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We reviewed data obtained in October 2021-May 2023 from youth who reported a history of sexual activity upon admission to 1 of 12 juvenile justice facilities in Utah, USA, that offered screening for Chlamydia trachomatis and Neisseria gonorrhoeae. Urinalysis revealed C. trachomatis positivity of 10.77%, N. gonorrhoeae positivity of 1.08%, and coinfection C. trachomatis N. gonorrhoeae) of 0.90%. Prevalence of infection was similar for youths in rural and urban facilities. A total of 12.01% of those identifying as male and 14.01% of those identifying as female tested positive for C. trachomatis, N. gonorrhoeae, or coinfection. Of young adults who tested positive, 74.65% received their results while incarcerated, all of whom accepted treatment. Our research underscores the feasibility of providing prompt C. trachomatis/N. gonorrhoeae screening and treatment in juvenile correctional facilities. The pervasiveness of infection emphasizes the urgent need for early identification and treatment for C. trachomatis and N. gonorrhoeae in incarcerated youth nationwide.
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Infecções por Chlamydia , Coinfecção , Gonorreia , Adulto Jovem , Adolescente , Masculino , Feminino , Humanos , Gonorreia/diagnóstico , Gonorreia/epidemiologia , Gonorreia/prevenção & controle , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/epidemiologia , Utah/epidemiologia , Coinfecção/epidemiologia , Neisseria gonorrhoeae , Chlamydia trachomatis , Estabelecimentos Correcionais , Prevalência , Programas de Rastreamento/métodosRESUMO
The global COVID-19 pandemic illustrates the importance of a close partnership between public health and juvenile justice systems when responding to communicable diseases. Many setting-specific obstacles must be navigated to respond effectively to limit disease transmission and negative health outcomes while maintaining necessary services for youth in confinement facilities. The response requires multidisciplinary expertise and collaboration to address unique considerations. Public health mitigation strategies must balance the risk for disease against the negative effects of restrictions. Key aspects of the COVID-19 response in the juvenile justice system of Colorado, USA, involved establishing robust communication and data reporting infrastructures, building a multidisciplinary response team, adapting existing infection prevention guidelines, and focusing on a whole-person health approach to infection prevention. We examine lessons learned and offer recommendations on pandemic emergency response planning and managing a statewide public health emergency in youth confinement settings that ensure ongoing readiness.
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COVID-19 , Adolescente , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias/prevenção & controle , Colorado/epidemiologia , Saúde Pública , Análise de SistemasRESUMO
In the wake of heightened concerns about gun violence and its impacts on youth, "what works" in gun violence prevention remains a critical public health concern. Gun violence prevention in the U.S. is increasingly interdisciplinary, involving both the criminal legal system and the health care system in developing an evidence base for promising programs and policies. The current study contributes to the literature by examining recidivism outcomes (i.e., rearrest) for a cohort of n = 409 Indianapolis youth involved in gun violence who were court-ordered to complete a health education-based prevention program called Project Life. The youth in our sample were predominantly from marginalized communities, all had been charged with a gun-involved or violence offense, 96% were detained by the juvenile justice system for some time, and 64% received at least one routine well check within five years prior to Project Life. Survival analyses of merged juvenile court records and health records show that routine health care (i.e., well visits) and completing the Project Life program were protective against recidivism, whereas time spent in detention increased risk. The findings provide evidence for the value of interdisciplinary approaches that include the health system in disrupting cycles of gun violence, while reducing the carceral footprint on youth.
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Armas de Fogo , Violência , Humanos , Adolescente , Violência/prevenção & controle , Promoção da Saúde , Análise de Sobrevida , Políticas , Atenção à SaúdeRESUMO
Lingering effects of the COVID-19 pandemic loom large in the United States but are particularly of concern in prison settings. In the current study, we examine the ongoing mental health consequences of the pandemic among young people incarcerated in a male juvenile prison. Sequential mixed methods data were obtained-78 young people assigned male at birth completed surveys and 19 completed individual interviews. Seven staff were also interviewed about youth experiences during and following the pandemic. Youth survey results indicated racial and ethnic identity exploration, feeling less safe at night, and experiencing staff harassment were significantly associated with some negative mental health concerns, yet lingering COVID-19 policies were not. Triangulation with interviews underscored these findings by highlighting more specific concerns related to COVID-19, such as social isolation, loneliness, and concerns about the indirect effects the pandemic might have on court outcomes and educational goals. Overall, results of the current analysis provide evidence that incarceration continues to be traumatizing and harmful to youth mental health even following the pandemic. To a lesser extent, these results also imply that lingering effects of the pandemic and concurrent cultural and racial tensions have delayed impacts on the mental health of incarcerated youth during this tumultuous time. Taken together, study findings suggests juvenile prisons must implement readiness plans to mitigate these and other harmful effects of juvenile incarceration in the future.
