The Saturation- and Dose-Dependent Effects of a Teen Sexual Harassment Prevention Program: Findings from a Randomized Controlled Trial

Using a randomized controlled trial, we investigated changes in both sexual harassment (SH) perpetration and victimization of 2104 middle school students in New York City who received divergent saturation and dosage levels of Shifting Boundaries, an SH prevention program, which was represented by the length of the program. We assessed the saturation effect of the program by comparing the outcomes across respondents from 26 schools in which there were varying percentages of students enrolled in the program. The data suggested that, overall, the program was effective in reducing sexual harassment victimization but achieved a null effect against respondents' SH perpetration and that neither the length nor the school-saturation level of the program exerted a significant effect on SH perpetration. Although the data indicated a significant difference in SH victimization between the treatment and control group, when comparing subgroups who received treatment with divergent saturation and dosage levels, no statistically significant difference was identified. Our results suggested that the program effect was not contingent on the portion of students in a school who enrolled in the program, nor was it contingent on the dosage.

Changes in partner seeking and sexual behavior among United States adults during the first two years of the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic may have influenced partner-seeking and sexual behaviors of adults.

METHODS

We examined cross-sectional survey data collected at the end of the first year (n = 1,161) and second year (n = 1,233) of the COVID-19 pandemic by the National Opinion Research Center's (NORC) nationally representative, probability-based AmeriSpeak panel. Data were analyzed to: 1) quantify behavioral changes across pandemic years, 2) examine changes of in-person dating prevalence during year 2, and 3) assess risk perception for acquiring COVID-19 or HIV/STIs through new partnerships during year 2. Weighted percentages were calculated for responses; univariate relationships between demographic characteristics and outcomes were assessed.

RESULTS

Prevalence of new partners for dating remained stable across pandemic years (year 1: n = 1,157 [10%]; year 2: n = 1,225 [12%]). The prevalence of in-person sex with new partners was also stable (year 1: n = 1,157 [7%], year 2: n = 1,225 [6%]), marking a decline from a prepandemic estimate (2015-2016: 16%). Partner-seeking experiences varied by age and sexual identity in both years, and by race/ethnicity during year 2. Reports of in-person dating fluctuated throughout year 2, without clear relationship to viral variants. Respondents who met new partners in person during year 2 generally reported greater concern and preparedness for reducing risks associated with HIV/STIs than COVID-19.

CONCLUSIONS

The prevalence of U.S. adults seeking new partners for dating or sex remained stable across pandemic years. During future public health emergencies, public health officials are encouraged to offer guidance for reducing disease risks in partnerships, while emphasizing sexual health and providing tailored messaging for persons more susceptible to infection.

Predictors of mental health among U.S. adults during COVID-19 early pandemic, mid- pandemic, and post-vaccine eras

BACKGROUND

A collective trauma like COVID-19 impacts individuals differently due to socio-contextual and individual characteristics. Younger adults, minorities, affiliates of certain political parties, and residents of some regions of the United States reported experiencing poorer mental health during the pandemic. Being diagnosed with COVID-19, or losing a friend/family to it, was related to more adverse mental health symptoms. While the negative impact of COVID-19 on health outcomes has been studied, mental health changes during this pandemic need further exploration.

METHODS

In a study of 8,612 U.S. households, using three surveys collected from a nationally representative panel between May 2020 and October 2021, using a repeated cross-sectional design, a linear mixed effect regression model was performed to investigate factors associated with the mental health status, based on the Mental Health Inventory-5, of individuals throughout different phases of the COVID-19 pandemic, and whether an improvement over time, especially after vaccines became available, was observed.

RESULTS

An overall improvement in mental health was observed after vaccines became available. Individuals with no COVID-related death in their household, those not wearing masks, those identifying as members of the Republican Party, race/ethnicities other than Asian, men, older adults, and residents of the South were less likely than others to report mental health challenges.

CONCLUSIONS

Our results highlight the need for widespread mental health interventions and health promotion to address challenges during the COVID-19 pandemic and beyond. Due to the worse mental health observed among Asians, younger adults, women, low-income families, those with a higher level of concern for COVID-19, people who lost someone to COVID-19, and/or individuals with histories of opioid use disorder and criminal legal involvement, over the period of this study, targeted attention needs to be given to the mental health of these groups.

Gender identity, stimulant drug use, and criminal justice history on internalized stigma among a nationally representative sample of adults who misuse opioids

PURPOSE

The rise of fatal stimulant use among adults who use opioids is a public health problem. Internalized stigma is a barrier to substance use treatment, which is greater for women and populations with criminal justice involvement.

METHODS

Using a nationally representative sample of adults in the United States from a probability-based survey on household opinions in 2021, we examined characteristics of women (n = 289) and men (n = 416) who misuse opioids. In gender-stratified multivariable linear regression, we investigated factors associated with internalized stigma, and tested for the interaction of stimulant use and criminal justice involvement.

RESULTS

Compared to men, women reported greater mental health symptom severity (3.2 vs. 2.7 on a 1 to 6 scale, p < 0.001). Internalized stigma was similar between women (2.3 ± 1.1) and men (2.2 ± 0.1). Among women and not men, however, stimulant use was positively associated with internalized stigma (0.36, 95% CI [0.07, 0.65]; p = 0.02). Interaction between stimulant use and criminal justice involvement was negatively associated with internalized stigma among women (- 0.60, 95% CI [- 1.16, -0.04]; p = 0.04); among men, the interaction was not significant. Predictive margins illustrate among women, stimulant use eliminated the gap in internalized stigma such that women with no criminal justice involvement had a similar level of internalized stigma as women with criminal justice involvement.

CONCLUSION

Internalized stigma between women and men who misuse opioids differed based on stimulant use and criminal justice involvement. Future research should assess whether internalized stigma influences treatment utilization among women with criminal justice involvement.

Endorsement of COVID-19 misinformation among criminal legal involved individuals in the United States: Prevalence and relationship with information sources

Criminal legal system involvement (CLI) is a critical social determinant of health that lies at the intersection of multiple sources of health disparities. The COVID-19 pandemic exacerbates many of these disparities, and specific vulnerabilities faced by the CLI population. This study investigated the prevalence of COVID-19-related misinformation, as well as its relationship with COVID-19 information sources used among Americans experiencing CLI. A nationally representative sample of American adults aged 18+ (N = 1,161), including a subsample of CLI individuals (n = 168), were surveyed in February-March 2021. On a 10-item test, CLI participants endorsed a greater number of misinformation statements (M = 1.88 vs. 1.27) than non-CLI participants, p < .001. CLI participants reported less use of government and scientific sources (p = .017) and less use of personal sources (p = .003) for COVID-19 information than non-CLI participants. Poisson models showed that use of government and scientific sources was negatively associated with misinformation endorsement for non-CLI participants (IRR = .841, p < .001), but not for CLI participants (IRR = .957, p = .619). These findings suggest that building and leveraging trust in important information sources are critical to the containment and mitigation of COVID-19-related misinformation in the CLI population.

