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BACKGROUND: Emerging adults (aged 18-26 years) are the most at-risk yet underserved age group among people with substance use disorder, especially rural emerging adults, and polysubstance use is common. Recovery capital is lower among emerging adults than older adults, and evidence-based treatments are typically unavailable or not developmentally tailored, especially in rural areas. Both supportive parents (or parental figures) and peer recovery support services (PRSS) can be leveraged to better support these emerging adults. Previous research indicates parents can be engaged to deliver contingency management (CM), an extensively researched evidence-based intervention for substance use. OBJECTIVE: This protocol describes a funded pilot of Launch, a novel, scalable service package that pairs web-based coaching for parents to deliver CM for emerging adults (CM-EA) at home and in-person PRSS with educational and vocational goal setting. Specifically, this protocol describes feasibility, acceptability, and appropriateness testing (implementation-related outcomes) and steps taken to prepare for a future large-scale trial of Launch. METHODS: Upon the recruitment of 48 emerging adult and parent pairs from sites serving primarily rural clients, participants will be randomized into 1 of 3 conditions for this randomized controlled trial: virtual parent coaching to deliver CM-EA, in-person PRSS for emerging adults, or both sets of services. Emerging adult eligibility includes polysubstance use, a substance use disorder, and availability of a consenting parent. Emerging adults will be interviewed at baseline and 6 months about substance use, quality of life, recovery capital, parental relationship, and Launch implementation-related outcomes (6-month follow-up only). Parents, peer workers delivering PRSS, and parent CM-EA coaches will be interviewed about implementation-related outcomes at the end of the study period. Peer workers and CM-EA coaches will be asked to complete checklists of services delivered after each session. Finally, payers and providers will be interviewed for additional insights into Launch implementation and to identify key outcomes of Launch. Data analysis for emerging adult outcomes will be primarily descriptive, but parent CM-EA training adherence will be assessed using nested mixed-effects regression models of repeated measures. RESULTS: Launch is currently ongoing, with funding received in August 2023, and is expected to end in September 2025, with data analysis and results in December 2026. Participants are expected to begin enrolling in June 2024. CONCLUSIONS: While this pilot is limited by the small sample size and restriction to emerging adults with an involved parent, this is mitigated by the study's strengths and is appropriate for the pilot stage. Launch uses an innovative combination of existing strategies to generate better outcomes for emerging adults while remaining scalable. This pilot will provide insights into the feasibility and acceptability of Launch from the perspectives of service recipients, providers, and payers to inform a larger-scale effectiveness trial. TRIAL REGISTRATION: ClinicalTrials.gov NCT06414993; https://clinicaltrials.gov/study/NCT06414993. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/60671.
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Estudios de Factibilidad , Padres , Grupo Paritario , Trastornos Relacionados con Sustancias , Adolescente , Adulto , Femenino , Humanos , Masculino , Adulto Joven , Padres/psicología , Padres/educación , Proyectos Piloto , Trastornos Relacionados con Sustancias/rehabilitación , Trastornos Relacionados con Sustancias/terapiaRESUMEN
INTRODUCTION: Emerging adults (EAs) in the criminal legal system are at high risk for substance use and related negative outcomes. EAs also have low levels of engagement in treatment services, a pattern exacerbated for those living in rural communities. This pilot study investigated implementation outcomes of task-shifting an evidence-based substance use intervention, via a developmentally targeted program, provided by probation officers (POs) to selected EA clients. METHODS: Ten POs recruited from two counties in Oregon who provide services to rural clients were trained and supported in delivering contingency management for EAs (CM-EA) to 17 EAs on their current caseloads. The pilot took place entirely during the COVID-19 pandemic. POs submitted session audiotapes and checklists from meetings with participating EA clients and participated in focus groups. EA clients completed baseline interviews and agreed to have their adult criminal records collected. Ten semi-structured interviews were completed with probation/parole administration and staff from four rural counties across three states highly impacted by the opioid epidemic about the barriers and facilitators for delivering a program like CM-EA in their offices. RESULTS: Based on self-reports and observational coding, POs demonstrated fidelity and adoption as they delivered all CM-EA components and engaged in CM-EA quality assurance protocols. Penetration was demonstrated by the selection of EAs reflecting the demographics of their local offices (i.e., White, non-Hispanic, balanced across sex), struggling with polysubstance use, and primarily holding felony convictions. Emerging themes from focus groups and interviews revealed feasibility, acceptability, and appropriateness of CM-EA, including use with clients not currently in the research program and reported intentions to continue CM-EA use. Barriers for future use include those found for the delivery of other programs in rural areas such as resource limitations. CONCLUSIONS: There is initial support for the implementation outcomes related to task-shifting a program like CM-EA to POs, particularly those serving rural clients, to increase access to evidence-based substance use services for EAs. Future research with larger samples and multiple follow-ups will allow for effectiveness testing and further program refinement for this high-priority population.
