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BackgroundMost justice-involved youth are supervised in community settings, where assessment and linkage to substance use (SU) treatment services are inconsistent and fragmented. Only 1/3 of youth with an identified SU need receive a treatment referral and even fewer initiate services. Thus, improving identification and linkage to treatment requires coordination across juvenile justice (JJ) and behavioral health (BH) agencies. The current study examines the comparative effectiveness of two bundled implementation intervention strategies for improving SU treatment initiation, engagement, and continuing care among justice-involved youth supervised in community settings. Exploration, Preparation, Implementation, Sustainment (EPIS) served as the conceptual framework for study design and selection/timing of implementation intervention components, and the BH Services Cascade served as the conceptual and measurement framework for identifying and addressing gaps in service receipt.MethodsPart of a larger Juvenile-Justice Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) Cooperative, this study involved a multisite, cluster-randomized control trial where sites were paired then randomly assigned to receive Core (training teams on the BH Services Cascade and data-driven decision making; supporting goal selection) or Core+Enhanced (external facilitation of implementation teams) intervention components. Youth service records were collected from 20 JJ community supervision agencies (in five states) across five study phases (baseline, pre-randomization, early experiment, late experiment, maintenance). Implementation teams comprised of JJ and BH staff collaboratively identified goals along the BH Cascade and used data-driven decision-making to implement change.ResultsResults suggest that Core intervention components were effective at increasing service receipt over time relative to baseline, but differences between Core and Core+Enhanced conditions were non-significant. Time to service initiation was shorter among Core+Enhanced sites, and deeper Cascade penetration occurred when external facilitation (of implementation teams) was provided. Wide variation existed in the degree and nature of change across service systems.ConclusionsFindings demonstrate the criticality of early EPIS phases, demonstrating that strategies provided during the formative exploration and preparation phases produced some improvement in service receipt, whereas implementation-focused activities produced incremental improvement in moving youth farther along the Cascade.

This study examines time-varying gender-responsive and gender-neutral predictors of recidivism over 3 years using baseline and quarterly follow-up interviews with 477 women released from a county jail. Of the 55 time-varying predictors tested in the longitudinal analysis, 39 were significant predictors of recidivism (new arrest or incarceration) even after controlling for baseline fixed predictors. Stepwise multivariate analysis simplified the model to 12 significant variables, including three time-varying variables associated with reduced risk of recidivism (custody of one’s children, self-help activity, environmental support), eight time-varying variables associated with increased risk of recidivism (illegal activity, type of crime, problems with probation/parole, days in jail/prison, number of sexual partners, past-year trauma, problem orientation, external pressure), and the composite measure of risk from baseline. These findings support the development of post-release re-entry services tailored for female offenders that address both gender-responsive and gender-neutral criminogenic risk factors.

This study examines predictors of recidivism over 3 years for 624 women released from a county jail using a comprehensive range of standardized measures derived from gender-responsive and gender-neutral criminogenic recidivism models. Although more than a dozen factors were related to recidivism in the univariate analysis, the multivariate analysis shows that recidivism can be reliably predicted (area under the curve = 0.90) with just four factors: age, no custody of children, substance use frequency, and number of substance problems. Exploratory analysis of women who recidivated in post-release months 1 to 3, 4 to 12, and 13 to 36 revealed that the effects of several variables (age, super optimism, and number of weeks in the jail treatment program) were dependent on the time elapsed since release from jail, whereas others (substance use and custody) had persistent effects over time. These findings support the development of re-entry services tailored for female offenders who address both gender-responsive and gender-neutral criminogenic risk factors.

Time-varying effect modeling (TVEM), a statistical technique for modeling dynamic patterns of change, presents new opportunities to study biobehavioral health processes. TVEM is particularly useful when applied to intensive longitudinal data (ILD) because it permits highly flexible modeling of outcomes over continuous time, as well as of associations between variables and moderation effects. TVEM coupled with ILD is ideal for the study of addiction. This article provides a general overview of using TVEM, particularly when applied to ILD, to better enable addiction scientists to conduct novel analyses that are important to realizing the dynamics of addiction-related processes. It presents an empirical example using ecological momentary assessment data from participants throughout their first 90 days of addiction recovery to estimate the (1) associations between morning craving and same-day recovery outcomes, (2) association between morning positive and negative affect and same-day recovery outcomes and (3) time-varying moderation effects of affect on the association between morning craving and recovery outcomes.We provide a didactic overview in implementing and interpreting the aims and results, including equations, computer syntax and reference resources. Our results highlight how affect operates as both a time-varying risk and protective factor on recovery outcomes, particularly when considered in combination with experiences of craving (i.e. dynamic moderation). We conclude by discussing our results, recent innovations and future directions of TVEM for advancing addiction science, including how 'time' can be operationalized to probe new research questions. [ABSTRACT FROM AUTHOR]

