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The exit from active substance use presents barriers to achieving and maintaining health, especially as individuals lack the economic resources to afford healthcare access. Treatment settings that strengthen resources may support stability in recovery and influence health. Analyzing a sample of recovery home residents over two years (N = 494), the current study assessed individually held resources (e.g., wages, employment) and the average economic conditions of a resident's house (e.g., house employment rate) to understand their association with self-reported health status. Employment status, but not wages or transportation access, was associated with reported health scores. The average employment rate of a recovery home was also positively correlated with the health of its residents. Results indicate the need to address employment and other economic issues which plague recovering individuals. Community aftercare settings may offer such a pathway through affordable housing, employment opportunities, and supportive relationships. [ABSTRACT FROM AUTHOR]

American children spend an average of 6 hours and 32 minutes each day using various forms of media. Research has suggested that this high level of exposure has a negative impact on children's attitudes and behaviors. For example, media violence increases aggression in children, especially video games which allows children to be the aggressor and obtain rewards for violent acts against others. In addition, media influences sexual behaviors and attitudes by sending contradictory messages that glamorize sexual activity and disregard the risks of such behaviors. Along with these negative behavioral influences, media also impacts children's health and is linked to the rise of childhood obesity. From 1980 to 2000, rates of children being overweight have doubled, while obesity continually is associated with higher rates of hypertension, asthma, type II diabetes, and cardiovascular disease. The majority of research has found a link between the amount of time children spend watching TV and their body weight. Given that 81% of children age 2-7 use media unsupervised (Kaiser Family Foundation, 1999), parents need to play a more active role in monitoring their children's use of electronic entertainment activities and structuring socialization activities. In this article, we will review behavioral technologies to assist parents in reducing their children's media use.

There is limited information on the specific impacts of Long COVID in youth. Long COVID presents as persisting or new symptoms following initial COVID-19 infection. The aim of this study was to better understand how children and their families describe their experiences seeking diagnosis and support following the onset of symptoms of Long COVID. Six children and five caregivers located in the United States participated in this study. Study procedures included an online video interview with caregiver–child dyads. Interview transcriptions were then analyzed using a conventional approach to content analysis, with two independent coders generating themes. Eight themes emerged from this analysis including the severity of illness and symptomatology, difficulty surrounding the diagnostic process and not being believed, the impact on family and social connections, poor school functioning, positive coping, subsequent positive medical experiences, mental health, and knowledge of the medical field and healthcare experience. Themes revealed difficulty for youth and families in navigating the medical system and functioning in areas of daily life as well as areas of positive experiences related to coping and medical involvement. These findings also highlighted areas of needed improvement for the medical community and for research on Long COVID in youth. [ABSTRACT FROM AUTHOR]

Qualitative studies have examined the recovery experiences of individuals prescribed medication‐assisted treatment (MAT), including their experiences within treatment facilities. However, the literature lacks qualitative studies exploring the recovery process of individuals prescribed MAT while living in recovery housing, such as Oxford House (OH). The purpose of this study was to explore how OH residents, who are prescribed MAT, make sense of recovery. The fact that OHs are drug‐free recovery housing is what makes the issue of using MATs potentially contentious in these settings. Interpretative phenomenological analysis (IPA) was used to document the lived experiences of individuals prescribed MAT in OH. The sample included: five women and three men, prescribed either methadone or Suboxone, that were living in an OH in the United States. Participants were interviewed on four topics: their recovery process, their transition to OH, and their experience living in and outside of an OH. Analysis of results followed the recommendations for IPA from Smith, Flowers, and Larkin. Four general themes emerged from the data: Recovery Process, Managing Logistics of MAT Utilization, Personal Development, and Familial Values. In conclusion, individuals prescribed MAT did benefit from living in an OH to manage their recovery as well as stay compliant with their medication. [ABSTRACT FROM AUTHOR]

Group homes sometimes face significant neighborhood opposition, and municipalities frequently use maximum occupancy laws to close down these homes. This study examined how the number of residents in Oxford House recovery homes impacted residents' outcomes. Larger homes (i.e., eight or more residents) may reduce the cost per person and offer more opportunities to exchange positive social support, thus, it was predicted that larger Oxford Houses would exhibit improved outcomes compared to smaller homes. Regression analyses using data from 643 residents from 154 U.S. Oxford Houses indicated that larger House size predicted less criminal and aggressive behavior; additionally, length of abstinence was a partial mediator in these relationships. These findings have been used in court cases to argue against closing down larger Oxford Houses. (Contains 1 footnote.)