Associations between partisan media consumption, opioid use disorder stigma, and opioid policy support: An exploration of the media's role in the ongoing opioid epidemic

We report on a preliminary investigation into the relationship between partisan media consumption (PMC) among U.S. adults and their (1) opioid use disorder (OUD) stigma, (2) national OUD policy support (e.g., Medicaid coverage for OUD treatment), (3) local OUD policy support (e.g., safe injection sites), (4) discriminatory OUD policies (e.g., denying housing), and (5) carceral OUD policies (e.g., jailing people who use opioids). We performed a cross-sectional survey of a nationally-representative sample of U.S. adults (n = 6,515) from October 1-November 19, 2021. We surveyed a sample of U.S. adults ages 18 and older drawn from NORC's AmeriSpeak® Panel. AmeriSpeak is a probability-based ongoing panel of over 40,000 households designed to represent the U.S. household population. Cross-sectional analyses revealed significant relationships between PMC and OUD stigma (b = 0.29, p <.001, CI95 = 0.14,0.43), support for national (b = -0.31, p <.01, CI95 = -0.54,-0.09) and local policy responses (b = -0.38, p <.001, CI95 = -0.59,-0.17), and support for discriminatory opioid use disorder policies (b = 0.27, p <.01, CI95 = 0.07,0.45). After controlling for self-reported political affiliation and other potential covariates, Republican-leaning media consumption was significantly associated with increased OUD stigma, less support for national and local harm reduction or rehabilitative policies, and more support for discriminatory policies against individuals experiencing OUD. The opposite associations were observed for Democratic-leaning media consumption. Markers for racism mediated the relationship between PMC and support for carceral policies (indirect path b = -0.41,p <.001, CI95 = -0.50,-0.31). Our results indicate that public health advocates must collaborate with conservative leaders to find bipartisan common ground for targeted communication campaigns.

Openness to change among COVID misinformation endorsers: Associations with social demographic characteristics and information source usage

RATIONALE

Misinformation is a major concern for public health, with its presence and impact strongly felt in the COVID-19 pandemic. Misinformation correction has drawn strong research interest. In contrast, relatively little attention has been given to the likelihood of favorable behavioral change post correction (i.e., openness to change).

OBJECTIVE

This study seeks to identify the characteristics of COVID misinformation endorsers who are open to adopt more self-protective behaviors after misinformation correction.

METHODS

COVID misinformation endorsers (N = 1991) in a large, nationally representative survey (fielded in October and November 2021) were asked how likely they would adopt self-protective behaviors if a source they trusted debunked their prior misperceptions. Multiple linear regression estimated the relationships between openness to change and socio-demographics, health-related factors, and health information source usage patterns.

RESULTS

Less than half of the misinformation endorsers in the sample (41.3%) indicated any openness to change. Openness to change was positively associated with minority status and negatively associated with leaning Republican in political affiliation, higher income, being currently unvaccinated or unsure about vaccination status, better health, and a greater number of misinformation items endorsed. Past-month use of government, community, and personal sources for health information positively predicted openness. The use of online media was negatively associated with openness.

CONCLUSIONS

Openness to change is not guaranteed after misinformation correction. Targeted interventions based on openness to change are needed to enhance the public health impact of misinformation correction efforts.

Latent class analysis of medical mistrust and COVID-19 vaccine hesitancy among adults in the United States just prior to FDA emergency use authorization

Using a nationally representative household sample, we sought to better understand types of medical mistrust as a driver of COVID-19 vaccine hesitancy. We used survey responses to conduct a latent class analysis to classify respondents into categories and explained this classification as a function of sociodemographic and attitudinal variables using multinomial logistic regression models. We then estimated the probability of respondents agreeing to receive a COVID-19 vaccine conditional on their medical mistrust category. We extracted a five-class solution to represent trust. The high trust group (53.0 %) is characterized by people who trust both their doctors and medical research. The trust in own doctor group (19.0 %) trust their own doctors but is ambiguous when it comes to trusting medical research. The high distrust group (6.3 %) neither trust their own doctor nor medical research. The undecided group (15.2 %) is characterized by people who agree on some dimensions and disagree on others. The no opinion group (6.2 %) did not agree nor disagree with any of the dimensions. Relative to the high trust group, those who trust their own doctors are almost 20 percentage points less likely to plan to get vaccinated (average marginal effect (AME) = 0.21, p <.001), and those who have high distrust are 24 percentage points less likely (AME = -0.24, p <.001) to report planning to get the vaccine. Results indicate that beyond sociodemographic characteristics and political attitudes, people's trust archetypes on parts of the medical field significantly predict their probability of wanting to get vaccinated. Our findings suggest that efforts to combat vaccine hesitancy should focus on building capacity of trusted providers to speak with their patients and parents of their patients, to recommend COVID-19 vaccination and build a trusting relationship; and increase trust and confidence in medical research.

Concerns about COVID-19 Vaccine Hesitancy among Law Enforcement Officers: Prevalence and Risk Factor Data from a Nationally Representative Sample in the United States

Scant research exists on COVID-19 vaccine hesitancy among law enforcement officers, hindering health messaging development for officers and, by extension, the communities they serve. This paper’s goal was to address this gap by providing the necessary data to better under hesitancy to guide training and policy interventions for officers. The objective was to conduct the first nationally representative survey of officers on COVID-19 vaccine hesitancy and its correlates. We collected data from February 2021 to March 2022 on officer COVID-19 vaccine hesitancy and examined their responses in terms of sociodemographic factors, health status, and job characteristics. We found that 40% of officers were COVID-19 vaccine hesitant. We found that officers with higher education, older officers, officers with more law enforcement experience, officers who received recent health checkups, and commanders (compared to line officers) were less likely to be COVID-19 vaccine hesitant. Critically, officers working in law enforcement agencies that provided masks for COVID-19 protection were less likely to be COVID-19 vaccine hesitant (compared to agencies not providing masks). Ongoing research is needed to understand how evolving attitudes and barriers toward vaccination change over time for officers and to test messaging to better align officers with health guidelines.

Relationship Dynamics and Abusive Interactions in a National Sample of Youth and Young Adults

Stemming intimate partner violence among adults demands earlier education and skill-building supportive of healthy youth and young adult dating relationships. The current U.S.-based study examines a spectrum of youth and young adult relationship dynamics (RDs), inclusive of abusive interactions. In a nationally representative cohort of youth aged 10-18 at baseline and one parent or caregiver, survey responses regarding RDs from 618 participants ages 15-23 at wave 5 follow-up were analyzed. Latent class analysis of four positive dynamics, six problematic dynamics, and three scales of adolescent relationship abuse (ARA) were estimated, yielding four latent profiles of dating RDs. Relationships characterized by Unhealthy and Intense RDs both exhibited high probability of ARA but differed from each other in terms of other positive and problematic dynamics. Relationships characterized by Disengaged RDs had lower probability of ARA but elevated probability of awkward communications, negative feelings, social liability, and other challenging dynamics. Several baseline covariates were significantly associated with profiles of dating RDs approximately 5 years later. Younger participants were more likely to subsequently fall in an Intense or Disengaged RDs profile, as were participants with baseline emotional health problems. Further, classification in the Unhealthy RDs profile was less likely for participants reporting a better baseline relationship with their parents and more likely for those exposed to violence in childhood. These findings suggest that in addition to developmental maturity, youth and young adults would benefit from closer investigation and processing of past emotional and relational issues and traumas to foster healthier dating relationships.

