Incorporating multiple data sources to assess changes in organizational capacity in child welfare systems.

Three federally funded Child Welfare Capacity Building Centers provide services to build the organizational capacity of public child welfare agencies to help meet federal requirements, improve practice, and improve outcomes for children and families. The aim of this study was to explore capacity outcomes in five dimensions - resources, infrastructure, knowledge and skills, culture and climate, and engagement and partnership - achieved by child welfare jurisdictions who received Center services. Analyses describe the capacities targeted for improvement and the amount and type of services provided by Centers; assess the relationship between services and capacity increase; and explore whether that relationship differs depending on the jurisdiction's level of foundational capacity. Data collected through surveys and a service delivery tracking system reflect the perspectives of service recipients and service providers. Results reveal jurisdictions typically targeted capacity outcomes in the dimensions of knowledge and skills and infrastructure and received an average of 28 hours of direct services to support their capacity-building efforts. Dosage of service was positively associated with achievement of capacity outcomes, though no interaction was found between service dosage and foundational capacity in the effect on outcomes. Methodological lessons learned and implications for future evaluations of organizational capacity building efforts are offered.

Age-varying trends in alcohol and cannabis co-occurring use: Implications for prescription drug misuse.

Background: Individuals who engage in alcohol and cannabis co-occurring use are at heightened risk for negative outcomes than individuals who only use alcohol or only use cannabis, but far less is known about implications of alcohol and cannabis co-occurring use for prescription drug misuse (PDM).Objectives: This study aimed to (1) identify whether co-occurring use was linked with greater risk for PDM across ages 18-60 and to determine ages at which this association was strongest, (2) determine whether associations remain after controlling for pain severity, and (3) test for gender differences.Methods: Cross-sectional data were from Wave 1 of the Population Assessment of Tobacco and Health (PATH) study. The analytic sample included 20,120 (50.6%wt men) individuals aged 18-60 reporting past-year alcohol and/or cannabis use.Results: Time-varying effect models indicated that individuals reporting co-occurring use were at increased risk for PDM than individuals reporting single-substance use across all ages, with odds ratios peaking at >3 at age 34. After controlling for pain severity, associations were only slightly weakened. Associations were slightly stronger for men than women from ages 28 to 35.Conclusion: Co-occurring use was linked with heightened risk for PDM compared to individuals who used only one substance; co-occurring use may be important to target for PDM prevention. Identifying factors underlying study associations, beyond pain, and how these factors evolve with age are important avenues for prevention work.

"Buzzwords": Crowd-sourcing and quantifying U.S. young adult terminology for subjective effects of alcohol and marijuana use.

Prevalence of heavy alcohol use remain high, and daily marijuana use is at an all-time high in young adults. As perceptions of drug effects may guide risky decision making, understanding subjective feelings for alcohol and marijuana use is critical. Existing laboratory-based and diary metrics (0-100 rating of "how drunk/high do you feel?") may be problematic in differentiating levels of subjective effects. Measures incorporating contemporary language may better capture subjective feelings in experimental and ambulatory assessment designs. We developed 2 sliding scales based on crowd-sourced and rank-ordered feelings of subjective alcohol and marijuana effects. Two U.S. young adult (18-25 years) samples were drawn from Amazon's Mechanical Turk (MTurk). In the first study, 323 (53.6% women, 68.4% White, M age = 23.0 years) alcohol and marijuana users provided words to describe subjective effects from alcohol use and from marijuana use. In a second study, 289 (46.4% female, 66.4% White, M age = 23.0 years) users rank-ordered the most common terms to correspond with subjective levels. The sliding scale for alcohol effects resulted in 4 anchors ranging from 0 to 100: slightly buzzed, tipsy/"happy," drunk, and wasted. The sliding scale for marijuana effects also had 4 anchors: relaxed, calm/chill, high, and stoned/baked. By incorporating broader and more contemporary subjective effects language, our metrics may better capture variability in young adults' perceived subjective effects from alcohol and marijuana use. Future work could build upon these findings by pairing sliding scales with measures of actual intoxication to understand within- and between-person covariation in subjective effects, actual impairment, and consequences. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Simultaneous alcohol and marijuana use in daily life: Implications for level of use, subjective intoxication, and positive and negative consequences.

