Cardiovascular Health among U.S. Indigenous Peoples: A Holistic and Sex-Specific Systematic Review

Tulane University of New Orleans

The purpose of this systematic review is to examine mental, sociocultural, behavioral, and physical risk and protective factors related to cardiovascular disease (CVD) and related outcomes among U.S. Indigenous peoples. A total of 51 articles met the inclusion criteria of research focusing factors for CVD among U.S. Indigenous peoples (Mental n = 15; Sociocultural, n = 17; Behavioral/Physical, n = 19). This review reveals clear risks for CVD, which tended to be elevated for females. Mental health problems (depression, anxiety, PTSD/trauma, alcohol, and other drug (AOD) abuse) were clearly associated with CVD, along with enculturation, social support, and the social environment – including discrimination and trauma. Poor diet and obesity, diabetes, hypertension, cholesterol were behavioral or physical factors. Overall, identified research was limited and in beginning stages, lacking more information on etiology of the interconnections across sex and the mental, sociocultural, and behavioral determinants of CVD.

Publication
Journal of Evidence-Based Social Work
Publication Year
2020

Measurement of Economic Abuse Among Women Not Seeking Social or Support Services and Dwelling in the Community

Washington University in St. Louis

Scholars have defined economic abuse (EA) as tactics used by abusive partners to undermine the self-sufficiency and economic self-efficacy of survivors of intimate partner violence (IPV). However, no measures of EA have been tested in non-IPV-service seeking samples. The current study assesses the psychometric properties of the Scale of Economic Abuse (SEA)-12 (Postmus, Plummer, & Stylianou, 2016) in a nonservice seeking sample of adult females attending community college. A quantitative web-based survey was administered to a simple random sample of female community college students (n = 435). Analyses included confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). CFA indicated a poor fit for the three-factor model of the SEA-12 in this sample. The results of the EFA found a single factor model retaining four items (the Scale of Economic Abuse-Short, or SEAS). Women are experiencing EA outside of IPV service-seeking populations, and that tactics of economic control seem to be central to EA in this sample.

Publication
Violence and Victims
Publication Year
2020

Disrupting hegemony in social work doctoral education and research: Using autoethnography to uncover possibilities for radical transformation

Fordham University

Social work has enhanced its profile in the United States by adopting a particular dialect of scientific inquiry wherein positivism and evidence-based practice are considered gold standards of social work research and practice. This ideological shift permeates doctoral education and research training, as well as social work more broadly. Little attention, however, is paid to the pedagogical approaches used to train doctoral students into a “science of social work,” and we know even less about critical methodologies in doctoral education. This collaborative autoethnography weaves together the personal narratives of three doctoral students and one early career faculty member navigating an academic context within a large public university in the United States. We employ a participatory and intersectional approach to analyze narrative data in terms of how our identities interact with the structures relevant to where we study and work. Three themes emerged from our collaborative analysis: becoming disillusioned by disciplinary shortcoming; confronting dissonance with radical solidarity; and making change on the inside using perspectives from the outside. We argue throughout that critical reflexivity is a tool to document, resist, and transform hegemonic discourse that narrowly defines what it means to embody social work research, practice, and education.

Publication
Qualitative Social Work
Publication Year
2020

Consideration of Heterogeneity in a Meta-analysis of Latino Sexual Health Interventions

University of Chicago

Latino adolescents are disproportionately affected by teenage pregnancy, sexually transmitted infections, and HIV, persistent sexual and reproductive health (SRH) disparities that represent a national public health concern. Despite progress nationally, Latina adolescents continue to exhibit above-average teenage pregnancy, birth, and repeat birth rates.1 Particularly concerning are the 17% increase in reportable sexually transmitted infections among 10- to 19-year-old Latino adolescents since 2014 and the 6% rise in new HIV diagnoses among 13- to 19-year-old Latino adolescents between 2016 and 2017 alone.2–4 Given these statistics, research is needed to strengthen the evidence on programs to reduce Latino adolescent SRH disparities.

Publication
Pediatrics
Publication Year
2020

A confirmatory factor analysis of the beck anxiety inventory in Latinx primary care patients

University of Nevada, Reno

Research on the Beck Anxiety Inventory (BAI) with ethnic minorities in the U.S. is limited. Because Latinxs constitute 18% of the U.S. population and are the second largest ethnic group in the country, the current study replicated the aforementioned study and examined the BAI factor structure with a Spanish-speaking Latinx sample in the United States. We investigated the original two-factor structure of the BAI with 149 Spanish-speaking Latinx primary care patients. Results from a confirmatory factor analysis indicated that the previous factor structures of the BAI did not represent an adequate fit for our sample. An exploratory factor analysis indicated that possibly an alternate two-factor model of anxiety was the best fit for the data. Cultural considerations are discussed including the possibility of utilizing cultural idioms of distress as a way to assess anxiety among Latinxs.