Daily Reports of Aggressive Behaviors in Interpersonal Conflicts

Interpersonal conflicts are inevitable, but the probability that conflicts involve aggressive behavior varies. Prior research that has tended to focus on victimization in intimate partnerships reported through retrospective designs. Addressing these limitations, the current study examines daily reports of behaving aggressively in any conflict across relationships in a sample of 512 young adults drawn from the nationally representative iCOR cohort. Respondent attitudes and affective measures were collected at the end of the daily data collection period. Regression methods were applied to examine the probability and frequency of aggression, investigating early and recent exposure to adversities, attitudes, self-control, affect and emotional states, and alcohol use behavior. Recent adversities and the propensity to endorse a defensive honor code attitude, consistent with theory and retrospective studies of aggression, predicted both prevalence and frequency of aggressive behavior. The associations of childhood maltreatment and self-control with the prevalence of behaving aggressively were as expected, but these constructs were significantly associated with the frequency of aggression with unexpected, inverse directionality. Moreover, respondents' affect and other emotional states were only associated with the frequency, not the prevalence, of aggressive behavior. Overall, this daily data collection constructively distinguished risk and protective factors for behaving aggressively more often. Further research is needed to disentangle the extent to which affective states drive or is a consequence of frequent aggressive behavior.

The effects of community-infused problem-oriented policing in crime hot spots based on police data: a randomized controlled trial

Objectives

This randomized controlled trial (RCT) assessed the effectiveness of a community-infused problem-oriented policing (CPOP) intervention on reducing property/violent crime.

Methods

In two mid-Atlantic cities, a total of 102 crime hot spots were randomly assigned to receive CPOP or standard patrol. Analyses examine changes in crime the year before, during, and one year after the intervention. We used hierarchical Poisson regression models.

Results

We found no main effects for the CPOP intervention on property and violent crimes in either site. In site B, the violent crime count in low treatment hot spots was 200% higher than controls post-intervention but this likely reflected officers paying less attention to treatment locations with lower levels of crime.

Conclusions

Our results suggest that CPOP was not effective in the unusual context of the COVID-19 pandemic and post-George Floyd killing. Given the challenges of implementing CPOP during this unique time, caution is needed in interpreting these findings.

Outcomes of Sexual Assault Victimization in Early Adulthood: National Estimates for University and Nonuniversity Students

Across the United States, 20% of women ages 18 and over are victims of penetrative sexual assault, with the highest rates occurring in early adulthood (i.e., ages 18-24). Despite the high prevalence and severe mental and physical health problems resulting from sexual assault, with few exceptions, little is known about how victims of sexual assault attribute subsequent academic and career outcomes. Approximately 901 adult participants were recruited from a probability-based nationally representative sample to examine the prevalence of and outcomes attributed to sexual assault victimization experienced during early adulthood. Of the 36% of female participants who reported sexual assault perpetrated against them between the ages of 18 and 24, 69.5% attributed at least one negative academic or career outcome to the sexual assault. Participants who identified as White and who were over the age of 30 at the time of the survey were more likely to attribute negative academic and career outcomes as a result of a sexual assault perpetrated against them during early adulthood than women of color and younger women (i.e., ages 25-29). Our findings expand the knowledge on negative outcomes attributed to sexual assault and yields more questions about the larger societal impacts. More research is needed to understand the intersection between an assault during young adulthood and the demographic characteristics of survivors.

The Psychometric Properties of the Measure of Adolescent Relationship Harassment and Abuse (MARSHA) With a Nationally Representative Sample of U.S. Youth

This article describes a new instrument that assesses adolescent dating abuse (ADA) victimization and perpetration. The Measure of Adolescent Relationship Harassment and Abuse (MARSHA) is a comprehensive instrument that includes items on physical, sexual, and psychological ADA, as well as cyber dating abuse, social control, and invasion of privacy. Data for this study came from a population-based, nationally representative sample of adolescents ages 11 to 21 years old (N = 1,257). Exploratory factor analysis was conducted for the victimization and perpetration versions of the MARSHA, and convergent and divergent validity were assessed using the Conflict in Adolescent Dating Relationships Inventory (CADRI) and the juvenile victimization questionnaire (JVQ), respectively. Results suggest that the MARSHA has good reliability and validity, and that each subscale had good internal consistency. The authors propose that the MARSHA may be a strong alternative to the CADRI or the conflict tactics scale (CTS) because it reflects contemporary forms of abuse, such as online harassment and pressure to send nude selfies, and the nonconsensual dissemination of sexually explicit images.

Sexual Harassment of Law Enforcement Officers: Findings From a Nationally Representative Survey

Sexual harassment continues to be a consistent destructive feature of American life and workplaces, especially in fields for which women are under-represented, such as law enforcement. We use one of the first nationally representative cross-sectional surveys (n = 2,867) of female and male law enforcement officers (LEOs) to assess the prevalence of workplace sexual harassment victimization. Next, we assess how risk factors are related to this harassment through multivariable modeling. We observed large differences between rates of sexual harassment for female compared to male officers on both our measures of non-physical and physical workplace sexual harassment (sexual assault). Our combined measure of non-physical sexual harassment and sexual assault of female officers (71%) was in the range found in prior research and our 41% rate for male officers is also not trivial and requires attention from law enforcement leaders. We tested two competing hypotheses on whether female officers (and possibly some male officers not meeting certain definitions of masculinity) viewed as the most threatening by virtue of their job role in the male-dominated hierarchy will have the highest probability of being a victim of workplace sexual harassment (power-threat model) or whether those viewed as the most vulnerable officers will have the highest probability of sexual harassment victimization (vulnerable-victim model). We found greater support for the vulnerable-victim model. We discuss the implications of these results for guiding training and prevention strategies to address sexual harassment in the law enforcement workplace.

Partner Seeking and Sexual Behavior in the United States During the COVID-19 Pandemic, March 2020 to March 2021

ABSTRACT

We examined partner seeking and sexual behaviors among a representative sample of US adults (n = 1161) during the first year of the COVID-19 pandemic. Approximately 10% of survey respondents sought a new partner, with age and sexual identity being associated with partner seeking behavior. Approximately 7% of respondents had sex with a new partner, which marks a decrease as compared with a prepandemic estimate from 2015 to 2016 in which 16% of US adults reported having sex with a new partner during the past year. Among respondents who had in-person sex with a new partner during the first year of the pandemic, public health guidelines for in-person sexual activity were infrequently followed.

Predictors of Mental Health among the General Population of U.S. Adults Eight Months into the COVID-19 Pandemic

Background:

The COVID-19 pandemic has had profound impacts on mental health. We examined whether mental health differed based on sociodemographic and background characteristics, political party affiliation, and concerns about COVID-19.

Methods:

A cross-sectional, national sample of 1095 U.S. adults were surveyed October 22–26, 2020. The survey collected information on demographics, risk and protective behaviors for COVID-19, and mental health using the Mental Health Inventory-5 (MHI-5) scale. Independent samples t-tests, one-way Analysis of Variance tests, and a multivariable linear regression model were conducted.

