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Childhood sexual assault (CSA) victimization and depression are global public health concerns that disproportionately affect youths involved in the juvenile justice system. Little research has examined the influence of CSA on the stability of depressive symptoms among repeat juvenile offenders. The present study tested a gendered model of the association between lifetime CSA victimization and depression for three time points: baseline juvenile assessment entry; second reentry; and third reentry. Further, covariate analyses were conducted to explore the impact of socio-demographics on CSA victimization and depression. Results indicate that CSA victimization was associated directly with baseline depression and indirectly with depression at second reentry for both male and female justice-involved youths. For white, male youth, there were significantly higher rates of depression over time, than other males. However, age, African American or Hispanic race/ethnicity, living situation, and urbanity were not significantly associated with CSA victimization at baseline or depression over time. These findings underscore the need for juvenile justice services that address exposure to childhood trauma and mental illness more effectively.

Little is known about longitudinal health risks and justice involvement among juvenile justice system (JJS) populations. This study used a sample of n = 388 males involved in the JJS to examined longitudinal associations of a latent health risk factor, comprised of depression, marijuana use, and sexually transmitted infections, with post-JJS placement. Results indicate the health risk factor was relatively stable over three time points of JJS entry and associated with present and future JJS placement. Youths who were Hispanic, older, or living with a family member struggling with alcohol use had higher health risk. These findings underscore the need for JJS services that address health risks among persistent juvenile offenders, with consideration of cultural and family dynamics.

Studies addressing risk factors among justice-involved girls in rural areas remain a neglected area of research. Following an intersectional framework, the current study examines the patterning of ...

Childhood sexual assault is a traumatic experience with negative consequences and correlates. Little research has examined the prevalence of self-reported childhood sexual assault among justice-inv...

Stress-related theories suggest exposures to stressful situations affect mental health, substance use, and other behaviors. Youth involved in the juvenile justice system demonstrate greater risk of...

Research has demonstrated justice-involved adolescents are at high risk for substance use, acquiring sexually transmitted infections (STIs), and engaging in risky sexual practices. Substance use and risky sexual practices have public health consequences and may place youths at risk for other long-term outcomes, such as recidivism. This study utilized data collected at two juvenile assessment centers (JACs) for 4033 adolescents criminally arrested/charged to explore gender (male vs. female) and location (urban JAC vs. rural JAC) group differences in health risk and recidivism. Results indicated a single factor of health risk comprised of biological assay test results for marijuana use and STIs and self-reported number of sexual partners fit the data for each of the groups. This health risk factor significantly predicted recidivism (return to JAC) for urban males and rural females, and near significantly predicted recidivism for rural males. Age and race differences were found in associations with the health risk factor and recidivism. The results confirm that marijuana use and sexual behavior reflect a risk propensity and should be considered when assessing needs for intervention services for justice-involved youths.

Although interorganizational relationships (IORs) are essential to the effective delivery of human services, very little research has examined relationships between juvenile justice agencies and behavioral health providers, and few studies have identified the most critical organizational and individual-level characteristics influencing IORs. Across 36 sites, juvenile probation officials (n = 458) and community behavioral health providers (n = 91) were surveyed about characteristics of their agencies, themselves, and IORs with each other. Generalized Linear Mixed Models were used to analyze the data. The strongest predictors included Perceived Organizational Support and individual Adaptability. Implications for research, theory and practice are discussed.

Recidivism, and the factors related to it, remains a highly significant concern among juvenile justice researchers, practitioners, and policy makers. Recent studies highlight the need to examine multiple measures of recidivism as well as conduct multilevel analyses of this phenomenon. Using data collected in a National Institute on Drug Abuse (NIDA)-funded Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) cooperative agreement, we examined individual- and site-level factors related to 1-year recidivism among probation youth in 20 sites in five states to answer research questions related to how recidivism rates differ across sites and the relationships between individual-level variables and a county-level concentrated disadvantage measure and recidivism. Our findings of large site differences in recidivism rates, and complex relationships between individual and county-level predictors of recidivism, highlight the need for more nuanced, contextually informed, multilevel approaches in studying recidivism among juveniles.

