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Partnerships between public health and faith-based organizations draw on the strengths of both sectors to achieve a shared interest in promoting health and reducing disparities. However, information about implementation of faith and public health partnerships-particularly those involving diverse racial-ethnic groups-is limited. This paper reports on findings from qualitative interviews conducted with 16 public health and congregational leaders around the country as part of the early phase of the development of a faith and public health partnership to address health disparities in Los Angeles, CA. We identified eight themes regarding the barriers and facilitators to building faith and public health partnerships and distilled these into 10 lessons for developing such approaches. These interviews identified that engaging religious organizations often requires building congregational capacity of the congregation to participate in health programs; and that trust is a critically important element of these relationships. Further, trust is closely related to how well each organization involved in the partnership understands their partners' belief structures, approaches to addressing health and well-being and capacities to contribute to the partnership. Tailoring congregational health programs to match the interests, needs and capacity of partners was identified as an important approach to ensuring that the partnership is successful. But, this is complicated by working across multiple faith traditions and the racial-ethnic backgrounds, thus requiring increased and diverse communication strategies on the part of the partnership leadership. These lessons provide important information for faith and public health leaders interested in developing partnered approaches to address health in diverse urban communities. [ABSTRACT FROM AUTHOR]

A small but growing body of research suggests that adolescents and young adults involved with the child welfare system and those transitioning out of foster care are at heightened risk of experiencing intimate partner violence (IPV). Understanding the factors that place youth at risk of IPV is central to prevention and treatment of this public health problem. However, questions remain about the prevalence and correlates of IPV among youth in foster care. Additionally, emotional abuse, a particular form of IPV in intimate partnerships, remains an understudied area in this population. This study aimed to address these gaps in research by exploring factors associated with IPV using longitudinal data from a representative sample of older youth in California Foster Care who participated in the California Youth Transitions to Adulthood Study (CalYOUTH). Our IPV outcome measures included victimization, perpetration, bidirectional IPV, and emotional abuse. Findings suggest that approximately one-fifth (20.4%) of CalYOUTH respondents had experienced some form of IPV at age 23, with emotional abuse and bidirectional violence being the most commonly reported types of IPV. Females reported emotional abuse, as well as bidirectional violence, at nearly double the rates of their male counterparts. Self-identified sexual minority youth (SMY; lesbian, gay, bisexual, transgender, queer, or questioning) were more likely to report IPV victimization, IPV perpetration, and bidirectional violence than their non-SMY peers. Youth with histories of emotional abuse, caregiver IPV victimization, sexual abuse in foster care, placement instability, substance use, anxiety, and incarceration were also at heightened risk of IPV involvement. Emotional abuse was most prevalent with SMY. The findings contribute to the growing research on IPV among transition-age foster youth with important implications for future research, practice, and policy. [ABSTRACT FROM AUTHOR]

From October 2008 through 2010, journalists Charles Ornstein and Tracey Weber produced for the Los Angeles Times and ProPublica a series of investigative reports on the performance of the California Board of Registered Nursing (BRN), finding that it took an average of 3.5 years to act on complaints of professional misconduct by registered nurses, including sexual assault of patients, substance use, and repeat medication errors that resulted in patients dying. In June 2009, Governor Arnold Schwarzenegger announced that he was firing members of the BRN. Its executive officer resigned shortly thereafter. This case study analyzes interviews with nine participants, including the journalists and individuals who were public and nurse members of the BRN in 2009. Four themes emerged: (1) There is a tension between what are perceived to be the public's interests versus nursing's interests; (2) Political naiveté about government and organizational culture can lead to the personalization of actions directed at institutions; (3) A sense of fatalism may be reinforced by organizational culture; and (4) The role and use of media in a free society may be obscured when one is the focus of investigative journalism. Nurses who seek to operate in the public sector must be grounded in the political realities of complex governmental forces that may appear to be illogical or personally offensive. Media, particularly news media, is a powerful tool for influencing these forces. Nurses should employ strategic approaches to the use of media in order to advance their voices as advocates for the public's interests. [ABSTRACT FROM AUTHOR]

Objectives. The purpose of this article is to describe a community-based participatory research pilot project conducted to investigate the knowledge, attitudes, and beliefs that Pacific Islanders (PIs) hold toward biospecimen collection, use, and banking, all of which will help drive higher PI participation rates in both medical and behavioral research studies. Method. Academic and community partners worked side by side to develop a conceptual model, study measures, and study protocols. PI community partners screened, recruited, and conducted data collection, which consisted of a paper-and-pencil survey and a 1-hour semistructured interview administered by trained community workers. Results. A total of 60 PI adults representing various PI ethnic groups completed the surveys and interviews. Results showed a general support for biospecimen studies that would benefit the community, and many are willing to provide their biospecimen samples if asked. Conclusion. Due to the established level of trust, community partners were able to successfully recruit and collect data for the study. Many of those interviewed also called for more outreach and education about the importance of biospecimen research in their communities. [ABSTRACT FROM PUBLISHER]

Domestic violence restraining orders (DVROs), although a widely used legal intervention in preventing future risk of intimate partner violence (IPV), there is a lack of documentation on the facilitators and barriers of utilization of DVROs among IPV survivors in Los Angeles County (LAC). We conducted 19 key informant interviews with various professionals working in domestic violence prevention in LAC. Factors such as survivors' motivation, ease of navigating the legal procedures, and availability of community resources facilitate the use of DVROs. Fear, ambivalence, structural barriers to access DVROs, and issues with the criminal justice system make it harder for survivors to obtain DVROs. [ABSTRACT FROM AUTHOR]

