Examining First and Second-Level Digital Divide at the Intersection of Race/Ethnicity, Gender, and Socioeconomic Status: An Analysis of the National Health and Aging Trends Study.

BACKGROUND AND OBJECTIVES: Significant societal and technological changes in the 2010s called for an up-to-date understanding of the digital divide among older adults in the United States (U.S.). This trend study aimed to examine the effects of race/ethnicity and the intersecting effects of race/ethnicity with other marginalized identities related to gender, income, education, and occupation on the first- and second-level digital divide. RESEARCH DESIGN AND METHODS: Utilizing a nationally representative sample of older community dwellers from the National Health and Aging Trends Study, we conducted weighted logistic regressions at three time points (2011/2013, 2015, and 2019). The first-level digital divide was measured by access to working phones or computers/laptops; the second-level divide was measured by seven activities in personal-task, social, and health-related Internet use. RESULTS: The first-level racial/ethnic digital divide became non-significant in 2019, whereas the disparities in all second-level measures persisted. The intersecting effects of race/ethnicity with low education and/or low income became non-significant in 2019 for personal-task use. However, the interactions with low education and/or low income became significant for social and health-related use in 2015 and/or 2019. DISCUSSION AND IMPLICATIONS: This study highlights the persistence of the second-level racial/ethnic digital divide among older community dwellers in the U.S., especially the exacerbated social and health-related digital divide for people of color with low socioeconomic status. By considering intersections of marginalized social identities, policymakers and stakeholders should develop targeted strategies to bridge the digital divide, promote health outcomes, and reduce health disparities.

Older adults' online activities and cognition: Investigating the psychological mechanisms and age and gender differences.

OBJECTIVES: This study aimed to investigate psychological mechanisms underlying the association between older adults' Internet use and cognition and examine potential age and gender group differences. METHODS: 2064 older participants were extracted from the Waves 2012, 2013, and 2016 Health and Retirement Study. Internet use was measured by two sets of variables: Internet access and different types of online activities (i.e., informational use, social use, online shopping, and online banking). Path analyses were applied to test the proposed mechanisms via three mediators (i.e., loneliness, depressive symptoms, and perceived control). Multi-group analyses were conducted to examine the potential group differences. RESULTS: Internet use was positively associated with cognition. Despite the large direct effect, small but significant indirect effects via depressive symptoms and perceived control were identified across all online activities. Multi-group analyses revealed age-group differences in the mechanisms: depressive symptoms mediated the effects of all online activities on cognition among young-old adults, while perceived control mediated all the effects among old-old adults. Gender group differences were also identified: depressive symptoms mediated the effects of all online activities on cognition among older women and most online activities among older men, whereas perceived control mediated the associations between informational and instrumental (i.e., online shopping and banking) use and cognition among older men. DISCUSSION: This study highlights the mediating effect of depressive symptoms and perceived control and age and gender differences regarding the Internet use-cognition association. Internet-based cognitive interventions should consider these psychological mediators and age and gender differences for the best results.

Substance use treatment counselors' attitudes toward evidence-based practice: the importance of organizational context.

This study addresses individual and organizational correlates of substance user treatment counselors' attitudes toward evidence-based practice. Counselors (n = 293) from a probability sample of outpatient treatment organizations in a northeastern US state were surveyed in 2008. Multilevel [hierarchical linear model (HLM)] models address the nested sample. Attitudes toward evidence-based practice were measured with the Evidence-Based Practice Attitude Scale (Aarons). Study limitations and implications for the implementation of evidence-based practices in routine substance user treatment organizations are addressed.

Integrated Substance Abuse and Child Welfare Services for Women: A Progress Review.

A review of empirical literature reveals improvements in service utilization and outcomes for women when substance abuse and child welfare services are integrated. The increased use of substances by women involved in the child welfare system has resulted in a call for integrated, coordinated, evidence-based practices. Since the late 1990s, specific system- and service-level strategies have been developed to coordinate and integrate the provision of substance abuse and child welfare services such that women are remaining in treatment longer and are more likely to reduce substance use and be reunited with their children. The strategies reviewed provide useful guidelines for developing components of effective, evidence-based programs for substance-involved women in the child welfare system.

Child maltreatment in rural southern counties: Another perspective on race, poverty and child welfare.

Building on research that has identified community characteristics associated with child maltreatment, this study investigates the adequacy and equity of the child welfare response at the county level. The study focuses on states in the U.S. south with demographic characteristics that make it possible to disentangle county racial composition from county rurality. County-level child maltreatment data were merged with data from the U.S. Census and other publicly-available sources for the 354 counties in four southern states. Results from multiple regression models indicated that, despite a greater preponderance of risk factors typically associated with child maltreatment, rural, majority African-American counties had lower rates of reported and substantiated child maltreatment compared to other southern counties. Cross-sectional results were consistent across three years: 2012, 2013, and 2014. The findings suggest that children and families in rural, majority African-American counties in the South may not be receiving adequate or equitable responses from the formal child welfare system.

Reproductive Justice: A Policy Window for Social Work Advocacy.

