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Background: Women with intellectual and developmental disabilities (IDD) in the USA are bearing children at increasing rates. However, very little is known whether racial and ethnic disparities in birth outcomes and labour and delivery‐related charges exist in this population. This study investigated racial and ethnic disparities in birth outcomes and labour and delivery‐related charges among women with IDD. Methods: The study employed secondary analysis of the 2004–2011 Healthcare Cost and Utilization Project National Inpatient Sample, the largest all‐payer, publicly available US inpatient healthcare database. Hierarchical mixed‐effect logistic and linear regression models were used to compare the study outcomes. Results: We identified 2110 delivery‐associated hospitalisations among women with IDD including 1275 among non‐Hispanic White women, 527 among non‐Hispanic Black women and 308 among Hispanic women. We found significant disparities in stillbirth among non‐Hispanic Black and Hispanic women with IDD compared with their non‐Hispanic White peers [odds ratio = 2.50, 95% confidence interval (CI): 1.16–5.28, P < 0.01 and odds ratio = 2.53, 95% CI: 1.08–5.92, P < 0.01, respectively]. There were no racial and ethnic disparities in caesarean delivery, preterm birth and small‐for‐gestational‐age neonates among women with IDD. The average labour and delivery‐related charges for non‐Hispanic Black and Hispanic Women with IDD ($18 889 and $22 481, respectively) exceeded those for non‐Hispanic White women with IDD ($14 886) by $4003 and $7595 or by 27% and 51%, respectively. The significant racial and ethnic differences in charges persisted even after controlling for a range of individual‐level and institutional‐level characteristics and were 6% (ln(β) = 0.06, 95% CI: 0.01–0.11, P < 0.05) and 9% (ln(β) = 0.09, 95% CI: 0.03–0.14, P < 0.01) higher for non‐Hispanic Black and Hispanic Women with IDD compared with non‐Hispanic White women with IDD. Conclusions: Our findings highlight the need for an integrated approach to the delivery of comprehensive perinatal services for racial and ethnic minority women with IDD to reduce their risk of having a stillbirth. Additionally, further research is needed to examine the causes of racial and ethnic disparities in hospital charges for labour and delivery admission among women with IDD and ascertain whether price discrimination exists based on patients' racial or ethnic identities. [ABSTRACT FROM AUTHOR]

High rates of infection for chlamydia and gonorrhea have been noted among youths involved in the juvenile justice system. Although both individual and community-level factors have been found to be associated with sexually transmitted disease (STD) risk, their relative importance has not been tested in this population. A two-level logistic regression analysis was completed to assess the influence of individual-level and community-level predictors on STD test results among arrested youths processed at a centralized intake facility. Results from weighted two level logistic regression analyses (n = 1,368) indicated individual-level factors of gender (being female), age, race (being African American), and criminal history predicted the youths' positive STD status. For the community-level predictors, concentrated disadvantage significantly and positively predicted the youths' STD status. Implications of these findings for future research and public health policy are discussed. [ABSTRACT FROM AUTHOR]

Knowledge of the rates and correlates of juvenile offenders' sexually transmitted diseases (STD) has been limited to samples of incarcerated youths comprised mostly of males. Data collected on 442 female and 506 male youths processed at a centralized intake facility enabled us to study this important public health problem among a sample of juvenile offenders at the front end of the justice system. Female-male, multi-group latent class analyses identified two subgroups, High Risk and Lower Risk, of youths described by a latent construct of risk based on drug test results, STD test results, and a classification for the seriousness of arrest charge. The results found: (1) a similar classification distinguished High Risk and Lower Risk male and female youths, and (2) important gender group differences in sexual risk related factors (e.g., substance use during sexual encounters). Among the youths in this sample who tested positive for an STD, 66% of the girls and 57% of the boys were released back into the community after arrest. Overall, our findings raise serious public health and social welfare concerns, for both the youths and the community. Prevention and intervention implications of these findings are also discussed. [ABSTRACT FROM AUTHOR]

Background: Adolescent offenders may be at high risk for sexually transmitted diseases (STDs). With previous research and interventions focused on incarcerated adolescents, data are needed on STD prevalence and risk factors among newly arrested youth released to the community, a far larger subgroup.Methods: Participants were recruited from all arrested youth processed at the Hillsborough County, Florida Juvenile Assessment Center during the last half of 2006 (506 males, 442 females). Participants voluntarily providing urine samples for drug testing as part of standard protocol were also consented to having their specimens split and tested for chlamydia and gonorrhea, using an FDA-approved nucleic acid amplification test.Results: STD prevalence was similar to those previously reported among incarcerated adolescents: 11.5% tested positive for chlamydia, 4.2% for gonorrhea, and 13.2% for either or both infections. Prevalence was significantly higher among females: 19.2% of females had either or both infections compared with 10.5% of males. Prevalence was higher for 17 to 18 year olds (15.2% of males, 25.5% of females), blacks, detained youths, drug users, and those engaged in sexual risk behaviors. Previous STD testing experience was limited.Conclusions: The study indicated that a voluntary STD screening protocol is feasible for arrested youth entering the juvenile justice system, and these offenders are at high risk for STDs. Because most arrested youths are released back to the community, routine testing and treatment of recently arrested youths, and expanded access to risk reduction and prevention programs, can yield substantial public health benefits. [ABSTRACT FROM AUTHOR]