Our ability to provide affirming care to individuals who engage in sex work is limited by punitive foundations of social work. This study originates from within the sex worker rights movement. I utilize qualitative dialogues aligned with participatory principles to consider how a Black feminist disability framework can be employed to explore how intersectionality weaves itself into the lives and networks of 13 sex workers in Los Angeles, CA. Specifically, this study engaged in Participatory Action Research (PAR) and collective knowledge production to examine how criminalization operates within larger intersecting systems of oppression and complicates workers' relationships with each other. The results of this study put forth the conceptualization of the sex worker-informed stratified social hierarchy – described as the "whorearchy" – and the ways that collective care is used to combat it. I conclude with a discussion on centering restorative sex worker narratives in order to examine how criminalization hinders sex worker solidarity and how, similarly, the state's role limits the ways social workers can support sex worker liberation. [ABSTRACT FROM AUTHOR]

Introduction: During the COVID-19 pandemic, substance use disorder (SUD) treatment settings experienced several abrupt changes, including decreased admissions, reduction in services, and modified requirements for medication for substance use disorder. While these changes were implemented to facilitate the maintenance of important treatment options, the ethical consequences of such changes remained unknown. The current study aimed to explore ethical issues related to COVID-19-related changes reported by counselors in SUD treatment facilities. Method: From May to August 2020, we conducted 60 to 90 minutes in-depth interviews with 18 front-line staff in 1 residential and 1 outpatient treatment program, exploring issues drawn from the ethical principles of the national organization representing SUD counselors. Counselors volunteered to participate via phone or email, and participation was confidential. Interviews were conducted via videoconferencing. Topics included day-to-day experiences of ethical dilemmas in the workplace, particularly during the COVID-19 era. Interviews were recorded, transcribed, and checked for accuracy and a trained team of analysts then coded transcripts using thematic analysis. Results: As a result of the COVID-19 pandemic, SUD treatment programs quickly modified procedures to adhere to public health mandates while also continuing to offer care to clients. SUD counselors reported several ways their programs adapted new and creative procedures to reduce the risk of COVID-19 transmission. SUD counselors also identified several novel ethical dilemmas that occurred during the COVID-19 pandemic, often resulting from the counselor balancing the needs for responding to public health mandates with providing services to clients. There were several ways that COVID-19 related changes resulted in therapeutic challenges for some clients, and the SUD counselors highlighted ways that changes resulted in more flexible services for other clients. Conclusions: This study highlights the quick response to COVID-19 that occurred within SUD treatment. While these changes resulted in novel ethical dilemmas, they also offered more flexible and client-centered approaches to treatment. [ABSTRACT FROM AUTHOR]

Within the United States, transgender women face a disproportionate burden of violence, experiencing increased rates of multiple forms of violence compared with cisgender women and other sexual/gender minority groups. Among transgender women, further racial/ethnic disparities in experiences of violence exist. Resilience has been shown to be protective against the adverse impacts of violence on mental and physical health outcomes, yet little is known about unique sources of resilience, coping, and strength among transgender women. Sixteen in-depth interviews were conducted with a racially diverse sample of transgender women between May and July, 2020 in Los Angeles. Participants were between the ages of 23 and 67 years. Four participants identified as African American/Black, four as Latina, four as White, two as Asian, and two as Native American. Participants were recruited from a local social service organization. Interview questions assessed social network characteristics, experiences of violence, coping mechanisms, and sources of resilience in response to violence. Deductive and inductive coding schemes were used to identify common themes, and data analysis focused upon experiences of violence and sources of resilience/coping. Violence was common among members of the sample, with every participant reporting a history of multiple forms of violence. Violence perpetration came from many sources, including cisgender male strangers, family members, intimate partners, and other transgender women. Women also reported multiple sources of strength and coping, including engaging in self-care and leisure activities, behavioral adaptations, mentorship/support from other transgender women, and striving to "pass" as cisgender. Despite having faced extensive violence, the participants in this sample were resilient, demonstrating many internal and external coping mechanisms and sources of strength. These findings can inform programs and services that target transgender women, providing participants with opportunities to build resilience and other coping mechanisms to buffer the harmful mental and physical health impacts of exposure to violence. [ABSTRACT FROM AUTHOR]

Campus-based sexual violence and sexual harassment (SVSH) are prevalent issues that impact students detrimentally. Guided by community-based participatory research, this qualitative study assessed undergraduate students' perceptions of available campus SVSH resources, gaps in services, and recommendations for solutions for SVSH at three universities in California via interviews and focus groups. Approximately half of participants were unaware of available SVSH services, while others had varying knowledge of service availability and experiences with services. Students want better-funded, trauma-informed, and survivor-centered services and providers who share their identities and lived experiences. We provide multi-level student-centered solutions to improve current campus-based SVSH prevention efforts. [ABSTRACT FROM AUTHOR]