Recovery homes may facilitate individuals with substance use disorders re-integration back into community settings by providing friendship, resources, and advice. Participants of the current study were over 600 residents of 42 Oxford House recovery homes. Findings indicated that willingness to share resources in the form of loans was associated with higher levels of house involvement in recovery home chapters. Active involvement in house and community affairs may influence more recovery within homes or may be an indicator of houses with residents with more capacities and skills for positive long-term health outcomes. Such findings suggest that recovery is a dynamic process with multiple ecological layers embedding individuals, their immediate social networks, and the wider community. [ABSTRACT FROM AUTHOR]

An important step in reducing health disparities among racial and ethnic minorities with substance use disorders involves identifying interventions that lead to successful recovery outcomes for this population. The current study evaluated outcomes of a community-based recovery support program for those with substance use disorders. Participants included 632 residents of recovery homes in three states in the US. A multi-item recovery factor was found to increase over time for these residents. However, rates of improvement among Black individuals were higher than for other racial/ethnic groups. Black Americans perhaps place a higher value on communal relationships relative to all other racial/ethnic groups, and by adopting such a communitarian perspective, they might be even more receptive to living in a house that values participation and involvement. The implications of these findings for health disparities research are discussed. [ABSTRACT FROM AUTHOR]

Recovery homes in the US provide stable housing for over 250,000 individuals with past histories of homelessness, psychiatric comorbidity and criminal justice involvement. We need to know more about how these settings help those who remain in recovery. Our study measured advice seeking and willingness-to-loan relationships, and operationalized them as a dynamic multiplex social network—multiple, simultaneous interdependent relationships—that exist within 42 Oxford House recovery homes over time. By pooling relationship dynamics across recovery houses, a Stochastic Actor-Oriented Modeling (SAOM) framework was used to estimate a set of parameters governing the evolution of the network and the recovery attributes of the nodes simultaneously. Findings indicated that advice and loan relationships and recovery-related attitudes were endogenously interdependent, and these results were affected exogenously by gender, ethnicity, and reason for leaving the recovery houses. Prior findings had indicated that higher advice seeking in recovery houses was related to higher levels of stress with more negative outcomes. However, the current study found that recovery is enhanced over time if advice was sought from residents with higher recovery scores. Our study shows that social embedding, i.e., one's position in relationship networks affects recovery prospects. More specifically, the formation of ties with relatively more recovered residents is an important predictor of better outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to examine the relationship between psychiatric severity and stress among persons utilizing medication assisted treatment (MAT), and there is a need to identify resources that promote resilience against these risk factors. Although recovery homes might complement pharmacological interventions for persons using MAT, a lack of homophily (e.g. similar experiences) among residents could produce stress and increase psychiatric severity. The purpose of this paper is to examine stress and psychiatric severity in relation to recovery outcomes, and whether homophily moderated these relationships. Design/methodology/approach: A cross-sectional analysis was conducted among recovery home residents who were recruited from the USA, including those using (n = 40) and not using (n = 132) MAT. Participants' levels of psychiatric severity, stress, abstinence self-efficacy and quality of life were assessed in addition to whether residents using MAT were living with at least one other resident who used MAT. Moderated mediation analyses were conducted to examine whether homophily among residents using MAT would moderate the mediating effects of stress on the relationships between psychiatric severity and recovery outcomes (abstinence-self efficacy, quality of life). Findings: Mediating effects were observed but they were significant only through homophily. Although stress increased the negative effects of psychiatric severity among residents using MAT, significantly lesser effects were observed among those living with residents using MAT. Practical implications: Although psychiatric (problem) severity and stress threaten recovery for persons with substance use disorders, little is known how they impact recovery among those living in community-based settings such as recovery homes. In addition, there is a need to identify community resources that would complement MAT protocols, as patients who use MAT face unique stressors related to their sense of shared interests and experiences (i.e. homophily) when developing social bonds with others in recovery. Social implications: This study suggests the social networks within recovery homes reduce the effects of psychiatric severity and stress, and that these effects are lessened for residents who use MAT when they live with others who also use MAT. Originality/value: Little is known about recovery home residents who use MAT and have high psychiatric severity. Findings suggest homophily among persons using MAT living in recovery homes who have high psychiatric severity can promote resilience. [ABSTRACT FROM AUTHOR]

Although recovery capital represents various resources for persons recovering from substance use disorders, measures of this construct examine components that might not necessarily reflect the recovery goals of individuals who base their recovery through involvement in 12-step groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). It is not clear whether 12-step involvement is related to recovery capital, particularly among individuals living in recovery homes who utilize social networks of recovering peers for their recovery. Thus, categorical involvement in a set of 12-step activities was examined in relation to recovery capital and abstinence social support. Differences in terms of general (recovery capital scores, retention rates) and abstinence-specific (abstinence social support) resources were examined in relation to recovery home residents who were (n = 395) and were not (n = 232) categorically involved in their 12-step recovery. Residents with categorical 12-step involvement reported significantly higher levels of recovery capital and abstinence social support, and there was no significant difference observed in retention rates between residents who were/were not categorically involved in 12-step groups. Findings suggest community resources such as recovery homes and categorical involvement in 12-step groups are important recovery capital components that help individuals who use a 12-step approach to their recovery. Recovery capital among those involved with 12-step fellowships such as AA and NA should be assessed by examining abstinence-specific components such as representative involvement in 12-step groups and social support that is abstinence-specific. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to identify correlates of employment among men in substance use recovery, including recovery-related discrimination and social support. A cross-sectional sample of men (N = 164) who lived in sober living homes located across the United States participated in the present study. Data were collected online and through mailed surveys. No socio-demographic variables were associated with employment status. Discriminant Analysis (DA) was conducted to understand how recovery-related discrimination and social support contributed to group separation (employed vs. not employed). Results from this analysis suggested that recovery-related discrimination was the driving force in classification, as men who were not employed had much higher recovery-related discrimination than men who were employed. Men who were not employed also had lower social support scores than men who were employed. Stigma and discrimination may play a large role in employment among former and current substance users. Treatment providers should discuss the impact of stigma on individuals while they are in treatment. However, additional research is needed to more fully understand the relations among discrimination, social support, and employment. [ABSTRACT FROM AUTHOR]

