
- Social Science Research Center, Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS 39759, USA.
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Robertson AA, Robertson AR, St Lawrence J, Morse DT, Baird-Thomas C, Liew H, Gresham K. The Healthy Teen Girls project: comparison of health education and STD risk reduction intervention for incarcerated adolescent females. Health Educ Behav 2011; 38:241-50. [PMID: 21393623 DOI: 10.1177/1090198110372332] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Adolescent girls incarcerated in a state reformatory (N = 246) were recruited and assigned to an 18-session health education program or a time-equivalent HIV prevention program. Cohorts were assigned to conditions using a randomized block design separated by a washout period to reduce contamination. Post intervention, girls in the HIV risk reduction program demonstrated the acquisition of risk-reduction behavioral skills and improved condom application skill. At a follow-up assessment approximately 9 months after release from the correctional facility, girls in both conditions reported fewer unprotected sexual intercourse occasions and less sex while under the influence of alcohol or other drugs.
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Chi G, Zhou X, McClure TE, Gilbert PA, Cosby AG, Zhang L, Robertson AA, Levinson D. Gasoline prices and their relationship to drunk-driving crashes. Accid Anal Prev 2011; 43:194-203. [PMID: 21094313 DOI: 10.1016/j.aap.2010.08.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Revised: 07/28/2010] [Accepted: 08/13/2010] [Indexed: 05/30/2023]
Abstract
This study investigates the relationship between changing gasoline prices and drunk-driving crashes. Specifically, we examine the effects of gasoline prices on drunk-driving crashes in Mississippi by several crash types and demographic groups at the monthly level from 2004 to 2008, a period experiencing great fluctuation in gasoline prices. An exploratory visualization by graphs shows that higher gasoline prices are generally associated with fewer drunk-driving crashes. Higher gasoline prices depress drunk-driving crashes among young and adult drivers, among male and female drivers, and among white and black drivers. Results from negative binomial regression models show that when gas prices are higher, there are fewer drunk-driving crashes, particularly among property-damage-only crashes. When alcohol consumption levels are higher, there are more drunk-driving crashes, particularly fatal and injury crashes. The effects of gasoline prices and alcohol consumption are stronger on drunk-driving crashes than on all crashes. The findings do not vary much across different demographic groups. Overall, gasoline prices have greater effects on less severe crashes and alcohol consumption has greater effects on more severe crashes.
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Affiliation(s)
- Guangqing Chi
- Department of Sociology, Mississippi State University, PO Box C, Mississippi State, MS 39762, USA.
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Konkle-Parker DJ, Robertson AA. HIV discharge planning: from correctional setting to community care in Mississippi. HIV Clin 2011; 23:1-5. [PMID: 21539028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Abstract
This study examined a stress-coping model for substance use among female adolescents (N = 305, 69% African American) involved in the Mississippi juvenile justice system. Participants were interviewed in 2006 , regarding exposure to adverse and traumatic events, and they completed self-administered measures of social support from relatives, coping strategies, and questions on frequency of alcohol and other drug use. Results from nested regression models revealed that stressors are associated with drug, but not alcohol use. The use of supportive kinship ties and religion to cope were protective factors. The implications and limitations of the study are discussed.
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Affiliation(s)
- Angela A Robertson
- Social Science Research Center, Mississippi State University, Starkville, Mississippi 39759, USA.
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Robertson AA, Gardner S, Xu X, Costello H. The impact of remedial intervention on 3-year recidivism among first-time DUI offenders in Mississippi. Accid Anal Prev 2009; 41:1080-6. [PMID: 19664449 DOI: 10.1016/j.aap.2009.06.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Revised: 04/17/2009] [Accepted: 06/12/2009] [Indexed: 05/10/2023]
Abstract
This study examines the impact of the Mississippi Alcohol Safety Education Program (MASEP), a court-mandated intervention program, on 3-year recidivism rates among first-time DUI offenders (i.e. those convicted of a first offense for driving under the influence of alcohol or another drug). It also examines whether a new version of the curriculum that incorporates activities to enhance motivation for change further ameliorates recidivism. Cox proportional hazard regression models are used to compare recidivism rates among DUI offenders who completed MASEP with those who did not complete or who failed to enroll in the program. Recidivism rates were also compared for MASEP participants across time periods during which curriculum revisions were introduced. The hazard of recidivism was lower for individuals who completed the program than for individuals who did not complete or did not enroll in the program. Recidivism rates were further reduced following the introduction of curriculum revisions. Attendance of court-mandated remedial intervention programs lower subsequent DUI arrests and program content is associated with lower rates.
