"It's time for a change. I need to. I have to": Substance misuse recovery turning points of unhoused Alaskans.

Substance misuse is a pernicious health concern for many unhoused people. A deep understanding of turning points - what propels someone to take concrete action toward addressing substance misuse - is needed to inform recovery policies and practices. This study sought to identify common elements in turning points among unhoused people vis-à-vis a phenomenological qualitative approach. Twenty people (Mage = 47.47, SD = 9.75; 50% female) who self-identified as being in recovery while unhoused participated in semi-structured interviews in Anchorage, Alaska, a community with high rates of both houselessness and substance misuse. Survival (life- and health-sustaining), individual (intrapersonal), and relational (interpersonal) motivations all shaped turning points. Limitations include the possible underrepresentation of individuals using a harm-reduction approach or capturing differences by housing type. Programs to address substance misuse should consider these motivations. Future research should identify and refine turning points and work to understand how they interact with change processes.

My Best Alaskan Life: Addressing Adolescent Mental and Reproductive Health in Alaska.

INTRODUCTION: Since 2020, a multisector research team has coordinated a youth-driven, community-based participatory research project to adapt a reproductive life plan for application in a statewide initiative called My Best Alaskan Life (MBAL). The RLP is adapted for Alaskan youth and is intended to support teens in decision-making processes reflecting cultural priorities, personal goals, and sexual and reproductive health. Background. With 46% of youth in Alaska reporting not having used a condom during their last sexual intercourse and 15% not having used contraception, unintended pregnancy and transmission of STIs will continue. Furthermore, Alaskan youth also cite high rates of hopelessness and suicidality, and research shows that poor mental health among adolescents is correlated with developing and maintaining high-risk sexual behaviors. An intervention focusing on supporting mental wellness and developing personal goals in the context of sexual health decision-making may encourage adolescents to adopt safer sexual health behaviors. METHODS: The MBAL research team completed a statewide pilot assessing the design and implementation of the tool, gathering feedback from over 700 survey responses (youth, ages 14-20); conducted 10 in-depth interviews (adult partners at community organizations and clinics); and hosted two youth-led design review sessions. FINDINGS: Questionnaire respondents were overwhelmingly positive about the tool (91% "liked or loved" the tool) and its potential applicability in their community (86% cited "very applicable"). Project next steps include incorporating design recommendations, a statewide randomized control trial and ultimately, open source access for all interested parties.

Then and now: A 50-year retrospective thematic analysis of Society for Community Research and Action presidential addresses.

The Society for Community Research and Action (SCRA) is the primary professional home for community psychologists in the United States and increasingly around the world. Since the formation of the American Psychological Association Division 27: Community Psychology in 1966, now SCRA, 54 people have served in the Presidential role. Presidential leaders' annual addresses both reflect the current state of the field and have the ability to shape the future of both SCRA as an organization and community psychology as a discipline given their positions as leaders. This commentary explores the trajectory of SCRA as an organization via 33 available presidential addresses, 28 of which were published in the American Journal of Community Psychology (AJCP). Using thematic analysis and drawing on both dialectical and life cycle organizational processes, three periods of SCRA and community psychology more broadly were identified: defining community psychology, applying community psychology, and re-imagining community psychology. Themes speak to tensions between the ideals of the society and the work of the society. We conclude by offering a series of questions for consideration as SCRA positions itself for the future.

Knowing Who You Are (Becoming): Effects of a university-based elder-led cultural identity program on Alaska Native students' identity development, cultural strengths, sense of community, and behavioral health.

In part due to cultural loss and identity disruption over many generations from colonial and neocolonial forces, significant emotional/behavioral health disparities exist among Alaska Native (AN) people. Such forces are apparent in higher education, where many AN students feel othered and are more likely to withdraw without a degree than their nonnative counterparts. A strong cultural identity has been found to buffer psychosocial difficulties. The AN Cultural Identity Project (CIP) was developed from the best available scientific literature, local data from AN students, and traditional wisdom from Elders to support cultural identity development. This 8-week Elder-led program incorporated storytelling, experiential learning, connection, exploration, and sharing of identity and cultural strengths to help students remain grounded in their cultures across settings in the hopes of improving emotional/behavioral health outcomes. Through a stepped-wedge design randomized controlled trial, we examined the impact of CIP on cultural identity, cultural strengths, sense of community, and emotional/behavioral health across two cohorts of 44 AN students who ranged in age from 18 to 54 years. On average, students attended 75% of the program. The program had positive impacts on students' cultural identity development, endorsement of cultural strengths, sense of community with AN people at the university, and overall emotional/behavioral health. While gains in some outcomes were sustained over time, others were not, suggesting the potential benefits of a lengthened program. As the first program of its kind directed at AN university students of diverse cultural groups in urban settings, CIP shows promise for supporting emotional/behavioral health through cultural identity development. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Elder-led cultural identity program as counterspace at a public university: Narratives on sense of community, empowering settings, and empowerment.