It is estimated that nearly 20 million adults in the United States have a substance use disorder (SUD), and 8.4 million of those adults have a comorbid mental disorder. Roughly half of those adults with a SUD and a psychiatric comorbidity fail to receive adequate treatment for either the SUD or the mental disorder (combined or separately). However, this sub-population has shown positive treatment outcomes (e.g., improved quality of life and increased length of stay in a recovery home) when allotted the proper resources to treat the overlapping symptomologies associated with their multiple diagnoses. Many individuals with SUD and psychiatric comorbidity receive community-based support from recovery residences, a ubiquitous form of aftercare treatment in the United States. The aim of the present study was to investigate the relationship between psychiatric severity index scores (a proxy for psychiatric comorbidity that measures social functioning, impairment, symptoms, and behavior), length of stay in Oxford Houses (OHs), and quality of life. The present study found a significant negative relationship between length of stay and psychiatric severity scores, and between psychiatric severity scores and quality of life scores. Psychiatric severity was observed to predict decreased quality of life, while length of stay predicted decreased psychiatric severity. Psychiatric severity mediated the relationship between length of stay and quality of life based on house composition. [ABSTRACT FROM AUTHOR]

Substance use recovery homes represent the largest residential, community-based post-treatment option for those with substance use disorders in the United States. It is still unclear what unique factors predict relapse after residents leave such homes. This study presents results of a longitudinal study of 497 residents who departed from 42 Oxford House recovery houses. We hypothesized that the predictors of post-departure relapse would be a multi-item measure of latent recovery, length of stay, and reason for departure from the home (voluntary vs. involuntary). Predictor effects were estimated as part of a two-step model with two outcomes: (a) lack of follow-up data after departure from the house, and (b) the likelihood of relapse. Determinants of missing follow-up data included less education, less time in residence, and involuntary departure. Relapse was more likely for individuals who were younger, had involuntarily left the house, and had lower values on the latent recovery factor. The implications of these important factors related to relapse following departure from residential recovery home settings are discussed. [ABSTRACT FROM AUTHOR]

This exploratory study aimed to understand how veterans' social identity influenced their experiences living in Oxford Houses (OH)—the largest network of substance use recovery homes in the United States. We conducted three focus groups, with 20 veterans who were current or former OH residents. Thematic analysis revealed several ways in which participants' veteran identity influenced their experiences living in OH, including: (1) thriving through OH organizational similarities with the military, (2) relationships with other OH residents, and (3) and growth and reintegration. The themes were interpreted using the Social Identity Theory and the Social Identity Model of Identity Change perspectives. Social identity processes were found to play an influential role in veterans' experiences in their recovery homes and reintegration into civilian life. Findings highlight the importance of veterans developing a community within a culturally congruent setting to facilitate their recovery from substance use disorders and adjustment to life post‐military service. [ABSTRACT FROM AUTHOR]

Various community recovery support services help sustain positive behavior change for individuals with alcohol and drug use disorders. This article reviews the rationale, origins, emergence, prevalence, and empirical research on a variety of recovery support services in U.S. communities that may influence the likelihood of sustained recovery. The community recovery support services reviewed include recovery high schools, collegiate recovery programs, recovery homes, recovery coaches, and recovery community centers. Many individuals are not provided with the types of environmental supports needed to solidify and support their recovery, so there is a need for more research on who may be best suited for these services as well as when, why, and how they confer benefit. [ABSTRACT FROM AUTHOR]

The effects of social support among persons utilizing medication assisted treatment (MAT) living in abstinence-based recovery homes is not clearly understood, and there is a need to identify social process components that engender social support for this population. The present investigation examined whether homophily (i.e., living with/without fellow MAT residents) among recovery home residents would moderate the mediating effects of social support on the relationships between stress and two recovery outcomes (quality of life, abstinence self-efficacy) among a sample of persons utilizing MAT living in recovery homes (Oxford Houses) in the U.S. Moderated mediational analyses were conducted to test whether potential mediating effects were moderated by homophily. Mediating effects were observed in both models, but they were significant only through the moderator (homophily) in that social support buffered the effects of stress among MAT residents who lived with other MAT residents in their recovery homes. Findings suggest that homophily effects are related to social networking for persons utilizing MAT living in abstinence-based recovery homes. [ABSTRACT FROM AUTHOR]

