"I am busy enough ": Navigating challenges experienced by Medicaid providers serving pregnant people living with substance use disorders in Alabama.

PURPOSE: Perinatal substance use is a clinical and public health concern. The purpose of the study was to understand the perspectives and experiences of perinatal healthcare providers serving pregnant people who receive Medicaid and are living with a substance use disorder. DESIGN AND METHODS: We conducted a secondary data analysis of the responses from perinatal healthcare providers who completed a survey to assess the state of Alabama's capability to effectively identify and treat individuals with substance use disorder. We analyzed short answer responses using consensus coding. FINDINGS: Nine-hundred and ninety-five Medicaid providers completed the survey, 36 of the respondents identified that they were employed in an obstetric practice. Health insurance limitations, a lack of time and resources, and limited treatment options were the primary barriers indicated in the participants' responses. CONCLUSIONS: Structural and health system barriers negatively impact the capacity of perinatal healthcare providers in Alabama to serve pregnant people who receive Medicaid and are living with a substance use disorder. CLINICAL RELEVANCE: Perinatal healthcare providers need educational opportunities, training, and up-to-date resources to provide supportive, comprehensive care programming for perinatal populations with substance use disorders.

Internalized racism's association with African American male youth's propensity for violence.

Youth violence in African American communities is still considered to be at epidemic proportions. The traditional risk factors for youth violence (i.e. delinquent friends, poverty, drug use, carrying a weapon etc.) do not account for the disproportionate overrepresentation of African American males. This study sought to better understand the propensity for violence among African American males ages 14-19 years (N=224) from four different programmatic sites: a Philadelphia high school, an African-centered charter high school, a youth detention facility, and a program that serves youth who are on probation or parole. The findings indicate that internalized racism enhances the variance explained above the variables typically explored in the delinquency and criminology literature. If further research can replicate these findings, this has implications for the content and direction of prevention approaches with African American male youth.