Institutionalizing Community-engaged Translational Science in an Academic Institution: A Community Stakeholder-Driven Process.

BACKGROUND: Although studies have described the power imbalance in academic-community partnerships, little has been published describing how community-based participatory research-informed practitioners can change academic institutions to promote more effective community-engaged research. OBJECTIVES: This paper describes a university-funded community-based participatory project in which academic researchers and their community partners worked together to articulate, develop and advocate for institutionalizing best practices for equitable partnerships throughout the university. METHODS: Findings derive from a collaborative ethnographic process evaluation. RESULTS: The study describes the integral steps proposed to promote equitable community-university research collaboration, the process by which these principles and best practice recommendations were developed, and the institutional change outcomes of this process. CONCLUSIONS: When universities make even small investments toward promoting and nurturing community-engaged research, the quality of the science can be enhanced to advance health equity and community-university relationships can improve, particularly if based on trust, mutual respect, and openness to accomplish a shared vision.

COVID-19 Testing and Vaccine Acceptability Among Homeless-Experienced Adults: Qualitative Data from Two Samples.

BACKGROUND: Homeless-experienced populations are at increased risk of exposure to SARS-CoV-2 due to their living environments and face an increased risk of severe COVID-19 disease due to underlying health conditions. Little is known about COVID-19 testing and vaccination acceptability among homeless-experienced populations. OBJECTIVE: To understand the facilitators and barriers to COVID-19 testing and vaccine acceptability among homeless-experienced adults. DESIGN: We conducted in-depth interviews with participants from July to October 2020. We purposively recruited participants from (1) a longitudinal cohort of homeless-experienced older adults in Oakland, CA (n=37) and (2) a convenience sample of people (n=57) during a mobile outreach COVID-19 testing event in San Francisco. PARTICIPANTS: Adults with current or past experience of homelessness. APPROACH: We asked participants about their experiences with and attitudes towards COVID-19 testing and their perceptions of COVID-19 vaccinations. We used participant observation techniques to document the interactions between testing teams and those approached for testing. We audio-recorded, transcribed, and content analyzed all interviews and identified major themes and subthemes. KEY RESULTS: Participants found incentivized COVID-19 testing administered in unsheltered settings and supported by community health outreach workers (CHOWs) to be acceptable. The majority of participants expressed a positive inclination toward vaccine acceptability, citing a desire to return to routine life and civic responsibility. Those who expressed hesitancy cited a desire to see trial data, concerns that vaccines included infectious materials, and mistrust of the government. CONCLUSIONS: Participants expressed positive evaluations of the incentivized, mobile COVID-19 testing supported by CHOWs in unsheltered settings. The majority of participants expressed a positive inclination toward vaccination. Vaccine hesitancy concerns must be addressed when designing vaccine delivery strategies that overcome access challenges. Based on the successful implementation of COVID-19 testing, we recommend mobile delivery of vaccines using trusted CHOWs to address concerns and facilitate wider access to and uptake of the COVID vaccine.

Neocolonialism and Health Care Access among Marshall Islanders in the United States.

In the Marshall Islands, a history of extensive nuclear weapons testing and covert biomedical research, coupled with the U.S.'s ongoing military presence in the country, has severely compromised the health of the local population. Despite the U.S.'s culpability in producing ill health along with high rates of emigration from the islands to the mainland United States, the large portion of Marshallese who reside in the United States face substantial barriers to accessing health care. Drawing from ongoing field research with a Marshallese community in Arkansas, this article explores the multifaceted impediments that U.S.-based Marshall Islanders face in receiving medical treatment. Calling on an expansive and inclusive notion of neocolonialism, I argue that Marshallese structural vulnerability with regard to health and health care treatment derives from their status as neocolonial subjects and from their limited claims to health-related deservingness associated with this status. [Marshall Islanders, health care access, neocolonialism, radiation exposure, immigrant health] L̗omn̗ak ko rottin̗o: Ilo M̗ajel̗, juon bwebwenato kon kommalmel im nuclear baam̗ ko im ekkatak ko rottin̗o̗ kon wawein an baijin ko jelot armej, barainwot an to an ri tarinae ro an Amedka pad ilo aelon̄ kein, em̗oj an jelot ajmour an armej ro ilo aelon̄ kein. Men̄e alikkar bwe Amedka in ear jino nan̄inmej kein im ej un eo armej rein rej em̗m̗akut jan ane kein ane er n̄an ioon Amedka, elon̄ iaan ri M̗ajel̗ rein rej jelm̗ae elon̄ apan̄ ko n̄an aer del̗o̗n̄e jikin ajmour ko. Jan ekkatak eo ej bok jikin kio, jerbal in ej etali kabojrak rak kein rolon̄ im armej in M̗ajel̗ ro ioon Amedka in rej jelm̗ae ilo aer jibadok lo̗k jikin takto. Ilo an kar Amedka jibadok juon jea eo eutiej imejan lal̗ in, ij kwal̗ok juon ao akweelel bwe apan̄ ko an armej in M̗ajel̗ ikijjeen ajmour im jikin takto ej itok jan aer kar ri kom̗akoko ilo an kar Amedka lelon̄ l̗o̗k etan ilo mejan lal̗ im jan aer jab pukot jipan kein ej aer bwe kon jokjok in.

