Study protocol for a cluster-randomized trial of a bundle of implementation support strategies to improve the fidelity of implementation of schoolwide Positive Behavioral Interventions and Supports in rural schools.

Background: Improving the implementation of evidence-based interventions is important for population-level impacts. Positive Behavioral Interventions and Supports (PBIS) is effective for improving school climate and students' behavioral outcomes, but rural schools often lag behind urban and suburban schools in implementing such initiatives. Methods/Design: This paper describes a Type 3 hybrid implementation-effectiveness trial of Rural School Support Strategies (RS3), a bundle of implementation support strategies selected to improve implementation outcomes in rural schools. In this two-arm parallel group trial, 40 rural public schools are randomized to receive: 1) a series of trainings about PBIS; or 2) an enhanced condition with training plus RS3. The trial was planned for two years, but due to the pandemic has been extended another year. RS3 draws from the Interactive Systems Framework, with a university-based team (support system) that works with a team at each school (school-based delivery system), increasing engagement through strategies such as: providing technical assistance, facilitating school team functioning, and educating implementers. The primary organizational-level outcome is fidelity of implementation, with additional implementation outcomes of feasibility, acceptability, appropriateness, and cost. Staff-level outcomes include perceived climate and self-reported adoption of PBIS core components. Student-level outcomes include disciplinary referrals, academic achievement, and perceived climate. Mediators being evaluated include organizational readiness, school team functioning, and psychological safety. Discussion: The study tests implementation strategies, with strengths including a theory-based design, mixed methods data collection, and consideration of mediational mechanisms. Results will yield knowledge about how to improve implementation of universal prevention initiatives in rural schools.

Ethnic Economic Inequality and Fatalities From Terrorism.

Few studies have explored the influence of horizontal (i.e., among group) inequalities on terrorism, yet it seems plausible that these inequalities may be relevant. Employing data from the Global Terrorism Database and Ethnologue, this article examines the effect of ethnic economic inequality on domestic terrorism for 130 countries over the period 2001 to 2018. We present evidence that higher degrees of ethnic inequality lead to higher numbers of terrorist attacks as well as a higher number of people killed or injured. This positive association between ethnic inequality and terrorism is robust to alternative measures of ethnic inequality, omission of influential countries and regions, the inclusion and exclusion of controls, and alternative estimation strategies. In contrast, countries with high degree of political freedom and high governance quality tend to suffer less from terrorism. Promoting economic equality among ethnic groups, therefore, has the potential to reduce the risk of domestic terrorism. We propose that a critical step towards promoting this equality is to enhance social inclusion. The benefits of increasing social inclusion extend beyond simply reducing the incidence of terrorism and inter-racial violence; creating a socially inclusive society is a social justice imperative and the responsibility of policymakers, social institutions, civil society, and the private sector. It is also consistent with the notion of inclusive economic growth, as championed by organizations such as the OECD and the United Nations Development Program.

Social-Ecological Predictors of Opioid Use Among Adolescents With Histories of Substance Use Disorders.

Adolescent opioid misuse is a public health crisis, particularly among clinical populations of youth with substance misuse histories. Given the negative and often lethal consequences associated with opioid misuse among adolescents, it is essential to identify the risk and protective factors underlying early opioid misuse to inform targeted prevention efforts. Understanding the role of parental risk and protective factors is particularly paramount during the developmental stage of adolescence. Using a social-ecological framework, this study explored the associations between individual, peer, family, community, and school-level risk and protective factors and opioid use among adolescents with histories of substance use disorders (SUDs). Further, we explored the potential moderating role of poor parental monitoring in the associations between the aforementioned risk and protective factors and adolescent opioid use. Participants included 294 adolescents (M age = 16 years; 45% female) who were recently discharged from substance use treatment, and their parents (n = 323). Results indicated that lifetime opioid use was significantly more likely among adolescents endorsing antisocial traits and those whose parents reported histories of substance abuse. Additionally, adolescents reporting more perceived availability of substances were significantly more likely to report lifetime opioid use compared to those reporting lower perceived availability of substances. Results did not indicate any significant moderation effects of parental monitoring on any associations between risk factors and lifetime opioid use. Findings generally did not support social-ecological indicators of opioid use in this high-risk population of adolescents, signaling that the social-ecological variables tested may not be salient risk factors among adolescents with SUD histories. We discuss these findings in terms of continuing care options for adolescents with SUD histories that target adolescents' antisocial traits, perceived availability of substances, and parent histories of substance abuse, including practical implications for working with families of adolescents with SUD histories.

The Effect of the Moscow Theatre Siege on Expectations of Well-Being in the Future.