Publication
International Journal of Mental Health
Publication Year
2020

Beyond the Classroom: The Intergenerational Effect of Incarceration on Children’s Academic and Nonacademic School-Related Outcomes in High School

Cornell University

The author uses strategic comparison regression and the Longitudinal Study of Adolescent to Adult Health (n = 11,767) to explore the effect of parental incarceration on academic and nonacademic outcomes in high school. This method compares youth whose parents were incarcerated before the outcomes are measured with those whose parents will be incarcerated after. The author examines most recent grades and a range of nonacademic outcomes, such as truancy, involvement in school activities, and suspension. Results indicate that the associations between parental incarceration and grades are largely accounted for by selection, but associations between parental incarceration and nonacademic processes persist. Maternal incarceration holds particular importance for behavioral outcomes (fighting and truancy), and paternal incarceration holds particular importance for behavioral, connectedness, and disciplinary outcomes. Researchers examining the intergenerational consequences of incarceration should examine school contexts beyond the classroom and explore the pathways through which this disadvantage occurs.

Publication
Socius: Sociological Research for a Dynamic World
Publication Year
2020

Test-Taking for Gifted and Talented Kindergarten: Underscoring the Importance of Outreach

New York University

Using proprietary data collected prior to the establishment of the public Universal Prekindergarten program in New York City, this study finds statistically significant differences in test-taking rates for the city’s Gifted & Talented (G & T) program between two matched samples of students—those who attended a public prekindergarten (pre-K) program and those who did not—for each of four cohorts from 2008 to 2011, favoring the public pre-K group. Results also demonstrate that access to information about the G & T program is a plausible mechanism underlying the higher test-taking rates among the public pre-K group, especially for underrepresented groups. With the establishment of the Universal Prekindergarten in New York City in 2015, our results highlight the importance of instituting new policies for promoting the dissemination of information regarding the G & T admissions process within the public school sector. If targeted to address diversity in G & T, such policies could help reduce inequality in gifted education.

Publication
Gifted Child Quarterly
Publication Year
2020

A Qualitative Study of Intimate Partner Violence and Employment Instability

The Ohio State University

Maintaining employment while suffering from intimate partner violence (IPV) is extremely difficult given the direct and indirect ways abusers disrupt work. The current qualitative study seeks to strategically fill a gap in knowledge regarding survivors’ employment instability and gain insight toward creating more supportive workplaces for survivors. Women (N = 19) receiving services for IPV at a Midwest U.S. agency were interviewed about their experiences of employment instability, workplace disruptions (including via technology), and their perceptions of policies and practices that employers use to support employees experiencing abuse. Specifically, the study asks four research questions to address gaps in literature: (a) What are the employment instability experiences of survivors related to IPV, including attendance, hours, and job loss? (b) What are survivors’ experiences of workplace disruptions, including with technology? (c) What formal employer policies and practices related to IPV are survivors familiar with? and (d) What workplace supports do IPV survivors perceive to be helpful or harmful? Findings uniquely contribute to existing literature by revealing employment instability among mothers, highlighting the use of technology to disrupt survivors’ work, and determining existing policies and procedures that workplaces use to address IPV. Implications for advocates working with survivors as well as employer and state policymakers are discussed.

Publication
Journal of Interpersonal Violence
Publication Year
2020

Neural Correlates of Smartphone Dependence in Adolescents

University of California, San Francisco

Increases in depressive and suicide-related symptoms among United States adolescents have been recently linked to increased use of smartphones. Understanding of the brain mechanisms that underlie the potential smartphone dependence may help develop interventions to address this important problem. In this exploratory study, we investigated the neural mechanisms underlying potential smartphone dependence in a sample of 19 adolescent volunteers who completed self-assessments of their smartphone dependence, depressive symptoms, and sleep problems. All 19 adolescents underwent diffusion MRI that allowed for assessment of white matter structural connectivity within the framework of connectomics. Based on previous literature on the neurobiology of addiction, we hypothesized a disruption of network centrality of three nodes in the mesolimbic network: Nucleus Accumbens, anterior cingulate cortex, and amygdala. Our results showed positive correlations between the node centrality of the right amygdala and self-reported smartphone dependence, between smartphone dependence and sleep problems, and between sleep problems and depressive symptoms. A higher phone dependence was observed in females compared to males. Supported by these results, we propose a model of how smartphone dependence can be linked to aberrations in brain networks, sex, sleep disturbances, and depression in adolescents.