Enhancing the Impact of Family Justice Centers via Motivational Interviewing: An Integrated Review.

The Family Justice Center (FJC) model is an approach to assisting survivors of intimate partner violence (IPV) that focuses on integration of services under one roof and co-location of staff members from a range of multidisciplinary agencies. Even though the FJC model is touted as a best practice strategy to help IPV survivors, empirical support for the effectiveness of this approach is scarce. The current article consolidates this small yet promising body of empirically based literature in a clinically focused review. Findings point to the importance of integrating additional resources into the FJC model to engage IPV survivors who have ambivalent feelings about whether to accept help, leave the abusive relationship, and/or participate in criminal justice processes to hold the offender accountable. One such resource, motivational interviewing (MI), holds promise in aiding IPV survivors with these decisions, but empirical investigation into how MI can be incorporated into the FJC model has yet to be published. This article, therefore, also integrates the body of literature supporting the FJC model with the body of literature supporting MI with IPV survivors. Implications for practice, policy, and research are incorporated throughout this review.

Perceived Unfair Treatment and Problem Drinking among U.S. Navy Careerists.

This mixed method paper assessed interrelationships of unfair treatment at work, stress, and problem drinking amongst a sample of U.S. Navy careerists. Survey data from current drinkers (n=2380) were analyzed, along with qualitative interviews from a quota sample of 81. More women than men (51.4% vs. 16.2%) reported gender unfair treatment; approximately 20% of respondents reported ethnic/racial unfair treatment. Unfair treatment was associated with likelihood of problem drinking, but associations were attenuated after adjusting for frequency of work problems and expecting alcohol to alleviate stress. Qualitative results revealed contexts of unfair treatment within bureaucratic structures, tradition, norms, and role modeling.

Divergent Drinking Patterns of Restaurant Workers: The Influence of Social Networks and Job Position.

Restaurant workers have higher rates of problem drinking than most occupational groups. However, little is known about the environmental risks and work characteristics that may lead to these behaviors. An exploration of restaurant workers' drinking networks may provide important insights into their alcohol consumption patterns, thus guiding workplace prevention efforts. Drawing from social capital theory, this paper examines the unique characteristics of drinking networks within and between various job categories. Our research suggests that these multiple, complex networks have unique risk characteristics, and that self-selection is based on factors such as job position and college attendance, among other factors.

Alcohol Policy Comprehension, Compliance and Consequences Among Young Adult Restaurant Workers.

This study explores relationships between young adult restaurant employees' understanding and compliance with workplace alcohol control policies and consequences of alcohol policy violation. A mixed method analysis of 67 semi-structured interviews and 1,294 telephone surveys from restaurant chain employees found that alcohol policy details confused roughly a third of employees. Among current drinkers (n=1,093), multivariable linear regression analysis found that frequency of alcohol policy violation was positively associated with frequency of experiencing problems at work; perceived supervisor enforcement of alcohol policy was negatively associated with this outcome. Implications for preventing workplace alcohol-related problems include streamlining confusing alcohol policy guidelines.

Food Service Employee Alcohol Use, Hangovers and Norms During and After Work Hours.