Recovery homes serve as an important resource for individuals in dealing with substance use disorders (SUD). Access to these community-based supports is critical for many individuals exiting inpatient SUD treatment facilities and criminal justice settings. Unfortunately, basic information about this large system of recovery homes is unavailable, such as the total number of recovery homes in the United States. Although existing databases are not comprehensive, we used available ones to tabulate the recovery homes in the United States and supplemented this with phone interviews from state SUD treatment experts. Based on this research, we estimate there are about 17,900 recovery homes in the United States, and about 1.2% of individuals with SUDs use recovery homes each year. There is a need to develop an accessible directory of recovery homes that provides their location, as well as available openings, house gender, and offered services. [ABSTRACT FROM AUTHOR]

Medications for opioid use disorder (MOUD) and recovery homes that have traditionally served those not taking medications for their recovery are important resources for treating opioid use disorder. However, little is known whether such recovery homes are a good fit for persons utilizing MOUD, and whether residents' characteristics such as drug histories and the composition of recovery homes in terms MOUD and non-MOUD residents are related to attitudes toward MOUD. The present investigation examined characteristics of persons utilizing MOUD, and attitudes regarding MOUD utilization among residents living in recovery homes (Oxford Houses, OH) in the U.S. consisting of MOUD and non-MOUD residents. Residents living with others who were utilizing MOUD reported more favorable attitudes than residents who were not living with such residents, but this was observed only among residents whose primary drug of choice involved heroin or opioids. There were no significant differences observed in terms of abstinence rates, involvement in 12-step groups, or previous MOUD treatments between residents utilizing or not utilizing MOUD. Findings suggest that persons utilizing MOUD benefit by recovery homes such as OHs whose residents have favorable attitudes toward MOUD, especially when living with fellow residents who utilize MOUD. [ABSTRACT FROM AUTHOR]

BACKGROUND: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating, chronic, multisystem disease that affects an estimated 1 to 2.5 million Americans. It has no widely accepted biomarkers and no FDA-approved treatment. ME/CFS has traditionally been one of the lowest funded diseases by the United States National Institutes of Health (NIH). OBJECTIVES: We provide here an update to our 2016 article, which estimated the disease burden of ME/CFS in the United States in 2013 and its relation to NIH's 2015 analysis of research funding and disease burden. This update incorporates more recent burden data from 2015 and funding data from 2017. METHODS: We perform a regression analysis on funding versus disease burden to determine 2017 funding levels that would be commensurate with burden. Burden figures for 2017 are estimated using population-based extrapolations of earlier data. RESULTS: We find the disease burden of ME/CFS is double that of HIV/AIDS and over half that of breast cancer. We also find that ME/CFS is more underfunded with respect to burden than any disease in NIH's analysis of funding and disease burden, with ME/CFS receiving roughly 7% of that commensurate with disease burden. CONCLUSIONS: To be commensurate with disease burden, NIH funding would need to increase roughly 14-fold. [ABSTRACT FROM AUTHOR]

Social support is a resource frequently utilized by persons recovering from substance use disorders. However, little is known about the effects of social support among persons utilizing medication-assisted treatments (MATs) living in abstinence-based recovery homes. The present investigation examined whether social support would mediate the relationship between stress and two recovery outcomes (quality of life and abstinence self-efficacy) among a sample of residents living in Oxford House abstinence-based recovery homes in the U.S. Moderated mediational analyses were conducted to test whether potential mediating effects were influenced by whether residents were (or were not) utilizing MATs. Mediating effects were observed in both models, and these were not moderated by residents' MAT status. Findings suggest abstinence-based recovery homes such as Oxford Houses provide valuable social support that helps persons utilizing MATs in their recovery. [ABSTRACT FROM AUTHOR]