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In autumn 1950 David and Elizabeth Lack chanced upon a huge migration of insects and birds flying through the Pyrenean Pass of Bujaruelo, from France into Spain, later describing the spectacle as combining both grandeur and novelty. The intervening years have seen many changes to land use and climate, posing the question as to the current status of this migratory phenomenon. In addition, a lack of quantitative data has prevented insights into the ecological impact of this mass insect migration and the factors that may influence it. To address this, we revisited the site in autumn over a 4 year period and systematically monitored abundance and species composition of diurnal insect migrants. We estimate an annual mean of 17.1 million day-flying insect migrants from five orders (Diptera, Hymenoptera, Hemiptera, Lepidoptera and Odonata) moving south, with observations of southward 'mass migration' events associated with warmer temperatures, the presence of a headwind, sunlight, low windspeed and low rainfall. Diptera dominated the migratory assemblage, and annual numbers varied by more than fourfold. Numbers at this single site hint at the likely billions of insects crossing the entire Pyrenean mountain range each year, and we highlight the importance of this route for seasonal insect migrants.
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Migración Animal , Insectos , Animales , España , Insectos/fisiología , Francia , Vuelo Animal , Estaciones del AñoRESUMEN
Invasive insects threaten ecosystem stability, public health, and food security. Documenting newly invasive species and understanding how they reach into new territories, establish populations, and interact with other species remain vitally important. Here, we report on the invasion of the South American leafhopper, Curtara insularis into Africa, where it has established populations in Ghana, encroaching inland at least 350 km off the coast. Importantly, 80% of the specimens collected were intercepted between 160 and 190 m above ground. Further, the fraction of this species among all insects collected was also higher at altitude, demonstrating its propensity to engage in high-altitude windborne dispersal. Its aerial densities at altitude translate into millions of migrants/km over a year, representing massive propagule pressure. Given the predominant south-westerly winds, these sightings suggest an introduction of C. insularis into at least one of the Gulf of Guinea ports. To assess the contribution of windborne dispersal to its spread in a new territory, we examine records of C. insularis range-expansion in the USA. Reported first in 2004 from central Florida, it reached north Florida (Panhandle) by 2008-2011 and subsequently spread across the southeastern and south-central US. Its expansion fits a "diffusion-like" process with 200-300 km long "annual displacement steps"-a pattern consistent with autonomous dispersal rather than vehicular transport. Most "steps" are consistent with common wind trajectories from the nearest documented population, assuming 2-8 hours of wind-assisted flight at altitude. Curtara insularis has been intercepted at US ports and on trucks. Thus, it uses multiple dispersal modalities, yet its rapid overland spread is better explained by its massive propagule pressure linked with its high-altitude windborne dispersal. We propose that high-altitude windborne dispersal is common yet under-appreciated in invasive insect species.