This paper reports the results of developing and evaluating a classification of 315 arrested youth processed at the Hillsborough County Juvenile Assessment Center from September 1, 1994 to January 31, 1998. Youth were characterized as physically or sexually abused if they reported abuse or if they had been referred to juvenile court for abuse. Stepwise logistic regression analysis revealed that family problems, friends' substance use, and delinquency involvement (marginally significantly related) were associated with both physical abuse and sexual victimization. In addition, physical abuse was associated with psychological problems and sexual victimization with being female, being older, and own substance use. The research implications of these results are discussed. [ABSTRACT FROM AUTHOR]

We report the results of latent growth model analyses examining the continuity of cocaine use among adolescents. This study examined a sample of 278 justice-involved juveniles completing at least one of three follow-up interviews as part of a National Institute on Drug Abuse funded study. Latent growth models were analyzed examining (1) changes in cocaine use over time; (2) the effects of sociodemographic characteristics on cocaine use over time; and (3) the effects of family problem characteristics, deviant peer associations, physical abuse, sexual victimization, and emotional/psychological functioning on cocaine use over time. The results of our analyses indicated that cocaine use among these youths continued over time. Further, consistent with findings from existing literature, cocaine use was significantly related to drug using and delinquent peer associations, and marginally related to family problemswith the justice system. Implications for policy and intervention service needs are discussed. [ABSTRACT FROM AUTHOR]

We report the results of a test of a structural model reflecting the longitudinal relationships of psychosocial problems among youths involved in a Center for Substance Abuse Treatment funded clinical trial for juveniles that participated in a diversion program. The project is evaluating the efficacy of an intensive 16-week case management service to youths and their families. The present study examines the continuity of (1) psychosocial problems, measured as a latent variable comprising family problems, peer problems, and educational problems, (2) drug involvement, use, and effects, and (3) self-reported delinquency for baseline and approximately 1-year follow-up interview data for 165 and 137 youths, respectively. The results support existing literature indicating that once problem behaviors are established at an early age, they have a strong likelihood of persisting over time. Implications for policy and intervention service needs are discussed. [ABSTRACT FROM AUTHOR]

We report the results of the relationship of lifetime and past year drug involvement to psychosocial functioning among youths entering a Juvenile Arbitration Program (a diversion program) in the 13th Judicial Circuit, who enrolled in a Center for Substance Abuse Treatment funded study. The project is a clinical trial evaluating an innovative intervention service providing sixteen weeks of intensive case management services to youths and their families. The present study examines baseline interview data for 165 youths who entered the Juvenile Arbitration Program between June 2002 and July 2003 and agreed to participate in the project. The results indicate that drug involvement is a significant issue among the youths we studied, and is related to functioning problems in a number of key areas of their lives. Indeed, the greater their drug involvement, the more psychosocial problems they report experiencing. These findings contradict public opinion that youths placed in diversion programs have relatively few problems. Policy implications based on these results are discussed. [ABSTRACT FROM AUTHOR]

Baseline, one-year and two-year follow-up interviews were obtained from 164 arrested youths processed at a juvenile assessment center in a prospective longitudinal study. A structural equation model that included cross-sectional and longitudinal associations arnong drug (alcohol and marijuana), drug sales and index offenses was supported by the data. Research, theoretical, and policy implications of the results are drawn. [ABSTRACT FROM AUTHOR]

Expanded analyses were completed on the efficacy of a family empowerment intervention for juvenile offenders and their families. The results indicate the promise of the intervention in regard to the youths drug use and involvement in drug sales during a one-year post initial interview follow up period. [ABSTRACT FROM AUTHOR]

Using data collected in a study of 163 arrested youths processed at a juvenile assessment center, who entered a home based family intervention project, we test a longitudinal, developmental damage model of the relationships between the youths' family problems (including their abuse experiences) and their drug use and delinquent behavior over time. The hypothesized model, specifying family problems affect the youths' problem behavior at Time 1 and Time 2, was supported by the data, involving both self-reports of physical and sexual abuse and official records of physical and sexual abuse, and neglect. Theoretical and policy implications of the results are drawn. [ABSTRACT FROM AUTHOR]