Simultaneous alcohol and marijuana (SAM) use is prevalent among young adult drinkers and associated with increased risk for harms. Less understood about SAM use is whether increased risk is incurred on SAM use occasions relative to occasions in which individuals used only 1 substance. From a sample of young adult SAM users, we compared occasions in which individuals simultaneously used alcohol and marijuana so that the effects overlapped ("SAM days"), occasions involving only alcohol ("alcohol days"), and occasions involving only marijuana ("marijuana days") on level of use, level of subjective intoxication, and negative and positive consequences. Eligible participants (N = 154; 57.8% female, 72.7% non-Hispanic/Latinx White) were 18-25 years old, reported past-month SAM use, and reported past 2-week binge drinking. Participants completed up to 14 daily assessments on their substance use behavior. Multilevel models indicated that, relative to alcohol days, SAM days had more negative consequences. SAM and alcohol days were not statistically different on level of use, level of subjective alcohol intoxication, or positive consequences. Relative to marijuana days, SAM days had more negative consequences and more positive consequences. Level of use (number of hits) and level of marijuana intoxication were not statistically different. In addition to SAM users being a more at-risk group, SAM occasions are associated with greater risk within this vulnerable population. Fine-grained ecological momentary assessments are needed to better understand perceptions and behavior throughout a SAM use episode. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Contemporary Patterns of Marijuana Use and Attitudes Among High School Seniors: 2010-2016.

PURPOSE: The goal of this study was to examine changes in contemporary patterns of marijuana use and attitudes over time. Given shifts in state-by-state marijuana legislation, there is a reason to believe that the patterns of high school seniors' marijuana use behavior and attitudes about use have changed from 2010 to 2016. METHODS: Data are from high school seniors in the 2010-2016 waves of Monitoring the Future, a nationally representative, cross-sectional survey in the United States. Latent class analysis was used to determine underlying patterns of marijuana use and related attitudes. Differences in latent class membership were examined across years, and gender and race/ethnicity were also examined. RESULTS: Five latent classes were identified: Intolerant Nonusers (49% of the sample), Tolerant Nonusers (12%), Disapproving Users (7%), Experimenters (6%), and Marijuana Enthusiasts (26%). Class prevalences remained relatively stable from 2010 to 2013; beginning in 2014 a significant decrease in prevalence was observed for Intolerant Nonusers and significant increases in prevalence were observed for Tolerant Nonusers and Marijuana Enthusiasts. Membership in the Marijuana Enthusiasts class was consistently more likely for males; Hispanic and black adolescents were more likely to be Disapproving Users. CONCLUSIONS: Contemporary patterns of marijuana use and attitudes have remained consistent over time, however, significant shifts in class prevalence emerged in 2014. Findings also suggest that a substantial subgroup of adolescents would benefit from prevention and intervention efforts targeting marijuana use and attitudes.

Ancestry-Adjusted Vitamin D Metabolite Concentrations in Association With Cytochrome P450 3A Polymorphisms.

We investigated the association between genetic polymorphisms in cytochrome P450 (CYP2R1, CYP24A1, and the CYP3A family) with nonsummer plasma concentrations of vitamin D metabolites (25-hydroxyvitamin D3 (25(OH)D3) and proportion 24,25-dihydroxyvitamin D3 (24,25(OH)2D3)) among healthy individuals of sub-Saharan African and European ancestry, matched on age (within 5 years; n = 188 in each ancestral group), in central suburban Pennsylvania (2006-2009). Vitamin D metabolites were measured using high-performance liquid chromatography with tandem mass spectrometry. Paired multiple regression and adjusted least-squares mean analyses were used to test for associations between genotype and log-transformed metabolite concentrations, adjusted for age, sex, proportion of West-African genetic ancestry, body mass index, oral contraceptive (OC) use, tanning bed use, vitamin D intake, days from summer solstice, time of day of blood draw, and isoforms of the vitamin D receptor (VDR) and vitamin D binding protein. Polymorphisms in CYP2R1, CYP3A43, vitamin D binding protein, and genetic ancestry proportion remained associated with plasma 25(OH)D3 after adjustment. Only CYP3A43 and VDR polymorphisms were associated with proportion 24,25(OH)2D3. Magnitudes of association with 25(OH)D3 were similar for CYP3A43, tanning bed use, and OC use. Significant least-squares mean interactions (CYP2R1/OC use (P = 0.030) and CYP3A43/VDR (P = 0.013)) were identified. A CYP3A43 genotype, previously implicated in cancer, is strongly associated with biomarkers of vitamin D metabolism. Interactive associations should be further investigated.