L. A. R. Stein’s research while affiliated with University of Rhode Island and other places

Background The coronavirus disease 2019 pandemic disproportionately impacted mental health and relationship satisfaction, particularly among individuals from lower socioeconomic status (SES) backgrounds. Aim The aim of this study is to examine the relationship between the pandemic and mental health outcomes (depression, anxiety, substance use, and psychological distress) using a mediated moderation analysis. Method Secondary data analysis was conducted using data from a state-wide screening, brief intervention, and referral to treatment project, with 1,718 participants throughout Rhode Island, United States. The Client Outcome Measures for Discretionary Programs tool was administered during interviews. A mediated moderation model assessed the pandemic’s impact (independent variable), relationship satisfaction (mediator), and SES (moderator) on five outcomes: alcohol use, cannabis use, anxiety, depression, and psychological distress. Generalized Linear Mixed Effects Models estimated associations, adjusting for participant and regional variations. Results While no significant total mediated effects were found (p > 0.05), higher relationship satisfaction was associated with lower anxiety (β = −0.13, p < 0.0001), depression (β = −0.18, p < 0.0001), and psychological distress (β = −0.16, p < 0.0001). A small positive association with alcohol use was found (β = 0.04, p = 0.0938) with relationship satisfaction. SES moderated mental health outcomes, with low-income participants experiencing greater depression (β = −0.09, p = 0.0015) and psychological distress (β = −0.12, p = 0.0015). Conclusion Findings underscore the role of SES and relationship satisfaction in mental health during crises. Targeted interventions and policies addressing SES disparities, and relationship-based services are recommended.

Research demonstrates a positive impact of Peer Based Recovery Support Services (PBRSS) facilitated by peer recovery specialists (PRS), who are people in recovery from behavioral health conditions (e.g., substance use disorders [SUD] and mental health conditions). This study investigated PBRSS, their impact on client outcomes (e.g., substance use, health), and the factors (e.g., self-efficacy, perceived relationship with/helpfulness of PRS) mediating the relationship between services and outcomes while controlling for sociodemographic information (e.g., age). Data were collected across 58 sites within 25 agencies providing PBRSS in a state located in Northeastern USA. Cross-lagged panel models were used to examine 12 longitudinal mediational models in a sample of N = 412. Models were examined over two time periods (i.e., T1 and T2). After alpha correction ( p = .00417), most results were nonsignificant. However, several findings indicated that constructs were significantly related across time in all models (e.g., self-efficacy at T1 significantly predicted self-efficacy at T2), while many point-in-time associations were also significant (e.g., number of services received was positively related to relationship/helpfulness of PRS at T1 and T2). Better PRS relationship/helpfulness at T1 significantly predicted a lower number of services received at T2, while receiving more services at T1 significantly predicted better PRS relationship/helpfulness at T2. Being older significantly predicted a worse overall health at T2 in some models. While no mediation was found, this study is important as it assists in building models with respect to the mechanisms by which PRS may effect change or not.

Group interventions are commonly used for treating youth. Assessing group processes during intervention has presented challenges. The present study evaluated the psychometric properties of a group process-group level measure. This measure examined behaviours (e.g., positive or deviant) of incarcerated youth during group substance use interventions. Adolescents and counsellors completed a series of questions after each group session (n = 584 sessions). Observers rated group behaviour from 153 video-recorded sessions. The results supported internal consistency (median α = 0.78), inter-rater reliability (median α = .63), and validity (e.g., r = 0.12–0.82, p < 0.01). Importantly, a measure with demonstrated reliability and validity at the group level can be part of quality control for researchers and practitioners when individual-level ratings are not needed or too costly.

Although discrimination is an important social determinant of alcohol involvement, there is a dearth of research testing these associations across race/ethnicity and gender. This is an important research gap given that experiences of discrimination and therefore links with alcohol involvement may vary as a function race/ethnicity and gender intersectional identities. We tested for measurement invariance in discrimination and alcohol involvement and examined group differences in means and covariances. The sample consisted of n = 1187 young adults (ages 18–26; n = 193 Black women, n = 209 Latina women, n = 186 White women, n = 198 Black men, n = 203 Latino men, and n = 198 White men). We found evidence for differential item functioning for discrimination and alcohol involvement that violated assumptions needed to make manifest between-group comparisons. To model the source and degree of differential item functioning, we used partial measurement invariance and dropped a discrimination item that did not reliably overlap with the latent factor for White women. After accounting for differential item functioning, Black women and men reported the highest discrimination, followed by Latinx women and men, and then White women and men. White women reported the most alcohol involvement, followed by White men, Latina women, Latino men, Black men, and Black women. Discrimination and alcohol involvement were positively associated for all groups except White women, though effect sizes varied with Black men exhibiting the largest effect. An intersectionally valid understanding of discrimination and alcohol involvement may necessitate statistical approaches that can test for (and model) differential item functioning prior to making between-group quantitative comparisons.