Higher education institutions present unique settings in which identities and life paths are distinctively shaped. While at their best universities should serve as empowering settings that support their members to grow and develop, to raise awareness of injustice, and to catalyze change, too often systems of higher education in the United States serve to marginalize Indigenous cultures and promote assimilation to White, Euro-American cultures. Counterspaces offer an important response, spaces developed by and for people experiencing oppression that allow for solidarity-building, social support, healing, resource attainment, skill-building, resistance, counter-storytelling, and ideally, empowerment. The Alaska Native (AN) Cultural Identity Project (CIP) is based at an urban U.S.-based university and was rolled out during the COVID-19 pandemic. Developed from the best available scientific and practice literature, local data from AN students, and traditional wisdom from Elders, CIP incorporated storytelling, experiential learning, connection, exploration, and sharing of identity and cultural strengths with the aim of helping AN students understand who they are and who they are becoming. In all, 44 students, 5 Elders, and 3 additional staff participated in the space. In this paper, we sought to understand how CIP was experienced by these unique members who co-created and engaged in this space through 10 focus groups with 36 of the CIP members. We found that the counterspace promoted a sense of community, served as an empowering setting, and set the stage for empowering actions and ripple effects beyond its impact on individuals.

The Vermont Family Based Approach in Primary Care Pediatrics: Effects on Children's and Parents' Emotional and Behavioral Problems and Parents' Health-Related Quality of Life.

This randomized controlled trial tested the Vermont Family Based Approach (VFBA) in primary care pediatrics. The VFBA is a model of healthcare delivery that shifts the focus from the individual to the family, emphasizes emotional and behavioral health, and uses evidence-based health promotion/prevention along with the treatment of emotional and behavioral problems. Participants were 81 families of 3-15-year-olds. For children, the VFBA was associated with greater reductions than the Control condition on the Child Behavior Checklist Emotionally Reactive, Withdrawn, Sleep Problems, Aggressive Behavior and Total Problems scales. For parents, the VFBA was associated with greater reductions than the Control condition on the Adult Self-Report Anxious/Depressed, Rule-Breaking Behavior, Internalizing Problems and Total Problems scales. The VFBA was also associated with greater improvement than the Control condition in the parents' health-related quality of life, as indicated by all scales of the Medical Outcomes Study Health Survey.

The impact of public policies on acculturation: A mixed-method study of Latinx immigrants' experiences in four US states.

AIMS: This study sought to understand the impact of public policies on Latinx immigrants' acculturation. METHODS: Four hundred thirty-eight first generation Latinx immigrants completed survey measures and a subset (n = 73) participated in 12 focus groups across four US states with distinct immigration-related policies: Arizona, New Mexico, Maryland, and Virginia. RESULTS: Latinx immigrants living in states with more restrictive immigration-related public policies were less likely to make cultural changes in the ways they desired. Policies impacted acculturation directly by requiring and restricting certain cultural expressions, and indirectly through cultivating the community's climate. Multiple factors appeared to shape policies' influences on acculturation, including confusion from swift policy changes, inconsistent policy implementation, competing policies at divergent ecological levels, and individuals' relative privilege from intersecting personal characteristics. CONCLUSIONS: More inclusive and supportive immigration-related policies may improve Latinx immigrants' abilities to acculturate in their preferred ways.

The Roles of Settings in Supporting Immigrants' Resistance to Injustice and Oppression: A Policy Position Statement by the Society for Community Research and Action: A Policy Statement by the Society for Community Research and Action: Division 27 of the American Psychological Association.