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Antisocial and illegal behavior generally declines as youth approach adulthood, but there is significant individual variation in the timing of the peak and decline of offending from adolescence to young adulthood. There are two primary research questions in the present study. First, are there subgroups of youth who follow similar patterns of offending over the nine years after their first arrest? Second, what baseline factors predict which youth will follow each pattern of offending? Data were drawn from the Crossroads study, which includes a sample of racially and ethnically diverse boys who were interviewed regularly for 9 years following their first arrest. Boys were between 13 and 17 years old at the start of the study and were approximately 24-25 years old at the final interview. Trajectories were measured with youths' self-reported offending using latent class growth analysis (LCGA). Results indicated that there were four subgroups of youth: a stable low group (55%), an escalating group (23%), a short-term recidivist group (15%), and a persistently high group (7%). Several baseline factors distinguished the groups. In particular, the results indicated that youth who were informally processed after their first arrest were more likely to be in the low offending group than any of the other LCGA groups. Age at first arrest, peer delinquency, exposure to violence, substance use, callous-unemotional traits, physical aggression, and perceptions of police legitimacy were also significantly related to group membership. Results suggest that certain risk factors identified after youths' first arrest may predict which youth continue to offend and which desist.
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Mental health concerns among juvenile-justice-involved youth (JJIY) continue to be a major health crisis in the United States (US). While scholarship has explored mental health concerns among JJIY, and the link to negative life outcomes, there are gaps in the existing research, particularly in effective interventions and models aimed at addressing both the mental health concerns and criminogenic risk contributing to recidivism and other negative life outcomes of this population. In this paper, we present Justice-Based Interdisciplinary Collective Care (JBICC), an innovative framework to address both the mental health needs and delinquent behavior of youth offenders. The model bridges community partners, with the purpose of informing future interventions, implementations, and research in this area. Increased justice-based interdisciplinary collective collaboration between the juvenile justice system and community programs/organizations would be a major benefit to youth offenders and their families. We also focus on the need for cultural responsiveness to be interwoven throughout all aspects of treatment. JBICC offers an opportunity to expanded services outside traditional settings and methods to ensure that youth offenders and their families receive validating and culturally responsive access to services.
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Delinquência Juvenil , Humanos , Delinquência Juvenil/reabilitação , Delinquência Juvenil/psicologia , Adolescente , Estados Unidos , Direito Penal , Criminosos/psicologia , Masculino , Serviços Comunitários de Saúde MentalRESUMO
Current criminology and corrections research is limited in its ability to fully conceptualize and analyze inequities in the legal systems' response to young people, particularly those with multiple marginalized identities. This article presents a novel methodological framework-the Critical Case File (CCF) approach-to advance methodological innovations in criminal and juvenile legal system research. Specifically, the CCF approach leverages the rich multisystem information available within case file data and analyzes it through a critical lens to examine (a) the structural factors (e.g., economic and housing precarity) undergirding legal system contact and (b) how the legal system responds to these structural factors to perpetuate the well-documented disparities that exist across the legal continuum. In this article, we present the CCF approach, which systematizes best practices for capturing the breadth of information available within case files. We first propose a six-step methodological process to describe how information from legal system-impacted people's case files can be extracted, analyzed, and disseminated with an equity-oriented lens. We then exemplify how the CCF approach differentiates from other methods typically used in social science and criminology research. Practice and policy implications are presented to demonstrate the ways that the CCF approach can leverage case file data to generate novel, meaningful, and data-driven solutions that illuminate structural factors that may drive and exacerbate legal system contact and delineate the potential of research-practice-policy partnerships to reduce structural disparities.