We examine how juvenile justice-involved youth of Haitian descent in Miami-Dade County cope with structural racism and its impact on their mental health. Drawing on longitudinal ethnography, psychosocial assessment data, and a family-based clinical intervention funded by the National Institute on Drug Abuse, this article explores youth narratives of discrimination prior to and during the COVID-19 pandemic. We use critical race theory and theory of practice to understand youths' perceptions as racialized bodies and stigmatized selves, highlighting the experiences and perspectives of a particular black immigrant group, ethnic beings caught up in the everyday practices of racialization, sociocultural marginalization, and racism. We frame these experiences as a variation of the complex continuum of structural racism and racial domination in the US. These experiences have caused anger, fear, anxiety, chronic anticipatory distress, and hopelessness among youth of Haitian descent. We conclude with some recommendations for therapeutic support that encourages youth to process their experiences, promotes their development of a positive self-concept, and provides them with mind-body techniques to attenuate the physical impacts of discriminatory events. The clinical trial registration number for this study intervention is NCT03876171.我们研究了青少年司法应对结构性种族主义及其对他们心理健康的影响，涉及的相关人群主要是迈阿密-戴德县海地裔青年。本文利用纵向民族志研究方法、心理社会评估数据和国家药物滥用研究所资助的以家庭为基础的临床干预项目，探讨了COVID-19大流行期间年轻人关于对种族歧视的叙述。我们使用批判种族理论和实践理论来理解年轻人如何看待对自己的身体被种族化和自我被污名化，突出表现一个特定的黑人移民群体的经历和视角，这个少数族裔在日常生活中被种族化、社会文化边缘化和应对种族主义。我们将这些经历视为美国结构性种族主义和种族统治这一复杂连续统一体的变体。这些经历在海地裔青年中引起愤怒、恐惧、焦虑、长期的预期痛苦和绝望。最后，我们提出了一些治疗支持建议，以鼓励青少年处理自己的经历，促进他们形成积极的自我概念，并为他们提供身心技术，以减轻歧视类的事件对身体的影响。本研究干预的临床试验注册编号为NCT03876171。.

Objective: Scant research exists on the validity of self-reported marijuana use using biological assays among adolescents involved in the juvenile justice system. This exploratory study examined gender (sex) differences in underreporting of marijuana use and the impact of age, race/ethnicity, living situation, depression, family problems, sexual risk behaviors, previous drug treatment, and juvenile justice placement. Methods: Self-reports of past year marijuana use were validated with urinalysis, and those testing positive for marijuana use were selected for study. The sample was 256 females and 885 males, aged 12 to 18, entering an urban juvenile assessment center in a southeastern U.S. state between 2017 and 2019. Results: Results indicated significant differences in marijuana underreporting (tested positive but self-reported no use), with 37% of females and 55% of males underreporting use. For males, Hispanic ethnicity, African American race, sexually transmitted infection (STI), and secure detention placement increased the odds of underreporting, while having an incarcerate parent and previous drug treatment decreased the odds. For females, number of sexual partners decreased the odds of underreporting of marijuana use. Conclusion: These findings imply use of collateral information, such as urine tests, as a recommendation for juvenile justice intake to corroborate self-reports and guide risk assessment.

Research indicates juvenile justice-involved youth experience increased risk of exposure to childhood trauma and health risks. Little is known about the heterogeneity in trauma and health risk experiences among delinquent youth, especially across gender. The current study uses latent class analysis to examine typologies of self-reported exposure to trauma and health risks among a sample of 435 female and 1,198 male juvenile offenders. The study objectives were to identify any subgroups of justice-involved youths with varying patterns of trauma and health risk behaviors across gender, examine the size of these trauma-health risk subgroups, and examine socio-demographic differences in the trauma-health risk latent classes. Findings suggest the presence of three groups of trauma and health risk behaviors within the gender groups. For females, the three subgroups demonstrated linear trends in increasing prevalence of trauma and health risks. For males, the three subgroups reflected a generally low-risk group, a group with high rates of marijuana use and risky sexual behaviors, and a group with high rates of depression, family problems, sexual assault victimization, and bullying. The analyses for the covariates revealed racial differences in trauma and health risks. The findings suggest gendered intervention strategies should be considered for justice-involved youth.