AIMS: This paper presents analyses of norms and behavior concerning drinking before, during, and after work hours among U.S. bar-restaurant chain employees, with a focus on hangovers at work and their correlates. METHODS: A mixed method approach combined qualitative analysis of 64 face-to-face interviews held with randomly chosen service, managerial and kitchen staff and quantitative analyses (including multivariable linear regression and bivariate analyses) of data drawn from 1,286 completed telephone surveys (response rate 68%) with 18-29 year old employees. RESULTS: Relatively few survey respondents reported past-year drinking in the hour prior to work (5%) or during work hours (2.7%), but extensive drinking in non- work hours (85.5%), and 36.5% of respondents reported coming to work with a hangover at least once. Correlates of hangover at work were past year intoxication and holding positive norms for hangovers. These findings were elaborated by interview data describing heavy drinking after work at nearby bars, restaurants and employee homes. CONCLUSIONS: The findings illustrated that employee drinking during work hours was not normative. However, study results portrayed widely-shared norms for heavy drinking outside of work, with hangovers and related harms appearing as the primary work time repercussions of after-work alcohol consumption.

Measuring intimate partner violence among male and female farmworkers in San Diego County, CA.

Although there are over one million farmworkers in the United States, little is known about intimate partner violence (IPV) among this population. Given the particular demands of agricultural labor, however, farmworkers and their partners are highly susceptible to a host of occupation-specific stressors that may result in relationship conflict, and thereafter IPV. In cases where one or both members of the dyad engage in problematic drinking, the likelihood of violence increases exponentially. The purpose of this exploratory quantitative study was to estimate the prevalence of IPV among a mixed gender sample of farmworkers in San Diego County, California, and assess the association of potential correlates (acculturation- and work-related stress, problem drinking, and impulsivity) to IPV. Bilingual interviewers conducted survey data collection by using standardized instruments (e.g., Revised Conflict Tactics Scale; Migrant Farm Work Stress Inventory; AUDIT). Nearly all participants (n = 100) were Mexican born. Results showed that approximately 16% of female individuals (n = 61) and 32% of male individuals (n = 37) reported partner violence perpetration, victimization, or both, in the past year. Significant correlates of IPV were problem drinking (among males) and impulsivity (among females). This study demonstrates the feasibility of conducting IPV research among male and female farmworkers. Additional research is warranted to more fully explore the role of acculturation- and work-related stress, drinking, and other personal characteristics and environmental factors in precipitating couple conflict and thereafter IPV.

PTSD Treatment-Seeking Among Rural Latino Combat Veterans: A Review of the Literature.

Latino combat soldiers report both higher prevalence and greater overall severity of post-traumatic stress disorder (PTSD) symptoms than non-Hispanic Caucasians. However, these veterans face unique social and cultural barriers to accessing treatment for PTSD that distinguish them from their non-Hispanic white counterparts. Latino veterans who reside in rural settings face additional socio-cultural and structural impediments, in that they are likely to reside far from VA (Veterans Administration) medical facilities, have limited access to public transportation, and hold more conservative views toward mental health treatment than those residing in urban locales. However, little is known about the unique individual, sociocultural, and structural barriers to treatment faced by rural Latino veterans. This paper synthesizes the separate mental health and treatment-seeking literatures pertaining to Latinos, rural populations, and veterans, with the goal of identifying fruitful areas of conceptual overlap, and providing direction for future theory building, research, and targeted interventions.

Parental Strategies for Knowledge of Adolescents' Friends: Distinct from Monitoring?

Parental monitoring is defined as a set of behaviors used to gain knowledge about an adolescent's whereabouts, friends and associates, and activities. However, can knowledge of adolescents' whereabouts/activities, and friends all be attained through the same strategies? Or do they require their own strategies? This study used qualitative interviews with 173 parents of older adolescents from 100 families. Emergent themes described strategies by which parents gain information about their adolescents' friends and the substance use of those friends. The strategies included direct interaction with the friend, gaining information from the teen, using second-hand sources, and making assumptions. Some of these strategies were consistent with previous research, while others raise new questions and provide interesting new directions to pursue. Primarily, additional consideration needs to be given to assessments of parental monitoring that include strategies for gaining knowledge of adolescents' friends and their substance use.

Day laborers and occupational stress: testing the Migrant Stress Inventory with a Latino day laborer population.