Background: Recovery community centers (RCCs) are the "new kid on the block" in providing addiction recovery services, adding a third tier to the 2 existing tiers of formal treatment and mutual‐help organizations (MHOs). RCCs are intended to be recovery hubs facilitating "one‐stop shopping" in the accrual of recovery capital (e.g., recovery coaching; employment/educational linkages). Despite their growth, little is known about who uses RCCs, what they use, and how use relates to improvements in functioning and quality of life. Greater knowledge would inform the field about RCC's potential clinical and public health utility. Methods: Online survey conducted with participants (N = 336) attending RCCs (k = 31) in the northeastern United States. Substance use history, services used, and derived benefits (e.g., quality of life) were assessed. Systematic regression modeling tested a priori theorized relationships among variables. Results: RCC members (n = 336) were on average 41.1 ± 12.4 years of age, 50% female, predominantly White (78.6%), with high school or lower education (48.8%), and limited income (45.2% <$10,000 past‐year household income). Most had either a primary opioid (32.7%) or alcohol (26.8%) problem. Just under half (48.5%) reported a lifetime psychiatric diagnosis. Participants had been attending RCCs for 2.6 ± 3.4 years, with many attending <1 year (35.4%). Most commonly used aspects were the socially oriented mutual‐help/peer groups and volunteering, but technological assistance and employment assistance were also common. Conceptual model testing found RCCs associated with increased recovery capital, but not social support; both of these theorized proximal outcomes, however, were related to improvements in psychological distress, self‐esteem, and quality of life. Conclusions: RCCs are utilized by an array of individuals with few resources and primary opioid or alcohol histories. Whereas strong social supportive elements were common and highly rated, RCCs appear to play a more unique role not provided either by formal treatment or by MHOs in facilitating the acquisition of recovery capital and thereby enhancing functioning and quality of life. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we provide estimates of the prevalence of tobacco use among residents in Oxford House (OH) recovery homes. We explore predictors for smoking cessation on future intentions to quit tobacco use, such as self-efficacy, motivation to quit, and level of nicotine dependence. We focus on examining smoking-related differences between 2 groups of tobacco users: (1) residents who only vape, and (2) residents who only smoke or who smoke and vape (ie, dual users). Methods: Data come from a research project examining the social networks of residents in OH homes at Wave 5 (N = 270) when questions were asked about tobacco use and cessation. We conducted multiple logistic regression analysis to assess the predictors on intentions to quit tobacco in the next 6 months. Results: Among residents, 60.4% report that they either smoke cigarettes, vape, or use both products. The odds of quitting are 92.5% lower for residents who only use e-cigarettes than for those who only smoke cigarettes or who smoke cigarettes and vape. Motivation to quit was associated with more than double the odds for self-efficacy on intentions to quit with odds ratios of 3.23 (95% CI: 1.81, 5.78; p = .00) and 1.47 (95% CI: 1.05, 2.07; p = .03) respectively. Conclusion: The high prevalence of smoking and vaping in this population makes it an important target for interventions. [ABSTRACT FROM AUTHOR]

There have been few efforts to systematically develop reliable and valid measures of social networks, particularly in studies dealing with individuals having substance use disorders. In the current study, individuals living in recovery homes called Oxford Houses completed a 6-item measure of social networks. The Cronbach’s alpha was .85 and a confirmatory factor analysis found excellent fit statistics with all items having substantial (> .70) load factors. In addition, the measure was independent of age, sex, and ethnicity and significantly related to length of stay in the recovery homes and quality of life. The authors have found that this instrument works well as an ego network with adequate psychometric properties and empirical relations to other recovery variables. [ABSTRACT FROM PUBLISHER]

BACKGROUND: Women in metropolitan areas have lower employment participation and employment rates than men. Although women face multiple challenges in the labor market, those who have a history of substance use and are abstinent may have a greater disadvantage in obtaining viable employment opportunities due to factors associated with substance use. No research to date has examined employment experiences among women in recovery from substance use. OBJECTIVE: This study examined employment characteristics and experiences of women who had a history of substance use and lived in sober-living environments in urban areas. METHOD: Data were collected through telephone interviews to sober living homes that were located in 20 urban areas. RESULTS: Themes identified through thematic analysis included employment challenges, the importance of work to substance abuse recovery, job satisfaction, employment aspirations, and employment support in the sober living home. CONCLUSION: Employment is important to women in substance abuse recovery, not only as a means for financial support, but also as a life priority. The results highlight howemployer scheduling practices, low-level positions, and lack of employment supports impact recovery. Findings provide insight into the need for employment support services, including employer education and flexible policies for women in recovery. [ABSTRACT FROM AUTHOR]

Social influences (social support for alcohol or drug use and social support for abstinence) were examined in relation to abstinence self-efficacy among a sample of 250 justice-involved persons exiting inpatient treatment for substance use disorders. Hierarchical linear regression was used to examine social influences in relation to abstinence self-efficacy. Social influences were significantly related to abstinence self-efficacy when examined independently. However, only social support for alcohol or drug use was significant when both social influences were entered into the model. Findings suggest social support for alcohol or drug use compromises abstinence social support, particularly among justice-involved persons who are early in their recovery from substance use disorders. [ABSTRACT FROM AUTHOR]

Housing First (HF) is an effective intervention for reducing homelessness and service utilization among vulnerable adults and is most often focused on individuals experiencing chronic homelessness. This study explored the effectiveness of a single-site HF program for 2 groups of people with serious mental illness: those experiencing chronic street homelessness, and those whose homelessness was limited but had high psychiatric service needs, often experiencing multiple hospitalizations or residential treatment. A sample of 91 HF and 91 matched usual care comparison participants were obtained from administrative records. Those in HF spent significantly less time homeless and psychiatrically hospitalized compared to usual care. Ninety percent of HF residents were housed after 1 year compared to 35% of the comparison group. Homelessness and hospitalization outcomes were unrelated to homelessness history. This study provides initial evidence for HF's effectiveness for promoting community stability among a population previously requiring a high level of intensive psychiatric care. [ABSTRACT FROM AUTHOR]