Youth involved in the justice system have high rates of alcohol and other drug use, but limited treatment engagement. JJ-TRIALS tested implementation activities with community supervision (CS) and behavioral health (BH) agencies to improve screening, identification of substance use service need, referral, and treatment initiation and engagement, guided by the BH Services Cascade and EPIS frameworks. This paper summarizes intervention impacts on referrals to treatment among youth on CS.This multisite cluster-randomized trial involved 18 matched pairs of sites in 36 counties in seven states randomly assigned to core or enhanced conditions after implementing the core intervention at all sites for six months. Enhanced sites received external facilitation for local change team activities to reduce unmet treatment needs; Core sites were encouraged to form interagency workgroups. The dependent variable was percentage referred to treatment among youth in need (N = 14,012). Two-level Bayesian regression assessed factors predicting referral across all sites and time periods. Generalized linear mixed models using logit transformation tested two hypotheses: (H1) referrals will increase from baseline to the experimental period, (H2) referral increases will be larger in enhanced sites than in core sites.Although the intervention significantly increased referral, condition did not significantly predict referral across all time periods. Youth who tested drug positive, had an alcohol/other drug-related or felony charge, were placed in secure detention or assigned more intensive supervision, or who were White were more likely to be referred. H1 (p .05) and H2 (p .0001) were both significant in the hypothesized direction. Interaction analyses comparing site pair differences showed that findings were not consistent across sites.The percentage of youth referred to treatment increased compared with baseline overall, and enhanced sites showed larger increases in referrals over time. However, variations in effects suggest that site-level differences were important. Researchers should carry out mixed methods studies to further understand reasons for the inconsistent findings within randomized site pairs, and how to further improve treatment referrals across CS and BH systems. Findings also highlight that even when CS agencies work collaboratively with BH providers to improve referrals, most justice-involved youth who need SU services are not referred.

Youth involved in the juvenile justice system demonstrate greater risk of exposure to negative life experiences. The present study explores the prevalence of three stress-related experiences (sexual assault victimization, bullying/victimization, and minority sexual orientation) among newly arrested adolescents. Gender (biological sex) differences were examined as well as associations with sociodemographic characteristics, depressive symptoms, substance use, and sexually transmitted infection (STI). Factor analyses found a single factor of stress for both genders. Prevalence rates for bullying/victimization, sexual assault victimization, and sexual minority status were higher for girls than boys. Girls were also more likely than boys to test positive for STIs and experience depressive symptoms, while boys were more likely than girls to test positive for marijuana use. Depression and drug-related problems were associated with the stress construct for girls only. Bivariate comparisons with the three stress measures and sociodemographic characteristics indicated age and race effects. Implications are discussed.

Most studies of bullying rely on school-based samples of youth; however, a few studies of justice-involved populations suggest delinquent youth experience higher rates of bullying than youth in the...

Youths in the juvenile justice system often do not access needed behavioral health services. The behavioral health services cascade model was used to examine rates of substance use screening, identification of substance use treatment needs, and referral to and initiation of treatment among youths undergoing juvenile justice system intake and to identify when treatment access is most challenged. Characteristics associated with identification of behavioral health needs and linkage to community services were also examined.Data were drawn from administrative records of 33 community justice agencies in seven states participating in Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System, funded by the National Institute on Drug Abuse (N=8,307 youths). Contributions of youth, staff, agency, and county characteristics to identification of behavioral health needs and linkage to community services were examined.More than 70% (5,942 of 8,307) of youths were screened for substance use problems, and more than half needed treatment. Among those in need, only about one-fifth were referred to treatment, and among those referred, 67.5% initiated treatment. Overall,10% of youths with identified needs initiated services. Multivariable multilevel regression analyses revealed several contributors to service-related outcomes, with youths' level of supervision being among the strongest predictors of treatment referral.Community justice agencies appear to follow an approach that focuses identification and linkage practices on concerns other than youths' behavioral health needs, although such needs contribute to reoffending. Local agencies should coordinate efforts to support interagency communication in the referral and cross-system linkage process.

The threat generated by the COVID‐19 pandemic has triggered sudden institutional changes in an effort to reduce viral spread. Restrictions on group gatherings and in‐person engagement have increased the demand for remote service delivery. These restrictions have also affected the delivery of court‐mandated interventions. However, much of the literature has focused on populations that voluntarily seek out face‐to‐face medical care or mental health services, whereas insufficient attention has been paid to telehealth engagement of court‐mandated populations. This article draws on data gathered on an NIH/NIDA‐funded study intervention implemented with juvenile justice‐involved youths of Haitian heritage in Miami‐Dade County, Florida, during the COVID‐19 public health crisis. We explore the process of obtaining consent, technological access issues, managing privacy, and other challenges associated with remote delivery of family‐based therapy to juvenile justice‐involved youth. Our aim is to provide some insights for consideration by therapists, healthcare workers, advocates, researchers, and policymakers tasked with finding alternative and safer ways to engage nontraditional populations in health services. The clinical trial registration number is NCT03876171.