In 2018, in response to increasingly oppressive and widespread federal immigration enforcement actions in the United States (U.S.) and around the globe - including family separation, immigration raids, detention, deportation of people who have lived in the country for much of their lives - the Society for Community Research & Action produced a statement on the effects of deportation and forced separation on immigrants, their families, and communities (SCRA, 2018). The statement focused exclusively on the impacts of deportation and forced family separation, documenting the damage done by oppressive U.S. policies and practices. We felt it was imperative to document this harm, and yet were uncomfortable producing a narrow paper that focused solely on harm. There are multiple ways immigrants and their allies resist deportation and other forms of oppression. This resistance is done individually, collectively, and in settings that vary in size and scope, including community-based, faith-based, direct care, and educational settings, as well as entire municipalities and transnational organizing settings. Settings facilitate resistance in many ways, focusing on those who are oppressed, their oppressors, and systems of oppression. In this statement, we describe the unique and overlapping ways in which settings facilitate resistance. We situate this review of the scientific and practice literature in the frameworks of change through social settings, empowering settings, healing justice, and decolonization. We also document recommendations for continued resistance.

Relative Privilege, Risk, and Sense of Community: Understanding Latinx Immigrants' Empowerment and Resilience Processes Across the United States.

Latinx immigrants regularly navigate adversity and oppression through resilience and empowerment; however, little research has sought to delineate when, how, and why they may engage in either process. Through the Transtheoretical Model of Empowerment and Resilience, this paper examines how Latinx immigrants living in distinct U.S. contexts interact with their communities. Seventy-three Latinx immigrants (ages 18 to 70, M = 40.85, SD = 13.65) participated in 12 focus groups in Albuquerque, NM; Maricopa County, AZ; Baltimore, MD; and Richmond, VA. Participants had lived in the United States for less than 1 to 39 years (M = 14.19, SD = 8.72) and had varying immigration statuses. Analyses revealed that empowerment and resilience goals diverged by individuals' beliefs in the degree to which external change was vital, possible, and theirs to attempt. Beliefs coincided with the fundamental risk posed, based on the interaction of a context's conditions with an individual's characteristics and sense of community. Results indicate that while resilience is important to navigate risky settings, it may uphold oppressive power structures because it is consistent with the status quo. Interventions to spur external change should involve empowering processes, including facilitating gains in relative privilege and fostering sense of community.

Bridging the research-policy divide: Pathways to engagement and skill development.

Researchers generally engage in few interactions with policymakers, which limits the extent to which empirical evidence is used to guide public policy and, consequently, the potential effectiveness of public policies in improving societal wellbeing. Although many researchers wish to see their work used for social impact, several factors contribute to researchers' limited policy engagement, including a lack of opportunities for developing policy competencies (i.e., knowledge, skills, and self-efficacy that support effective policy engagement) and limited support or incentives from research, training, and philanthropic institutions. Moreover, despite work that shows that researchers are more likely to engage in policy when they report greater policy competencies, little descriptive or evaluative research has explored the effectiveness of policy training. The current work seeks to expand the limited empirical base by drawing connections between training approaches and conditions that support policymakers' use of research evidence. Policy training approaches that combine direct instruction (i.e., information-based, often didactic teaching via classes) and experiential learning (i.e., skills and knowledge obtained through active engagement, hands-on application) appear most promising. Various pathways for policy training are described, and one specific policy training and engagement strategy is further described alongside evaluation data regarding benefits associated with direct instruction and experiential learning approaches. We conclude with recommendations to strengthen researchers' policy competency development and engagement. These recommendations range from increasing access to training opportunities to adjusting institutional incentive systems that currently hinder researchers' policy engagement. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Managing and Adapting Practice: Provider Perceptions of an Evidence-Informed Framework for Delivering Mental Health Services.

This study examined providers' reflections on delivering managing and adapting practice (MAP), an evidence-informed framework that guides decision-making from scientific and client data. Consensual qualitative research methods were used to analyze the reflections of 201 youth mental health providers. Results indicated that providers approached MAP according to their own preferences and particular cases. While most appeared to approach MAP from a practice management standpoint, when faced with challenging cases, providers used coordination and outcomes management resources. Regardless of approach, most providers came to appreciate the full framework through reflective practice. Their diverse approaches offer lessons for evidence-based practice implementation and sustainment.

"It has cost me a lot to adapt to here": The divergence of real acculturation from ideal acculturation impacts Latinx immigrants' psychosocial wellbeing.