Reproductive rights are at risk in many parts of the United States. To inspire social workers to act, this article begins by defining and describing the concepts of reproductive rights and reproductive justice. Next, it summarizes threats to reproductive rights in five areas: preventing pregnancy, terminating pregnancy, pregnancy loss, personhood measures, and drug use during pregnancy. Applying John Kingdon's policy streams framework, the article urges more social workers to embrace the current policy window and advocate for pregnant women and others whose reproductive rights are in jeopardy. The article also provides suggestions for ways that social work practitioners, educators, and researchers can act to promote reproductive justice for all.

Client-service matching in substance abuse treatment for women with children.

This article addresses the relation between services matched to client-identified needs and substance abuse treatment outcomes for women with children. The study uses data collected for a program evaluation of an enhanced substance abuse services program for mothers involved with the child welfare system. In-person surveys were conducted with 183 women who were currently attending, or had recently completed substance abuse treatment. Bivariate tests and multivariate logistic regression models were conducted to assess the association between matched client-identified service needs and two treatment outcomes: substance use and satisfaction with treatment. Matched counseling services (domestic violence services, family counseling) were associated with reports of reduced substance use; matched ancillary services (housing, job training, legal services) were associated with clients' satisfaction with treatment. However, the total number of services clients received had a stronger relationship to treatment outcomes than did services matched to client-identified needs.

The risk of subsequent maltreatment allegations in families with substance-exposed infants.

OBJECTIVE: This study seeks to: (1) assess the relationship between identified prenatal substance use and the risk of subsequent maltreatment allegations among families involved with child protective services; and (2) compare the types of safety threats encountered by children whose parents had substance-exposed infant (SEI) allegations to the types of safety threats faced by children whose parents had other types of allegations. METHOD: Survey data from a probability sample of parents were linked to state administrative data over a 33-month time frame. Cox regression models were conducted to assess the relative risk of subsequent allegations associated with parents whose child welfare case opened following an SEI allegation (the SEI group) compared to parents whose case opened following other types of allegations. RESULTS: The likelihood of subsequent allegations is greater among parents in the SEI group. However, the increased risk stems almost entirely from subsequent SEI-related allegations. Parents in the SEI group are not more likely to incur other types of allegations such as physical abuse or lack of supervision. CONCLUSIONS: An increased risk of subsequent maltreatment has been used to justify opening child protective cases on the basis of an SEI allegation alone. By looking closely at the types of subsequent allegations as well as the incidence of subsequent allegations, this research helps to clarify the maltreatment risks associated with SEI cases.

How parental drug use and drug treatment compliance relate to family reunification.

This study uses Cox regression to assess the relationships among parental drug use, drug treatment compliance, and reunification from substitute care. The study finds that drug treatment compliance is associated with faster reunification, even when accounting for ongoing drug use and three parenting measures. The findings are consistent with a conceptual framework suggesting that certain client actions, such as drug treatment compliance, may serve as markers that substantially affect client outcomes.

Latent practice profiles of substance abuse treatment counselors: do evidence-based techniques displace traditional techniques?

As more substance abuse treatment counselors begin to use evidence-based treatment techniques, questions arise regarding the continued use of traditional techniques. This study aims to (1) assess whether there are meaningful practice profiles among practitioners reflecting distinct combinations of cognitive-behavioral and traditional treatment techniques; and (2) if so, identify practitioner characteristics associated with the distinct practice profiles. Survey data from 278 frontline counselors working in community substance abuse treatment organizations were used to conduct latent profile analysis. The emergent practice profiles illustrate that practitioners vary most in the use of traditional techniques. Multinomial regression models suggest that practitioners with less experience, more education, and less traditional beliefs about treatment and substance abuse are least likely to mix traditional techniques with cognitive-behavioral techniques. Findings add to the understanding of how evidence-based practices are implemented in routine settings and have implications for training and support of substance abuse treatment counselors.

Frontline counselors in organizational contexts: a study of treatment practices in community settings.

This study addresses the challenge of implementing evidence-based treatment approaches in typical community settings. It identifies individual and organizational characteristics associated with two contrasting treatment approaches used by frontline practitioners. One treatment approach involves techniques supported by research; the other approach involves techniques primarily supported by experience and tradition. The study uses a nested probability sample of 45 organizations and 279 frontline practitioners. Multilevel (hierarchical linear modeling) regression models appropriately address the nested sample. The findings indicate that practitioner beliefs and components of organizational social contexts are associated with treatment approach. The use of an evidence-supported treatment approach is associated with opportunities to use training and with transformational leadership. A traditional treatment approach is more commonly used when practitioners have more positive perceptions of the organizational climate. The findings underscore the challenge of implementing evidence-based treatment techniques among counselors committed to traditional approaches.

Evaluating federally-funded child welfare training partnerships: a worthwhile challenge.

This article assesses the state of evaluation research on federally-funded child welfare training, including both Section 426 and Title IV-E partnerships. The article discusses the need for stronger evaluations of child welfare training and describes some factors which may have impeded past evaluation efforts. It recommends strengthening evaluations of federally-funded child welfare training through well-targeted questions, strong research designs, strong research methods, innovative methods, and theory-driven studies. The article concludes by promoting the development of child welfare research and training centers.