Family Reunification among Two Groups of Runaway Adolescents Utilizing Emergency Shelters

Limited research has addressed reunification of runaway youths with their families following an emergency shelter stay; however, recent studies have shown that those who reunify with their families following a shelter stay have more positive outcomes than those relocated to other residences. This study evaluated differences between two samples of runaway youth utilizing youth emergency shelters in New York (n = 155) and Texas (n = 195) and identified factors associated with reunification among these two groups of adolescents. Less than half (43.7%) of the youths were reunited with their families. Among New York runaway youths, those who had lived primarily with someone other than a parent before shelter admission, were physically abused, or neglected were less likely to return home. Among youths admitted to emergency shelter services in Texas, those with longer shelter stays, living primarily with someone other than a parent before shelter admission, or being pregnant or a parent were less likely to reunify. This study provides valuable information concerning family reunification following shelter service use; however, additional research is needed to delineate youth, family, and shelter system factors that distinguish successful from unsuccessful reunification over an extended period of time

Linking critical consciousness and health: The utility of the critical reflection about social determinants of health scale (CR_SDH)

Introduction: Critical consciousness (CC) theory has been proposed as a framework to inform health interventions targeting a wide variety of health conditions. Unfortunately, methodological limitations have made it difficult to test CC as a mediator of health outcomes. Specifically, standardized and widely accepted measures of health- related CC are needed. The goal of this study was to develop and test a measure of critical reflection on social determinants of health (SDH). This measure focused on critical reflection, an essential dimension of CC. Methods: Community-based participatory research principles and a mixed methods design were used with three samples: (1) experts in SDH and CC, (2) 502 individuals completing online surveys, and (3) 602 men with histories of substance use disorder and incarceration. All participants were over 18 years of age. Analysis included descriptive frequencies, exploratory factor analyses (EFA), confirmatory factor analysis (CFA), generalized linear regression models, correlations, and Cronbach ’ s alpha calculations. Results: The Critical Reflection about SDH scale (CR_SDH) is a short, unidimensional, and reliable scale ( α = 0.914). Construct validity was supported and known-groups validity showed that the scale discriminated different levels of CR_SDH based on political views, educational level, knowledge of health inequities, and gender. Conclusion: The CR_SDH is a standardized measure that can assess critical reflection about the impact of SDH on health among providers and consumers of health care. The CR_SDH can be used to identify critical reflection related training needs and inform decisions about development and testing of critical reflection related health interventions and health care policy

Optimizing a community-engaged multi-level group intervention to reduce substance use: an application of the multiphase optimization strategy

Abstract Background Rates of alcohol and illicit drug use (AIDU) are consistently similar across racial groups (Windsor and Negi, J Addict Dis 28:258–68, 2009; Keyes et al. Soc Sci Med 124:132–41, 2015). Yet AIDU has significantly higher consequences for residents in distressed communities with concentrations of African Americans (DCAA - i.e., localities with high rates of poverty and crime) who also have considerably less access to effective treatment of substance use disorders (SUD). This project is optimizing Community Wise, an innovative multi-level behavioral-health intervention created in partnership with service providers and residents of distressed communities with histories of SUD and incarceration, to reduce health inequalities related to AIDU. Methods Grounded in critical consciousness theory, community-based participatory research principles (CBPR), and the multiphase optimization strategy (MOST), this study employs a 2 × 2 × 2 × 2 factorial design to engineer the most efficient, effective, and scalable version of Community Wise that can be delivered for US$250 per person or less. This study is fully powered to detect change in AIDU in a sample of 528 men with a histories of SUD and incarceration, residing in Newark, NJ in the United States. A community collaborative board oversees recruitment using a variety of strategies including indigenous field worker sampling, facility-based sampling, community advertisement through fliers, and street outreach. Participants are randomly assigned to one of 16 conditions that include a combination of the following candidate intervention components: peer or licensed facilitator, group dialogue, personal goal development, and community organizing. All participants receive a core critical-thinking component. Data are collected at baseline plus five post-baseline monthly follow ups. Once the optimized Community Wise intervention is identified, it will be evaluated against an existing standard of care in a future randomized clinical trial. Discussion This paper describes the protocol of the first ever study using CBPR and MOST to optimize a substance use intervention targeting a marginalized population. Data from this study will culminate in an optimized Community Wise manual; enhanced methodological strategies to develop multi-component scalable interventions using MOST and CBPR; and a better understanding of the application of critical consciousness theory to the field of health inequalities related to AIDU. Trial registration ClinicalTrials.gov, NCT02951455 . Registered on 1 November 2016.https://deepblue.lib.umich.edu/bitstream/2027.42/143194/1/13063_2018_Article_2624.pd

Surviving oppression under the rock : New York drug laws and the lived experiences of African American women in distressed households

textDrawing on standpoint and intersectionality theories, this study explores the degree to which New York State’s Rockefeller Drug Laws and interactions between criminal, educational, and welfare policies have contributed to the maintenance of a culture of surveillance in which the lives of African American women in distressed households are overseen and influenced by oppressive policies and governmental institutions. Qualitative secondary analysis of longitudinal ethnographic data was conducted. Two detailed family cases are the focus of the study. Findings demonstrate multiple disadvantages that impoverished African American families struggling with alcohol and/or other drugs (AOD) use and/or sale experience. These disadvantages accumulated intergenerationally, in a snowball effect making it difficult for participants to maintain stable lives. For instance, oppressive policies, discrimination, poverty, AOD use, and violence hindered many participants’ ability to obtain a high school degree which in turn contributed to the obstacles they faced finding meaningful employment. Findings explored the tension between participants’ experiences with oppression and the multiple ways they either assimilated or resisted their oppression. While the Rockefeller Drug Laws assume that harsh sentences deter people from AOD use/sale, none of the participants mentioned imprisonment as a motivator to avoid AOD. Participants’ classification of crack, cocaine, and heroin as the most dangerous AOD were congruent with the Rockefeller Drug Laws’ classification of AOD. However, the way the law dispensed prison sentences reduced people to their AOD use because it disregarded all other aspects of their lives. Unlike the Rockefeller Drug Laws, participants found drug use to be sometimes a functional activity insofar as it was an additional source of income and a coping strategy in dealing with oppression. Findings indicate that simply addressing problematic AOD use among impoverished African American families in New York at the micro level is not sufficient or feasible. While it is important to examine and address individual needs and problems associated to AOD use, macro forces such as lack of meaningful employment for unskilled workers must be addressed. Social workers must foster critical thought, support an operational definition of AOD abuse/dependence, and advocate for social justice within the field of AOD use.Social Wor