This document introduces Version 0.4 of the TRANS4D software, where TRANS4D is short for Transformations in Four Dimensions. TRANS4D enables geospatial professionals and others to transform three-dimensional positional coordinates across time and among several popular terrestrial reference frames. Version 0.4 introduces new crustal velocity models for the vicinities of Alaska and the Bering Sea, including parts of northwestern Canada and eastern Russia. These new models supplement existing velocity models for the continental United States as well as for most of Canada and for a neighborhood of the Caribbean plate. This document also provides evidence for the existence of a Bering tectonic plate, and it presents estimates for the Euler-pole parameters of this hypothesized plate. Moreover, estimated horizontal velocities computed at several geodetic stations located in Alaska provide evidence for the existence of part of the plate boundary separating the North American plate and the hypothesized Bering plate. [ABSTRACT FROM AUTHOR]

In this paper, we explore the unmet need for substance use disorder (SUD) treatment among youth, its consequences, and the opportunity to address this gap due to the expansion of behavioral health services to school-based settings under the Parity and Affordable Care Acts. We discuss the importance of using evidence-based approaches to assessment and treatment to ensure effectiveness and cost-effectiveness and show how the severity of SUD is related to a wide range of school, substance, mental, health, and health care utilization problems. Next, we introduce the other three articles in the special issue that further demonstrate the feasibility and impact of using these evidence-based practices in school-based settings, the challenges of identifying and interviewing with youth, and the need for a full continuum of interventions. In each of these areas we try to draw out the policy implication of these trends and papers.

The expansion of behavioral health services to school-based health centers under the Affordable Care Act (Public Law 111-148) presents an opportunity to improve access to substance use disorders treatment for youth and reduce their substance use, and emotional, health, and school problems. We explore the feasibility of implementing five to seven sessions of motivational enhancement therapy--cognitive behavioral therapy (MET/CBT) in school settings relative to a matched cohort in community settings. Results indicate that MET/CBT in school settings is feasible, effective, and cost-effective. Moreover, it reaches youth earlier after the onset of substance use and has the possibility to reduce existing health disparities for girls and ethnic minorities.

This simulation study sought to compare four different computerized adaptive testing (CAT) content-balancing procedures designed for use in a multidimensional assessment with respect to measurement precision, symptom severity classification, validity of clinical diagnostic recommendations, and sensitivity to atypical responding. The four content-balancing procedures were (a) no content balancing, (b) screener-based, (c) mixed (screener plus content balancing), and (d) full content balancing. In full content balancing and in mixed content balancing following administration of the screener items, item selection was based on (a) whether the target number of items for the item's subscale was reached and (b) the item's information function. Mixed and full content balancing provided the best representation of items from each of the main subscales of the Internal Mental Distress Scale. These procedures also resulted in higher CAT to full-scale correlations for the Trauma and Homicidal/Suicidal Thought subscales and improved detection of atypical responding. (Contains 5 tables.)

In assessing criminality, researchers have used counts of crimes, arrests, and so on, because interval measures were not available. Additionally, crime seriousness varies depending on demographic factors. This study examined the Crime and Violence Scale (CVS) regarding psychometric quality using item response theory (IRT) and invariance of the crime seriousness hierarchy for gender, age, and racial/ethnic groups on 7,435 respondents. The CVS is a useful measure of criminality, though some items could be improved or dropped. Differential item functioning (DIF) analysis revealed that crime seriousness varies by age and gender. IRT shows promise in assessing and adjusting for demographic variations in crime seriousness. (Contains 4 tables and 3 figures.)

This article examines the effectiveness of quarterly Recovery Management Checkups (RMCs) for people with substance disorders by level of co-occurring mental disorders (34% none, 27% internalizing disorders, and 39% internalizing and externalizing) across two randomized experiments with 92% to 97% follow-up. The 865 participants are 82% African American, 53% female, and age 37 on average. RMC involves identification of those in need of treatment, motivational interviews, and treatment linkage assistance. It is effective in linking participants in need to treatment, with equal or better outcomes among those with more mental disorders. The data support the utility of monitoring and re-intervention for clients with co-occurring disorders. (Contains 2 figures and 4 tables.)