Despite efforts in Implementation Science, there remains a considerable gap between establishing intervention effectiveness and their widespread adoption in real-world settings. Shockingly, only about 14% of these interventions make it into practice. This study recognized the urgent need for a paradigm shift within the field and sought to develop a comprehensive understanding of the systemic barriers and facilitators affecting intervention implementation. To achieve this goal, a qualitative methodology known as constructivist grounded theory was employed. This approach allowed for the exploration of rich, in-depth descriptions and theoretical insights derived from the experiences of 30 prevention professionals who have been involved in implementing evidence-based interventions for substance use prevention. Data collection involved various methods, including semi-structured interviews, elicited descriptions of lived experiences, participant documents, and analysis of existing literature. Through systematic analysis, the study constructed a central process characterized as a human-centered innovating process. This process was found to be cyclical, nonsequential, and iterative, involving overlapping stages of engagement, collaboration, negotiation, iteration, and implementation. These findings shed light on the complexities inherent in implementing evidence-based interventions and provide valuable insights for researchers and practitioners alike. Ultimately, this grounded theory offers a substantive approach to understanding evidence-based intervention implementation as an innovation process. By highlighting the importance of human-centered approaches and iterative strategies, it provides a roadmap for optimizing the translation of evidence-based interventions into real-world practice.

At the intersection of drug policy, the opioid crisis, and fragmented care systems, persons with opioid use disorder (OUD) in the United States are significantly vulnerable to contact with the criminal legal system (CLS). In CLS settings, provision of evidence-based treatment for OUD is variable and often secondary to punitive approaches. Linkage facilitation at every touch point along the CLS Sequential Intercept Model has potential to redirect persons with OUD into recovery-oriented systems of care, increase evidence-based OUD treatment connections, and therefore reduce CLS re-exposure risk. Research in this area is still nascent. Thus, this narrative review explores the state of the science on linkage facilitation across the varied CLS contexts, including general barriers, facilitators, and opportunities for using linkage facilitation for OUD treatment and related services. Following the CLS Sequential Intercept Model, the specific CLS contexts examined include community services, police encounters, the courts (pre- and post-disposition), incarceration (pre-trial detention, jail, and prison), reentry (from jails, prisons, and unified systems), and community supervision (probation and parole). Examples of innovative linkage facilitation interventions are drawn from the Justice Community Opioid Innovation Network (JCOIN). Areas for future research and policy change are highlighted to advance the science of linkage facilitation for OUD services in the CLS.

Background: Motivational interviewing (MI) is an evidence-based practice that has been successfully applied to at-risk youth. Well-validated measures that track MI integrity may not be used in practice settings due to the time to complete them, recording requirements and training involved. A simpler, less resource-intensive instrument may encourage programs and providers to attend more to the quality of MI use during implementation. Purpose: To validate a method involving two measures, Youth and Provider Logs, to assist in monitoring MI use. Methods: Clients and providers reported on provider behaviors consistent and inconsistent with MI during the session. Factor analyses were conducted to examine whether measures showed clear scales assessing MI use and analyses were conducted to assess validity of these measures. Results: Both Youth and Provider Logs showed a clear and consistent 3-factor structure assessing MI-consistent behavior, MI-inconsistent behavior, and alcohol-related topics. Significant correlations were found between Youth Logs and youth reports of rapport with providers, and satisfaction with services. Provider MI-inconsistent scores were significantly inversely predictive of observer fidelity scores over time. Conclusion: This study offers provider and client measures for tracking use of MI in sessions, which are a simpler, less resource-intensive method for monitoring MI, and may encourage fidelity during implementation.

p style="text-align: justify;">Psychosocial and educational intervention approaches employ diverse treatment frameworks, most of which involve delivering some form of feedback to participants about their behavior. General conceptions of feedback are well-known to underlie mainstream therapeutic and educational approaches. Recently emerging ‘smart’ approaches also rely on feedback principles. However, little scholarship is available to stitch together evolving strands of feedback principles and no literature characterizes explicitly the diverse landscape of feedback practices employed in education or intervention science. This paper reviews intrinsic conceptions of feedback along with diverse cases of its use in intervention and education. Based on our consideration, we present a typology of feedback modalities that we hope will enrich the efforts of interventionists and educators to design treatment and educational frameworks incorporating feedback.</p

Introduction This article proposes a taxonomy of linkage facilitation services used to help persons with opioid use disorder access treatment and recovery resources. Linkage facilitation may be especially valuable for persons receiving medication for opioid use disorder (MOUD) given the considerable barriers to treatment access and initiation that have been identified. The science of linkage facilitation currently lacks both consistent communication about linkage facilitation practices and a conceptual framework for guiding research. Methods To address this gap, this article presents a taxonomy derived from expert consensus that organizes the array of practitioners, goals, and activities associated with linkage services for OUD and related needs. Expert panelists first independently reviewed research reports and policy guidelines summarizing the science and practice of linkage facilitation for substance use disorders generally and OUD specifically, then met several times to vet the conceptual scheme and content of the taxonomy until they reached a final consensus. Results The derived taxonomy contains eight domains: facilitator identity, facilitator lived experience, linkage client, facilitator-client relationship, linkage activity, linkage method, linkage connectivity, and linkage goal. For each domain, the article defines basic domain categories, highlights research and practice themes in substance use and OUD care, and introduces innovations in linkage facilitation being tested in one of two NIDA-funded research networks: Justice Community Opioid Innovation Network (JCOIN) or Consortium on Addiction Recovery Science (CoARS). Conclusions To accelerate consistent application of this taxonomy to diverse research and practice settings, the article concludes by naming several considerations for linkage facilitation workforce training and implementation.