Results:

Regression results showed respondents with criminal justice (B = −6.56, 95% CI = −10.05, −3.06) or opioid misuse (B = −9.98, 95% CI = −14.74, −5.23) histories reported poorer mental health than those without. Those who took protective behaviors (e.g., wearing masks) reported poorer mental health compared to those who indicated protective behaviors were unnecessary (B = 7.00, 95% CI = 1.61, 12.38) while those who took at least one risk behavior (e.g., eating in a restaurant) reported better mental health than those who did not.

Conclusions:

Our study shows that certain groups have experienced poorer mental health during the COVID-19 pandemic, suggesting that mental health should continue to be monitored so that public health interventions and messaging help prevent the spread of COVID-19 without increasing poor mental health outcomes.

Online sexual harassment and cyberbullying in a nationally representative sample of teens: Prevalence, predictors, and consequences

INTRODUCTION

There are burgeoning bodies of research on cyberbullying and online sexual harassment. Yet existing work often fails to distinguish between these two unique forms of online victimization, is largely cross sectional, and based on convenience or specialized samples. We examined the prevalence, predictors, and mental health and behavioral consequences of cyberbullying and online sexual harassment using a large, representative sample of adolescents. We also considered the potential compounding effects of multiple forms of victimization, as well as gender differences in the effects of online victimization.

METHODS

We used nationally representative, longitudinal data from the National Survey on Teen Relationships and Intimate Violence (STRiV) (n = 1,152), a US-based sample of adolescents 10-18 years old.

RESULTS

Approximately 37% of participants reported being victims of cyberbullying, and nearly 15% reported online sexual harassment experiences. Despite cyberbullying being relatively more common, the risk factors for these two forms of online victimization were similar. In addition, cyberbullying and online sexual harassment victimization were independently associated with the full range of mental health and behavioral problems examined in this investigation. Nevertheless, our findings also provided some evidence of conditional effects, such that female adolescents, and adolescents who experienced both forms of online victimization, suffered greater deleterious outcomes.

CONCLUSIONS

Online sexual harassment and cyberbullying victimization have similar risk profiles, and both contribute to heightened risk of mental health and behavioral problems. Yet the prevalence and gendered nature of these experiences underscore the importance of making distinctions. We provide recommendations for future research and programmatic efforts.

National variability in Americans' COVID-19 protective behaviors: Implications for vaccine roll-out

Protective behaviors such as mask wearing and physical distancing are critical to slow the spread of COVID-19, even in the context of vaccine scale-up. Understanding the variation in self-reported COVID-19 protective behaviors is critical to developing public health messaging. The purpose of the study is to provide nationally representative estimates of five self-reported COVID-19 protective behaviors and correlates of such behaviors. In this cross-sectional survey study of US adults, surveys were administered via internet and telephone. Adults were surveyed from April 30-May 4, 2020, a time of peaking COVID-19 incidence within the US. Participants were recruited from the probability-based AmeriSpeak® national panel. Brief surveys were completed by 994 adults, with 73.0% of respondents reported mask wearing, 82.7% reported physical distancing, 75.1% reported crowd avoidance, 89.8% reported increased hand-washing, and 7.7% reported having prior COVID-19 testing. Multivariate analysis (p critical value .05) indicates that women were more likely to report protective behaviors than men, as were those over age 60. Respondents who self-identified as having low incomes, histories of criminal justice involvement, and Republican Party affiliation, were less likely to report four protective behaviors, though Republicans and individuals with criminal justice histories were more likely to report having received COVID-19 testing. The majority of Americans engaged in COVID-19 protective behaviors, with low-income Americans, those with histories of criminal justice involvement, and self-identified Republicans less likely to engage in these preventive behaviors. Culturally competent public health messaging and interventions might focus on these latter groups to prevent future infections. These findings will remain highly relevant even with vaccines widely available, given the complementarities between vaccines and protective behaviors, as well as the many challenges in delivering vaccines.

Opioid Use Disorder Stigma, Discrimination, and Policy Attitudes in a National Sample of U.S. Young Adults

PURPOSE

A small fraction of people with opioid use disorder (OUD) receives appropriate care. Public opinion about addiction contributes to the availability and accessibility of effective treatment services. Little is known about such attitudes toward OUD among young adults, a population at heightened risk for OUD onset. The current study examined endorsement of social stigma, discrimination, and policy attitudes about OUD and hypothesized correlates of such attitudes (familiarity with OUD, criminal justice involvement, respondent demographic characteristics).

METHODS

A national sample of 190 young adults (weighted n = 408; 69% female, 42% White, non-Hispanic) aged 19-29 years completed web and telephone surveys covering opioid social stigma, discrimination, policy attitudes, personal experience with opioids, and criminal justice, and participant characteristics (age, sex, race, education, employment, income). Linear regressions were performed to examine associations between respondent characteristics and attitudes.

RESULTS

Young adults, on average, endorsed moderate levels of stigma and discrimination toward people with OUD and support for treatment-oriented policies. Stigma was positively associated with discrimination and negatively associated with support for policies favorable to people with OUD. Regression results revealed that more negative attitudes toward OUD were endorsed as a function of older age and less personal experience or familiarity with OUD.

CONCLUSIONS

Heterogeneity in young adults' attitudes about OUD may be explained, in part, by personal characteristics and familiarity with OUD. Adolescence may be an opportune developmental period to prevent or reduce public stigma related to OUD and MOUD and increase public attitudes in support of expanded access to effective OUD treatments.

Profiles of Youth In-Person and Online Sexual Harassment Victimization

This study examines whether online sexual harassment (SH) is a unique form of behavior, separate and apart from in-person SH. Data were drawn from the National Survey on Teen Relationships and Intimate Violence (STRiV), a national representative household survey focused on youth interpersonal aggression. A weighted sample of 1,184 youth (12-21 years old) completed a baseline and a follow-up survey 1 year later. Through latent class analysis (LCA), we investigate our first research question of whether there are distinct classes/profiles of mutually exclusive online or in-person SH victims or whether they mostly overlap. Second, does there exist a high-rate group of SH victims who experience most of the SH behaviors both in-person and online? Third, what individual characteristics and behaviors, based on past research, are associated with these identified profiles of SH? LCA did not reveal an in-person-only or online-only SH class. The majority of the sample (78.5%) were represented in a Low/Near Zero SH class; 15.3% in a Sexual Orientation Harassment class suffering sexual orientation-related verbal harassment online and in-person; 4.2% in a Verbal SH class suffering verbal sexual comments, being forced to talk about sex, and being shown sexual pictures in-person and online; and 1.9% in a High SH class featured by a high probability of experiencing all online and in-person forms of SH. Biological sex, attitudes, anger, previous violence exposure, and gender stereotyping each predicted at least one latent class. The findings can help inform the design of more effective interventions to prevent SH, highlighting the overlapping nature of in-person and online SH. Prevention efforts designed to address in-person SH need to also consider online SH and vice versa. Clinicians should also consider the risk factors of SH identified in this study in their work identifying at-risk youth.

Profiles of US Law Enforcement Officers' Diagnosed Health Conditions: Results From a Probability-Based Sample of Officers

OBJECTIVE

To assess comorbidity across five common health conditions.