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Affiliation(s)
- Angela A Robertson
- Social Science Research Center, Mississippi State University, Starkville, MS 39759, USA.
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Abstract
Exposure to multiple traumatic events and high rates of mental health problems are common among juvenile offenders. This study draws on Conservation of Resources (COR) stress theory to examine the impact of a specific trauma, Hurricane Katrina, relative to other adverse life events, on the mental health of female adolescent offenders in Mississippi. Teenage girls (N=258, 69% African American) were recruited from four juvenile detention centers and the state training school. Participants were interviewed about the occurrence and timing of adverse life events and hurricane-related experiences and completed a self-administered mental health assessment. Hierarchical linear regression models were used to identify predictors of anxiety and depression. Pre-hurricane family stressors, pre-hurricane traumatic events, hurricane-related property damage, and receipt of hurricane-related financial assistance significantly predicted symptoms of anxiety and depression. Findings support COR theory. Family stressors had the greatest influence on symptoms of anxiety and depression, highlighting the need for family based services that address the multiple, inter-related problems and challenges in the lives of female juvenile offenders.
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Affiliation(s)
- Angela A Robertson
- Social Science Research Center, Mississippi State University, Starkville, MS, USA.
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Abstract
This study examines the effects of family characteristics, parental monitoring, and victimization by adults on alcohol and other drug (AOD) abuse, delinquency, and risky sexual behaviors among 761 incarcerated juveniles. The majority of youth reported that other family members had substance abuse problems and criminal histories. These youth were frequently the victims of violence. Relationships between victimization, parental monitoring, and problem behaviors were examined using structural equation modeling. Monitoring was negatively related to all problem behaviors. However, type of maltreatment was related to specific problem behaviors. The effects of family substance abuse and family criminal involvement on outcomes were mediated by monitoring and maltreatment. The study underscores the need to provide family-focused and trauma-related interventions for juvenile offenders.
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Robertson AA, Stein JA, Baird-Thomas C. Gender differences in the prediction of condom use among incarcerated juvenile offenders: testing the Information-Motivation-Behavior Skills (IMB) model. J Adolesc Health 2006; 38:18-25. [PMID: 16387244 DOI: 10.1016/j.jadohealth.2004.08.013] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2004] [Accepted: 08/23/2004] [Indexed: 11/22/2022]
Abstract
PURPOSE To validate the predictive value of the Information-Motivation-Behavioral Skills (IMB) model of human immunodeficiency virus (HIV) prevention for sexually active juvenile offenders and to explore gender differences in IMB model constructs for condom-protected vaginal intercourse. METHODS Self-report measures of acquired immune deficiency syndrome (AIDS) knowledge, pro-condom peer influence, risk perception, condom attitudes, condom use self-efficacy, frequency of vaginal intercourse, and frequency condom-protected vaginal intercourse were collected from predominantly African-American adolescent detainees. Analysis consisted of structural equation models for the combined sample (N = 523) and for separate gender groups (328 males and 195 females). RESULTS In the combined model, condom use was significantly predicted by male gender, peer influence, positive condom attitudes, and condom self-efficacy. In separate gender analyses, condom use among adolescent males was predicted by peer influence (modestly) and by positive condom attitudes, whereas condom use among females was predicted by peer influence, self-efficacy, and condom attitudes. Compared with males, females reported significantly greater knowledge, less peer influence, higher perceived risk for infection, more positive condom attitudes, and more self-efficacy, but they reported less condom use. CONCLUSIONS Females may find it difficult to use condoms consistently despite their awareness of their efficacy. Power imbalances or other dynamics operating in their relationships with males need further exploration. Gender differences in the relationship between condom self-efficacy and condom use were masked in the analysis of the total sample, indicating the value of testing theories of HIV prevention separately by gender.