Adults experiencing homelessness experience a disproportionate burden of health disparities which has further exacerbated mental health, substance use, and coping during the COVID-19 pandemic. As limited data is available to understand the experience of adults experiencing homelessness and their health during this time, the purpose of this study was to explore how COVID-19 may have impacted their mental health, substance use, and ways of coping in this population. Using community-based participatory research, a community advisory board was established and remote individual interviews with 21 adults experiencing homelessness and 10 providers were conducted in Skid Row, Los Angeles. Using a qualitative, data analytic approach, the following major themes emerged: (1) Negative Impact of COVID-19 on Mental Health; (2) Negative Impact of COVID-19 on Limitation of Harm Reduction Services; and (3) Coping Strategies Utilized During the COVID-19 Pandemic. More research is needed to understand the impact of this pandemic on underserved communities. [ABSTRACT FROM AUTHOR]

Workplace violence (WV) is a significant and growing problem for health care workers. Increased recognition of the need for improved protections has led to policy initiatives at the state and federal levels, including national Joint Commission requirements that went into effect January 2022. California's WV prevention legislation was phased in during 2017-2018 and requires hospitals to use a new incident reporting system, the Workplace Violent Incident Reporting System (WVIRS) for Hospitals. We analyzed WVIRS data collected during the first three years of its implementation, July 1, 2017 – June 30, 2020. In addition, we collected qualitative data from six California hospitals/hospital systems during 2019-2020 to better understand reporting practices. Over the three-year period, the 413 hospitals using the WVIRS reported between zero and six incidents per staffed bed. Sixteen hospitals (3.9%) reported two or more incidents per staffed bed while the rest reported fewer than two incidents. Qualitative analysis identified that reporting procedures vary considerably among hospitals. Several organizations rely on workers to complete incident reports electronically while others assign managers or security personnel to data collection. Some hospitals appear to report only those incidents involving physical harm to the worker. Regulatory guidance for reporting practices and hospitals' commitment to thorough data collection may improve consistency. As hospitals throughout the U.S. consider practice changes to comply with new WV standards, those engaged in implementation efforts should look closely at reporting practices. Greater consistency in reporting across facilities can help to build evidence for best practices and lead to safety improvements. [ABSTRACT FROM AUTHOR]

Background: Critical care nurses have risked their lives and in some cases their families through hazardous duty during the COVID-19 pandemic and have faced multiple ethical challenges. Research/aim: The purpose of our study was to examine how critical care nurses coped with the sustained multi-faceted pressures of the critical care environment during the unchartered waters of the COVID-19 pandemic. It was anticipated that our study might reveal numerous ethical challenges and decision points. Research design: A qualitative descriptive study, utilizing an interpretivist paradigm. Participants and research setting: Critical care nurses, working in either intensive care units or emergency departments (N = 11) who were primarily from Northern California hospitals. Individual in-depth ZOOM® session interviews, guided by semi-structured questions, were used to collect data. Interviews lasted between 18 and 59 min, with an average length of 33 min. Session interviews were transcribed and analyzed. Ethical considerations: This study was approved by the researchers' university Institutional Review Board. Findings: Five main themes emerged: Fear of the Unknown, Adapting to Practice Changes and Challenges, Patient Advocacy and Moral Distress, Isolation and the Depersonalization of Care, and Professionalism and a Call to Duty. Discussion and conclusion: Fear of becoming ill or bringing COVID-19 home to their families was a constant source of anxiety for nurses. There were numerous changes in policy and challenges to standard practice protocols, including most notably shortages in personal protective equipment, which nurses navigated resourcefully. Most nurses interviewed were motivated by a sense of professional duty. The nurses experienced some moral distress in their inability to advocate as they might like for their patients, especially at end of life. Infection control requirements for isolation. [ABSTRACT FROM AUTHOR]

Parents play a critical role in the progression and outcomes of juvenile dependency (child welfare court) cases. Yet, very little is known about these parents' knowledge, attitudes, and experiences. We examined legal understanding and attitudes among 201 parents involved in ongoing dependency cases in California and Florida via semi-structured, in-person interviews. We expected parents' understanding to be low and attitudes to be negative, particularly among parents of color and low SES parents. We expected greater dependency understanding to be related to more positive justice attitudes, and procedural and distributive justice attitudes to be indistinguishable in this population. Findings partially confirmed expectations. Parents' understanding of the system was low, especially among parents of color and less educated parents. Parents felt less than satisfied about the fairness of procedures and decisions. However, procedural and distributive justice attitudes were distinguishable. Finally, and unexpectedly, parents' knowledge and attitudes were negatively related. The consistently low levels of knowledge across CA and FL suggest the critical need to increase parental knowledge. It is also important to promote fair court procedures and decision-making to improve parents' attitudes about procedural and distributive justice, which were found to be distinct and important factors among parents navigating juvenile dependency cases. [ABSTRACT FROM AUTHOR]

Trauma-focused research highlights the reactions of seasoned professionals when engaging with vulnerable clients; however, less is known about the common reactions of novices engaged in trauma research, who may lack the skills to cope and interact with traumatized participants. The purpose of this study is to (a) describe common reactions experienced by novice trauma interviewers; (b) examine whether the issues they face are similar to those of seasoned helping professionals; and (c) discuss ways in which training and supervision can increase the well-being of interviewers in trauma research. A semi-structured assessment was administered to novice interviewers who had previously conducted psychosocial and trauma assessments with diverse community participants. Participation was voluntary. The assessment elicited responses concerning secondary traumatic stress, vicarious trauma, posttraumatic growth, and self-help and resources. Audio files were transcribed; responses were compiled to explore themes and identify illustrative quotes. Eight interviewers (two males, six females) participated. Six reported no prior experience working with populations with histories of trauma. Novice interviewers described experiences of secondary traumatic stress, vicarious trauma, compassion fatigue, posttraumatic growth, and resilience. Novice interviewers described symptoms consistent with those reported by seasoned helping professionals; positive and negative symptoms often coexisted. Interviewers who completed more assessments described reactions of sadness, anger, insomnia, and changes in worldview. Interviewers who shared similar traumatic histories or environments reported more examples of countertransference. All reported similar feelings of posttraumatic growth, such as hope and optimism, for their participants and an increased appreciation of their resilience. Implications for training and supervision are discussed. [ABSTRACT FROM AUTHOR]