METHODS

Surveys were collected from a probability-based sample of US law enforcement officers, and latent class models estimated for hypertension (HTN), high blood cholesterol (LDL), diabetes (DM), a gastrointestinal disorder (GI), and sleep apnea (SA).

RESULTS

The majority of officers (69.4%) were classified in a Healthy profile. One in four officers (23.7%) were classified in a LDL-HTN-DM profile. About 7% of officers were classified in a GI-SA-HTN profile. Age, sex, body mass index (BMI), exercise, and working a rotating shift assignment distinguished class membership.

CONCLUSION

Most officers reported good health. Law enforcement administrative or clinical assessments using readily accessible measures might be informative in identifying risk categories of need for more targeted prevention and treatment support.

A nationally representative study of law enforcement shiftwork and health outcomes

The purpose of this study was to estimate the effect of past and current rotating shift assignments on U.S. law enforcement officers' health outcomes. In a nationally representative sample of 2,867 officers, with an oversample of female officers, we estimated models of sleep quality and fatigue, physical health outcomes, and psychological health outcomes. Further, we examined individual and agency-level factors associated with officers who reported currently working a rotating shift, to investigate what patterns there may be in shift assignments. A history of rotating shift assignments was positively associated with lower sleep quality, and with hypertension, diabetes, and high cholesterol, but not with gastrointestinal disorders, perceived stress, emotional well-being, or suicidality. The associations of shiftwork with health outcomes did not vary by gender. Demographic characteristics did not predict current rotating shift assignments, but a longer history of shiftwork and more working hours did predict a current shift assignment. Attention to mitigating shift system designs as well as the effect of cumulative years of working a rotating shift for the benefit of officer health outcomes is warranted.

Social Stigma toward Persons with Opioid Use Disorder: Results from a Nationally Representative Survey of U.S. Adults

Background: This study seeks to understand the general adult population's knowledge, attitudes, and stigma towards opioid use disorder (OUD), people with histories of opioid misuse, and policies related to OUD. Methods: We conducted a cross-sectional national survey of the U.S. adult population, using AmeriSpeak's® web, probability-based panel. The number of participants were 947 (493 females and 454 males) general population adults ages 19 -89 years old who completed a self-report survey covering: social stigma of OUD, opioid policy attitudes, perceptions of OUD as a crime, knowledge and beliefs about opioids and treatment, personal experience with opioids and the criminal justice (CJ) system, and demographics. Results: Thirteen percent self-reported ever misusing opioids, 3% reported an opioid overdose, and 14% reported personal experience with the CJ system. On average, the general adult population moderately endorses stigmatizing behaviors, agrees that OUD is a medical condition, agrees with policies to increase access to OUD treatment, and is less likely to endorse OUD as a crime. Having a disregard for OUD as a medical condition was most associated with higher levels of stigma, endorsing OUD as a crime, and disagreeing with policies to help people access OUD treatment. Conclusions: Our data provide guidance to policymakers concerning individuals with certain characteristics to target for public education efforts to reduce stigma and draw more support for public heath interventions for OUD. Our data also suggest that the content of this education should include improving understanding of OUD as a medical condition.

Sexual Harassment and Sexual Assault in Early Adulthood: National Estimates for College and Non-College Students

Young adults are at high risk for sexual harassment and sexual assault. Although attention has been given to prevention on college campuses, the need for prevention may be at least as high for young adults who do not attend college as for young adults who do. In October 2019, we administered a nationally representative survey of 893 adults to measure sexual harassment and sexual assault victimization during a recall period defined as "during college years" for respondents who had enrolled in college at any time or "ages 18-24" for respondents not in college. Reported rates of sexual harassment (32.7%) and sexual assault (24.6%) during early adulthood were similar for respondents who reported having ever enrolled in college and for respondents who reported never attending college. Women were more likely than men to report both sexual harassment (37.4% vs 22.4%) and sexual assault (36.0% vs 16.0%) during early adulthood. Compared with respondents aged ≥30, respondents aged 18-29 were 105% more likely to report sexual harassment and 65% more likely to report sexual assault. Moreover, sexual harassment experiences predicted sexual assault victimization (adjusted odds ratio = 18.1). This study highlights the importance of attending to sexual harassment and sexual assault risks for young adults through research, policy, and criminal justice structures beyond institutions of higher education. Evidence that sexual harassment is strongly associated with sexual assault victimization of young adults highlights the importance of naming and stemming early behavioral transgressions across the US population.

The Campus Sexual Assault Policy and Prevention Initiative: Findings From Key Informant Interviews

Addressing the widespread problem of sexual assault in college environments requires both prevention programming and policies addressing sexual misconduct in institutions of higher education. Through the Campus Sexual Assault Policy and Prevention Initiative, nine programs funded by the Office on Women's Health approached this problem within a network of eight to 13 campuses apiece, supported by national organizations and local task forces. Near the close of the 3-year project period (June 2016-June 2019), key informant interviews were conducted with project directors and campus representatives. Contextual factors elucidating the project approaches, challenges, and successes were investigated through 31 interviews (nine grantee interviews and 22 campus representative interviews). Analyses across all interview content contributed to the development of several key themes related to staffing efforts to strengthen campus policies and prevention programs, working within institutions of varying structural characteristics, infusing efforts with trauma-informed perspectives, attending to cultural differences across campuses, and seeking to follow recommended guidelines in the context of campus-specific factors. Overall, the interviewees reported specific progress toward the program goals.

Perpetration of Adolescent Dating Relationship Abuse: The Role of Conditional Tolerance for Violence and Friendship Factors

Research has pointed to the salience of friendships in predicting abuse in adolescent dating relationships. The current study investigates the perpetration of physical and sexual dating abuse as predicted by individual conditional tolerance for dating abuse within the context of friendship behaviors and group characteristics. Using two waves of the National Survey of Teen Relationships and Intimate Violence (STRiV; N = 511 daters aged 12-18 years), we investigated the effects of baseline individual tolerance for hitting dating partners and friendship factors on perpetration of physical and sexual adolescent dating abuse (ADA) approximately 1 year later. Conditional tolerance for hitting boyfriends was associated with ADA perpetration in the absence of friendship characteristics. Daters who reported recent discussion of a problem with friends and female daters who named all-girl friendship groups were more likely to report ADA perpetration. Close friendships are an avenue for preventing ADA perpetration. Furthermore, ADA perpetration may be reduced by targeting conditional tolerance for violence particularly against male partners within female friendship groups.

Financial Behaviors, Couple-Level Conflict, and Adolescent Relationship Abuse: Longitudinal Results From a Nationally Representative Sample

Financial disagreements have been identified as a severe source of discord in adult relationships, yet limited work has considered whether financial considerations contribute to conflict among younger samples. Drawing on longitudinal data from a nationally representative sample of adolescents, the current investigation examined the extent to which money lending practices, feelings of financial resentment, and exposure to economic control contribute to couple-level interactions, and in turn, to conflict that escalates to the point of violence. Findings provide evidence of an association between adolescent financial behaviors and concurrent conflict due to economic considerations. Moreover, conflict due to economic considerations was an important predictor of future adolescent relationship abuse perpetration. We discuss the implications of our findings for intervention/prevention efforts.

