Using Concept Mapping to Operationalize Mental Well-Being for Men and Boys.

A primary purpose of many prevention-oriented interventions is to improve the general well-being and quality of life for individuals and their communities. Unfortunately, well-being is often poorly defined, with definitions embracing related issues of quality of life, happiness, and physical health. Mental well-being as a concept is also poorly defined, particularly for different population groups. As part of a larger study to assess community-level prevention efforts aimed at men and boys, a participatory approach was used to operationalize mental well-being from a male-centered, community-based perspective using concept mapping. A set of 96 statements perceived as important aspects of mental well-being for men and boys were developed and sorted by 90 participants from the study communities. The 8-cluster solution was selected as the most parsimonious and the best conceptual fit in relation to the mental well-being concept, namely, positive self-worth, supportive community, community connections, positive masculinity, responsive institutions, strong social connection, dignity and respect, and safety. These eight clusters of mental well-being, which were classified into two overarching domains of socio-environmental and emotional well-being, can provide a basis by which to assess community-based programs aimed at this population.

Trajectories of Substance Use among Child Welfare-Involved Youth: Longitudinal Associations with Child Maltreatment History and Emotional/Behavior Problems.

BACKGROUND: Maltreated children experience a variety of adverse outcomes including substance use problems. Although previous research indicated that there may be distinct trajectories of substance use among these youth, studies have examined them as if they were a single homogeneous group. OBJECTIVES: The goals of this study were to explore substance use trajectories among child welfare-involved youth and to identify characteristics that distinguish substance use trajectories. METHODS: Data from the National Survey of Child and Adolescent Well-Being (NSCAW II) were used. Multilevel latent growth mixture modeling (MLGMM) was performed using a subsample of 625 youth from ages 11-17 years investigated for maltreatment in 2008-2009. Measures included self-reported use of substance use during the previous 30 days, demographic characteristics, maltreatment history, placement in out-of-home care, and behavioral health problems. RESULTS: MLGMM identified two distinct substance use trajectory classes including High Stable Substance Use and Rapid Progression Use. Findings suggest that the experience of physical abuse is the key factor that distinguishes the two groups. When the effects of class-specific covariates were examined, results suggest that involvement in substance use behavior and its escalation vary between groups and are affected by youth's different previous experiences. Conclusions/Importance: The results have important implications for understanding individual differences in substance use behavior over time and how these differences were shaped by youth's experiences of family adversity. Study findings may be helpful for developing and enhancing the effectiveness of interventions targeted at decreasing substance use behaviors in child welfare-involved youth.

Recovering Individuals' Feelings About Addict and Alcoholic as Stigmatized Terms: Implications for Treatment.

Background: The current emphasis among addiction treatment providers is to use person-first language, such as "a person with a substance use disorder," as a way to reduce stigma around addiction and resulting barriers to treatment. This study considers how individuals recovering from substance use feel about the terms "alcoholic" and "addict," particularly how they self-identify and whether they believe the terms carry stigma. Method: Thirty-five individuals were interviewed, recruited primarily, but not exclusively, from 12-step meetings (Alcoholics Anonymous, Narcotics Anonymous), from 3 locations throughout a rural New England state. Interviews were transcribed and coded in Atlas Ti qualitative analysis software, and a content analysis of text coded with "stigma" was conducted. Results: Some comments reflected a belief that the terms "addict" and "alcoholic" carry a stigma. However, more comments rejected the notion of these being stigmatized terms; or acknowledged the stigma but reflected the subject's lack of internalizing of any stigma. Comments reflected other themes including a sense of pride, identity and ownership when self-identifying as an addict or alcoholic. Several comments suggested that person-first language is part of a larger movement to "soften everything," without changing the underlying condition (addiction). The findings may reflect the fact that subjects were recruited from 12-step programs, where the convention is to self-identity using the terms "alcoholic" and/or "addict." Conclusions: Some individuals seeking treatment for addiction may prefer self-identifying using old-school terminology (addict, alcoholic) rather than person-first language, for a variety of reasons (eg, they do not internalize the stigma of such terms).

The Longitudinal Impact of Arrest, Criminal Conviction, and Incarceration on Smoking Classes.