This study examines the process and effects of using facebook (FB) to locate and re-contact study participants targeted for follow up in a longitudinal study of adult methamphetamine users (N = 649). A follow-up interview was conducted in 2009-11 approximately 8 years after previous study participation. Our paper describes re-contact efforts involving FB, including IRB regulatory issues and the effectiveness of using FB compared to mailings and phone calls. A total of 48 of the 551 surviving non-incarcerated participants who agreed to be contacted for follow up studies were contacted via FB, of whom 11 completed the follow-up interview. Those contacted through FB were more likely to be younger, female, relocated out-of-state, and reported somewhat higher rates of anxiety and cognitive problems compared to those not located on FB. Although participants contacted through FB are likely to differ demographically from those contacted by phone or mail, FB provides a potentially effective means to expand conventional methods of correspondence for contacting hard to reach participants. [ABSTRACT FROM AUTHOR]

Homeless youth experience all types of violence at higher rates than their housed counterparts. This is typically the result of many contributing factors including childhood experiences of trauma, subsistence survival strategies, and exposure to perpetrators while living on the streets. Reducing violence in the lives of homeless youth is imperative and can contribute to a young person's ability to safely and successfully exit the streets and lead a long and productive life in society. However, developing public health and social interventions to reduce violence in adolescent and young adult populations is difficult due to the complex interplay of extrinsic and intrinsic drivers of this phenomenon. Los Angeles area homeless youth (N = 366) were asked questions regarding recent violence experiences, emotion regulation, and their social network. Multivariable logistic regressions tested the overall effect of emotion regulation on violence, controlling for age, gender, race, sexual identity, experience of childhood abuse, and data collection site. In this sample, 56% of youth endorsed fighting in the previous year, and those who reported more difficulties with emotion regulation were significantly more likely to fight. In addition, youth who scored below the mean on difficulties with regulation and belonged to networks characterized by low-difficulty peers were 60% less likely to report fighting. Emotion regulation skills represent a malleable target for intervention that may contribute to reduced propensity for violence in this population. Implications for network-based interventions to improve individual emotion regulation and reduce overall violence among homeless youth and other at-risk populations are discussed. [ABSTRACT FROM AUTHOR]

This paper reports the results of a study on the use of illicit drugs and related problems in groups that are often considered hidden populations at high risk for drug abuse. Face-to-face interviews were conducted in 1992-94 with 5,168 subjects from sexually transmitted disease (STD) clinics, hospital emergency rooms (ER), and jails in Los Angeles County, California. Extensive drug involvement and other HIV-risk behaviors were reported by all three samples. Excluding marijuana, crack and cocaine were the most prevalent drugs used; the rate of positive cocaine urinalysis was 8.5% for STD subjects, 18.1% for ER subjects, and 52.8% for the arrestees. About 40% of the subjects from both STDs and jails and 27% from ERs reported three or more sex partners in the past year. About 41% of SID and 49% of ER samples also reported having arrest records. Current use of heroin and cocaine was highly associated with multiple sex partners and an arrest record. The study confirmed the high prevalence of drug abuse and other high-risk behaviors in these samples. The importance of targeting these groups for early identification and intervention is underscored. [ABSTRACT FROM AUTHOR]

This article discusses the study objectives and survey methods associated with the California Disability Survey (CDS), a large-scale telephone study of the California household population. The CDS project was designed to estimate the prevalence of disability and disabling conditions for the state as a whole and in a variety of smaller administrative areas, and to assess the service needs of the disabled and the degree to which they utilize existing forms of governmental assistance. The CDS project was also the first large-scale academic or governmental study to use the new survey methods associated with computer-assisted telephone interviewing (CATI). This article reviews the rationale for the general CDS design and its use of computer-assisted methods, and emphasizes those aspects of the CDS experience that may be relevant for other large-scale studies in the area of human services. [ABSTRACT FROM AUTHOR]

Emerging adults have been raised in the digital age and are therefore prime candidates for using a patient portal to manage chronic conditions. The limited body of research both identifies the underutilization of the patient portal and suggests increased use of the portal for the chronically ill as a tool to alleviate caregiver stress, as well as a potential modality to assist emerging adults to manage their chronic illnesses. This qualitative study was completed to obtain an understanding of emerging adults familiarity with the electronic patient portal and to elicit the perception of the usefulness of the portal to support self-management of type I diabetes. Findings provide a preliminary understanding of how a sampling of emerging adults with type I diabetes uses, perceives the benefits of, and wants to improve technology for diabetes self-management. [ABSTRACT FROM AUTHOR]