The wellbeing of Latinx immigrants in the United States varies widely. Immigrants' changes and maintenance of their cultures, a process known as acculturation, has been postulated to explain differences in wellbeing. However, the mechanisms by which acculturation impacts wellbeing are not fully understood. This study sought to understand the relation between acculturation and wellbeing through a person-environment fit lens, with the hypothesis that the better immigrants can acculturate in ways they prefer (e.g., taking on the practices, values, and identifications they desire), the better their self-reported wellbeing. An explanatory mixed-method approach was used to examine this hypothesis. Four hundred thirty-eight Latinx immigrants (ages 18-77, M = 37.88) who had lived in the United States for less than a year to 55 years (M = 16.75 years) completed survey measures in Arizona, New Mexico, Maryland, and Virginia. A subset (n = 73) participated in 12 focus groups. The sample included naturalized citizens (31.0%) along with authorized (33.2%) and unauthorized (35.8%) immigrants, and matched community immigration patterns. Data were analyzed through path analyses and constructivist grounded theory methods. Results indicated that the better Latinx immigrants could acculturate in the ways they preferred, the better their wellbeing. This relation was explained, in part, through lower levels of acculturative stress. This research suggests that practitioners and policymakers should consider ways to support immigrants to acculturate in the ways they desire as opposed to solely focusing their efforts on particular acculturation strategies. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Shared Communities: A Multinational Qualitative Study of Immigrant and Receiving Community Members.

Community psychology is central to understanding how immigrants and more established residents of their new settings join together to develop a shared sense of community and membership. In our present study, we explored how newer (i.e., first- and second-generation immigrants) and more established community members form multiple positive psychological sense of community (PSOC) with one another. We conducted a multinational, qualitative study of PSOC through interviews with 201 first- and second-generation immigrants and third generation or more "receiving community members" in three contexts (Baltimore-Washington corridor of the U.S.; Torino, Italy; Lecce, Italy). Results indicated numerous similarities among the ways in which participants constructed PSOC in shared and nonshared communities, regardless of immigration/citizenship status, length of community residence, city, country, age, or gender. Small, proximal, and salient communities were often particularly important to building positive PSOC, which was formed around diverse membership boundaries. As intersectional beings, members converged and diverged on many characteristics, providing multiple opportunities for members to bring diversity to their communities while sharing other characteristics deemed essential to membership. Nonetheless, findings point to significant, structural challenges rooted in power and privilege that must be confronted to bridge the community-diversity dialectic and build strong, shared sense of community.

The Common Elements of treatment engagement for clinically high-risk youth and youth with first-episode psychosis.

AIM: Without treatment, clinically high-risk (CHR) youth or youth with first-episode psychosis (FEP) have increased risk for significant complications from their illness; yet, treatment engagement among these youth is critically low. The purpose of this study was to examine engagement efforts with CHR/FEP youth to stimulate new ideas that might facilitate participation in services for this population. METHODS: A literature review using distillation methods identified engagement practices reported in two bodies of literature. The first body of literature (i.e. 'CHR/FEP engagement') included 13 studies employing qualitative designs to explore consumer perspectives about treatment engagement practices in samples of CHR/FEP youth and their families. The second body of research (i.e. 'CHR/FEP RCTs') included 18 randomized controlled trials (RCTs) testing treatments for CHR/FEP youth and their families. Engagement practice frequencies were compared with the frequency of these practices within effective engagement interventions, as tested in 40 RCTs within the broader child and adolescent mental health literature (i.e. 'CAMH engagement'). RESULTS: Treatment attrition and attendance were the most frequent engagement outcomes measured in the CHR/FEP RCTs. There were notable efforts described in the CHR/FEP RCTs towards engaging youth and families, yet CHR/FEP RCTs reportedly included only a small proportion of engagement practices described in either the CHR/FEP or CAMH engagement literatures. CONCLUSION: Results suggest there might be practices available to complement current efforts at engaging CHR/FEP youth in treatment, and that increased attention to the measurement of engagement outcomes could provide important information regarding engagement in a population with low treatment engagement rates.

Engaging youth and families in school mental health services.

In this article, an overview is provided of strategies to engage youth and their families in school mental health (SMH) services throughout the course of treatment. Resources are outlined to help SMH providers determine which strategies are most suitable for youth and their families, based on outcomes desired, barriers to engagement, and stage of treatment. Four case vignettes are presented to describe implementation of these strategies.