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Girls of color are overrepresented in the juvenile legal system and experience high levels of unmet needs. Assessing and meeting girls' needs may prevent system contact or deeper involvement by providing for these needs in community-based settings, rather than through juvenile legal systems. This study used a structured interview-based assessment adapted from an advocacy intervention to examine girls' self-identified needs and perceived effectiveness and difficulty of accessing resources for these needs. Descriptive analyses found that girls reported needing resources beyond those typically assessed and supported in existing programming, such as technology, extracurriculars, and employment. Latent class analysis revealed four subgroups of girls with distinct but overlapping areas of needs: (1) High Employment, Current School, and Logistical Needs, (2) Low Overall Needs, (3) High Employment Needs, and (4) High Employment, Current School, and Social/Emotional Needs. Girls also reported wide variation in their ability and difficulty accessing needed resources, with employment being most difficult to access and school and social/emotional resources being the easiest to access. These findings suggest that more comprehensive and individualized approaches to programming and community services for system-impacted girls of color are essential.
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Emprego , Análise de Classes Latentes , Humanos , Feminino , Adolescente , Avaliação das Necessidades , Delinquência Juvenil , Instituições Acadêmicas , Hispânico ou Latino/psicologia , Negro ou Afro-Americano/psicologiaRESUMO
Juvenile court-involved youth (JCIY) face unique psychosocial challenges, with a higher prevalence of mental health concerns and substance use disorders. The COVID-19 pandemic intensified these challenges, prompting a need for interventions that address trauma and discrimination experienced by this vulnerable population that could be delivered virtually during the pandemic. This study describes implementation and evaluation of a Raja yoga and mindfulness program among JCIY, with particular attention to barriers and facilitators to participation to inform next steps in this work. The nine-session program aimed to promote mindfulness practices, build coping skills, and address elements of JCIY's emotional health and well-being. Despite challenges in participant retention, participants expressed intent to use skills they learned in the future. Challenges related to implementation included technological barriers, staff turnover, and competing responsibilities; abrupt closure of the county juvenile detention center further strained resources. Successes included providing real-time resources during the early pandemic stages and building relationships between program facilitators and juvenile court staff. Involving youth and court personnel in program design and evaluation, adopting implementation science approaches to refine program delivery, and developing tailored support systems for JCIY are among the key lessons learned. Given the many structural inequities that make JCIY more vulnerable to poor health outcomes, insights may inform broader efforts to improve receipt of relevant services and programs to enhance their well-being, including use of virtual modalities.
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INTRODUCTION: Closed educational centres (CEC) receive young offenders who most often have a conduct disorder (CD). Mental disorders other than conduct disorder are a negative factor in the effect of educational actions. Moreover, adverse life experiences are frequent vulnerability factors in this population. This article aims to document the prevalence and links between psychiatric disorders, exposure to trauma, and the psycho-behavioural characteristics of adolescents placed in CEC. METHOD: We conducted a multicentre epidemiological study on a sample of 101 adolescents placed in nine closed educational centres in France. Psychiatric disorders were measured by the MINI-KID 2 and Conners Rating Scale questionnaires. Several questionnaires were used to collect sociodemographic data and the psychological profile of each adolescent. RESULTS: Among the adolescents, 90.2% had at least one mental disorder with a predominance of conduct disorder (80%). Comorbidity was also frequently found: among the subjects with conduct disorder, 37% had at least one other psychiatric disorder. Interestingly, the intensity of conduct disorder and the Adverse Childhood Experiences (ACE) score were significantly correlated. Furthermore, two subgroups were identified: adolescents with isolated conduct disorder (44.6%) and adolescents with other psychiatric disorders (45.7%) with or without conduct disorder. The latter subgroup showed higher vulnerability and poorer outcomes in terms of attachment patterns, feelings of abandonment, hostility and impulsivity. CONCLUSION: This study is the first French epidemiological study of mental disorders in juvenile offenders. It suggests that the detection of psychiatric disorders in young people in CEC is an important prerequisite for the implementation of targeted interventions according to different profiles. Furthermore, collaboration between the medical-psychological and judicial fields, in the form of an operational partnership, is necessary to guarantee better support for these young people.