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Affiliation(s)
- Angela A Robertson
- Social Science Research Center, Mississippi State University, Mississippi, USA.
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Abstract
OBJECTIVE The objective of this study was to examine the prevalence, multiple correlates, and gender differences in chlamydia and gonorrhea infections among adolescents, aged 13 to 18, incarcerated in a youth detention center in the southern region of the United States. GOAL The goal of this study was to identify factors associated with juvenile offenders' sexually transmitted disease (STD) risk that may guide the development of interventions specifically tailored for this population. STUDY The authors conducted a cross-sectional survey. RESULTS Rates of undiagnosed chlamydia were 24.7% for incarcerated girls and 8.1% for boys. Gonorrhea was detected in 7.3% of the girls and 1.5% of the boys. Predictors of STD positivity differed for boys and girls. Demographic characteristics (gender, race, and age) account for 52% of the total variance in STD infections; youths' behavior accounts for approximately one third of the total variance, and psychologic and family variables account for 8.6% and 7.2% of the total variance, respectively. CONCLUSIONS An approach that considers psychologic and social influences on adolescent sexual behavior is useful for identifying potential risk and protective factors of adolescent STD/HIV risk that are amenable to intervention.
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Affiliation(s)
- Angela A Robertson
- Social Science Research Center, Mississippi State University, MS 39762, USA.
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Abstract
The prevalence of psychiatric disorders among incarcerated juveniles in Mississippi was examined. A total of 482 adolescents completed a diagnostic questionnaire and a subset (N = 317) was assessed with face-to-face semi-structured interview. Most of the study participants met criteria for one mental disorder, 71-85% depending on assessment method, one-third have co-occurring mental health and substance abuse disorders. Gender and placement site differences in rates of some psychiatric disorders were also noted. Routine mental health screening should be performed on all juveniles placed in secure detention facilities to identify those who need treatment services.
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Affiliation(s)
- Angela A Robertson
- Social Science Research Center, Mississippi State University, Mississippi State, MS 39762, USA.
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Vitacco MJ, Neumann CS, Robertson AA, Durrant SL. Contributions of impulsivity and callousness in the assessment of adjudicated male adolescents: a prospective study. J Pers Assess 2002; 78:87-103. [PMID: 11936214 DOI: 10.1207/s15327752jpa7801_06] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This study examined whether delinquent adolescents with low scores on personality scales related to callousness and impulsivity would show less antisocial behavior and better psychosocial functioning compared to those elevated on 1 or both scales. A group of 162 White and African American male adolescents, recently adjudicated in a southern youth court system, were assessed at baseline and at 18-month follow-up. Dependent variables included measures of antisocial and prosocial behaviors, days detained in juvenile detention, and symptoms of psychopathology. As hypothesized, adolescents low on both callousness and impulsivity spent fewer days detained and reported less antisocial behavior and fewer symptoms of psychopathology compared to those high on I or both scales. Finally, African American participants were detained for more days, but did not report significantly more antisocial behaviors or symptoms of psychopathology compared to the White adolescents. The results suggest that being low on callousness and impulsivity may serve a protective role for future delinquent behavior for both African American and White adolescents.
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Affiliation(s)
- Michael J Vitacco
- Department of Psychology, University of North Texas, Denton 76203-1280, USA.
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Kiddle G, Bennett RN, Botting NP, Davidson NE, Robertson AA, Wallsgrove RM. High-performance liquid chromatographic separation of natural and synthetic desulphoglucosinolates and their chemical validation by UV, NMR and chemical ionisation-MS methods. Phytochem Anal 2001; 12:226-242. [PMID: 11705329 DOI: 10.1002/pca.589] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Methods are described for the optimised extraction, desulphation and HPLC separation of desulphoglucosinolates. These methods provide rapid separation, identification and quantitative measurements of glucosinolates extracted from Brassica napus L and related crops, of unusual glucosinolates found in crucifer weed species, and also of synthetic alkylglucosinolates. The desulphoglucosinolates used in these studies were either chemically synthesised (at least one example from each major structural class), or purified from various plant sources. Validation of the identities of the desulphoglucosinolates was by comparison of retention times with standards, and by UV, 1H- and 13C-NMR and chemical ionisation MS analysis. A list of useful species, and the specific tissues, from which high concentrations of standards can be extracted is included.