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Radar networks hold great promise for monitoring population trends of migrating insects. However, it is important to elucidate the nature of responses to environmental cues. We use data from a mini-network of vertical-looking entomological radars in the southern UK to investigate changes in nightly abundance, flight altitude and behaviour of insect migrants, in relation to meteorological and celestial conditions. Abundance of migrants showed positive relationships with air temperature, indicating that this is the single most important variable influencing the decision to initiate migration. In addition, there was a small but significant effect of moonlight illumination, with more insects migrating on full moon nights. While the effect of nocturnal illumination levels on abundance was relatively minor, there was a stronger effect on the insects' ability to orientate close to downwind: flight headings were more tightly clustered on nights when the moon was bright and when cloud cover was sparse. This indicates that nocturnal illumination is important for the navigational mechanisms used by nocturnal insect migrants. Further, our results clearly show that environmental conditions such as air temperature and light levels must be considered if long-term radar datasets are to be used to assess changing population trends of migrants. This article is part of the theme issue 'Towards a toolkit for global insect biodiversity monitoring'.
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Migración Animal , Vuelo Animal , Insectos , Animales , Insectos/fisiología , Iluminación , Radar , Luna , TemperaturaRESUMEN
Many insects depend on high-altitude, migratory movements during part of their life cycle. The daily timing of these migratory movements is not random, e.g. many insect species show peak migratory flight activity at dawn, noon or dusk. These insects provide essential ecosystem services such as pollination but also contribute to crop damage. Quantifying the diel timing of their migratory flight and its geographical and seasonal variation, are hence key towards effective conservation and pest management. Vertical-looking radars provide continuous and automated measurements of insect migration, but large-scale application has not been possible because of limited availability of suitable devices. Here, we quantify patterns in diel flight periodicity of migratory insects between 50 and 500 m above ground level during March-October 2021 using a network of 17 vertical-looking radars across Europe. Independent of the overall daily migratory movements and location, peak migratory movements occur around noon, during crepuscular evening and occasionally the morning. Relative daily proportions of insect migration intensity and traffic during the diel phases of crepuscular-morning, day, crepuscular-evening and night remain largely equal throughout May-September and across Europe. These findings highlight, extend, and generalize previous regional-scale findings on diel migratory insect movement patterns to the whole of temperate Europe. This article is part of the theme issue 'Towards a toolkit for global insect biodiversity monitoring'.
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Altitud , Migración Animal , Vuelo Animal , Insectos , Animales , Vuelo Animal/fisiología , Europa (Continente) , Insectos/fisiología , Estaciones del AñoRESUMEN
Long-distance migrations of insects contribute to ecosystem functioning but also have important economic impacts when the migrants are pests or provide ecosystem services. We combined radar monitoring, aerial sampling, and searchlight trapping, to quantify the annual pattern of nocturnal insect migration above the densely populated agricultural lands of East China. A total of ~9.3 trillion nocturnal insect migrants (15,000 t of biomass), predominantly Lepidoptera, Hemiptera, and Diptera, including many crop pests and disease vectors, fly at heights up to 1 km above this 600 km-wide region every year. Larger migrants (>10 mg) exhibited seasonal reversal of movement directions, comprising northward expansion during spring and summer, followed by southward movements during fall. This north-south transfer was not balanced, however, with southward movement in fall 0.66× that of northward movement in spring and summer. Spring and summer migrations were strongest when the wind had a northward component, while in fall, stronger movements occurred on winds that allowed movement with a southward component; heading directions of larger insects were generally close to the track direction. These findings indicate adaptations leading to movement in seasonally favorable directions. We compare our results from China with similar studies in Europe and North America and conclude that ecological patterns and behavioral adaptations are similar across the Northern Hemisphere. The predominance of pests among these nocturnal migrants has severe implications for food security and grower prosperity throughout this heavily populated region, and knowledge of their migrations is potentially valuable for forecasting pest impacts and planning timely management actions.