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Previous research indicates that youth exhibiting antisocial behavior are at risk for utilizing a disproportionate amount of health services compared to youth without these problems. The present study investigates whether being processed by the juvenile justice system and showing callous-unemotional (CU) traits independently predict health service utilization (medical and mental health service use and out-of-home placement) over and above the severity of antisocial behavior across adolescence. A total of 766 participants who had been arrested for the first time in adolescence provided data at ten appointments over a period of seven years. Results showed that self-reported antisocial behavior at the time of arrest predicted increased use of most health service use types over the next seven years (i.e. medicine prescriptions, tests for sexually transmitted infections, mental health service appointments, and out-of-home placements). All except prescription medication use remained significant when controlling for justice system processing and CU traits. Further, justice system processing added significantly to the prediction of medical service appointments. Whereas CU traits were associated with mental health service appointments and out-of-home placements, these did not remain significant when controlling for severity of antisocial behavior. These findings are consistent with prior research documenting the health care costs of antisocial behavior.
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Delinquência Juvenil , Serviços de Saúde Mental , Humanos , Adolescente , Masculino , Feminino , Delinquência Juvenil/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Transtorno da Personalidade Antissocial , Emoções , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricosRESUMO
Despite awareness about high rates of sexual abuse among girls in the juvenile justice system, little is known about the additional risk conferred upon sexually diverse (SD) youths, as well as the combined vulnerability of sexual abuse and commercial sexual exploitation of children (CSEC) - frequently a survival behavior amplifying disproportionate juvenile justice contact among SD and non-SD juvenile justice-involved (JJI) girls. In a sample of JJI-girls, we compared SD (n = 52) with non-SD (n = 46) JJI-girls on sexual victimization (e.g. sexual abuse occurring within different relationship-types, CSEC), and broader developmental adversity burden disadvantage (cumulative trauma/loss exposure-types) and distress (posttraumatic stress disorder [PTSD]; cumulative stressor-reactivity, grief-specific, and adversity-related symptoms), health distress/impairment, and sexual and physical health-risk indicators. While comparable on childhood sexual abuse frequency, SD JJI-girls reported greater cumulative sexual abuse severity across relationship-types, higher sexual abuse within non-familial contexts, and more CSEC involvement. They also reported more social determinants of health (e.g. trauma/loss exposure-types) and showed elevations on all health-risk indicators, and most cumulative adversity burden indicators, despite comparable PTSD severity. Our findings emphasize the need to consider multiple sexual victimization facets, including the combined vulnerability of sexual abuse and CSEC, and utilize cumulative developmental assessment approaches among youths vulnerable to maltreatment and exploitation.
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This study aimed to identify trajectories of substance use from adolescence to young adulthood among 166 females with dual child welfare and juvenile justice system involvement, and to explore the influence of adolescent child custody status and substance use treatment on substance use trajectories. Results identified four substance use trajectory groups (stable moderate substance use, decreasing substance use, increasing substance use, stable high substance use). Custody loss during adolescence predicted membership in the stable high substance use trajectory group (log odds estimate = 2.99, p = < 0.01). No significant associations were found with adolescent substance use treatment. The findings can inform policymakers, foster care professionals, and law enforcement officers to promote the delivery of timely and appropriate substance use services that respond to the unique needs of females across the child welfare and juvenile justice system populations.
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BACKGROUND: The juvenile justice system in the USA adjudicates over seven hundred thousand youth in the USA annually with significant behavioral offenses. This study aimed to test the effect of juvenile justice involvement on adult criminal outcomes. METHODS: Analyses were based on a prospective, population-based study of 1420 children followed up to eight times during childhood (ages 9-16; 6674 observations) about juvenile justice involvement in the late 1990 and early 2000s. Participants were followed up years later to assess adult criminality, using self-report and official records. A propensity score (i.e. inverse probability) weighting approach was used that approximated an experimental design by balancing potentially confounding characteristics between children with v. without juvenile justice involvement. RESULTS: Between-groups differences on variables that elicit a juvenile justice referral (e.g. violence, property offenses, status offenses, and substance misuse) were attenuated after applying propensity-based inverse probability weights. Participants with a history of juvenile justice involvement were more likely to have later official and violent felony charges, and to self-report police contact and spending time in jail (ORs from 2.5 to 3.3). Residential juvenile justice involvement was associated with the highest risk of both, later official criminal records and self-reported criminality (ORs from 5.1 to 14.5). Sensitivity analyses suggest that our findings are likely robust to potential unobserved confounders. CONCLUSIONS: Juvenile justice involvement was associated with increased risk of adult criminality, with residential services associated with highest risk. Juvenile justice involvement may catalyze rather than deter from adult offending.