Individuals born between 1945 and 1965 ("baby boomers") account for an estimated three quarters of all hepatitis C (HCV) infections in the United States. This article describes the evaluation of Test4HepC, a program that uses social media and a website to promote HCV testing to baby boomers in Los Angeles County, California. The first 16 months of Test4HepC were evaluated using an online survey (n = 302), qualitative interviews (n = 20), website and social media analytics, and records of free testing offered though the program. Test4HepC.org had 6,919 visitors; 48 individuals used the free testing offered. Within 1 month of visiting the website, 24.5% (74) of survey participants tested for HCV, 67.6% (50) received a negative HCV antibody test result, 2.7% (2) received a positive HCV antibody test result, and 25.7% (19) had not received their results as of taking the survey. Most of those not tested (60.5%) reported intention to test. In multivariable analysis, male sex and high perceived usefulness of the program website were associated with HCV testing. Qualitative interviews suggested that Test4HepC increased baby boomers' HCV risk perception and encouraged testing. Social media is a promising strategy for promoting HCV testing to baby boomers. Expanding Test4HepC to other areas and prioritizing the highest risk baby boomers could enable many people with HCV to benefit from new treatments. [ABSTRACT FROM AUTHOR]

For criminalized people, particularly those who have been recently incarcerated, applying for and maintaining public assistance—cash aid and/or food assistance—is an immediate and crucial element of survival. Yet relative to a substantial body of research that documents pathways into and out of carceral citizenship, this aspect of postincarceration work has received little scholarly attention. Likewise, frontline welfare workers are often simplistically portrayed as gatekeepers who restrict poor people's access to public assistance. In this article, we make visible the intersection of welfare and criminal-legal involvement by examining how criminalized clients are understood by welfare workers in one large, densely populated California county. Our data come from a larger ethnographic study of women's postincarceration experiences of public institutions and include in-depth interviews with 19 frontline welfare workers and participant observation of welfare offices. We find that (a) criminal-legal awareness varies among welfare workers; (b) workers engage in substantial invisible labor, in large part to counteract the carceral logics of the welfare system; and (c) in absence of professional training, workers draw heavily on their own situated knowledge to manage the challenges of their work. Contextualizing these findings within a broader trend toward the deprofessionalization of welfare workers, we argue that the training and education of this workforce, particularly around criminal-legal issues, is an important avenue for social work advocacy. [ABSTRACT FROM AUTHOR]

Scholars, advocates, and victims have repeatedly criticized the police treatment of sexual assault (SA) complainants. Apathetic attitudes and hostile behavior on the part of the police have likely resulted from socialization into a culture that condones the use of force and violence and blames SA victims for their victimization. Using data from in-depth semistructured interviews with 52 Los Angeles Police Department sex crimes detectives, we examine officer attitudes toward teenage complainants of SA. Notably, almost three fourths of the respondents (n = 38; 73%) mentioned that teenagers lie about SA. Practical implications, theoretical advancements, and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

From kindergarten through college, students perceive boys as more intelligent than girls, yet few sociological studies have identified how school processes shape students' gender status beliefs. Drawing on 2.5 years of longitudinal ethnography and 196 interviews conducted at a racially diverse, public middle school in Los Angeles, this article demonstrates how educators' differential regulation of boys' rule-breaking by course level contributed to gender-based differences in students' perceptions of intelligence. In higher-level courses—where affluent, White, and Asian American students were overrepresented—educators tolerated 6th-grade boys' rule-breaking, such that boys challenged girls' opinions and monopolized classroom conversations. By 8th grade, students perceived higher-level boys as more exceptionally intelligent than girls. However, in lower-level courses—where non-affluent Latinx students were overrepresented—educators penalized 6th-grade boys' rule-breaking, such that boys disengaged from classroom conversations. By 8th grade, lower-level students perceived girls as smarter than boys, but not exceptional. This article also demonstrates how race intersected with gender when shaping students' perceptions of intelligence, with students associating the most superlatives with affluent White boys' capabilities. Through this analysis, I develop a new theoretical understanding of how school processes contribute to the gendered social construction of exceptionalism and reproduce social inequalities in early adolescence. [ABSTRACT FROM AUTHOR]

Cultural norms surrounding gender and family have failed to keep pace with demographic trends of family change, resulting in a wide range of family forms that are excluded from family normativity. Yet the contexts in which diverse families confront normative expectations, and the strategies they use to navigate such situations, have received limited attention. Using participant observation with gay father groups and interviews with 41 gay fathers in California and Texas, this study examines how structures of gender and family affect gay fathers’ everyday lives, as well as the management strategies that contribute to gay fathers’ resilience within exclusively paternal families. Results show that community support and norms of outness and visibility among gay fathers aid in their ability to navigate heteronormative ideologies. The concept of incidental activism is introduced to theorize the relationship between gay fathers’ resistance strategies and discourses of respectability within LGBTQ collective action. [ABSTRACT FROM AUTHOR]

This article reports findings on violence, safety, and coping strategies from interviews conducted with 281 male youth incarcerated in California’s Division of Juvenile Justice (DJJ). Descriptive analyses revealed that youth report that violence is a common occurrence and that some locations, such as school or housing units, were particularly dangerous. Analysis of how youth avoid violence revealed three distinct precautionary or coping strategies. These three categories highlight a range of conflict management techniques from avoidance to aggression. Those youth who were younger, sex offenders, or newer to the facility used more passive avoidance techniques while gang members and those more active in violent misconduct used more aggressive techniques. A third group, those youth proactively navigating their interactions, had spent more time in their current institution and were marginally more likely to be adult court commitments. Intervention and policy implications of this study are also discussed. [ABSTRACT FROM AUTHOR]