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Altitud , Migración Animal , Estaciones del Año , Animales , China , Migración Animal/fisiología , Agricultura/métodos , Ecosistema , Insectos/fisiología , Viento , Vuelo Animal/fisiologíaRESUMEN
The iconic European stag beetle (Lucanus cervus) (Coleoptera: Lucanidae) is one of the largest terrestrial beetles in Europe. Due to decreasing population numbers, thought to be a consequence of habitat loss, this beetle has become a near-threatened species across much of Europe, and a reliable monitoring system is required to measure its future population trends. As part of a programme aimed at conserving UK populations, we have investigated the chemical ecology of the beetle, with a view to developing an efficient semiochemical-based monitoring system. Such a scheme will be beneficial not only in the UK but across the European range of the species, where the beetle is of conservation concern. Here, we report on a surprising discovery of a male-produced pheromone, which provokes initial sexual receptivity in females, and which has not been previously identified in the animal kingdom. Furthermore, we assign sex pheromone function to a previously described female-specific compound.
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Escarabajos , Atractivos Sexuales , Animales , Masculino , Femenino , Feromonas , Ecosistema , Especies en Peligro de ExtinciónRESUMEN
BACKGROUND: Risky sexual behaviour (RSB) is a serious public health problem for adolescents. We examined whether a contingency management intervention implemented by juvenile probation officers (JPOs) targeting substance use also impacted RSB. METHODS: A total of 218 adolescents on probation were randomly assigned to contingency management or to probation as usual. RESULTS: The substance use intervention delivered by JPOs reduced rates of RSB over time (ß =-0.32, P =0.041 at 6months; ß =-0.32, P =0.036 at 9months). CONCLUSIONS: Adolescents receiving a substance use intervention from JPOs demonstrated reduced/prevented RSB. Interventions targeting single risk behaviours in juvenile probation populations should measure changes in other risk behaviours . Under-resourced communities lacking clinicians might consider JPOs delivering interventions.
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Trastornos Relacionados con Sustancias , Humanos , Adolescente , Trastornos Relacionados con Sustancias/prevención & control , Conducta Sexual , Asunción de RiesgosRESUMEN
The opioid and methamphetamine crises in Oregon have a consequential impact on young families, as an increasing number of parents experience substance use disorder (SUD). As parental substance use escalates, the child welfare system (CWS) becomes overwrought with families who have complex needs. The burden placed on families and on the CWS indicates a need for prevention and treatment interventions for parental SUDs. In response to the worst statewide opioid and methamphetamine epidemics in the USA, a Hybrid Type 2 trial of PRE-FAIR-a prevention intervention for parents-is being implemented in five Oregon counties. Establishing strong partnerships within the communities helped identify the need to implement the evidence-based FAIR treatment model alongside PRE-FAIR. A strong focus on implementation includes meeting the needs of communities and establishing the infrastructure necessary for sustainment of the FAIR programs at the provider agencies. Despite implementation efforts to direct toward PRE-FAIR referrals, parents in need of treatment are being referred at a disproportionate rate, as are older parents who fall outside of study-eligibility. Both challenges have delayed the ability to enroll a sufficient number of participants for the prevention trial. This commentary describes the impact of the opioid and methamphetamine epidemics in Oregon as the crises relate to implementing prevention versus treatment interventions-highlighting the importance of addressing community needs and establishing strong partnerships, which has allowed creative strategies to increase PRE-FAIR recruitment.