We employ the Russia Longitudinal Monitoring Survey-Higher School of Economics (RLMS-HSE), a survey of 6,000 individuals, and a difference-in-differences estimation strategy to examine the effect of the 2002 Moscow theatre siege on the level of self-reported expectations of life in the future of the Russian population. The longitudinal nature of the data allows us to explore both the short- and long-term effects of terrorism on this population as well as contribute to the limited number of quasi-experimental studies in this area. By focusing on expectations of life in the future, we broaden our understanding of the social consequences of terrorism. Controlling for a range of sociodemographic variables including self-assessed relative income, our findings suggest that the well-being effects of terrorism are complex and the net effect of a terrorism incident on well-being may not necessarily be negative. This can be explained, at least in part, by the theory of posttraumatic growth-a theory that refers to the positive psychological change experienced as a result of adversity, with terrorism incidents inadvertently promoting more meaningful interpersonal relationships, new views of the self and new views of the world. That is not to suggest that terrorism is a positive phenomenon-rather, that individuals have a lifelong plasticity rendering them capable of recovery from adversity. The primary objectives of terrorists, therefore, are unlikely to be fully achieved. It is hoped that our research allows for the development of more refined policies that aim to encourage posttraumatic growth while simultaneously attempting to minimize posttraumatic stress disorder. This may involve engaging with the psychological community to devise policies and programs that target those in the population who are most vulnerable and for these groups devise strategies to enhance their psychological resilience following a terrorist (or other traumatic) event.

Substance Use Profiles Among Gang-Involved Youth: Social Ecology Implications for Service Approaches.

Substance use is a frequently cited health risk behavior in the youth gang literature, yet little is known about how substance use patterns vary among gang-involved youth or the social ecological factors that contribute to potential variation. Developing relevant and effective service approaches will require an understanding of this variation and the malleable factors that are likely to promote or inhibit particular patterns of use. Using latent class analysis, we identified four substance use classes within a school-based sample of gang-involved youth (n = 2,770): Non-Users (38%), Past Users (15%), Casual Users (27%), and Frequent Multi-Users (21%). These classes were distinguished by substance type, frequency of use, and source of access. Demographic and substance use-specific ecological factors across the family, peer, school, and neighborhood contexts were found to significantly differentiate these classes. Specifically, acceptance of use by parents, friends, and neighbors, along with a lack of family rules and high accessibility in the neighborhood, significantly differentiated use patterns. Findings highlight the need for service approaches that are responsive to the unique needs of individuals and their environments. Implications for practice are discussed, including the potential utility of applying a harm reduction service framework to address youth gang substance use.

Incarceration and adversity histories: Modeling life course pathways affecting behavioral health.

A consequence of a growing incarceration rate is that an increasing number of children face having an incarcerated household member, a known contributor to diverse lifelong behavioral health risks such as substance use and mental health impairment. Few studies have explored how household incarceration uniquely contributes to these subsequent behavioral health concerns, nor mediational contributors to these associations, within a theoretical framework. Using state Behavioral Risk Factor Surveillance System survey data (n = 14,001), this study tests pathways of household incarceration and Adverse Childhood Experiences (ACEs) to mental health impairment and substance use in adulthood. Within a life course stress process perspective, this study uses structural equation modeling to examine mediational pathways through adulthood incarceration and indicators of adulthood adversity, low income, and supportive resources. In line with stress process theorizing, results indicate significant direct and indirect paths of ACEs through nearly all theorized mediators, and indirect pathways of household incarceration, through incarceration and low income, to adulthood mental health impairment and substance use. Implications of these findings address preventive and interventive leverage points to mitigate long-term consequences of household incarceration and other childhood adversities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Evaluating the efficacy of the Family Check-Up Online: A school-based, eHealth model for the prevention of problem behavior during the middle school years.

This study evaluated the efficacy of a family-centered preventive intervention, the Family Check-Up (FCU), delivered as an online, eHealth model to middle school families. To increase accessibility of family-centered prevention in schools, we adapted the evidence-based FCU to an online format, with the goal of providing a model of service delivery that is feasible, given limited staffing and resources in many schools. Building on prior research, we randomly assigned participants to waitlist control (n = 105), FCU Online as a web-based intervention (n = 109), and FCU Online with coaching support (n = 108). We tested the effects of the intervention on multiple outcomes, including parental self-efficacy, child self-regulation, and child behavior, in this registered clinical trial (NCT03060291). Families engaged in the intervention at a high rate (72% completed the FCU assessment) and completed 3-month posttest assessments with good retention (94% retained). Random assignment to the FCU Online with coaching support was associated with reduced emotional problems for children (p = .003, d = -0.32) and improved parental confidence and self-efficacy (p = .018, d = 0.25) when compared with waitlist controls. Risk moderated effects: at-risk youth showed stronger effects than did those with minimal risk. The results have implications for online delivery of family-centered interventions in schools.

Optimizing Assessment of Risk and Protection for Diverse Adolescent Outcomes: Do Risk and Protective Factors for Delinquency and Substance Use Also Predict Risky Sexual Behavior?

