Understanding problematic substance use among first responders during the COVID-19 pandemic: A survey of law enforcement, fire, and EMS workers in the United States.

BACKGROUND: First responders have experienced increased levels of stress, anxiety, and depression due to job-related pressures associated with the COVID-19 pandemic. However, little is known about the factors associated with first responder drug and alcohol use during this time. METHODS: We conducted a nationwide survey of first responders (n = 2801) to understand the relationship between work pressures, workplace support strategies, and problematic substance use during the early stages of the COVID-19 pandemic. We employed structural equation modeling to analyze whether burnout mediated these relationships. RESULTS: Descriptive statistics showed that 60.8 % reported no concerns with substance use. While general workplace support strategies were negatively associated with problematic substance use, specific COVID-related strategies, such as providing compensation during quarantine, were positively associated with problematic substance use. Burnout fully mediated relationships between workplace support strategies and problematic substance use. Finally, providing spaces at work to decompress was negatively associated with problematic substance use and burnout. CONCLUSION: Although work pressures increased burnout and problematic substance use among first responders, general workplace support strategies (e.g., decompression spaces) reduced problematic substance use while some COVID-related strategies (e.g. compensation during quarantine) increased problematic substance use. Policy interventions to address problematic substance use should focus on providing spaces for first responders to decompress at work, as well as implementing strategies (e.g., access to mental health services, time off) to reduce burnout. However, organizations should be mindful that not all interventions will have their intended impact and some interventions may unintentionally contribute to negative employee outcomes.

Cultivating Metacognition in Each of Us: Thinking About "Thinking" in Interdisciplinary Disaster Research.

Although there is an emerging literature on interdisciplinary disaster research (IDR), one of the overlooked aspects relates to our thinking itself: how to actively think about our thinking-metacognition-while embarking on our interdisciplinary journeys. This article argues that metacognition has an instrumental value both for IDR projects and for individual researchers involved in IDR. For IDR projects, metacognition can help: (1)overcome disciplinary barriers in IDR by revealing cognitive abilities and inabilities for each team member through identifying what is hindering or enabling individuals and the group to transcend disciplinary boundaries toward true integration across the disciplines; (2)deal with "wicked" problems that characterize disaster contexts in a more effective and creative manner; (3)oversee team functioning; and (4)monitor and evaluate progress toward meeting project goals and objectives. For individual researchers, metacognition can help them grow intellectually, and understand the fallacies and limitations in their thinking. It can also encourage them to live an authentic and unified life as an individual. The article concludes with guidance on how individual researchers, principal investigators of IDR projects, and institutions such as universities and funding agencies can cultivate metacognition. To our knowledge, this is the first article that introduces metacognition as a tool for enhancing our thinking on IDR.

Toward Convergence Disaster Research: Building Integrative Theories Using Simulation.

Scholars across disciplines use simulation methods as tools to build theories; however, the full potential of simulation methods has not been fully used for building theories in convergence disaster research. Simulation methods could provide four unique opportunities for building theories for convergence disaster research. First, simulation methods could help researchers model the underlying mechanisms of disaster phenomena by enabling integration of qualitative and quantitative data. Second, they could help researchers specify and characterize the mechanisms affecting specific disaster phenomena by facilitating integration of empirical information with existing theoretical elements from different disciplines. Third, simulation methods could enable multilevel understanding of relationships between factors influencing disaster phenomena and emergent behaviors across different levels of analysis (e.g., individual, household, neighborhood, and community levels). Fourth, simulation methods could help researchers integrate theoretical elements on disasters across different disciplines (e.g., engineering, social science, sociology, and epidemiology) for a more convergent understanding of complex relationships affecting resilience at different levels.

In their Own Words: Resilience among Haitian Survivors of the 2010 Earthquake.

Social sciences literature highlights the importance of resilience in relation to risk and trauma. The 2010 Haitian earthquake compounded trauma for a nation that has endured slavery/despotic leadership, structural violence and poverty. Since 2010, various sources broadly describe Haitian survivors as resilient. We reviewed definitions of resilience published between 1990 and 2013, comparing them with perspectives of earthquake survivors from economically diverse communities in Haiti who, participated in semi-structured interviews (n=38) and in six focus groups (n=63) between 2010-2011. Haitian resilience accords with some definitions from the literature. It also comprises independent, discrete, and isolated contextual resignation and intentional choice to survive and function-when there is no alternative course of action. Understanding Haitian resilience, can inform health/mental health and policy interventions, if these are taken as cultural resources. Intervention efforts should incorporate survivors' input as key informants on what constitute resilience and reconstruction goals for them.

Shelter recovery in urban Haiti after the earthquake: the dual role of social capital.

This paper documents the culture-specific understanding of social capital among Haitians and examines its benefits and downsides in post-disaster shelter recovery following the 12 January 2010 earthquake. The case study of shelter recovery processes in three socioeconomically diverse communities (Pétion-Ville, Delmas and Canapé Vert) in Port-au-Prince suggests that social capital plays dual roles in post-disaster shelter recovery of the displaced population in Haiti. On the one hand, it provides enhanced access to shelter-related resources for those with connections. On the other hand, it accentuates pre-existing inequalities or creates new inequalities among displaced Haitians. In some cases, such inequalities lead to tensions between the haves and have-nots and instigate violence among the displaced.

Spatial Disparity of HIV/AIDS Service Providers: The Case of Miami-Dade County.

This paper examines the spatial disparity between the HIV/AIDS service providers and the HIV/AIDS patients. The empirical focus is on Miami-Dade, a large metropolitan county in the United States with a Latino population majority and a high AIDS incidence rate. This exploratory study contributes to the existing literature on geographical access to health providers. Geographic Information System (GIS) is used to examine the spatial disparity between the service providers and the patients. The study reveals that aggregate-level analysis masks the reality of the spatial disparity. Miami Dade County's Health Department focuses on aggregate zones for prioritizing its resources. At this level, there is little spatial disparity. However, evidence of spatial disparity emerges at the ZIP-code-level analysis. The major lesson from the study is that health policies need to be based on a finer-grained analysis to address spatial disparity.