Although day laborers are likely to suffer from high rates of work-related stress, there are no survey measures that focus on stress among this occupational group. Accordingly, we tested the validity and reliability of the Migrant Stress Inventory (MSI), a scale originally designed for migrant farmworkers. Based on survey data collected from day laborers (N = 102) in two Northern California communities, the MSI was found to have adequate internal consistency, yet additional analyses indicated a different factor structure for the subscales. New subscales (relationships, communication, alcohol and other drug use, years in the United States, age, deportation concerns, discrimination experience) with this sample had strong reliability, as well as construct validity. In all, 57.8% of day laborers experienced high rates of stress, and factor analysis differentiated four stressor domains: instability, relationships, communication, and alcohol and other drug use. Moreover, 39.2% of respondents reported lifetime difficulties with alcohol, although alcohol difficulties were not associated with stress. Implications for further research are discussed based on these findings.

The Effects of Problem Drinking and Sexual Risk Among Mexican Migrant Workers on Their Community of Origin.

Although the financial remittances sent by male Mexican migrant workers residing in the United States can result in higher standards of living for their families and home communities, out-migration may lead to increased migrant problem drinking and sexual risk behaviors, which may in turn impact these same communities of origin. Based on semi-structured interviewing (n=60) and participant observation in a migrant sending community in central Mexico and a receiving community in the Northeastern United States, this paper explores the effects of out-migration on HIV risk and problem drinking among United States-based migrants from a small agricultural community in the Mexican state of Puebla. We argue that problem drinking and risky sexual behaviors among these migrant workers have had significant consequences for their home community in terms of diminished remittances, the introduction of HIV and other sexually transmitted infections, and loss of husbands or kinsmen to automobile accidents. Moreover, although rumor and gossip between the two communities serve as a form of social control, they may also contribute to increased problem drinking and sexual risk.

Dimensions of problem drinking among young adult restaurant workers.

BACKGROUND: Nationwide surveys identify food service workers as heavy alcohol users. OBJECTIVES: This article analyzes dimensions and correlates of problem drinking among young adult food service workers. METHODS: A telephone survey of national restaurant chain employees yielded 1,294 completed surveys. RESULTS: Hazardous alcohol consumption patterns were seen in 80% of men and 64% of women. Multivariate analysis showed that different dimensions of problem drinking measured by the AUDIT were associated with workers' demographic characteristics, smoking behaviour, and job category. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: These findings offer evidence of extremely high rates of alcohol misuse among young adult restaurant workers.

Challenges of contraceptive use and pregnancy prevention among women in the U.S. Navy.

In this article we present the results of a study to illuminate the explanatory factors related to unplanned pregnancies in the United States Navy, particularly with regard to female contraceptive training and practices, and occupational culture. The data set consists of 52 semistructured interviews with key informants, sailors, and enlisted personnel who were recruited via a quota sample stratified by gender, occupation, and location. The research team carried out semistructured interviews at seven different naval facilities in the mainland United States, the South Pacific, and Europe. Textual analysis of the interview data revealed four domains pertinent to unplanned pregnancies: (a) ineffective training for women regarding contraceptive options, proper dosing, and potentially negative side effects; (b) discrepancies between contraceptive knowledge and their proper use; (c) different foci of contraceptive training for men (sexually transmitted infection prevention) and women (pregnancy prevention); and (d) cultural norms that equate contraceptive use with promiscuity.

Alcohol use in adolescents whose fathers abuse drugs.

This study examined the interrelation of several domains, including father attributes, father-child relations, peer influences, environmental factors, and youth personality, as they related to adolescent alcohol use. Several aspects of the father-child relationship were also examined as possible protective factors against adolescent drinking. Subjects consisted of 204 HIV-positive and HIV-negative drug-abusing fathers and their adolescent children between the ages of 12-20. Data were collected via individual structured interviews of both the fathers and the youth. Results indicated that several items from each domain were related to adolescent drinking, and that an affectionate father-child bond had a protective effect. Moreover, hierarchical regression analyses demonstrated that the youth's personality mediated between all other domains and adolescent alcohol use. There was also a direct effect of peer influences on adolescent drinking. Findings extend the literature on the specific mechanisms which link parental substance use with adolescent alcohol use in a high-risk population.