Goal-oriented thinking, including hope and self-efficacy, might play a constructive and integral role in the substance abuse recovery process, although such an effect may differ by race. The current study investigated hope and self-efficacy, specifically abstinence self-efficacy, as predictors of negative affect (i.e. depression and anxiety) in a longitudinal sample of men and women in substance abuse recovery who lived in sober living homes. We found hope agency and self-efficacy were related but not identical constructs; hope agency and self-efficacy predicted depressive and anxiety symptoms for individuals in recovery, yet these relationships were moderated by race. Theoretical and clinical implications for promoting positive affect among individuals in substance abuse recovery are discussed. [ABSTRACT FROM AUTHOR]

Research has shown employment to be a central mediator to sustained recovery and community reentry for substance abusers; however, heroin users have lower employment rates and report lower mean incomes than other drug users. The authors of the present study assessed income-generating behaviors of substance users recruited from substance abuse treatment facilities (N = 247). Heroin users had higher mean incomes from illegal sources. Further, logistic regression analysis found heroin use to increase the likelihood of engagement in illegal income generating behaviors. As these results increase the likelihood of involvement in the criminal justice system, the implications for heroin specific treatment and rehabilitation are discussed. [ABSTRACT FROM AUTHOR]

Acute treatment aftercare in the form of sober living environments-i.e., recovery houses-provide an inexpensive and effective medium-term treatment alternative for many with substance use disorders. Limited evidence suggests that house-situated social relationships and associated social support are critical determinants of how successful these residential experiences are for their members, but little is known about the mechanisms underlying these relationships. This study explored the feasibility of using dynamic social network modeling to understand house-situated longitudinal associations among individual Alcoholics Anonymous related recovery behaviors, length of residence, dyadic interpersonal trust, and dyadic confidant relationship formation processes. Trust and confidant relationships were measured 3 months apart in U.S. urban-area recovery houses, all of which were part of a network of substance use recovery homes. A stochastic actor-based model was successfully estimated from this data set. Results suggest that confidant relationships are predicted by trust, while trust is affected by recovery behaviors and length of residence. Conceptualizing recovery houses as a set of independent, evolving social networks that can be modeled jointly appears to be a promising direction for research. [ABSTRACT FROM AUTHOR]

Individuals with comorbid internalizing psychological symptoms and substance abuse issues often have more negative outcomes and evidence a relative disparity in treatment gains compared to those with only substance abuse issues. The present study examined social mechanisms over time for individuals living in self-governed recovery homes (Oxford Houses) such as 12-step group activities and social support, which likely influence both abstinence and psychological outcomes. Participants (n= 567) from a national US sample of Oxford Houses completed baseline and multiple follow-up self-report assessments over a one-year period. A structural equation model was utilized to evaluate predicted relationships among baseline symptoms, 12-step activities, social support, and outcome variables. Results indicated that internalizing symptoms were associated with subsequent mutual-help activities, but not directly with social support. Living in an Oxford House for six months and number of 12-step meetings attended were partially mediated by social support variables in predicting abstinence outcomes, but not psychological outcomes. Environments such as Oxford Houses may be viable options for recovering individuals with comorbid internalizing psychological problems, although social support mechanisms primarily promote abstinence. Implications for future research and for Oxford House policies are discussed. [ABSTRACT FROM AUTHOR]

Empowerment is an interdisciplinary construct heavily grounded in the theories of community psychology. Although empowerment has a strong theoretical foundation, few context-specific quantitative measures have been designed to evaluate empowerment for specific populations. The present study explored the factor structure of a modified empowerment scale with a cross-sectional sample of 296 women in recovery from substance use who lived in recovery homes located throughout the United States. Results from an exploratory factor analysis identified three factors of psychological empowerment which were closely related to previous conceptualizations of psychological empowerment: self-perception, resource knowledge and participation. Further analyses demonstrated a hierarchical relationship among the three factors, with resource knowledge predicting participation when controlling for self-perception. Finally, a correlational analysis demonstrated the initial construct validity of each factor, as each factor of empowerment was significantly and positively related to self-esteem. Implications for the application of psychological empowerment theory and research are discussed. [ABSTRACT FROM AUTHOR]

In this article, the various players are delineated in a story of a contested illness and patient advocacy, played out within the corridors of federal power. It is suggested that the mistreatment and negative attitudes that health care providers and others have towards those with chronic fatigue syndrome (CFS) is possibly due to the social construction of this illness as being a 'Yuppie flu' disease. Institutional factors are identified that created these norms and attributions, as well as the multiple stakeholders and constituent groups invested in exerting pressure on policy makers to effect systemic change. This article also provides examples of how the field of Community Psychology, which is fundamentally committed to/based on listening to and giving voice to patients, is broadly relevant to patient activism communities. This approach focused, over time, on epidemiological studies, the name, the case definition, and ultimately the change in CFS leadership at the Centers for Disease Control and Prevention. Keys to this 'small wins' approach were coalition building, use of 'oppositional experts' (professionals in the scientific community who support patient advocacy goals) to challenge federal research, and taking advantage of developing events/shifts in power. Ultimately, this approach can result in significant scientific and policy gains, and changes in medical and public perception of an illness. [ABSTRACT FROM AUTHOR]