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Padres , Trastornos Relacionados con Sustancias , Humanos , Analgésicos Opioides , Protección a la Infancia , Metanfetamina , Trastornos Relacionados con Sustancias/prevención & controlRESUMEN
BACKGROUND: Migration is a strategy that shifts insects to more favorable habitats in response to deteriorating local environmental conditions. The ecological factors that govern insect migration are poorly understood for many species. Plutella xylostella causes great losses in Brassica vegetable and oilseed crops, and undergoes mass migration. However, the physiological and behavioral basis for distinguishing migratory individuals and the factors driving its migration remain unclear. RESULTS: Daily light trap catches conducted from April to July in a field population of P. xylostella in central China revealed a sharp decline in abundance from late-May. Analysis of ovarian development levels showed that the proportion of sexually immature females gradually increased, while the mating rate decreased, indicating that generations occurring in May mainly resulted from local breeding and that emigration began in late-May. Physiological and behavioral analyses revealed that emigrant populations had a higher take-off proportion, stronger flight capacity and greater energy reserves of triglyceride compared to residents. Furthermore, a gradual increase in temperature from 24 °C to >30 °C during larval development resulted in a significant delay in oogenesis and increased take-off propensity of adults compared with the control treatment reared at a constant temperature of 24 °C. CONCLUSION: Our results provide the physiological and behavioral factors that underpin mass migration in P. xylostella, and demonstrate that exposure to increased temperature increases their migration propensity at the cost of reproductive output. This study sheds light on understanding the factors that influence population dynamics, migratory propensity and reproductive tradeoffs in migratory insects. © 2023 Society of Chemical Industry.
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Brassica , Mariposas Nocturnas , Humanos , Animales , Femenino , Fitomejoramiento , Temperatura , Respuesta al Choque Térmico , LarvaRESUMEN
Background: Adherence to intervention training implementation strategies is at the foundation of fidelity; however, few studies have linked training adherence to trainee attitudes and leadership behaviors to identify what practically matters for the adoption and dissemination of evidence-based practices. Through the conduct of this hybrid type 3 effectiveness-implementation cluster randomized controlled trial, we collected Exploration, Preparation, Implementation, and Sustainment (EPIS) data and merged it with tailored motivational interviewing training adherence data, to elucidate the relationship between provider attitudes toward evidence-based practices, leadership behaviors, and training implementation strategy (e.g., workshop attendance and participation in one-on-one coaching) adherence. Method: Our sample included data from providers who completed baseline (pre-intervention) surveys that captured inner and outer contexts affecting implementation and participated in tailored motivational interviewing training, producing a dataset that included training implementation strategies adherence and barriers and facilitators to implementation (N = 77). Leadership was assessed by two scales: the director leadership scale and implementation leadership scale. Attitudes were measured with the evidence-based practice attitude scale (EBPAS-50). Adherence to training implementation strategies was modeled as a continuous outcome with a Gaussian distribution. Analyses were conducted in SPSS. Results: Of the nine general attitudes toward evidence-based practice, openness was associated with training adherence (estimate [EST] = 0.096, p < .001; 95% CI = [0.040, 0.151]). Provider general (EST = 0.054, 95% CI = [0.007, 0.102]) and motivational interviewing-specific (EST = 0.044, 95% CI = [0.002, 0.086]) leadership behaviors were positively associated with training adherence (p < .05). Of the four motivational interviewing-specific leadership domains, knowledge and perseverant were associated with training adherence (p < .05). As these leadership behaviors increased, knowledge (EST = 0.042, 95% CI = [0.001, 0.083]) and perseverant (EST = 0.039, 95% CI = [0.004, 0.075]), so did provider adherence to training implementation strategies. Conclusions: As implementation science places more emphasis on assessing readiness prior to delivering evidence-based practices by evaluating organizational climate, funding streams, and change culture, consideration should also be given to metrics of leadership. A potential mechanism to overcome resistance is via the implementation of training strategies focused on addressing leadership prior to conducting training for the evidence-based practice of interest.
Researchers and practitioners, who aim to improve the uptake of evidence-based practices, continue to seek ways in which to improve provider participation in training implementation strategies. The persistent challenge in addressing provider disengagement, while linking this disinterest to poor patient outcomes, has been ascertaining how to quantify relevant delivery considerations, for example, provider attitudes and leadership behaviors that may influence commitment to learning or apathy to behavior change, concurrently with training adherence. Through the conduct of this study, we collected both types of data: (1) provider attitudes and leadership behaviors and (2) training adherence outcomes. We found that provider openness, general leadership behaviors, and motivational interviewing-specific leadership behaviors were associated with adherence to training implementation strategies. As more emphasis is placed on assessing clinic readiness prior to adopting new evidence-based practices, a discussion on including metrics of provider attitudes to evidence-based practice, innovation, and the specific intervention is warranted, alongside consideration for how implementation training strategies focused on addressing leadership can bolster change-supportive behaviors prior to delivery of innovations.