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Criminosos , Delinquência Juvenil , Adolescente , Criança , Humanos , Adulto , Estudos Prospectivos , Crime , ViolênciaRESUMO
Youth in the juvenile justice system evince high rates of mental health symptoms, including anxiety and depression. How these symptom profiles change after first contact with the justice system and - importantly - how they are related to re-offending remains unclear. Here, we use latent growth curve modeling to characterize univariate and multivariate growth of anxiety, depression, and re-offending in 1216 male adolescents over 5 years following their first arrest. Overall, the group showed significant linear and quadratic growth in internalizing symptoms and offending behaviors over time such that levels decreased initially after first arrest followed by a small but significant upturn occurring a few years later. Crucially, multivariate growth models revealed strong positive relationships between the rates of growth in internalizing symptoms and offending behaviors such that improvements in mental health related to greater decreases in offending, and vice versa. These results highlight the reciprocal nature of internalizing and externalizing problems in adolescence, underscoring the importance of considering mental health alongside offending in the juvenile justice system.
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Criminosos , Humanos , Masculino , Adolescente , Criminosos/psicologia , Depressão , Ansiedade , Transtornos de Ansiedade , Saúde MentalRESUMO
Single parent adoption (SPA) is a relatively new construct worldwide and in India. The Ministry of Women and Child Development, Government of India, has laid down criteria for adoption in general and SPA in particular, in conjunction with the Juvenile Justice Act (Care and Protection of Children), 2015. There is scant literature on this topic of SPA, more so in India, that looks into the various psychological nuances of SPA from a mental health professional's (MHP) perspective. This review paper aims to assess SPA from the perspective of a MHP that will focus on its various legal nuances as well as the psychological connotations attached to it. For this, a search strategy was employed that included a thorough literature search from two databases (PubMed and Google Scholar) with relevant keywords related to the topic. The various legal issues pertaining to SPA in the current scenario, the psychological issues and challenges faced by single parents, the behavioral outcomes of adoptees who are adopted by single parents, and ways to deal with the various obstacles of SPA are discussed.
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Saúde Mental , Pais Solteiros , Criança , Humanos , Feminino , Adoção/psicologia , ÍndiaRESUMO
Youth involved in the legal system (YILS) experience rates of opioid and substance use disorders (OUD/SUDs) and overdose that is well above those in the general population. Despite the dire need, and the existing programs that focus on treatment of these problems in YILS, research on opioid initiation, and OUD prevention, including feasibility and sustainability, are severely limited. We present four studies testing interventions that, while not necessarily novel as SUD treatments, test novel structural and interpersonal strategies to prevent opioid initiation/OUD precursors: (1) ADAPT (Clinical Trial No. NCT04499079) provides real-time feedback using community-based treatment information system data to create a more effective mental health and SUD treatment cascade to prevent opioid use; (2) HOME (Clinical Trial No. NCT04135703) provides youth experiencing homelessness, including YILS, with direct access to shelter in independent living without prerequisites as an opioid initiation prevention strategy; (3) LeSA (Clinical Trial No. NCT04678960) uses the Trust-Based Relational Intervention® to equip YILS and their caregivers with self-regulatory and communication skills during the transition from secure confinement to reduce opioid initiation/re-initiation; and (4) POST (Clinical Trial No. NCT04901312) tests two interventions integrating interpersonal/drinking and drug refusal skills, case management, and goal setting among YILS in transitioning out of secure detention as opioid initiation prevention strategies. We discuss early implementation barriers and facilitators, including complexities of prevention research with YILS and adaptations due to COVID-19. We conclude by describing anticipated end products, including implementation of effective prevention interventions and integration of data from multiple projects to address larger, multi-site research questions.