Publication
Frontiers in Human Neuroscience
Publication Year
2020

Substantiated allegations of failure to protect in the child welfare system: Against whom, in what context, and with what justification?

University of California, Berkeley

Failure to protect (FTP), a sub-type of neglect, is used by child welfare systems to categorize and substantiate allegations of child maltreatment. Scholars and advocates have raised concerns that FTP is disproportionately used to substantiate mothers and people of color for harm perpetrated by others, particularly in the contexts of sexual abuse and domestic violence. Limited data exist about how FTP is used in practice or if substantiation of FTP varies by context across gendered or racialized groups. This study extends our understanding of use of FTP by examining who workers substantiate for FTP, in what context, and the justifications they use. Data for this study were drawn from child welfare records in a large, Midwestern county. Mixed methods were used to analyze data from 150 maltreatment referrals which included at least one substantiated allegation of FTP. Findings indicate that the contexts and rate at which caregivers were substantiated for FTP differed significantly across gendered groups. Mothers were most frequently substantiated for FTP in the contexts of sexual abuse, physical abuse, and domestic violence. Fathers were most frequently substantiated in the context of substance use. In addition, rates of FTP substantiation varied across racialized groups. Black caregivers were substantiated disproportionately across all contexts. White caregivers were overrepresented among those substantiated for FTP in the context of substance use. Notably, justification for substantiation decisions was often not documented in data. Implications for policy and practice are discussed.

Publication
Children and Youth Services Review
Publication Year
2020

The Role of Social Support in the Link Between Economic Abuse and Economic Hardship

Washington University in St. Louis

More data is needed about the pathways through which intimate partner violence (IPV) impacts the economic well-being of survivors. The current study assesses the moderating influence of social support on the association between economic abuse (EA) and economic hardship. Female participants (n = 435) were recruited to participate in a web-based survey which included standardized measures of EA, other forms of IPV, domains of social support, and economic hardship. Analysis included bivariate and multivariate regression with an investigation into interaction effects.Experiencing EA was significantly correlated with economic hardship, even with extent of physical and emotional IPV controlled. Both tangible and appraisal support had significant negative association with extent of material hardship. Significant interactions between forms of social support and economic abuse were observed. For those at high levels of economic abuse, support had less influence on economic hardship. A mix of direct economic aid, advocacy, education and support could provide a blueprint for addressing the economic hardship experiences of community-dwelling survivors of economic abuse. A comprehensive response to EA requires interventions aimed directly at economically controlling and exploitative tactics, including credit building, individual economic advocacy, and education. Interventions that seek to enhance survivors’ access to social support may be necessary but not sufficient to buffer the impacts of violence on survivors’ economic outcomes.

Publication
Journal of Family Violence
Publication Year
2020

Organizing as “Collective-Self” Care Among African American Youth in Precarious Times

Fordham University

African American youth have responded with hope and action to protect their well-being in violent political, economic, and social conditions, through organizing. While contemporary organizing frameworks prioritize self-care to promote sustainability, there is little research on the meaning and definition of self-care for African American youth organizers, in their own words. In this paper, findings from interviews with 20 Black youths in navigating organizing spaces in New York City will be presented, highlighting how they destabilize the narrowness of commonly defined self-care to embody “collective-self” care strategies. Implications for community practice, recovery from systemic violence, and historical trauma among African Americans will be explored.

Publication
Journal of African American Studies
Publication Year
2020

#PrEP4Love: success and stigma following release of the first sex-positive PrEP public health campaign

University of Chicago

Pre-exposure prophylaxis (PrEP) is an effective yet under-utilised method for preventing HIV transmission in high-risk groups. Despite ongoing social marketing to increase PrEP awareness, few studies have evaluated public responses. This paper contextualises negative responses to Chicago’s PrEP4Love campaign. In February 2016, a sex-positive ad campaign called PrEP4Love was launched online and throughout public spaces in Chicago. A gender and sexuality inclusive campaign, PrEP4Love is intended to be culturally responsive and sex positive, while retaining a focus on risk reduction. Advertisements prominently feature Black sexual minority men, and Black transgender women, and were strategically placed in diverse Chicago neighbourhoods. In response, there were 212 new callers to the PrEPLine during the two-month study period. Negative responses were concerned with: negatively depicting Black homosexuality (4), general anti-LGBTQ comments (7), adverse effects on children (6), sexually explicit nature (5), and general stigmatisation of racial minorities (4). Discussion focuses on sex-positive frameworks, normalising intimacy, stigma and historical mistrust of medical and pharmaceutical institutions, and the social meanings of biomedical prevention technologies (e.g. PrEP) in relation to dominant norms of sexuality and gender. This study is the first to investigate public responses to a sex-positive PrEP campaign. More studies of PrEP social marketing are needed to evaluate targeted public health campaigns to guide future PrEP promotion strategies.