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High altitude mountain passes in the Pyrenees are known to be important migratory hotspots for autumn migrating insects originating from large swathes of northern Europe. In the Pyrenees, prior research has focused on diurnal migratory insects. In this study, we investigate the nocturnal component of the migratory assemblage and ask if this transient food source is also used by bat species. Three seasons of insect trapping revealed 66 species of four different orders, 90% of which were Noctuid moths, including the destructive pest Helicoverpa armigera, otherwise known as the cotton bollworm. Acoustic bat detectors revealed that high activity of Nyctalus spp. and Tadarida teniotis bats were closely synchronized with the arrival of the migratory moths, suggesting this food source is important for both resident and migratory bats to build or maintain energy reserves. Bats of the Nyctalus spp. are likely migrating through the study site using fly-and-forage strategies or stopping over in the area, while resident T. teniotis may be exploiting the abundant food source to build fat stores for hibernation. This study shows that nocturnal migratory insects are abundant in the Pyrenees during autumn and interact during migration, not only with their co-migrant bats but also with resident bat species.
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BACKGROUND: A recent implementation science stepped-wedge trial of motivational interviewing (MI) in adolescent HIV clinics indicated variable degrees of implementation success. The present mixed-methods study analyzed trajectories of postimplementation MI competence scores and compared postimplementation qualitative interviews among the clinics with the highest levels of provider competency and the lowest levels of competency to further understand mechanisms of successful implementation. SETTING: Ten HIV clinics in the Adolescent Trials Network for HIV/AIDS Interventions. METHODS: This study used a sequential explanatory mixed-methods design. Continuous MI competency data from the parent study were structured with repeated measurements nested within providers nested within 10 sites. A mixed-effects regression model rank ordered the clinics by competence scores. Key stakeholders (N = 77) at the 10 randomized clinics completed a 1-hour qualitative interview at 12-month follow-up (immediately postimplementation). Using the phases of reflexive thematic analysis, interviews from the 3 highest competence clinics and the 3 lowest competence clinics were pragmatically analyzed. RESULTS: Thematic analysis suggested 3 central themes that influenced successful evidence-based practice (EBP) implementation. Organizational culture included the leadership, collective effort, and resources that influenced how the organization at large responded to the implementation intervention. Staff attitudes encapsulated individual providers' mindsets and attitudes about MI and the implementation intervention. EBP integration reflected the perception and use of MI by individuals and the organization as a whole. These themes and their subthemes are interconnected and exerted an influence on each other through the implementation process. CONCLUSIONS: Findings suggest additional implementation strategies to improve implementation of EBPs. Such mixed-methods research is critical to understanding the mechanisms of successful implementation of EBP and improving future implementation strategies.