The U.S. government has a long tradition of providing direct care services to many of its most vulnerable citizens through market-based solutions and subsidized private entities. The privatized welfare state has led to the continued displacement of some of our most disenfranchised groups in need of long-term care. Situated after the U.S. deinstitutionalization era, this is the first study to examine how immigrant Filipino women emerged as owners of de facto mental health care facilities that cater to the displaced, impoverished, severely mentally ill population. These immigrant women–owned businesses serve as welfare state replacements, overseeing the health and illness of these individuals by providing housing, custodial care, and medical services after the massive closure of state mental hospitals that occurred between 1955 and 1980. This study explains the onset of these businesses and the challenges that one immigrant group faces as owners, the meanings of care associated with their de facto mental health care enterprises, and the conditions under which they have operated for more than 40 years. [ABSTRACT FROM AUTHOR]

Purpose: The prevalence of diabetes is increasing in Hmong Americans, an understudied ethnic minority group. This research sought to identify barriers and facilitators related to the diabetes education experience of Hmong Americans with type 2 diabetes, living in central California. Method: This qualitative study employed a hybrid design to identify barriers and facilitators to diabetes education. Two focus group interviews were conducted among 16 participants. Findings: The three barriers identified are language, self-management, and stress; the three facilitators are focused culturally specific education, use of media, and peer support group. A priori elements of the Study of Access framework were confirmed. Discussion/Conclusion: There is a need for diabetes education in Hmong Americans. Health care access and education should incorporate culturally appropriate strategies that could improve health outcomes for the Hmong. Implication: To improve diabetes care in the Hmong population, health educators should consider the use of cultural competency, language assistance, and culturally appropriate education to achieve better clinical outcomes. [ABSTRACT FROM AUTHOR]

This article examines the intersection of two structural developments: the growth of surveillance and the rise of "big data." Drawing on observations and interviews conducted within the Los Angeles Police Department, I offer an empirical account of how the adoption of big data analytics does--and does not--transform police surveillance practices. I argue that the adoption of big data analytics facilitates amplifications of prior surveillance practices and fundamental transformations in surveillance activities. First, discretionary assessments of risk are supplemented and quantified using risk scores. Second, data are used for predictive, rather than reactive or explanatory, purposes. Third, the proliferation of automatic alert systems makes it possible to systematically surveil an unprecedentedly large number of people. Fourth, the threshold for inclusion in law enforcement databases is lower, now including individuals who have not had direct police contact. Fifth, previously separate data systems are merged, facilitating the spread of surveillance into a wide range of institutions. Based on these findings, I develop a theoretical model of big data surveillance that can be applied to institutional domains beyond the criminal justice system. Finally, I highlight the social consequences of big data surveillance for law and social inequality. [ABSTRACT FROM AUTHOR]

Background. The 2014 Surgeon General’s Report noted that high smoking rates in vulnerable populations such as the homeless have been a persistent public health problem; smoking prevalence among individuals experiencing homelessness exceeds 70%. Historically, service providers for the homeless have not enacted comprehensive tobacco control policies. Method. We conducted a qualitative study of homeless housing programs in San Francisco. Administrators representing 9 of the city’s 11 homeless service agencies were interviewed to assess institutional smoking-related policies and cessation programs and perceived barriers and receptivity to instituting tobacco control interventions. Results. Respondents indicated that although most programs had adopted smoke-free grounds and some had eliminated evidence of staff smoking, the smoking status of clients was assessed only when required by funders. None of the programs offered smoking cessation interventions. Most administrators were receptive to adopting policies that would promote a tobacco-free culture; however, they noted that their clients had unique challenges that made traditional smoking cessation programs unfeasible. Conclusions. Homeless housing programs in San Francisco have not yet adopted a tobacco-free culture. Existing policies were created in response to external mandates, and smoking cessation programs may need to be modified in order to effectively reach clients. [ABSTRACT FROM AUTHOR]

To understand health, research needs to move outside of controlled research settings into the environments where health activities occur—homes, streets, and neighborhoods. I offer the docent method as a qualitative place-based approach for exploring health in a participant-driven, structured, and flexible way. The docent method is a participant-led, audiotaped, and photographed walking interview through broad “sites of interest” (SOIs). It is rooted in grounded theory and influenced by community-based participatory research and walking interviews. The three stages of the docent method involve: (a) a warm-up interview focusing on positionality, participant background, and mapping/planning SOIs; (b) a participant-led, photographed walking interview to and around the SOI; and (c) a wind-down interview in the community. I describe the methodological influences, development, and procedures of the docent method drawing from my own experiences conducting it with formerly homeless women living in permenant supportive housing in the Tenderloin neighborhood of San Francisco. [ABSTRACT FROM AUTHOR]

How African American men and women respond to and manage living with coronary heart disease (CHD) is not well understood despite the well-documented disproportionate burden of CHD and its complications among African Americans in the United States. Through a critical interactionist perspective, we explore illness experiences of African Americans living with CHD and describe a broad range of micro-, meso-, and macro-contextual factors that influence their illness experiences. For participants in this study, CHD has become a “Black disease” wherein certain bodies have become historically and racially marked; a conceptualization maintained and passed on by African Americans themselves. Such findings highlight that CHD is more than a “lifestyle disease” where high-risk behaviors and lack of healthy choices are ultimate culprits. Rather, CHD is perceived by African Americans who have it as yet another product of ongoing racial and socio-structural dynamics through which their health burdens are created, sustained, and reproduced. [ABSTRACT FROM AUTHOR]