The Center for Epidemiological Studies Depression Scale (CES-D) is a widely used screening tool for depression among adults and children. However, the validity of the CES-D has yet to be establishe...

Youth involved in the juvenile justice system experience a disproportionate prevalence of serious mental health issues, substance abuse, and are at an increased risk of engaging in risky sexual practices. Gender differences exist, with girls at a markedly greater risk of acquiring a sexually transmitted disease.The present study seeks to determine if there are subgroups of male and female youth who differ in their health risk behavior. If so, do any male or female subgroups at different levels of health risk differ in regard to their sociodemographic and psychological factors, and finally, what are intervention/service delivery implications of these differences.Youth were participants in an innovative health service at a centralized intake facility located in a large southeastern U.S. city. Latent class analysis and multinomial logistic regression is utilized to examine the heterogeneity of health risk behaviors across gender groups in a sample of 777 newly arrested youth.Results indicate a three class solution provided the optimal fit with the data for each gender group: a Lower Health Risk group, a Higher Health Risk group, and a Highest Health Risk group. Multinomial logistic regression analysis identified significant sociodemographic and depression effects among both male and female youth. Conclusions/Importance: Youth characterized by risky sexually behavior, elevated depression, and drug involvement should be the focus of integrated intervention services. This study documents the critical need for front end, juvenile justice intake facilities to provide behavioral and public health screening, with treatment follow-up, on newly arrested youth.

In a study aimed at improving the quality of HIV services for inmates, an organizational process improvement strategy using change teams was tested in 14 correctional facilities in 8 U.S. states and Puerto Rico. Data to examine fidelity to the process improvement strategy consisted of quantitative ratings of the structural and process components of the strategy and qualitative notes that explicate challenges in maintaining fidelity to the strategy. Fidelity challenges included (1) lack of communication and leadership within change teams, (2) instability in team membership, and (3) issues with data utilization in decision-making to implement improvements to services delivery.

OBJECTIVES: This study sought to expand the sparse literature examining the extent to which family engagement interventions and the structural characteristics of juvenile community supervision agencies influence caregiver participation in youths’ behavioral health (i.e., mental health and substance use) treatment. METHODS: We analyzed data from a national survey of juvenile community supervision agencies, conducted as a part of a Juvenile Justice Translational Research on Interventions for Adolescents in the Legal System (JJTRIALS) Cooperative Agreement funded by NIH/NIDA. RESULTS: Findings indicated agencies employ a variety of family engagement strategies, with passive strategies like services referrals and flexible schedules being more common than active strategies like provision of family therapy. Multivariate prediction of caregiver involvement in behavioral health care showed the most consistent effects for rural-urban location of the agency; rural agencies more successfully engaged families in their youth’s behavioral healthcare. Relatedly, the more family engagement services, the greater the involvement of families in behavioral health treatment. Agencies with a juvenile drug treatment court also showed greater involvement. CONCLUSIONS: Our findings that juvenile justice agencies are using multiple techniques to engage families, and that there is a relationship between use of these techniques and actual family engagement, would benefit from replication over time and in other jurisdictions. Analysis of data from a second wave of the national survey, recently completed, is expected to test the reliability of our findings over time, as well as identify whether and what kind of changes occurred in the two years following the first survey.

This chapter describes a case study conducted within an innovative juvenile assessment facility that examined the relationships among depression, age, race/ethnicity, age at first arrest, drug involvement, and sexual behaviors among youth in the criminal justice system. After a thorough discussion of the results, implications for larger services and practices are presented.

Research on samples of truant adolescents is limited, with little known about mental health problems among truant youths. This study provided an exploratory, multilevel examination of mental health problems for a sample of 300 truant adolescents. Confirmatory factor analysis indicated a single factor of multiple mental health problems at the individual level, but the structure of these problems was not the same at the school level. A number of covariate effects were found at the individual level on the mental health factor. Further, youths attending middle school were more likely to report attention deficit hyperactivity disorder (ADHD) problems than those in high school. Service and practice implications of better understanding school and mental health issues of truant youth are discussed.