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Infecciones por VIH , Entrevista Motivacional , Humanos , Estados Unidos , Adolescente , Infecciones por VIH/prevención & control , Ciencia de la Implementación , Actitud del Personal de SaludRESUMEN
BACKGROUND: Most implementations fail before the corresponding services are ever delivered. Measuring implementation process fidelity may reveal when and why these attempts fail. This knowledge is necessary to support the achievement of positive implementation milestones, such as delivering services to clients (program start-up) and competency in treatment delivery. The present study evaluates the extent to which implementation process fidelity at different implementation stages predicts achievement of those milestones. METHODS: Implementation process fidelity data-as measured by the Stages of Implementation Completion (SIC)-from 1287 implementing sites across 27 evidence-informed programs were examined in mixed effects regression models with sites nested within programs. Implementation process fidelity, as measured by the proportion of implementation activities completed during the three stages of the SIC Pre-Implementation phase and overall Pre-Implementation (Phase 1) and Implementation (Phase 2) proportion scores, was assessed as a predictor of sites achieving program start-up (i.e., delivering services) and competency in program delivery. RESULTS: The predicted probability of start-up across all sites was low at 35% (95% CI [33%, 38%]). When considering the evidence-informed program being implemented, that probability was nearly twice as high (64%; 95% CI [42%, 82%]), and 57% of the total variance in program start-up was attributable to the program. Implementation process fidelity was positively and significantly associated with achievement of program start-up and competency. The magnitude of this relationship varied significantly across programs for Pre-Implementation Stage 1 (i.e., Engagement) only. Compared to other stages, completing more Pre-Implementation Stage 3 (Readiness Planning) activities resulted in the most rapid gains in probability of achieving program start-up. The predicted probability of achieving competency was very low unless sites had high scores in both Pre-Implementation and Implementation phases. CONCLUSIONS: Strong implementation process fidelity-as measured by SIC Pre-Implementation and Implementation phase proportion scores-was associated with sites' achievement of program start-up and competency in program delivery, with early implementation process fidelity being especially potent. These findings highlight the importance of a rigorous Pre-Implementation process.
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Práctica Clínica Basada en la Evidencia , ConocimientoRESUMEN
BACKGROUND: Knowing how future-oriented repetitive thought - i.e., repeated consideration of whether positive or negative outcomes will happen in one's future - leads to hopelessness-related cognitions may elucidate the role of anticipating the future in depressive symptoms and suicide ideation. This study examined future-event fluency and depressive predictive certainty - i.e., the tendency to make pessimistic future-event predictions with certainty - as mechanisms explaining the relation between future-oriented repetitive thought, depressive symptoms, and suicide ideation. METHODS: Young adults (N = 354), oversampled for suicide ideation or attempt history, completed baseline measures of pessimistic future-oriented repetitive thought (i.e., the degree to which people consider whether negative outcomes will happen or positive outcomes will not happen in their futures), future-event fluency, depressive predictive certainty, depressive symptoms, and suicide ideation severity and were followed up 6 months later (N = 324). RESULTS: Pessimistic future-oriented repetitive thought predicted depressive predictive certainty at 6-months, partially mediated by lower positive but not increased negative future-event fluency. There was an indirect relationship between pessimistic future-oriented repetitive thought and 6-month suicide ideation severity via 6-month depressive predictive certainty through 6-month depressive symptoms, and also via 6-month depressive symptoms (but not depressive predictive certainty) alone. LIMITATIONS: Lack of an experimental design limits inferences about causality, and a predominantly female sample may limit generalizability by sex. CONCLUSION: Clinical interventions should address pessimistic future-oriented repetitive thought - and its impact on how easily people can think about positive future outcomes - as one potential way to reduce depressive symptoms and, indirectly, suicide ideation.
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Depresión , Intento de Suicidio , Adulto Joven , Humanos , Femenino , Masculino , Ideación Suicida , Predicción , CogniciónRESUMEN
Probation is a common sanction for youth substance users, and as such, juvenile probation officers (JPOs) shoulder much of the burden for treatment and rehabilitation. To improve youth outcomes and alleviate some of the burden, JPOs may seek parental involvement in the probation and substance use desistance processes. Using focus group data, we analyzed JPO perceptions of the role parents play in contingency management (CM)-an incentive system designed to produce and reward decreased substance use-and whether they perceived any value in CM. We found that most JPOs perceived parental involvement as critical to the success of both substance use treatment and CM for youth. Our findings also suggest JPOs found parental involvement in CM valuable given that CM was employed on nonstudy clients and future clients. This has implications for the practicality and sustainability of CM as a youth probation intervention.