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Affiliation(s)
- G Kiddle
- Crop Performance and Improvement Division, IACR-Rothamsted, Harpenden, Hertfordshire AL5 2JQ, UK.
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Cruickshank DJ, Robertson AA, Campbell DM, MacGillivray I. Does labetalol influence the development of proteinuria in pregnancy hypertension? A randomised controlled study. Eur J Obstet Gynecol Reprod Biol 1992; 45:47-51. [PMID: 1618361 DOI: 10.1016/0028-2243(92)90192-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
It is the development of proteinuria in pregnancy-induced hypertension which is associated with an increased perinatal mortality. There is some evidence to suggest that labetalol may diminish the amount of proteinuria in patients who have already developed proteinuric pre-eclampsia. A randomised controlled study design was used to investigate whether labetalol treatment, started when a persistent diastolic blood pressure greater than 90 mmHg was observed, influenced the subsequent development of proteinuria. One hundred and fourteen women with singleton pregnancies and hypertension in the absence of proteinuria were randomised to receive either labetalol or no antihypertensive therapy. At recruitment maternal age, blood pressure and gestation were similar in both the labetalol and control groups. There was no difference in the frequency, quantity or timing of subsequent proteinuria between treatment and control groups. Overall 34% of primigravidae and 10% of parous women developed proteinuria. Labetalol did, however, control the blood pressure in 45 of the 51 treated women (88%) within 24 h. This effect was often shortlived requiring dose escalation after 3 to 5 days in the majority of cases. Labetalol was well tolerated and no significant maternal toxicity was noted.
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Affiliation(s)
- D J Cruickshank
- Department of Obstetrics and Gynaecology, Maternity Hospital, Foresterhill, Aberdeen, UK
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Skidmore CA, Robertson JR, Robertson AA, Elton RA. After the epidemic: follow up study of HIV seroprevalence and changing patterns of drug use. BMJ 1990; 300:219-23. [PMID: 2106928 PMCID: PMC1662036 DOI: 10.1136/bmj.300.6719.219] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To follow up known intravenous drug users to determine current health state and drug use, compare characteristics with those of recent drug users, and examine HIV exposure and serostate. DESIGN Subjects were identified from conventional general practice records and recruited from 1980 to the end of 1985; they were followed up during 1987 and 1988 and compared with drug users identified in the same way but recruited after 1985. SETTING General practice and community in north west Edinburgh. Follow up conducted throughout the United Kingdom. SUBJECTS Subjects known to have injected illegal drugs before 1986 (n = 203) and since that time. MAIN OUTCOME MEASURES Mortality from and prevalence of HIV seropositivity and various parameters indicative of abstinence. RESULTS Of the 203 subjects in the follow up group, 189 (93%) were traced; 16 (8%) had died and the remaining 173 (85%) were interviewed. In all, 146 (72% of the follow up cohort) had been tested for HIV antibodies, 94 (64%) having positive and 52 (36%) negative results; 57 (28%) had not been tested. Of the 65 subjects in the recently recruited group, 51 (79%) had been tested for HIV, 15 (29%) having positive results. A further 21 (43%) were currently negative for HIV antibody but still at risk. Thirty three (19%) of those followed up were confirmed abstinent, although more (about half) showed evidence of diminished drug injecting. Age correlated strongly with abstinence (p less than 0.001). One third of the group currently used cannabis, buprenorphine, dihydrocodeine, or diazepam. When the two groups were analysed together there was a strong association between the date of starting injecting and HIV seropositivity (chi 3 = 23.81, df = 2, p less than 0.001), with a peak around 1980-3. CONCLUSIONS Although only a fifth of the followed up group were convincingly abstinent, a much larger group showed evidence of prolonged periods of remission. Overall, much use of oral drugs was confirmed and worrying trends towards taking buprenorphine and benzodiazepines were evident. The peak incidence of starting drug use and the comparatively low seroprevalence of HIV in the newer drug users probably explain the anomalous high seroprevalence in Edinburgh drug users during 1980-5. The epidemic of HIV during the first half of the 1980s in the group suggests that the virus was probably being transmitted because of a pattern of behaviour. Changing patterns of HIV transmission suggest a need to concentrate on heterosexual transmission as the main problem in the future.