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Overdose de Drogas , Transtornos Relacionados ao Uso de Opioides , Humanos , Adolescente , Analgésicos Opioides , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Overdose de Drogas/prevenção & controle , Problemas SociaisRESUMO
The USA incarcerates more young people than any other industrialized nation in the world, and black youth are much more likely to be incarcerated than white youth. Young people who interface with the criminal justice system are at higher risk for poor health upon release and the justice system is believed to be a contributor to racial health disparities. Sport participation during incarceration has the potential to improve health and health equity, but the evidence on the health benefits of youth sport participation has almost exclusively focused on school and community settings in the USA with little attention to non-traditional settings, such as the justice system. Given the poor health consequences of incarceration, the potential of sport to improve health, and the lack of research on this phenomenon in the USA, our objective was to describe the landscape of sport programming in juvenile correctional facilities and provide a baseline understanding upon which future research can build. Through a cross-sectional survey of all long-term secure juvenile correctional facilities in the USA (n = 211), we found 55.1% operate a sport program. Among facilities with programs, there was a range of sport program offerings. Gender disparities in access to various types of programs exist, with girls generally having less opportunity than boys. Most facilities reported a purpose of positive youth development in the operation of their programs. These findings have important implications for health promotion and the further integration of sport and juvenile justice as part of a public health agenda.
In the USA, we have more young people in prison than anywhere in the world. Time in prison is linked with a wide range of negative consequences, including worse health. Research on young people in general shows that participating in sports has the potential to protect them from a range of risky behaviors and can improve their health. It follows that sports in prison may help to protect those particularly at-risk youth from the negative health consequences of incarceration. Because so little is known about the availability of sport programs in youth prisons in the USA, we conducted a survey of the most restrictive facilities across the country and found that just over half offer sport programs to the young people in their care. Further, we found that girls in prison had less opportunity to play sports than boys. It was encouraging to learn that most of the facilities that offer sports do so with the purpose of promoting positive development which is often found in traditional sport programs and may improve the wellbeing of young people. More research is needed to see if these programs actually result in positive health impacts for young people who are incarcerated.
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Equidade em Saúde , Esportes , Adolescente , Feminino , Humanos , Masculino , Estudos Transversais , Países Desenvolvidos , Negro ou Afro-Americano , Estados Unidos , Delinquência Juvenil/prevenção & controleRESUMO
Background: Adverse childhood experiences (ACEs) are linked to substance use (SU) and substance use disorders (SUD). However, this relationship has yet to be tested among justice-involved children (JIC), and it is unclear if racial/ethnic differences exist. This study aimed to determine: (1) whether ACEs are associated with increased risk of SU and SUD among JIC; and (2) if the effects of ACEs on SU and SUD are moderated by race/ethnicity. Methods: Bivariate and multivariate logistic regression analyses were employed to examine a statewide dataset of 79,960 JIC from the Florida Department of Juvenile Justice. Marginal odds were estimated to examine how race moderates the relationship between ACEs and SU and SUD. Results: Results showed higher ACEs scores were linked to SU and SUD. Black JIC were 2.46 times more likely, and Latinx JIC were 1.40 times more likely to report SU than white JIC. Specifically, Black and Latinx JIC with a higher average ACEs score were more likely to report SU but less likely to have ever been diagnosed with a SUD when compared to white JIC with equivalent ACEs. Conclusions: Study results highlight the need to develop trauma-informed and culturally appropriate interventions for SU and SUD among JIC.
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Experiências Adversas da Infância , Delinquência Juvenil , Transtornos Relacionados ao Uso de Substâncias , Humanos , Criança , Etnicidade , Florida/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologiaRESUMO
Justice-involved adolescents (JIAs) have an increased risk for opioid use disorder and overdose related to opioid misuse (OM). Consequences of untreated OM include recidivism and poor educational outcomes, which can be harsher for female JIA. Therefore, identifying relevant factors and settings that reduce the risk for OM is critical. Schools are a central institution in adolescent development. Drawing on social control theory, JIA with higher levels of school bonding was hypothesized to attenuate risk for OM. Cross-sectional data on 79,960 JIA from the Florida Department of Juvenile Justice were examined. Multivariate and stratified logistic regression analyses were employed. On average, for every one-unit increase in school bonding, JIA had 22%, female JIA had 23%, and male JIA had 22% lower odds of OM. Results suggest school bonding and the school context should be considered in treatment and how this setting may impact OM intervention outcomes among JIA.