Publication
Culture, Health & Sexuality
Publication Year
2020

Examining Caretaker Attitudes Towards Primary Prevention of Pediatric Behavioral Health Problems in Integrated Care

University of Nevada, Reno

Understanding caretaker attitudes towards the prevention of pediatric behavioral disorders is important for the effective delivery of prevention services. Caretakers of children ages 0–18 (N = 385) read a description of pediatric prevention services in an integrated primary care setting. Attitudes towards these services were assessed. The majority of participants (80%) agreed that prevention is important, 87% reported interest in learning their child’s risk for a behavioral disorder, 84% were interested in learning the results of a screen for behavioral disorders, and 88% were interested in learning parenting strategies. Participants endorsed similarly positive attitudes towards prevention in integrated care. Perceived risks outweighing perceived benefits, younger caregiver age, and identifying as non-Hispanic White predicted less favorable attitudes towards prevention. Other socio-demographic characteristics (e.g., caretaker education) were associated with disorder-specific beliefs about the importance of prevention, but not general attitudes. Findings suggest generally positive attitudes towards preventing behavioral disorders in an integrated care setting.

Publication
The Journal of Behavioral Health Services & Research
Publication Year
2020

The Process of Change in Systemic Family Therapy

Oklahoma State University

This chapter provides a comprehensive review of the research on the processes of change in systemic family therapy (SFT). We begin by clearly defining SFT process research including what it fully entails: systemically oriented mechanisms and contexts of change. Our review of the research is uniquely organized according to our view of the evolution of SFT practice (a) beginning with an overview of process findings from the traditional schools of SFT, (b) followed by findings from empirically supported treatments in SFT, and then (c) finalized by an assessment of the research from an integrative perspective of SFT including common and unique change processes (systemic alliances, systemic engagement and retention, systemic reframing, and systemic enactments). Following this overview, we provide directions for future areas of research that will need to be explored in order to more fully articulate the pathways of change in SFT including the need to better clarify the contexts in which certain process are most important. Finally, several implications for SFT training and practice are articulated including how this review points to the need for a potential paradigm shift that squarely places systemically oriented principles of change and client system‐centered integration and at the heart of our work.

Publication
The Handbook of Systemic Family Therapy
Publication Year
2020

The effect of Medicaid expansion on use of opioid agonist treatment and the role of provider capacity constraints

Washington University

To determine the effect of Medicaid expansion on the use of opioid agonist treatment for opioid use disorder (OUD) and to examine heterogeneous effects by provider supply and Medicaid acceptance rates. Yearly state-level data on methadone dispensed from opioid treatment programs (OTPs), buprenorphine dispensed from OTPs and pharmacies, number of OTPs and buprenorphine-waivered providers, and percent of OTPs and physicians accepting Medicaid. This study used difference-in-differences models to examine the effect of Medicaid expansion on the amount of methadone and buprenorphine dispensed in states between 2006 and 2017. Interaction terms were used to estimate heterogeneous effects. Sensitivity analyses included testing the association of outcomes with Medicaid enrollment and state insurance rates. The estimated effects of Medicaid expansion on buprenorphine and methadone dispensed were positive but imprecise, meaning we could not rule out negative or null effects of expansion. The estimated associations between state insurance rates and dispensed methadone and buprenorphine were centered near zero, suggesting that improvements in health coverage may not have increased OUD treatment use. The effect of Medicaid expansion was larger in the states with the most waivered providers compared to states with the fewest waivered providers. In the states with the most waivered providers, the average estimated effect of expansion on buprenorphine dispensed was 12 kg/y, enough to treat about 7500 individuals. We did not find evidence that the effect of expansion was consistently modified by OTP concentration, OTP Medicaid acceptance, or physician Medicaid acceptance. Gains in health coverage may not be sufficient to increase OUD treatment, even in the context of high treatment need. Provider capacity likely limited Medicaid expansion’s effect on buprenorphine dispensed. Policies to increase buprenorphine providers, such as ending the waiver requirement, may be needed to ensure coverage gains translate to treatment access.