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Evidence-based programs (EBPs) delivered in elementary schools show great promise in reducing risk for emotional and behavioral disorders (EBDs). However, efforts to sustain EBPs in school face barriers. Improving EBP sustainment thus represents a priority, but little research exists to inform the development of sustainment strategies. To address this gap, the Sustaining Evidenced-Based Innovations through Multi-level Implementation Constructs (SEISMIC) project will: (a) Determine if malleable individual, intervention, and organizational factors predict EBP treatment fidelity and modifications during implementation, sustainment, or both; (b) Assess the impact of EBP fidelity and modifications on child outcomes during implementation and sustainment; and (c) Explore the mechanisms through which individual, intervention, and organizational factors influence sustainment outcomes. This protocol paper describes SEISMIC, which builds upon a federally-funded RCT evaluating BEST in CLASS, a teacher-delivered program for K-3rd grade children at risk for EBDs. The sample will include 96 teachers, 384 children, and 12 elementary schools. A multi-level, interrupted time series design will be used to examine the relationship between baseline factors, treatment fidelity, modifications, and child outcomes, followed by a mixed-method approach to elucidate the mechanisms that influence sustainment outcomes. Findings will be used to create a strategy to improve EBP sustainment in schools.
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OBJECTIVE: Efficient and effective fidelity measurement is necessary to improve rigor and reduce burden of motivational interviewing (MI) implementation studies for both fidelity outcomes and quality improvement strategies. This article reports on such a measure developed with rigorous methodology and tested in community-based substance abuse treatment settings. METHODS: This scale development study analyzed data from a National Institute on Drug Abuse study testing the Leadership and Organizational Change for Implementation (LOCI) strategy. Utilizing item response theory (IRT) methods and Rasch modeling, we analyzed coded recordings (N = 1089) of intervention sessions of 238 providers from 60 substance use treatment clinics across nine agencies in an implementation trial focusing on MI. RESULTS: These methods yielded a reliable and valid 12-item scale representing single construct dimensionality, strong item-session maps, good rating scale functionality, and item fit. Separation reliability and absolute agreement for adjacent categories was high. No items were significantly misfitting, though one was borderline. The LOCI community providers were less likely to be scored in the advanced competence range and items were more difficult compared to the original development sample. CONCLUSIONS: The 12-item Motivational Interviewing Coach Rating Scale (MI-CRS) showed excellent performance in a large sample of community-based substance use treatment providers using real recordings. The MI-CRS is the first efficient and effective fidelity measure appropriate for diverse ethnic groups, with interventions that are MI only or interventions that integrate MI with other treatments, and with adolescents and adults. Follow-up coaching by trained supervisors may be needed for community-based providers to achieve the highest level of MI competence.
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Entrevista Motivacional , Trastornos Relacionados con Sustancias , Adulto , Humanos , Adolescente , Entrevista Motivacional/métodos , Reproducibilidad de los Resultados , Trastornos Relacionados con Sustancias/diagnóstico , LiderazgoRESUMEN
There is a significant gap in research examining the prevalence of problem behaviors among youth involved in the juvenile justice system in rural areas. The current study sought to address this gap by exploring the behavioral patterns of 210 youth who were on juvenile probation in predominantly rural counties and who were identified as having a substance use disorder. First, we examined the correlation among 7 problem behaviors representing different forms of substance use, delinquency, and sexual risk-taking and 8 risk factors related to recent service utilization, internalizing and externalizing difficulties, and social support networks. Then, we used latent class analysis (LCA) to identify distinct behavioral profiles based on the observed problem behaviors. LCA identified a 3-class model representing distinct groups labeled Experimenting (70%), Polysubstance Use + Delinquent Behaviors (24%), and Diverse Delinquent Behaviors (6%). Finally, we assessed differences (i.e., ANOVA, χ2) in each risk factor across the behavioral profiles. Important similarities and differences in the association among the problem behaviors, behavioral profiles, and the risk factors were revealed. These findings underscore the need for an interconnected behavioral health model within rural juvenile justice systems that is able to address youths' multidimensional needs including criminogenic, behavioral, and physical health needs.