Case management helps prevent criminal justice recidivism for people with serious mental illness.

Purpose The purpose of this paper is to discuss how case management can decrease recidivism for people with serious mental illness (SMI) because people with SMI are at high risk for incarceration and recidivism. Design/methodology/approach Examples of successful case management models for formerly incarcerated individuals with SMI found through a secondary analysis of qualitative data and an analysis of the literature are presented. Findings Currently, no international, national, or statewide guidelines exist to ensure that formerly incarcerated individuals with SMI receive case management upon community reentry despite evidence that such services can prevent further criminal justice involvement. Recommendations include establishment of and evaluation of best practices for case management. In addition, the authors recommend additional funding for case management with the goal of greatly increasing the number of individuals with SMI leaving the criminal justice system in their ability to access adequate case management. Originality/value Providing effective case management tailored to the needs of formerly incarcerated people with SMI improves their quality of life and reduces their involvement in the criminal justice system with clear positive outcomes for public safety and public health.

Ten-year trends in the health of young children in California: 2003 to 2011-2012.

This policy brief presents 10-year trends in several key health and wellness indicators for children ages 0-5 in California. These indicators are health insurance coverage; source of medical care; dental visits; overweight-for-age; parents singing and reading to their child and going out with the child; and preschool attendance. The data are from the California Health Interview Survey (CHIS), the largest state health survey in the U.S. The survey gathers information on a range of health behaviors and health conditions, as well as on access to health care among children, adolescents, and adults in California. A number of these key indicators are compared by income and by racial/ethnic group. This policy brief covers the years 2003 to 2011-2012, a period in which public health efforts for children focused on childhood obesity and improved nutrition, access to low-cost and free dental services, and the expansion of children's health insurance programs. CHIS data show improvement in health insurance coverage and access to dental services for low-income children over the 10-year period. However, the percentage of children who were overweight for their age remained unchanged among those in households with incomes below 200 percent of the federal poverty level (FPL). In terms of measures associated with school readiness, preschool attendance dropped overall between 2003 and 2011-2012, but the proportions of parents who sang, read, and went out with their children every day increased significantly during the 10-year period.

Children's exposure to secondhand smoke: nearly one million affected in California.

Despite the steady decline of smoking rates in California, over 200,000 children under age 12 live in homes where smoking is allowed, and another 742,000 live with an adult or adolescent smoker. Significant differences in children's exposure to tobacco smoke and risk of exposure are found by race/ethnicity, geographic regions within the state and by poverty level. African-American children were found to have a significantly higher rate of exposure than other racial and ethnic groups, while children in the Northern/Sierra and San Joaquin Valley regions were at the highest risk of exposure to secondhand smoke. Children living in lower-income households were also at higher risk. These findings can aid strategies to decrease children's exposure to tobacco smoke in the home through targeted public health messages and outreach to those enrolled in public programs.

The link between intimate partner violence, substance abuse and mental health in California.

This policy brief presents findings on the linkages between intimate partner violence (IPV), emotional health and substance use among adults ages 18-65 in California. Among the 3.5 million Californians who have ever been victimized by IPV as adults, over half a million report serious psychological distress (SPD) in the past year. Almost half of all adult IPV victims indicate that their partner was under the influence of alcohol or other drugs during the most recent incident. Two-fifths of adult IPV victims report past-year binge drinking and 7% report daily or weekly binge drinking. One in three IPV victims expressed a need for mental health, alcohol or other drug (AOD) services and almost one-fourth used mental health or AOD services during the past year. These disturbing findings can aid strategies to identify, intervene with and assist IPV victims who experience emotional and/or substance use problems.

Are adolescents being screened for emotional distress in primary care?