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Affiliation(s)
- C A Skidmore
- Edinburgh Drug Addiction Study, Muirhouse Medical Group, Edinburgh
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Brown EM, Depares J, Robertson AA, Jones S, Hughes AB, Coles EC, Morgan JR. Amoxycillin-clavulanic acid (Augmentin) versus metronidazole as prophylaxis in hysterectomy: a prospective, randomized clinical trial. Br J Obstet Gynaecol 1988; 95:286-93. [PMID: 3285883 DOI: 10.1111/j.1471-0528.1988.tb06871.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
In order to determine the most effective regimen for the prevention of infection after elective hysterectomy, 300 patients were randomly assigned to receive three perioperative doses of either amoxycillin-clavulanic acid (1.2 g intravenous) or metronidazole (1 g suppository). Of the 280 patients who were assessable 138 were given amoxycillin-clavulanic acid and 142 received metronidazole; 268 underwent abdominal hysterectomy and 12 had vaginal hysterectomy. Patients in the amoxycillin-clavulanic acid group had significantly less infectious morbidity (13.8%) than those in the metronidazole group (33.1%). There were also statistically significant differences in favour of amoxycillin-clavulanic acid with respect to operative site infection, duration of hospital stay, need for postoperative antimicrobials, and surgery for operative site infection. But for one isolate of Bacteroides fragilis, all pathogens isolated from wound infections in the metronidazole group were aerobes. No anaerobes were isolated from patients in the amoxycillin-clavulanic acid group. The results suggest that prophylaxis for hysterectomy should consist of an agent, or combination of agents, with activity against both aerobic and anaerobic bacteria. Amoxycillin-clavulanic acid fulfils this criterion and appears to be effective and safe.
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Affiliation(s)
- E M Brown
- University Hospital of Wales, Heath Park, Cardiff
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Robertson AA. Points: Use of penicillins. West J Med 1978. [DOI: 10.1136/bmj.2.6131.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Robertson AA. Points from letters: Medical manpower. West J Med 1976. [DOI: 10.1136/bmj.1.6004.285-e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Robertson AA. Ampicillin for sore throat. Br Med J 1973; 3:352. [PMID: 4579403 PMCID: PMC1586498 DOI: 10.1136/bmj.3.5875.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Robertson AA. Ampicillin for sore throat. Br Med J 1973; 2:614. [PMID: 4713999 PMCID: PMC1592194 DOI: 10.1136/bmj.2.5866.614-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Robertson AA. A good diagnosis. J R Coll Gen Pract 1970; 19:311-4. [PMID: 4914804 PMCID: PMC2237301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Kuenssberg EV, Laurence AR, MacNaughtan G, Large AH, Knox JD, Robertson AA, Maclean IM. Detection of bacteriuria. Lancet 1970; 1:241. [PMID: 4189035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Robertson AA, Hodge JV, Laverty R, Smirk FH. Tissue catecholamine levels in normotensive, genetically hypertensive and renal hypertensive rats. Aust J Exp Biol Med Sci 1968; 46:689-96. [PMID: 5729724 DOI: 10.1038/icb.1968.175] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Robertson AA. The use of computers in medicine with particular reference to general practice. J R Coll Gen Pract 1968; 15:329-35. [PMID: 4870118 PMCID: PMC2236593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Knox JD, Laurence AR, MacNaughtan G, Robertson AA. Bacteriology in the surgery. Lancet 1968; 1:141. [PMID: 4169621 DOI: 10.1016/s0140-6736(68)92748-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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