Neighborhood violent crime and adolescent relationship aggression

Research has shown that neighborhoods play a role in the etiology of violence. However, few adolescent relationship aggression (ARA) studies have objective measures of violent neighborhoods. Drawing on a nationally representative sample of youth, this study examines the association between ARA and local levels of violent crime (measured using geocoded Uniform Crime Report data from each of the youths' residential neighborhoods). Study analyses are based on survey data from 723 youth (ages 10-18) in current or recent dating relationships (351 males and 372 females) in the Survey on Teen Relationships and Intimate Violence (STRiV), a national representative household panel survey exploring interpersonal violence and related aggression among adolescents. About 19% of the sample reported ARA victimization in their most recent dating relationship (ARA perpetration was 17%). Neighborhood violent crime in the study (males living in 86.9 and females 99.8) was slightly lower than the national average of 100. With a broad national sample, 40% non-Whites, hypotheses guided by theories of neighborhood influence were tested. The study did not find an association between neighborhood violent crime and ARA victimization and perpetration, controlling for key demographic factors. The results, for a broad range of high- and low-crime neighborhoods, suggest that neighborhood violence does not seem to affect individual rates of ARA. The results suggest the ARA victimization and perpetration are perhaps ubiquitous and found both in low and high violent crime neighborhoods, suggesting that addressing local violent crime rates alone does not seem to be a path to also reducing ARA.

Dating Relationship Dynamics, Mental Health, and Dating Victimization: A Longitudinal Path Analysis

The purpose of this study was to assess the longitudinal association between adolescent dating relationship dynamics (measures of intimacy and problem dynamics), mental health, and physical and/or sexual victimization by a dating partner. Gender-stratified analyses were conducted in a sample of 261 adolescents, ages 10-18 at baseline, interviewed in three annual waves (2013-2015) of the nationally representative Survey on Teen Relationships and Intimate Violence (STRiV). Among male daters, better mental health at baseline was negatively associated with problem dynamics at follow-up, and aspects of problem dynamics at baseline predicted worse mental health at follow-up. However, unexpectedly, aspects of relationship intimacy at baseline were also negatively associated with mental health at follow-up. Male daters' victimization did not mediate longitudinal measures of mental health or of relationship dynamics, but did predict worse mental health at follow-up. Among female daters, we found no longitudinal associations between mental health and intimacy or problem relationship dynamics, in either direction. However, victimization mediated aspects of female daters' reported relationship dynamics. Dating violence prevention efforts should reflect that adolescent females reporting controlling behaviors and feelings of passionate love may be at increased risk for victimization. Positive youth development efforts should attend to the bidirectional associations of mental health and dating relationship dynamics over time, particularly for male adolescents.

The interpersonal context of depression and violent behavior: A social psychological interpretation

Depression is a particularly prevalent form of psychopathology affecting millions of individuals worldwide. It is associated with a variety of adverse social and behavioral outcomes. Numerous observational studies have found that depressed individuals have significantly elevated rates of interpersonal violence. As of now, the social mechanisms that explain the association between depression and violence remain understudied and not well understood. Drawing on the aggression and social psychology literatures, we argue that depressed actors suffer skills deficits and exhibit hostile communication styles that provoke grievances and disputes. We suggest that, because of these interpersonal tendencies, depression increases involvement in verbal disputes, and that frequent participation in verbal disputes foments social contexts where interpersonal violence is more common. Findings from a series of regression models based on a nationally representative sample of 2171 respondents offer support for our assumptions. The study suggests a consideration of interpersonal dynamics, particularly verbal disputes, might unlock clues about the association between depression and violence involvement.

Longitudinal trajectories of perpetration of adolescent dating abuse in a national sample

Despite extensive research regarding patterns and outcomes of victimization in dating relationships, there has been limited investigation of the developmental profiles of the perpetration of adolescent dating abuse (ADA). We estimated longitudinal latent growth models of ADA perpetration in a sample of 2,269 U.S. adolescents/young adults ages 12-18 at baseline, drawing on four waves (2013-2017) of data from the nationally representative Survey of Teen Relationships and Intimate Violence. Model results revealed three classes representing "nondaters," respondents showing "increasing dating/ADA," and respondents with "high/stable dating/ADA." Results support prior research finding heightened patterns of ADA perpetration by older youth, and distinguish individual and family characteristics associated with adolescent/young adults' ADA perpetration for the purpose of informing individual and programmatic prevention efforts.

The social anatomy of adverse childhood experiences and aggression in a representative sample of young adults in the U.S

Objective The current study assesses the effect of adverse childhood experiences on later aggression and violence across young adult relationships contexts, including intimate partners, friends, or strangers. Method Surveys were conducted with a nationally representative sample of young adults ages 18-32, drawn from the AmeriSpeak panel, a probability-based panel with coverage of 97% of U.S. households. The weighted study sample is 2284 young adult respondents, of whom 1561 reported being in an intimate partnership. Results Rates of verbal aggression perpetrated by young adults declined with the intimacy of the relationship, such that aggression against a partner (72%) exceeded aggression directed at friends (43%) and strangers (34%). Similar rates of physical violence (about 9%) were reportedly perpetrated against partners, friends, and strangers. Adjusting for a range of personal characteristics, both adverse childhood experiences and recent stressors in these young adult lives exhibited direct associations with verbal and physically aggressive outcomes. Conclusions In models of verbal and physical aggression across relationship contexts, childhood adversity exhibits lasting effects unaccounted for by important proximal life circumstances, including recent life stressors, mental health, and substance use behaviors. These results provide empirical insights for clinical treatment of young adults prone to aggressive conflicts as well as input to positive youth development programming to foster healthy approaches to conflict.

Money Lending Practices and Adolescent Dating Relationship Abuse: Results from a National Sample

Research on adult intimate partner violence has demonstrated that economic considerations and financial decision-making are associated with the use of violence in marital and cohabiting relationships. Yet limited work has examined whether financial behaviors influence the use of violence in adolescent dating relationships. We use data from the National Survey on Teen Relationships and Intimate Violence (STRiV) (n = 728), a comprehensive national household survey dedicated specifically to the topic of adolescent relationship abuse, to examine associations between requests for money lending, economic control/influence, financial socialization and adolescent relationship abuse among a large, diverse sample of male and female adolescents [48 % female; 30 % non-White, including Black (10 %), Hispanic (2 %), and other (18 %)]. Findings suggest that requests for money lending are associated with heightened risk of moderate and serious threats/physical violence perpetration and victimization, net of traditional predictors. We discuss the implications of our findings for intervention and prevention efforts.

Lessons Learned in Evaluating a Multisite, Comprehensive Teen Dating Violence Prevention Strategy: Design and Challenges of the Evaluation of Dating Matters: Strategies to Promote Healthy Teen Relationships

OBJECTIVE

This paper describes the multisite, longitudinal cluster randomized controlled trial (RCT) design of the evaluation of the Dating Matters: Strategies to Promote Healthy Relationships initiative, and discusses challenges faced in conducting this evaluation.