Background: Previous research identifies three to six smoking classes over the life course. This study expands on earlier work about the impact of getting arrested in early adulthood on individuals' smoking classes, by including additional, more serious measures of justice system involvement (JSI), specifically criminal conviction and incarceration. Family processes were examined as secondary outcomes. Method: Data from seventeen waves (1997-2015) of the National Longitudinal Survey of Youth were analyzed via group-based trajectory modeling (GBTM), multinomial logistic regression, and latent transition analyses (LTA). Smoking behavior through age 36 is examined. Marital status, parenthood, juvenile smoking, juvenile arrest, and prior crime victimization experiences were also included in the models. Results: Seven smoking classes were revealed: two low- or non-smoking classes; two decreasing classes; and three "problem" smoking (e.g., increasing, or chronic) classes. All JSI types increased the likelihood of being in a smoking class rather than a non-smoking class. Arrest and conviction had larger odds ratios than the most severe form of JSI-incarceration-with respect to respondents' likelihood of being in an increasing or chronic smoking class. Juvenile smoking was the most robust predictor of smoking in adulthood. Conclusion: Involvement with the justice system in all forms remains a negative health factor that increases smoking. While not typically a goal of criminal justice officials, attention should be paid to this unintended consequence of involvement with the justice system-increased smoking-given smoking's connection to serious illnesses such as cancer. As juvenile smoking is a strong risk factor for adult smoking, smoking prevention and cessation programs should start with youth; and be part of the offerings to individuals ensnared in the justice system at all levels.

Examining Arrest and Cigarette Smoking in Emerging Adulthood.

BACKGROUND: Despite prior studies, transitions in smoking patterns are not fully understood. Getting arrested may alter an individual's smoking pattern through processes proscribed by the criminological labeling theory. This study examined how arrest during emerging adulthood altered smoking behavior during subsequent years and whether there were differential effects by race/ethnicity and gender. METHODS: We analyzed 15 waves of data from the National Longitudinal Survey of Youth 1997. Multinomial logistic regressions were performed using Stata software version 14. RESULTS: For both genders, arrested black men and women had the most distinct smoking transitions (both increases and decreases) as compared with their non-arrested counterparts. Among men, particularly black males, arrest in early adulthood was associated with the men transitioning to both increased and decreased smoking. Patterns in smoking transitions for women were less clear, suggesting that women's smoking may be influenced by factors not in the models. Women had a low probability of starting to smoke or increasing smoking if they were never arrested between 18 and 21 years of age. CONCLUSIONS: The results for transitioning into increased smoking offer some support for labeling theory processes. Other findings suggest that arrest may lead to some men reducing or quitting smoking. Early adulthood arrest may serve to "shock the system" and contribute to males altering their prior smoking behavior. IMPLICATIONS: Tobacco use over the life course, particularly across different racial and ethnic groups, remains understudied. This study contributes to the literature using a nationally representative sample to examine the effect of getting arrested in emerging adulthood on cigarette use during subsequent years. In conducting the study, investigators combined theories and methodological approaches from 2 complementary disciplines: public health and criminal justice. Because criminal justice policymakers tend to focus on issues like ex-offender unemployment, public health officials can provide guidance regarding the effect of justice system involvement on smoking, particularly given the adverse health outcomes of using cigarettes.

How does early adulthood arrest alter substance use behavior? Are there differential effects by race/ethnicity and gender?

PURPOSE: Much criminal justice research has ignored racial/ethnic and gender differences in substance use subsequent to criminal justice involvement. This paper investigated how early adulthood arrest (i.e., 18 to 21 years of age) influences individuals' subsequent transitions from non-substance use to substance use, and substance use to non-substance use through age 30. We also consider if these relationships differ by race/ethnicity and gender. Processes proscribed by labeling theory subsequent to getting arrested are considered. METHODS: We analyzed 15 waves of data from the National Longitudinal Survey of Youth 1997. Multinomial logistic regressions were performed using Stata software version 14. RESULTS: We found racial/ethnic differences in the effect of arrest on subsequent substance use, particularly marijuana. Being arrested was associated with shifting non-binge drinkers and non-marijuana users into binge drinking and marijuana use; as well as shifting binge drinkers and marijuana users into non-use. This pattern was most evident among White and Black men. For Black men, the association between arrest and both becoming a binge drinker and becoming a non-binge drinker was experienced most strongly during their early twenties. Women's patterns in substance use transitions following an arrest were less clear than for the men. CONCLUSION: Some results, particularly transitioning into marijuana use, offer qualified support for processes proscribed through labeling theory. Findings that arrest shifts individuals into non-marijuana use suggest that factors not accounted for by labeling theory - arrest serving as a teachable moment for those using substances - may be at play.

The training of New Jersey emergency service first responders in autism awareness.

This study investigated the extent and adequacy of training among New Jersey first responders (e.g., police, firefighters, emergency medical technicians) specifically as relates to a 2008 state law mandating that autism and hidden disability recognition and response training be conducted. The results show that a significant percentage of emergency service personnel have not completed the state mandated training. Recommendations for improving the training, such as by involving parents, advocates, and field and training personnel as a part of the training process, are discussed.