The authors tested a model of the influence of arrested youths' family problem factors, including their sexual victimization and physical abuse experiences, on their drug use and frequency of involvement in index offenses. The sample involved 277 youths processed at the Hillsborough County Juvenile Assessment Center, in Tampa, Florida, who entered a NIDA funded service delivery project, called the Youth Support Project. The self-reported data we analyzed were collected during confidential in-depth, baseline interviews lasting an average of 2 hours. The hypothesized model was supported by the data overall and for the male youths, with the female youth data suggesting they use alcohol and marijuana for different reasons. The authors' findings underscore the importance of prevention and early intervention efforts involving at-risk youth and their families to reduce the prevalence and adverse consequences of these traumatic experiences. [ABSTRACT FROM AUTHOR]

A study was completed comparing the sociodemographic characteristics, delinquency and dependency referral histories and psychosocial functioning of 856 eight to twelve year-old, 2,512 thirteen and fourteen year-old and 6,215 fifteen to twenty year-old youths processed at the Hillsborough County Juvenile Assessment Center between May 5, 1993 and December 31, 1995. The results indicate that, compared to older aged youths, the 8 to 12 year-old youngsters tend to be ethnic minorities, live in mother-headed households of low economic status, and have a relatively severe lag between their actual and school grade. The policy implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

We report the results of an in-depth study of 119 youths at the Hillsborough County (Tampa), Florida, Juvenile Assessment Center involved in a community-based intervention study. Comparisons were made of the male and female youths on a wide range of demographic, offense and psychosocial characteristics. Consistent with previous research, results indicated that male youths were more involved in delinquent activities, whereas female youths came from more troubled family backgrounds involving sexual victimization. Conclusions are drawn regarding the health service implications of these findings. [ABSTRACT FROM AUTHOR]

We report the results of the predictors of recidivism to the Hillsborough County, Florida Juvenile Assessment Center involving over 9,000 youths processed at the center during the period May 5, 1993 through December 31, 1995. The youths accounted for nearly 20,000 admissions. Significant relationships were found between the youths' demographic characteristics, their dependency referral factors (physical abuse and neglect), and delinquency referral history variables (property, violence and public disorder offenses; and drug offenses), and their recidivism to the Juvenile Assessment Center. The service delivery and policy implications of these results are discussed. [ABSTRACT FROM AUTHOR]

We report the results of a study of the processing of youths at the Hillsborough County (Tampa), Florida, Juvenile Assessment Center (JAC) involving the preliminary screening, assessor staff service recommendations and service utilization outcomes of 143 youths processed at Tampa JAC. The relationships between the youths' potential problems identified during the preliminary screening process and assessor recommendations for follow-up service examined. The outcomes of youths referred for further services are described. The policy and service delivery implications of the findings are drawn. [ABSTRACT FROM AUTHOR]

The Problem Oriented Screening Instrument for Teenagers (POSIT) is a key aspect of the preliminary screening activities at the Hillsborough County Juvenile Assessment Center. We report the results of the third in a series of studies examining the test-retest reliability of the POSIT, involving an examination of the relationships between the youths' initial and second admission POSIT results for different time intervals between administration of the instrument. Comparisons are also made in POSIT scores for youths with different sociodemographic characteristics. Further, logistic regression analyses involving various predictors of involvement in mental health or substance abuse treatment are reported. The results continue to document the usefulness of the POSIT as a preliminary screening tool. [ABSTRACT FROM AUTHOR]

We report the results of a study of substance use, measured by self-reports and hair test results, and delinquency among arrested youths entering a service intervention program. The results highlight important relationships between their alcohol and other drug use and involvement in delinquency in the year prior to their interviews. The research and service implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

We report the results of an expanded study of the predictors of recidivism to a Juvenile Assessment Center in Hillsborough County, Florida, involving over 5200 youths processed at the center during the period May 5, 1993 through December 31, 1994. Significant relationships were found between the youths' demographics, their dependency referral factors (physical abuse and neglect) and delinquency referral history variables (property, violence and public disorder offenses), and their recidivism to the Juvenile Assessment Center. The service delivery and policy implications of these results are discussed. [ABSTRACT FROM AUTHOR]

The relationships between child physical and sexual abuse and illicit drug use are relatively unexplored and obscure. Data gathered from a sample of youths in a juvenile detention center permitted an examination of this important issue. A structural model, specifying the influence of child physical and sexual abuse variables on the youths' illicit drug use, directly and as mediated by self-derogation, was estimated among male and female detainees. Results suggest that for both gender groups, sexual victimization had a primarily direct effect on drug use, whereas physical abuse had both a direct and an indirect effect on drug use. The indirect effect of physical abuse on drug use was mediated by self-derogation. Further analysis indicated race did not affect the results. The implications of these results for theory and research on the etiology of drug use and the identification of youths in high risk groups who are likely to become seriously involved in drug use are discussed. [ABSTRACT FROM AUTHOR]