METHOD

Health departments in 4 communities are partnering with middle schools in high-risk, urban communities to implement 2 models of teen dating violence (TDV) prevention over 4 years. Schools were randomized to receive either the Dating Matters comprehensive strategy or the "standard of care" strategy (an existing, evidence-based TDV prevention curriculum). Our design permits comparison of the relative effectiveness of the comprehensive and standard of care strategies. Multiple cohorts of students from 46 middle schools are surveyed in middle school and high school, and parents and educators from participating schools are also surveyed.

RESULTS

Challenges discussed in conducting a multisite RCT include site variability, separation of implementation and evaluation responsibilities, school retention, parent engagement in research activities, and working within the context of high-risk urban schools and communities. We discuss the strengths and weaknesses of our approaches to these challenges in the hopes of informing future research.

CONCLUSIONS

Despite multiple challenges, the design of the Dating Matters evaluation remains strong. We hope this paper provides researchers who are conducting complex evaluations of behavioral interventions with thoughtful discussion of the challenges we have faced and potential solutions to such challenges.

A National Descriptive Portrait of Adolescent Relationship Abuse: Results From the National Survey on Teen Relationships and Intimate Violence

This article reports results from the National Survey on Teen Relationships and Intimate Violence (STRiV) for 12- to 18-year-old youth (n = 1,804). STRiV provides the first nationally representative household survey focused on adolescent relationship abuse (ARA), covering perpetration and victimization. Among respondents (37%) reporting current- or past-year dating, 69% reported lifetime ARA victimization (63% lifetime ARA perpetration). Although psychological abuse was most common for these youth (more than 60%), the rates of sexual abuse (18%) and physical abuse victimization (18%), as well as 12% reporting perpetrating physical abuse and/or sexual abuse (12%) were substantial as well. Other than differences by age and gender, ARA rates were consistent by race/ethnicity, geographic region, urbanicity, and household characteristics, highlighting the importance of universal prevention programs. Compared with youth aged 15 to 18, those 12 to 14 years old reported lower rates of psychological and sexual ARA victimization. Similarly, we found lower ARA perpetration rates for those 12 to 14. We found no gender differences for ARA victimization but found that girls perpetrated more physical ARA than boys. Girls aged 15 to 18 reported perpetrating moderate threats/physical violence at more than twice the rate of younger girls and 3 times the rate compared with boys aged 15 to 18; girls aged 15 to 18 reported perpetrating more than 4 times the rate of serious psychological abuse than boys 15 to 18. Finally, these data document the significant positive correlation between ARA victimization and perpetration. Findings suggest that when working with youth in prevention services, interventions should not be designed for monolithic groups of "victims" or "perpetrators."

Parenting Profiles and Adolescent Dating Relationship Abuse: Attitudes and Experiences

Parenting behaviors such as monitoring and communications are known correlates of abusive outcomes in adolescent dating relationships. This longitudinal study draws on separate parent (58 % female; 61 % White non-Hispanic, 12 % Black non-Hispanic, 7 % other non-Hispanic, and 20 % Hispanic) and youth (ages 12-18 years; 48 % female) surveys from the nationally representative Survey of Teen Relationships and Intimate Violence. Latent class analyses were applied to investigate whether there are distinguishable parenting profiles based on six measures of parent-youth relationship and interactions, with youth's attitudes about abusive dating behavior and both perpetration and victimization examined in a follow-up survey as distal outcomes (n = 1117 parent-youth dyads). A three-class model-a "Positive Parenting" class, a "Strict/Harsh Parenting" class, and a "Disengaged/Harsh Parenting" class-was selected to best represent the data. The selected latent class model was conditioned on parents' (anger trait, relationship quality, attitudes about domestic violence) and youth's (prior victimization and perpetration) covariates, controlling for parent's gender, race/ethnicity, income, marital status, and youth's age and gender. Youth in the "Positive Parenting" class were significantly less likely 1 year later to be tolerant of violence against boyfriends under any conditions as well as less likely to perpetrate adolescent relationship abuse or to be a victim of adolescent relationship abuse. Parents' anger and relationship quality and youth's prior perpetration of adolescent relationship abuse as well as gender, age, and race/ethnicity predicted class membership, informing universal prevention program and message design, as well as indicated efforts to target communications and services for parents as well as for youth.

Prevalence of teen dating violence and co-occurring risk factors among middle school youth in high-risk urban communities

PURPOSE

This study describes the lifetime prevalence of teen dating violence (TDV) perpetration in a sample of middle school students from high-risk urban communities and examines the relation between TDV and related cognitive and behavioral risk factors.

METHODS

Surveys were administered to 2,895 middle school students in four U.S. cities; 1,673 students (58%) reported having dated and were included in analyses. The sample was 52.3% female, 48.2% non-Hispanic black/African-American, 38.2% Hispanic, 4.8% non-Hispanic white, and 7.6% other race. Six types of TDV perpetration were assessed: threatening behaviors, verbal/emotional abuse, relational abuse, physical abuse, sexual abuse, and stalking.

RESULTS

Of the students who had dated, 77% reported perpetrating verbal/emotional abuse, 32% reported perpetrating physical abuse, 20% reported threatening a partner, 15% reported perpetrating sexual abuse, 13% reported perpetrating relational abuse, and 6% reported stalking. Girls were more likely than boys to report perpetrating threatening behaviors, verbal/emotional abuse, and physical abuse, and boys were more likely to report perpetrating sexual abuse. Involvement in bullying positively predicted perpetration of TDV, albeit, in different ways for boys and girls. Other risk factors differed by sex. For instance, alcohol use and sex initiation predicted multiple forms of TDV perpetration for boys, whereas weapon carrying and emotional symptoms predicted several forms of TDV perpetration for girls.

CONCLUSIONS

The prevalence of TDV was high in our sample. Important sex differences in rates of perpetration and risk factors emerged. Comprehensive prevention programs that target TDV and related risk factors, such as bullying and other risk factors, seem warranted.

Effectiveness of "shifting boundaries" teen dating violence prevention program for subgroups of middle school students

PURPOSE

We examine whether the Shifting Boundaries (SB) intervention, a primary intervention to prevent youth dating violence and sexual harassment (DV/H), is differentially effective for girls compared with boys or for youth with a history of DV/H experiences.

METHODS

We randomly assigned SB to 30 public middle schools in New York City, enrolling 117 sixth and seventh grade classes to receive a classroom, building, combined, or neither intervention. The SB classroom intervention included six sessions emphasizing the laws/consequences of DV/H, establishing boundaries and safe relationships. The SB schoolwide/building intervention included the use of school-based restraining orders, greater faculty/security presence in unsafe "hot spots" mapped by students, and posters to increase DV/H awareness and reporting. Student surveys were implemented at baseline, immediately after intervention, and 6 months after intervention.

RESULTS

At 6 months after intervention, the SB building-level intervention was associated with significant reductions in the frequency of sexual harassment (SH) perpetration and victimization; the prevalence and frequency of sexual dating violence victimization; and the frequency of total dating violence victimization and perpetration. We also had one anomalous finding that the interventions were associated with an increase in the prevalence of SH victimization. These results were consistent for girls and boys, and those with or without a history of DV/H, with the one exception for those exposed to the SB building condition who had earlier reported perpetrating SH had a significantly lower frequency of perpetrating SH at the follow-up than those without such a history.