Abstract: A longitudinal analysis was conducted among a U.S. national sample of persons affiliated with Alcoholics Anonymous and Narcotics Anonymous living in self-run recovery homes (Oxford Houses). Categorical involvement in a set of 12-step activities (i.e., having a sponsor, reading 12-step literature, doing service work, and calling other members for help) and averaged summary scores of involvement were examined in relation to abstinence and self-efficacy for abstinence. Participants who were categorically involved in all 12-step activities reported significantly higher levels of abstinence and self-efficacy for abstinence at 1 year compared with those who were less involved, whereas averaged summary scores of involvement were not a significant predictor of abstinence. Participants'' number of days in Oxford Houses, but not rates of 12-step meeting attendance, was significantly related to increased abstinence. Findings suggest that categorical involvement in a number of 12-step activities equip persons with substance use disorders with resources for ongoing recovery. [Copyright &y& Elsevier]

Objective: Because of psychometric limitations and varied adaptations of the Important People Inventory (IP; a measure of alcohol social support), Groh et al. (7) performed factor analyses and created a three-factor model (i.e., Support for Drinking from Network Members, Drinking Behaviors of Network Members, and General Social Support) . This present study examined the ability of the three-factor model to predict alcohol use. Methods: This study consisted of 293 women and 604 men who were US residents of a network of self-run recovery homes known as Oxford House (OH). Logistic regression models were run. The first model examined which of the three IP factors was the best predictor of alcohol use over a 4-month period; next, models compared Drinking Behaviors of Network Members (the three-factor model) and Network Support for Drinking from Network Members (the original two-factor model) as predictors of 4-month alcohol use. Results: Of the three factors measuring general support, network drinking behaviors, and support for drinking, Drinking Behaviors of Network Members was the only significant predictor of alcohol use over a 4-month period. Additionally, this component was a better predictor of drinking than the Support for Drinking from Network Members summary score from the original model. Conclusions: Compared to the original model, this new three-factor model of the IP is shorter, has stronger internal reliability, and is a better predictor of alcohol use over time. It is strongly recommended that researchers continue to explore the utility of this new model. [ABSTRACT FROM AUTHOR]

The current study examined the development of community psychology through publications in the main journals of the field, the American Journal of Community Psychology (AJCP) and Journal of Community Psychology (JCP). The investigation assessed which individuals played a major role in shaping the field through their publications by recording information from every citation in AJCP and JCP since the journals started in 1973 through 2004. Each author and the year of publication were documented. In addition, the number of times each article was cited by other researchers was also documented as an approximation of the impact of the article. To document trends over time, three periods (1973–1983; 1984–1994; 1995–2004) were assessed. The relative contribution of authors to the field's literature is presented by rank orders of productivity and influence. Historical trends are discussed. © 2009 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background: ME/CFS is characterized by debilitating fatigue in addition to other physical and cognitive symptoms. It is estimated to affect over 800,000 adults in the U.S. ME/CFS often results in diminished functionality and increased economic impact. The economic impact of an illness is generally divided into two categories: direct and indirect costs. Despite high prevalence rates and the disabling nature of the illness, few studies have examined the costs of ME/CFS at the individual and societal level. In fact, of the four studies examining the economic impact of ME/ME/CFS only two used a U. S. sample. The current study used community and tertiary samples to examine the direct costs of ME/CFS. Methods: Using archival data, Study 1 examined the direct cost of ME/CFS in a community-based sample in Chicago. Study 2 estimated the direct cost of ME/CFS in a tertiary sample in Chicago. Both Study1 and Study 2 assessed direct costs using office visit costs, medical test costs, and medication costs. Results: For Study 1, the annual direct total cost per ME/CFS patient was estimated to be $2,342, with the total annual direct cost of ME/CFS to society being approximately $2 billion. In Study 2, the annual direct was estimated to be $8,675 per ME/CFS patient, with the total annual direct cost of ME/CFS to society being approximately $7 billion. Conclusion: Using ME/CFS prevalence data of 0.42 and indirect costs estimates from Reynolds et al. (2004), the direct and indirect cost of ME/CFS to society was estimated to be $18,677,912,000 for the community sample and $23,972,300,000 for the tertiary sample. These findings indicate that whether or not individuals are recruited from a community or tertiary sample, ME/CFS imposes substantial economic costs. [ABSTRACT FROM AUTHOR]

Substance abuse prevalence rates for Latinos/as generally mirror those of the general U.S. population; however, a number of indicators of assimilation to U.S. culture as well as sociodemographic variables predict substance use and abuse among this group. Latinos/as have poorer outcomes in substance abuse treatment programs. Yet there is little empirical evidence that explains the problems these individuals experience in treatment, and there are few studies on the use and effectiveness of mutual help groups among this population. New developments in the conceptualization and measurement of acculturation will lead to a greater understanding of the role of culture in the prevalence and treatment of substance-related problems. [ABSTRACT FROM AUTHOR]

