Assessing need for medication-assisted treatment for opiate-dependent prison inmates.

Individuals with a history of heroin dependence are overrepresented in American correctional facilities and 75% of inmates with a drug use disorder do not receive treatment during incarceration or after release. Medication-assisted treatment (MAT) with opiate agonists, such as methadone or buprenorphine, constitutes standard of care; to guide planning for an expansion of drug treatment services in correctional facilities, a needs assessment was conducted at the Department of Correction and Rehabilitation (DCR) of Puerto Rico (PR). The authors report on the research process, the findings that informed their recommendations for the DCR to expand MAT for eligible inmates, and lessons learned.

Cultural adaptation and psychometric properties of the Substance Abuse Self-Stigma Scale among Latinos with Substance Use Disorders: An effective screening tool for correctional and community settings.

The present study involves a psychometric evaluation of the Substance Abuse Self-Stigma Scale (SASSS), a 40-item dimensional measure of internalized or self-stigma developed by Jason Luoma and collaborators, among Latinos with Substance Use Disorders (SUDs). The current study's specific aim is to assess the psychometric properties (factor structure and reliability) of the translated and culturally adapted SASSS instrument in a cross-sectional study of individuals (n = 412) with SUDs with or without HIV from correctional facilities and community treatment programs. A confirmatory factor analysis evidenced the four-factor structure of SASSS. Results showed significant correlations with HIV felt stigma among those participants with co-occurring SUD and HIV (n=119), internalized shame, stigma-related interpersonal rejection due to substance abuse, symptoms of depression, substance use within the last 30 days, psychological flexibility, self-esteem, and self-efficacy, supporting good convergent validity. The measure showed a strong factor structure and adequate reliability estimates supporting its applicability to Latinos with SUDs from community and criminal justice settings. Findings are discussed in terms of their implications for studies of stigma impact and intervention.

Factor structure of the CES-D and measurement invariance across gender for low-income Puerto Ricans in a probability sample.

OBJECTIVE: The authors of this study aimed to evaluate 2-factor structures for the Center for Epidemiologic Studies Depression Scale (CES-D) reported in the literature to determine which one proves to be a better fit with the data on low-income Puerto Ricans living on the island. METHOD: The sample consisted of 3,504 civilian noninstitutionalized Puerto Ricans, ranging in age from 18 to 64 who were living in low-income areas of Puerto Rico. A confirmatory factor analysis (CFA) was implemented, and model fit was assessed with the Tucker-Lewis Index (TLI), the comparative fit index (CFI), and the root-mean-square error of approximation (RMSEA). RESULTS: The CFA results obtained for the Radloff (1977) and Guarnaccia, Angel, and Worobey (1989) models show that neither model obtained adequate fit indexes. Exploratory factor analysis revealed that the 2-factor structure not only obtained better fit indexes (TLI = .948, CFI = .955, RMSEA = .048) but also reflected a better conceptual organization of the factors (basically divided into 2 components: Negative Affect and Positive Affect). When we assessed the model fit by gender, the model consistently fit the data for the female subsample but not for the male one. CONCLUSIONS: Results confirm the need to address the issues related to measurement equivalence for specific cultural and language gaps in assessment of depressive symptoms. Lack of factor invariance across gender also raises the question of the appropriateness of this measure for the male subsample and the need for further research in the manifestation of depression in this group.