CONCLUSIONS

SB can provide effective universal prevention of middle school DV/H experiences, regardless of students' prior exposure histories, and for boys and girls.

Middle school sexual harassment, violence and social networks

OBJECTIVES

To pilot a study of social networks informing contextual analyses of sexual harassment and peer violence (SH/PV).

METHODS

Seventh and 8th grade students (N = 113) in an urban middle school were surveyed via a Web-based instrument.

RESULTS

Boys and girls reported SH/PV victimization and perpetration at comparable rates. The proportion of nominated friends who reported SH/ PV outcomes was greater in boys' than in girls' social networks. Structural descriptors of social networks were not significant predictors of SH/PV outcomes.

CONCLUSIONS

Collection of sensitive relationship data via a school-based Web survey is feasible. Full-scale studies and greater flexibility regarding the number of friendship nominations are recommended for subsequent investigations of potential sex differences.

Illicit Retail Methamphetamine Markets and Related Local Problems: A Police Perspective

In this paper we examine whether features of the operation of retail methamphetamine markets affects communities in three domain areas (public safety, health, and economy). We use data from a national survey of law enforcement agencies (n= 1,367) with narcotics officers to examine the operational characteristics of methamphetamine markets. We found that the operational features of a market (the source of methamphetamine and the most common location for selling methamphetamine) can have a significant impact on the types of public safety, health, and economic problems that communities are experiencing. In particular, jurisdictions distinguished by largely semi-private markets (strip clubs and bars) are more likely to be characterized as localities that have a large public safety and health problem. Jurisdictions that are supplied by multiple local and international sources (compared to a single source) were more likely to be characterized as jurisdictions that have problems in the three domains.

Measuring the stability of illicit drug markets: why does it matter?

Contemporary drug policy in the United States favors a balanced approach including a supply side dimension. The supply side dimension is grounded in the assumption that the disruption of illicit drug markets will result in diminished capacity of the markets to provide for consumer demand and thereby a reduction in the use of illicit drugs and a related increase in demand for treatment. In this paper we consider the disruption of methamphetamine markets in 10 cities in terms of the relative stability of those markets. We use data from the Arrestee Drug Abuse Monitoring (ADAM) program for the years 2000-2003. We conduct a comparative analysis of those markets and look at patterns of methamphetamine use and participation in treatment in those cities. Our findings demonstrate how it is possible to construct measures of market stability, and how to use those measures to assess the stability of illicit drug markets in terms of both relative value and in fluctuation over time. We also demonstrate that markets with different patterns of stability will exhibit different patterns of drug using and treatment participation. We conclude that understanding patterns of market stability will help us to understand and respond to patterns of drug using and treatment participation.

Drug screening and confirmation by GC–MS: Comparison of EMIT II and Online KIMS against 10 drugs between US and England laboratories

Drug screening through urinalysis is a widely accepted tool for rapid detection of potential drug use at a relatively low cost. It is, therefore, a potentially useful method for detecting and monitoring drug use in a variety of contexts such as the criminal justice system, pre-employment screening and a variety of treatment centers. This article explores the efficacy of two commercially available drug-screening assays: Online KIMS assay (Roche) and EMIT II assays. First, we evaluate the sensitivity and specificity of two immunoassays. A total of 738 urine samples were collected among adult arrestee populations from Chicago, New Orleans and Seattle through the Arrestee Drug Abuse Monitoring (ADAM) program. Partial samples were split within one laboratory and analyzed by both enzymes multiplied immunoassay technique (EMIT) II and kinetic interaction of microparticle in solution (KIMS) assays for a 10-drug panel (amphetamine, barbiturates, benzodiazepines, marijuana, cocaine, methadone, methaqualone, opiate, phencyclidine and propoxyphene). Gas chromatography-mass spectrometry (GC-MS) was used as a confirmation method for all positives from either EMIT II or KIMS for all experiments. Second, the paper examines whether using different testing laboratories plays a role in the final results. The same experiments were repeated at two different testing locations: one in California and one in London and England. Third, the paper studies whether drug testing results vary between two laboratories when each of them had used their own routine screening method: the Forensic Science Service (FSS) at Birmingham, United Kingdom with KIMS assay and Medscreen Limited at London, United Kingdom with EMIT II. In summary, both EMIT II and KIMS assays generate fairly consistent results. The concordance rate against each of the 10 drugs tested is relatively high (97.4-100%). The discrepancies, in most cases, occurred at drug concentrations near the cut-off levels. There were more discrepant results between two laboratories compared to when specimens were analyzed at the same laboratory using two different assays.

The validity of adult arrestee self-reports of crack cocaine use

Despite the many problems associated with crack use, little validated empirical evidence about the prevalence of crack cocaine exists. Researchers that track crack cocaine use have relied on self-reports to differentiate crack and powder cocaine. Prior research suggests that the accuracy of self-reports for the use of a variety of illicit substances is relatively low. To examine the validity of self-reports of crack use, this article employs a newly developed technology to detect specifically the presence of markers of crack cocaine in urine specimens. With a sample of 2327 arrestees from six cities that participate in the Arrestee Drug Abuse Monitoring (ADAM) Program, both face-to-face interview and urinalysis data were examined. Using a positive urinalysis result as the validity standard, we assessed the extent to which arrestees underreport crack cocaine use as compared to the use of marijuana, opiates,and methamphetamine. Logistic regression models were also de veloped to predict the factors that relate to underreporting. The results showed a considerable amount of underreporting for all the drug measures. In most cases, only about half the people who had a positive urinalysis test for drugs admitted using drugs. Overall, the least amount of underreporting occurred for the use of marijuana (63.6% told the "truth"), followed by methamphetamine (56.1% told the truth), crack (48.2% told the truth), and opiate (45.9% told the truth). Female crack users, as compared to male crack users, were more likely to admit using crack. Black arrestees were more likely to admit using crack than white or Hispanic arrestees. Arrestees with a history of prior drug treatment or a prior arrest, as compared to those without such histories, were more likely to admit using crack. The older the arrestee was, the more likely the arrestee would admit using crack. The more money an arrestee spent on drugs, the more likely the arrestee would admit using crack. Differences in underreporting were also observed across the six cities in this study. The implications of these findings for the monitoring of crack use are discussed.

Drug Screening: A Comparison of Urinalysis Results from Two Independent Laboratories

Urinalysis for detection of drug abuse is widely used in pre-employment screening and correctional administration. Substantial protocols have been developed in these applications of drug testing to minimize the impact of any given vendor on results. Much less documentation exists for epidemiological drug testing programs such as the Arrestee Drug Abuse Monitoring (ADAM) program. This paper explores the impact that changes in laboratory vendors and data collection methods have on drug testing results. Here, we report the findings from a comparison study. The project was designed to determine the consistency of the urinalysis results when the same urine specimens were analyzed by two independent laboratories.

Nodular pulmonary infiltrates and septic arthritis associated with Yersinia enterocolitica bacteremia

A 58-year-old black man presented with left wrist pain, septicemia, and a chest roentgenographic pattern compatible with septic embolization. Yersinia enterocolitica was grown from joint fluid, blood, and sputum. This unusual constellation of clinical manifestations due to an organism rarely reported as the cause of human disease warrants reporting the case.