Social support may be considered from several different dimensions. While general social support promotes well-being, specific social support is tied to particular functions, such as alcohol use. Not only may the form of social support vary, but also the source (ie, friends vs. family). This study investigated the impact of general and specific support for alcohol use from family versus friends on alcohol use among 897 U.S. residents of abstinent communal-living settings (Oxford Houses). Results indicated that general support from friends and length of stay in Oxford House significantly predicted less alcohol use. Implications for alcohol recovery are discussed. [ABSTRACT FROM AUTHOR]

The article compares the neighborhood characteristics of Oxford Houses, communal-living, mutual help settings for persons in recovery of alcohol and substance abuse, in the United States and Melbourne, Victoria. The study shows that Oxford Houses in Victoria are safe and sober settings for persons in recovery consistent with the original model in physical dwelling settings in the United States.

The article examines the interior and exterior physical characteristics of substance abuse recovery program dwellings from three geographic sections of the United States. Oxford House is a network of homes that offers residents a supportive, democratic, mutual-help setting, established and maintained by recovering substance abusers living together to develop long-term abstinence skills. Residents created a safe and sober "house-as-home." The study found that self-governance within a communal-living family environment is appropriate for diverse populations.

The article explores the sense of community among women and women with children living in Oxford House, a communal living for individuals recovering from substance abuse in the United States. The study focuses on how the presence of children might affect the household. The results of the study revealed that sense of community did not vary between participants with more or less than three months residence. Residents demonstrated very high levels of satisfaction with the home. Children had a positive impact on the household and their own recovery process.

The article examines medical care need and utilization patterns among a substance abusing and recovering population in the United States. The study found that unemployed needed and utilized greater medical care than those who were employed. Heroine, cocaine and/or alcohol use was not predictive of medical care need or utilization, while pharmaceutical drug use was predictive of medical care need and utilization.

The article examines the structural social support of men living in a network of self-run, substance abuse recovery homes in the United States. The authors investigate the effect of different types of social relationships on individuals' substance use patterns and recovery attempts. Varying relationship types demonstrate different influences on use and recovery. Moreover, each type of relationship had differential effects on use versus recovery.

The article investigates ethnic and gender differences in reported resource losses and gains for recovering substance abusers living in Oxford Houses in the United States. The results showed significant individual differences in resources, based on gender, ethnicity and the length of residential stay. African-Americans demonstrated greater gains and losses in resources than European-Americans.

The article estimates the annual program costs per person for Oxford House model for substance abuse recovery based on federal loan information and data collected from Oxford House Inc. in the United States. Annual treatment and incarceration costs were analyzed based on participant data prior to Oxford House residence. The results show that societal costs associated with the Oxford house program were relatively low. Estimated costs were high in relation with inpatient and incarceration history.

The article examines the potential effect of government policy and technical assistance on the development and expansion of men and women's substance abuse recovery homes known as Oxford Houses in the United States. The authors hypothesized that women's houses expanded more rapidly in states that used technical assistance. They expected a greater decrease among women's houses compared to men in states that did not use technical assistance or dropped the loan fund in 1999. The expansion of male houses is more likely to remain consistent and stable

Focuses on application of advances in technology to facilitate the implementation of a large-scale, community research project. Application of technology by members of the social sciences; Improvement of the way scientists conduct community research in the U.S.

As a form of aftercare, Oxford House (OH) is a recovery home that is democratically operated by residents, with. no designated limit on length of stay. These homes are behaviorally based settings that provide clear consequences for any substance use or disruptive behavior. What is unique about these settings is that training, supervision, and implementation. of the contingencies are provided by the residents. In order to increase the number of these mutual-help recovery homes, two groups of states utilized state funds to hire recruiters and set up a loan, fund to establish new OHs. Using a multiple baseline design., findings indicated that this intervention, involving the hiring of recruiters and a loan. program. was effective in. facilitating increases in the number of U.S. OHs in each group of states. An. immediate increase in the opening of new houses occurred when the intervention was introduced, resulting in the opening of 559 new OHs across these states. [ABSTRACT FROM AUTHOR]

Since the publication of the case definition for chronic fatigue syndrome (CFS) in 1988 the diagnostic criteria have been revised twice in the U.S. None of the case definitions were derived empirically. As a result, there is concern regarding the sensitivity, specificity, and reliability of the criteria. The goal of the present study was to identify methods for improving the diagnostic criteria for CFS. Three groups of 15 participants each were recruited: participants with (1) CFS, (2) major depressive disorder (MDD), and (3) healthy controls. Using statistical procedures, three methods for improving the diagnostic criteria were explored: identification of new diagnostic symptoms, the use of severity ratings for symptomatology, and the identification of standardized measures that differentiate cases of CFS from other conditions. Results of the present study suggest that these three methods hold promise for improving the sensitivity, specificity, and reliability of the diagnostic criteria for CFS. [Copyright &y& Elsevier]