Assessments of youth risk and protective factors (RPFs) for substance use, delinquency, and violence have been used by communities to identify priorities and target them with prevention interventions. These same RPFs may also predict other youth problems. This study examined the strength and consistency of relationships of 41 ecological RPFs that predict antisocial behavior and substance use with sexual behavior outcomes in a sample of 2150 urban youth in 10th and 12th grade. After adjusting for controls, findings identify significant associations among the majority of community, school, family, peer, and individual risk factors, and family, peer, and individual protective factors, with sexual behavior outcomes, specifying unique associations among multiple factors with risky sex relative to both safe sex and not being sexually active. Prevention programming that targets common predictors for multiple problems may address a broad array of outcomes, including sexual health risk behaviors.

Life Course Pathways From Adverse Childhood Experiences to Adult Physical Health: A Structural Equation Model.

OBJECTIVE: This study examines pathways from adverse childhood experiences (ACEs) to physical health, directly and indirectly through lower income, health risk behaviors, social support, and adult adversity within a theoretical framework postulating stress proliferative and biological trajectories of cumulative adversity. METHOD: Data were obtained from 12,549 adult respondents of a state Behavioral Risk Factor Surveillance System survey. Multigroup structural equation modeling elucidated pathways differentiated by sex and age (older/younger than 45). RESULTS: Good model fit was achieved in each test, indicating consistency with stress theorizing that ACEs significantly contribute to poorer physical health through direct and mediated paths. Younger adults evidenced direct ACE pathway to poor health suggesting early biological erosion, whereas paucity of social support among older adults was directly associated. DISCUSSION: Findings indicate that stress process roles in eroding physical health and experience of wellness. Addressing early adversity is an important strategy toward reducing preventable health problems.

Cumulative Adversity Profiles Among Youth Experiencing Housing and Parental Care Instability.

This study applies cumulative adversity and stress proliferation theories to examine risk and protective resource profiles of youth with three different levels of housing and parental care instability. Data derive from a state representative sample (n=27,087) of school-based adolescent students. ANCOVA analyses identified significant differences in sociodemographic and psychosocial functioning variables for youth with 0, 1, or 2 forms of housing and parental care instability, with more deleterious functioning being observed among youth with greater levels of instability. Those experiencing either or both housing and parental care instability are more represented by males, sexual minorities, and youth of color; psychosocial risk and protective factors demonstrated consistent differences between instability groups. Dimensions of cumulative adversity operate with social marginalities (e.g., race, sexual minority status) relative to instability, with higher frequency of victimization, lower grades, diminished self-regulation capabilities and school engagement, weakened psychological health, and strained family and peer relationships. The paper discusses theorized mechanisms through which cumulative adversity conveys effects as well as implications for social work prevention and resilience-fostering strategies in schools and other youth-serving settings.

Modeling life course pathways from adverse childhood experiences to adult mental health.

Although the association between adverse childhood experiences (ACEs) and adult mental health is becoming well established, less is known about the complex and multiple pathways through which ACEs exert their influence. Growing evidence suggests that adversity early in life conveys not only early impacts, but also augments risk of stress-related life course cascades that continue to undermine health. The present study aims to test pathways of stress proliferation and stress embodiment processes linking ACEs to mental health impairment in adulthood. Data are from the 2011 Behavioral Risk Factor Surveillance Survey, a representative sample of Washington State adults ages 18 and over (N = 14,001). Structural equation modeling allowed for testing of direct and indirect effects from ACEs though low income status, experiences of adversity in adulthood, and social support. The model demonstrated that adult low income, social support and adult adversity are in fact conduits through which ACEs exert their influence on mental health impairment in adulthood. Significant indirect pathways through these variables supported hypotheses that the effect of ACEs is carried through these variables. This is among the first models that demonstrates multiple stress-related life course pathways through which early life adversity compromises adult mental health. Discussion elaborates multiple service system opportunities for intervention in early and later life to interrupt direct and indirect pathways of ACE effects.

Evaluating betterment projects.

In the past decade Australia has experienced a series of large-scale, severe natural disasters including catastrophic bushfires, widespread and repeated flooding, and intense storms and cyclones. There appears to be a prima facie case for rebuilding damaged infrastructure to a more disaster resilient (that is, to 'betterment') standard. The purpose of this paper is to develop and illustrate a consistent and readily applied method for advancing proposals for the betterment of essential public assets, which can be used by governments at all levels to determine the net benefits of such proposals. Case study results demonstrate that betterment investments have the potential to deliver a positive economic return across a range of asset types and regions. Results, however, are highly sensitive to underlying assumptions; in particular the probability of the natural disaster affecting the infrastructure in the absence of betterment.

Web-based surveys as an alternative to traditional mail methods.

Environmental economists have long used surveys to gather information about people's preferences. A recent innovation in survey methodology has been the advent of web-based surveys. While the Internet appears to offer a promising alternative to conventional survey administration modes, concerns exist over potential sampling biases associated with web-based surveys and the effect these may have on valuation estimates. This paper compares results obtained from a travel cost questionnaire of visitors to Fraser Island, Australia, that was conducted using two alternate survey administration modes; conventional mail and web-based. It is found that response rates and the socio-demographic make-up of respondents to the two survey modes are not statistically different. Moreover, both modes yield similar consumer surplus estimates.