PURPOSE: To assess primary care providers' rates of screening for emotional distress among adolescent patients. METHODS: Secondary data analysis utilizing data from: (1) well visits in pediatric clinics within a managed care plan in California, and (2) the 2003 California Health Interview Survey (CHIS), a state population sample. The Pediatric clinic sample included 1089 adolescent patients, ages 13 to 17, who completed a survey about provider screening immediately upon exiting a well visit. The CHIS sample included 899 adolescents, ages 13 to 17, who had a routine physical exam within the past 3 months. As part of the survey, adolescents answered a question about whether they had talked with their provider about their emotions at the time of the exam. Logistic regressions, controlling for age, gender, race/ethnicity, and adolescent depressive symptoms were performed. RESULTS: About one-third of adolescents reported a discussion of emotional health. Females were significantly more likely to be screened than males (36% vs. 30% in clinic; 37% vs. 26% in CHIS); as were older and Latino adolescents in the clinic sample. Although 27% of teens endorsed emotional distress, distress was not a significant predictor of talking to a provider about emotions. CONCLUSIONS: Primary care clinicians/systems need to better utilize the primary care visit to screen adolescents for emotional health.

Adolescent preventive services: rates and disparities in preventive health topics covered during routine medical care in a California sample.

PURPOSE: The objective was to examine rates and disparities in preventive health topics covered during routine medical care for adolescents, using a California sample. METHODS: Utilizing 2003 California Health Interview Survey data, the sample included 2192 adolescents attending a physical exam within the past 6 months. Adolescents reported whether nine health topics: tobacco, alcohol, drugs, seatbelts, helmets, violence, exercise, nutrition, and sexually transmitted diseases (STDs) were discussed during their most recent physical exam. Outcomes were rates of health topics discussed and disparities in rates based on age, gender, race/ethnicity, income level, and insurance status. RESULTS: Rates ranged from 15% (violence) to 76% (nutrition, exercise). Compared to older teens, younger teens reported discussing safety more, but substances, nutrition, and STDs less. Compared to males, females reported discussing tobacco and helmets less, but exercise and STDs more. Compared to white youths, Hispanic youths reported more discussion of most topics, black youths reported more discussion of nutrition and less of violence, and Asian youths reported more discussion of seatbelts and helmets. Lower income and uninsured groups reported more discussion of health topics compared to higher income and insured groups. CONCLUSIONS: Rates of coverage of health topics are below recommended levels. Contrary to expectations, minority, uninsured, and lower income groups reported higher rates of discussing health topics. Strategies to increase the coverage of preventive health topics during routine medical care should address these findings.

Questionnaire design from a cross-cultural perspective: an empirical investigation of Koreans and non-Koreans.

A persistent challenge to self-report data across racial, ethnic, or cultural groups is the inherent difficulty of attaining cross-cultural comparability of key measures. The current research study investigated the cross-cultural functioning of health-survey questions presented to four groups: (1) Koreans who were monolingual in Korean; (2) non-Korean native speakers of English; (3) bilingual Koreans interviewed in English, and (4) bilingual Koreans interviewed in Korean. This design allowed us to include those likely to be medically underserved, and to assess both linguistic and cultural barriers to collecting health survey data. A total of 36 cognitive interviews were conducted to identify (a) translation problems; (b) problems of cultural adaptation that impede cross-cultural comparability; and (c) generic problems of questionnaire design that affect all groups. An important category of problems was identified that appeared to result from the interaction of respondent and question characteristics. Such problems can best be assessed through explicit consideration of the socio-cultural backgrounds of survey respondents, as opposed to the more usual focus on details of item translation and wording.

Benefits of a hospital-based peer intervention program for violently injured youth.