Minority students at risk for math difficulties (MD) struggle with word problems for various reasons beyond procedural or calculation challenges. As a result, these students require support in reading and language development in addition to math. The purpose of this study was to assess the effectiveness of a math comprehension strategy based on a dynamic assessment (DA) framework, which provided scaffolding support based on the student's reading and language levels. A multiple baseline design was used to assess eight third-grade minority students at risk for MD. As compared with the baseline phase, the strategy increased problem-solving ability for all participants. All students maintained performance levels during follow-up sessions. Results suggest that the intervention facilitated word-problem-solving performance. [ABSTRACT FROM AUTHOR]

Rapid proliferation of smartphone ownership and use among Latinos offers a unique opportunity to employ innovative visually enhanced low-text (VELT) mobile health applications (mHealth app) to promote health behavior change for Latinos at risk for lifestyle-related diseases. Using focus groups and in-depth interviews with 16 promotores and 5 health care providers recruited from California clinics, this qualitative study explored perceptions of visuals for a VELT mHealth app promoting physical activity (PA) and limiting sedentary behavior (SB) for Latinos. In this Phase 1 study, participants endorsed visuals portraying PA guidelines and recommended visuals depicting family and socially oriented PA. Overall, participants supported a VELT mHealth app as an alternative to text-based education. Findings will inform the future Phase 2 study development of a culturally appropriate VELT mHealth app to promote PA for Latinos, improve health literacy, and provide an alternative to traditional clinic text-based health education materials. [ABSTRACT FROM AUTHOR]

A movement worldwide, and specifically new to our hospital, is the implementation of Patient- and Family-Centered Care. We were unsure, however, what the needs were of our patients’ families. This triangulated study, on a 28-bed oncology unit, studied family members at the bedside. We asked family members what their needs were in a three-step process (open-ended interview, use of the Draw a Bridge art therapy technique, and the Family Inventory of Needs survey). Nineteen interviews revealed needs for physical comfort, emotional support, cultural sensitivity, recognition of help provided by family members and improved pain management. Art therapy revealed the stress of caregiving and helped to uncover unmet needs for interviewers to explore. The FIN identified that care at home after discharge was a major worry. Knowledge of family members’ needs while a loved one is in the hospital allows for planning and provision of modalities to assist them in their caregiving. [ABSTRACT FROM AUTHOR]

This study examined coercive conditions experienced by trafficked persons in the context of Biderman’s theory of coercion. We conducted semi-structured interviews with 12 adult women trafficked into Los Angeles County, from 10 countries, for domestic work and/or sex work. Participants described health problems they experienced in relation to their trafficking experience and their perceptions of conditions that caused health problems. Utilizing a framework analysis approach, we analyzed themes using Biderman’s framework. Participants reported experiencing the range of nonphysical coercive tactics outlined by Biderman, including isolation, monopolization of perception, induced debility or exhaustion, threats, occasional indulgences, demonstration of omnipotence, degradation, and enforcement of trivial demands. Our analysis demonstrates how these coercion tactics reinforced the submission of trafficked persons to their traffickers even in the absence of physical force or restraints. Such psychological abuse creates extreme stress that can lead to acute and chronic, physical and mental health problems. [ABSTRACT FROM AUTHOR]

Latino day laborers endure many hardships as they struggle to adjust as an immigrant community in the United States. This study sought to identify the extent of chronic stress reported by day laborers and the factors associated with stress. A total of 725 Latino day laborers were interviewed. The most reported sources of stress were having immigration-related problems, not having enough money to cover basic needs, having no savings, and having work hours change for the worse. Higher chronic stress was associated with homelessness (p < .001) and HIV-related risk behaviors in the previous 12 months (p < .05). In addition, chronic stress was found to be higher among respondents reporting incomes of US$5,000 to US$10,000 (p = .007) and still higher among respondents reporting incomes greater than US$10,000 (p < .001) compared with those in the lowest income level. Lower chronic stress was associated with having a partner (p < .05) or being single (p = .001) compared with being married. Addressing the stress experienced by day laborers is necessary to prevent potential negative health and mental health consequences among this population. [ABSTRACT FROM AUTHOR]

Previous research documents that street-involved youth experience rates of trauma and posttraumatic stress disorder (PTSD) that are significantly higher than their housed counterparts. Trauma and PTSD are of particular concern for homeless youth as they can negatively affect youths’ ability to function adaptively and to transition off the streets. This mixed-methods study investigates the intricacies of trauma experienced by homeless youth across three U.S. cities. Qualitative interviews were conducted with a sample of 145 homeless youth in Los Angeles (n = 50), Denver (n = 50), and Austin (n = 45) to explore youths’ perspectives on the definition of trauma and the contexts associated with victimization. Quantitative standardized assessments investigated youths’ trauma experiences before and after becoming homeless. Trauma screening identified high rates of trauma incidents (78%), with 28% of participants meeting criteria for PTSD. Participants reported various traumatic experiences that occurred before leaving home and while on the streets, and high rates of polyvictimization. Qualitative themes describe particular people and places most vulnerable on the streets. Implications for services to prevent and treat trauma among homeless youth are discussed. [ABSTRACT FROM AUTHOR]