Publication
Health Services Research
Publication Year
2020

Gender Differences in Intimate Partner Violence Victimization, Help-Seeking, And Outcomes Among College Students

University of Georgia

Many college students experience intimate partner violence (IPV). Although receiving help from formal and informal sources may ameliorate possible negative impacts of IPV victimization, the outcomes of help-seeking are not always positive. This study used survey data collected at six universities across the United States (U.S.) to examine gender differences in IPV, help-seeking, and its outcomes (n=3,070). Major variables included IPV victimization, IPV consequences, help-seeking, and outcomes. Descriptive and bivariate analyses revealed higher rates of victimization among females as well as poorer health status, higher levels of depression, and more daily routine problems. Females also used more formal help, and reported it as being useful more often than males. Inversely, more males than females reported that informal supports were helpful. Recommendations include social workers providing tailored services both for male and female survivors, service providers developing educational programs that target informal help sources, and social work education providing relevant trainings.

Publication
Advances in Social Work
Publication Year
2020

Marginalized Youth, Mental Health, and Connection with Others: A Review of the Literature

Rutgers University

For marginalized youth, the transition to adulthood is a stage of life in which inequalities can be either magnified or reduced. While most descriptions of these young people highlight their difficulties achieving self-sufficiency, the ability to form connections with others is an equally significant marker of adult maturity. Given that social isolation poses serious risks to health and well-being, the relational experiences of marginalized youth are a critical component of the transition to adulthood. Experiences of trauma, marginalization, and involvement in public systems of care can place these youth at heightened risk for mental health difficulties, all of which can pose particular challenges for interpersonal relationships. This critical review of the literature explores the research on the relational experiences of marginalized young people living with emotional and behavioral challenges. It discusses the unique developmental context of marginalized youth, including experiences with trauma, mental illness, marginalization, and involvement in public systems of care. It then reviews the benefits young people derive from mutually empathic connections with others. The review explores facilitators of connection for marginalized youth, as well as barriers to connection for these young people. Following this review, the article identifies several gaps in the literature, and ends with a call for both practitioners and researchers to focus on the importance of connection as an underappreciated and crucial resource for marginalized youth.

Publication
Child and Adolescent Social Work Journal 
Publication Year
2020

Exploring the relationship between cumulative trauma and recidivism among older adults: Does race and offense history matter?

Fordham University

There is a dearth of knowledge on the role of cumulative trauma, stress, and minority oppression on recidivism among incarcerated elder population. The current study fills a gap in the literature by exploring the association between race, trauma, offense history, and recidivism among incarcerated elders. This study used a cross-sectional correlational design with 607 adult males aged 50 and older in a Northeastern state correctional system. Results of a series of moderation analyses revealed that drug offense history had a significant moderating effect on the relationship between trauma and recidivism. However, minority status or violent offense history was not found to be a significant moderator of the trauma and recidivism relationship. These findings suggest prevention and intervention efforts would benefit from incorporating trauma-informed approaches and principles of restorative justice that facilitate individual, family, and community healing.

Publication
Traumatology
Publication Year
2019

Preadolescents’ Daily Peer Victimization and Perceived Social Competence: Moderating Effects of Classroom Aggression

University of Delaware

Few studies have assessed children’s daily peer experiences, and even fewer have considered their daily self-perceptions. This daily diary study examined relations between preadolescents’ daily reports of peer victimization and perceived social competence, along with moderating effects of classroom aggression. A racially diverse sample of 182 children in 5th grade (105 boys; M age = 10.64 years; 35% White, 31% Black, 17% Hispanic, 17% other or not reported) completed daily measures of peer victimization and perceived social competence, with most children completing measures on 8 school days. Teachers completed measures of aggression for each participating pupil. Four types of peer victimization (verbal victimization, social manipulation, social rebuff, and property attacks) predicted decreased daily perceived social competence. Daily social rebuff predicted decreased daily perceived social competence beyond the effects of the other types of victimization. Classroom aggression moderated the relation of verbal victimization with perceived social competence, such that this relation was significant in classrooms with lower aggression and nonsignificant in classrooms with higher aggression. Results indicate that preadolescents’ daily self-perceptions fluctuate with daily victimization by peers, particularly with social rebuff. Findings also suggest that the impact of verbal victimization on children’s self-views could be exacerbated in classrooms that better manage peer-to-peer aggression. Accordingly, targeted interventions appear critical for children who continue to experience peer victimization in schools with highly effective aggression prevention programs.

Publication
Journal of Clinical Child & Adolescent Psychology
Publication Year
2019