Using Social Network Analysis to Strengthen Organizational Relationships to Better Serve Expectant and Parenting Young People.

INTRODUCTION: Expectant and parenting young people (young parents) need a range of supports but may have difficulty accessing existing resources. An optimally connected network of organizations can help young parents navigate access to available services. Community organizations participating in the Pathways to Success (Pathways) initiative sought to strengthen their network of support for young parents through social network analysis (SNA) undertaken within an action research framework. METHOD: Evaluators and community partners utilized a survey and analysis tool to map and describe the local network of service providers offering resources to young parents. Respondents were asked to characterize their relationship with all other organizations in the network. Following survey analysis, all participants were invited to discuss and interpret the results and plan the next actions to improve the network on behalf of young parents. RESULTS: Scores described the diversity of organizations in the network, density of connections across the community, degree to which the network was centralized or decentralized, which organizations were central or outliers, frequency of contact, levels of collaboration, and levels of trust. Findings were interpreted with survey participants and used by Pathways staff for action planning to improve their network. DISCUSSION: SNA clarified complex relationships and set service providers on a path toward optimizing their network. The usefulness of SNA to impact and improve a network approach to supporting young parents is discussed, including lessons learned from this project.

Creating Systems-Level Change to Better Support Expectant and Parenting Young People: A Case Study.

INTRODUCTION: Expectant and parenting young people (young parents) require diverse services to support their health, educational success, and family functioning. Rarely can the needs of young parents be met by a single school or service provider. This case study examines how one large school district funded through the pathways to success initiative was able to facilitate systems change to increase young parents' access to and use of supportive services. METHODS: Data sources include a needs and resources assessment, quarterly reports documenting grantee effort, sustainability plans, social network analysis, and capstone interviews. All data sources were systematically reviewed to identify the existing context prior to the start of the initiative, the changes that resulted from the initiative, and efforts that could potentially be maintained beyond the grant period. RESULTS: The community context prior to Pathways implementation was one of disconnected services and missed opportunities. The full-time program coordinator hired by the district focused on systems-level change and facilitated connections between organizations. This greater connectivity contributed to increased collaboration with the goal of producing lasting benefits for young parents. DISCUSSION: Promoting sustainable connections and collaboration at the systems level can help dismantle barriers to service access and benefit young parents.

Assessment of nonsuicidal self-injury: development and initial validation of the Non-Suicidal Self-Injury-Assessment Tool (NSSI-AT).

Research tools for assessing nonsuicidal self-injury (NSSI) epidemiology in community populations are few and are either limited in the scope of NSSI characteristics assessed or included as part of suicide assessment. Though these surveys have been immensely useful in establishing the presence of NSSI and in documenting basic epidemiological characteristics, they have been less useful in describing secondary NSSI features such as NSSI context, habituation, or perceived life impact. The aim of the current study was to examine the reliability of the test scores and validity of test score interpretations in a university population for the Non-Suicidal Self-Injury-Assessment Tool (NSSI-AT), a web-based measure of NSSI designed to assess primary (such as form, frequency, and function) and secondary (including but not limited to NSSI habituation; contexts in which NSSI is practiced; and NSSI perceived life interference, treatment, and impacts) NSSI characteristics for research purposes. Data for these analyses were drawn from 3 samples, all of which were originally part of a 2007 study of randomly selected students from 8 northeast and midwest public and private universities that participated in a web-based study entitled the Survey of Student Wellbeing. Overall, results provide support for the reliability of NSSI-AT test scores (as assessed by test-retest) and validity of NSSI-AT test score interpretations for the behavior and frequency modules (as assessed using concurrent, convergent, and discriminant evidence) in this population. Implications for research as well as next steps are discussed.

Young adult respondent experiences of disclosing self-injury, suicide-related behavior, and psychological distress in a web-based survey.

The objective of this study was to examine the impact of questions regarding self-injury, suicide, and psychological distress in a web-based survey on respondents, particularly those with relevant personal histories. Drawn from a random 8-college sample, 14,372 students completed the survey. Adjusted odds ratios were used to model the likelihood of responses based on respondent characteristics. The constant comparative method identified salient themes in qualitative data. Few individuals (2.7%) reported negative survey experiences. Individuals with relevant personal experience reported greater discomfort with the survey yet were also significantly more likely to report that it caused them to think more deeply about their lives. Surveys may be beneficial in promoting self-reflection, particularly among individuals with relevant experience.

Nonsuicidal self-injury as a gateway to suicide in young adults.

PURPOSE: To investigate the extent to which nonsuicidal self-injury (NSSI) contributes to later suicide thoughts and behaviors (STB) independent of shared risk factors. METHODS: One thousand four hundred and sixty-six students at five U.S. colleges participated in a longitudinal study of the relationship between NSSI and suicide. NSSI, suicide history, and common risk/protective factors were assessed annually for three years. Analyses tested the hypotheses that the practice of NSSI prior to STB and suicide behavior (excluding ideation) reduced inhibition to later STB independent of shared risk factors. Analyses also examined factors that predicted subsequent STB among individuals with NSSI history. RESULTS: History of NSSI did significantly predict concurrent or later STB (AOR 2.8, 95%, CI 1.9-4.1) independent of covariates common to both. Among those with prior or concurrent NSSI, risk of STB is predicted by > 20 lifetime NSSI incidents (AOR 3.8, 95% CI, 1.4-10.3) and history of mental health treatment (AOR 2.2, 95% CI, 1.9-4.6). Risk of moving from NSSI to STB is decreased by presence of meaning in life (AOR .6, 95% CI, .5-.7) and reporting parents as confidants (AOR, .3, 95% CI, .1-.9). CONCLUSIONS: NSSI prior to suicide behavior serves as a "gateway" behavior for suicide and may reduce inhibition through habituation to self-injury. Treatments focusing on enhancing perceived meaning in life and building positive relationships with others, particularly parents, may be particularly effective in reducing suicide risk among youth with a history of NSSI.

Nonsuicidal self-injury in a college population: general trends and sex differences.

OBJECTIVE: To describe basic nonsuicidal self-injury (NSSI) characteristics and to explore sex differences. METHODS: A random sample from 8 universities were invited to participate in a Web-based survey in 2006-2007; 38.9% (n = 14,372) participated. Analysis assessed sex differences in NSSI prevalence, practices, severity, perceived dependency, and help-seeking; adjusted odds ratios for NSSI characteristics were calculated by sex status. RESULTS: Lifetime NSSI prevalence rates averaged 15.3%. Females were more likely than males to self-injure because they were upset (adjusted odds ratio [AOR] = 1.6; 95% confidence interval [CI] = 1.3-2.1) or in hopes that someone would notice them (AOR = 1.6, 95% CI = 1.1-2.7). Males were 1.6 times (95% CI = 1.2-2.2) more likely to report anger and 4.0 times (95% CI = 2.3-6.8) more likely to report intoxication as an initiating factor. Sexual orientation predicted NSSI, particularly for women (Wald F = 8.81, p ≤ .000). Only 8.9% of the NSSI sample reported disclosing NSSI to a mental health professional. CONCLUSIONS: NSSI is common in college populations but varies significantly by sex and sexual orientation. NSSI disclosure is low among both sexes.