Objectives. The San Francisco Department of Public Health (SFDPH) has the goal of offering HIV partner services (PS) to all individuals newly diagnosed with HIV in San Francisco. However, measuring the potential impact of these services is challenging. Building on an existing syphilis partner notification program, we developed a framework for expanding and monitoring HIV PS in San Francisco. Methods. We identified process and outcome measures to evaluate HIV PS in San Francisco, including the number of index patients interviewed, the proportion of named partners who had previously diagnosed HIV infection, the proportion of HIV-uninfected partners who tested through HIV PS, and the positivity rate among the partners tested. Results were recorded in a locally developed electronic surveillance and case-management system at SFDPH. Results. We examined HIV PS data from 2005-2011. In 2011, 426 new HIV diagnoses were reported, and 178 were assigned for HIV PS; of these, 124 (69.7%) patients were successfully interviewed, naming a total of 109 sex partners. Of the named partners, 34 (31.2%) had been previously diagnosed with HIV. Among the remaining named partners not known to be HIV infected, 31 (32.3%) were tested, for a positivity of 22.6% (n57). The proportion of HIV that was newly diagnosed by a provider who participated in the citywide HIV PS program increased from 15.4% in 2005 to 69.5% in 2011. Conclusions. As HIV PS expand, locally relevant outcome measures are increasingly important. Using these criteria, HIV PS as a targeted screening activity resulted in the identification of newly diagnosed HIV cases. [ABSTRACT FROM AUTHOR]

Research on immigration, educational achievement, and ethnoraciality has followed the lead of racialization and assimilation theories by focusing empirical attention on the immigrant-origin population (immigrants and their children), while overlooking the effect of an immigrant presence on the third-plus generation (U.S.-born individuals of U.S.-born parents), especially its white members. We depart from this approach by placing third-plus-generation individuals at center stage to examine how they adjust to norms defined by the immigrant-origin population. We draw on fieldwork in Cupertino, California, a high-skilled immigrant gateway, where an Asian immigrant-origin population has established and enforces an amplified version of high-achievement norms. The resulting ethnoracial encoding of academic achievement constructs whiteness as having lesser-than status. Asianness stands for high-achievement, hard work, and success; whiteness, in contrast, represents low-achievement, laziness, and academic mediocrity. We argue that immigrants can serve as a foil against which the meaning and status of an ethnoracial category is recast, upending how the category is deployed in daily life. Our findings call into question the position that treats the third-plus generation, especially whites, as the benchmark population that sets achievement norms and to which all other populations adjust. [ABSTRACT FROM PUBLISHER]

Objectives. Calls for public health practices, including research, to better integrate social theories of power, agency, and social change suggest that increased reflexivity about both the process and outcomes of community engagement is warranted. Yet few community-based participatory research (CBPR) projects specifically report nonresearch outcomes of such projects. The authors analyzed “secondary outcomes” of Protecting the ’Hood Against Tobacco (PHAT), a CBPR project conducted in San Francisco, California. Methods. Interpretive analysis of quasi-ethnographic project documentation, including meeting minutes, field notes, retrospective observations, and interviews. Results. PHAT participation created “ripple effects,” encouraging healthier behaviors and public health promotion among community research partners, prompting academics to confront power asymmetries and recognize community knowledge, and widening social networks. Conclusions. CBPR benefits both communities and researchers beyond the findings of the research itself. More systematically capturing these effects, perhaps through wider use of ethnographic approaches, could help enhance understanding of CBPR’s true contributions. [ABSTRACT FROM PUBLISHER]

The disproportionate impact of type 2 diabetes (T2DM) on low-income groups and the social and biological processes linking poverty and T2DM inequalities are well-documented. Moreover, millions of dollars are invested annually in programs aimed at reducing T2DM inequalities, yet these remain stubbornly high. Our article explores how public discourses influence T2DM and related health inequalities in a low-income neighborhood in Northern California, through a thematic analysis of interviews and focus groups of staff and clients at a non-governmental organization. We probe participants' beliefs vis-à-vis the causes of, and solutions to, T2DM inequalities and explore whether and how the discourses normalizing them are challenged. We find that staff identify the ultimate source of T2DM inequalities within health sufferers (i.e., their lifestyle choices, psychological makeup, or cultural preferences), even as they acknowledge the widespread poverty, unemployment, and other social determinants that present serious barriers to their health. Notably, we find this normalizing discourse among clients themselves. While our study is empirical, its goal is primarily conceptual: to add to the evolving understanding of discourse as a social practice that may contribute both to status quo reproduction and to social change and resistance. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the association between acculturation, birthplace, and alcohol-related social problems across Hispanic national groups. A total of 5,224 Hispanic adults (18+ years) were interviewed using a multistage cluster sample design in Miami, New York, Philadelphia, Houston, and Los Angeles. Multivariate analysis shows no association between acculturation and problems among men or women. Birthplace is a risk factor for social problems among both genders. Among men, Mexican Americans, Puerto Ricans, and South/Central Americans are more likely to report social problems than Cuban Americans. Other risk factors for men are unemployment, a higher volume of drinking, and a higher frequency of binge drinking. Among women, Mexican American origin and binge drinking are also risk factors for reporting problems. U.S.-born Hispanics may experience stress and other detrimental effects to health because of their minority status, which may increase the likelihood of more drinking and the development of alcohol-related problems. [ABSTRACT FROM PUBLISHER]