BACKGROUND: Exposure to violence predisposes youths to future violent behavior. Breaking the cycle of violence in inner cities is the primary objective of hospital-based violence intervention and prevention programs. An evaluation was undertaken to determine if a hospital-based, peer intervention program, "Caught in the Crossfire," reduces the risk of criminal justice involvement, decreases hospitalizations from traumatic reinjury, diminishes death from intentional violent trauma, and is cost effective. STUDY DESIGN: We designed a retrospective cohort study conducted between January 1998 and June 2003 at a university-based urban trauma center. The duration of followup was 18 months. Patients were 12 to 20 years of age and were hospitalized for intentional violent trauma. The "enrolled" group had a minimum of five interactions with an intervention specialist. The control group was selected from the hospital database by matching age, gender, race or ethnicity, type of injury, and year of admission. All patients came from socioeconomically disadvantaged areas. RESULTS: The total sample size was 154 patients. Participation in the hospital-based peer intervention program lowered the risk of criminal justice involvement (relative risk=0.67; 95% CI, 0.45, 0.99; p=0.04). There was no effect on risks of reinjury and death. Subsequent violent criminal behavior was reduced by 7% (p=0.15). Logistic regression analysis showed age had a confounding effect on the association between program participation and criminal justice involvement (relative risk=0.71; p=0.043). When compared with juvenile detention center costs, the total cost reduction derived from the intervention program annually was $750,000 to $1.5 million. CONCLUSIONS: This hospital-based peer intervention program reduces the risk of criminal justice system involvement, is more effective with younger patients, and is cost effective. Any effect on reinjury and death will require a larger sample size and longer followup.

The supply and demand for guns to juveniles: Oakland's gun tracing project.

In response to Oakland, California's high level of gun violence affecting young people, the East Oakland Partnership to Reduce Juvenile Gun Violence, a citywide collaboration, was formed in 1997. In 1999, the Partnership established the Oakland Gun Tracing Project to develop evidence-based policy recommendations aimed at reducing the supply of and demand for gun acquisition among urban youth. The advocacy project involved gathering, analyzing, and using police record and gun sale/registration data to inform policy and practice. Such data were collected for all gun crimes committed in Oakland, California between 1998 and 1999 in which a juvenile was either the suspect or the victim. The 213 cases involved 263 juveniles of which 170 were suspects/perpetrators and 93 were victims. Suspects as well as victims were predominantly male and African American. The 213 cases involved 132 recovered guns. Only 55% of the cases were traced to a federally licensed dealer. Three-quarters of the guns were purchased near Oakland, California. Successful traces, defined as the ability to identify federally licensed dealers and initial purchasers, were completed on only 52 of the 132 guns, demonstrating systemic tracing difficulties. Data gathered for the project was used to advocate for numerous policy changes. Recommended policy strategies include initiating a comprehensive gun tracing program so police can track all secondary sales, new laws requiring federal handgun registration which would track ownership changes, required reporting of stolen firearms, and providing effective intervention services to all juveniles the first time they enter the criminal justice system.

Community-based participatory research in the California Health Interview Survey.

INTRODUCTION: The California Health Interview Survey, the largest state health survey in the United States, uses community-based participatory research principles to develop each cycle. Other large-scale health surveys rarely include participatory research approaches. Every 2 years, the California Health Interview Survey generates state and local population-based data on health insurance coverage, access to health care, chronic disease prevalence and management, health behaviors and disease prevention, and other health issues in California. The survey is used for policy and program development, advocacy, and research. METHODS: The development of the California Health Interview Survey involves more than 145 people from more than 60 state and local policymaking bodies, public health agencies, advocacy groups, research organizations, and health care organizations. They participate as volunteers in an advisory board, on technical advisory committees, and in work groups that interact with California Health Interview Survey research staff in an accountable advisory process that shapes survey topics, measures, and sample design and determines languages selected for translation. Survey results and data are provided to the communities involved in the survey. RESULTS: California Health Interview Survey data have been widely used by local, state, and national public health leaders, policymakers, advocates, and researchers to improve access to health insurance and health care services and to develop and target prevention programs for obesity and chronic illnesses. CONCLUSION: The California Health Interview Survey participatory research model has been an effective approach to planning and implementing a health survey and should be considered by developers of other large health surveys.