Truant youths are likely to engage in a number of problem behaviors, including sexual risky behaviors. As part of a National Institute on Drug Abuse (NIDA)-funded, prospective intervention project, a sample of truant youths' sexual risk behavior was tracked over five time points. Analyses of the data was informed by four objectives: (a) determine if a growth model parameterization was consistent with the youths' sexual risk behavior, (b) assess the impact of a brief intervention (BI) targeting substance use on their sexual risk behavior over time, (c) identify any sexual risk behavior subgroups, and (d) identify any differential, longitudinal effects of the BI on the youths' sexual risk behavior. Results indicated the youths' sexual risk behavior reflected a linear growth model; no intervention effects were found on their sexual risk behavior over time; distinct sexual risk behavior subgroups were found; and no patterned intervention effects were found in regard to the sexual risk behavior subgrou...

School truancy among teenagers remains a serious national problem, as evidenced by its significant association with school performance, psychological, and behavioral problems. Truancy is also positively associated with substance abuse. This study presents 18-month outcome data from a National Institute on Drug Abuse (NIDA)-funded controlled trial that examined the efficacy of a brief intervention (BI) to reduce marijuana use among truant youths. Adolescents and their parents were randomly assigned to receive either a two-session youth-only session (BI-Y), two-session youth and additional parent session (BI-YP), or standard truancy services (STS). Analyses of an auto-regressive lag model examined marijuana use at three months, six months, 12 m onths, and 18 m onths post-intervention. Results indicated adolescents receiving BI services, especially BI-Y services, showed significant reductions in marijuana use, at 18-month follow-up. BI-YP youths showed a greater increase in marijuana use than BI-Y yo...

Few studies investigating the validity of marijuana use have used samples of truant youth. In the current study, self-reports of marijuana use are compared with urine test results for marijuana to identify marijuana underreporting among adolescents participating in a longitudinal Brief Intervention for drug-involved truant youth. It was hypothesized that marijuana underreporting would be associated with alcohol underreporting and engaging in sexual risk behaviors. The results indicated marijuana underreporting was significantly associated with self-denial of alcohol use, but not associated with sexual risk behavior. Also, there was an age effect in marijuana use underreporting such that younger truant youth were more likely to underreport marijuana use, compared to older truant youth. Implications for policy and future research are discussed.

Justice-involved youth display higher prevalence rates of sexually transmitted diseases (STDs), in comparison with youth in the general population, highlighting a critical public health concern. Individual factors are important predictors of STDs, but only provide a partial understanding of this public health issue. Communities experiencing higher levels of disorder and lower levels of cohesion tend to have fewer institutional resources available, which may impact sexual risk behavior and STDs. However, few studies have examined the association between community characteristics and STD prevalence among adolescents. The current study examined community-level (n = 106) characteristics and individual-level attributes in explaining STDs among justice-involved youth (n = 1233: n = 515 female; n = 718 male). At the individual level, results showed older males and those with more drug-related problems were more likely to be STD positive, while females with more sexual partners and those with less drug-related problems were more likely to be STD positive. At the community level, females residing in areas with fewer educated residents were more likely to be STD positive. These gender differences were significant, suggesting a gendered perspective is important for understanding STD infection. The justice system represents a critical opportunity in the treatment and prevention of STDs for youth.

This article presents findings from a multisite cluster randomized trial of a structured organizational change intervention for improving HIV testing services in jails and prisons. Matched pairs of prison and jail facilities were randomized to experimental and control conditions; all facilities received baseline training about best practices in HIV testing and other HIV services and selected an area of HIV services on which to focus improvement efforts. The experimental facilities formed local change teams and were provided external coaching based on the Network for the Improvement of Addiction Treatment (NIATx) process improvement model. Difference-indifference analyses indicate a significant relative increase in HIV testing in the experimental compared to the control condition. Meta-analyses across the matched pairs indicated a small to medium effect of increased testing overall. The results indicate that the local change team model can achieve significant increases in HIV testing in correctional facilities. Implications for HIV testing policies and challenges for expanding testing are discussed.

Truant youths are likely to engage in a number of problem behaviors, including sexual risky behaviors. Previous research involving non-truant youths has found sexual risk behaviors to be related to marijuana use and depression, with differential effects for male and female youths. Using data collected in a National Institute on Drug Abuse (NIDA)-funded, prospective intervention project, results are reported of a male-female, multi-group, longitudinal analysis of the relationships among truant youth baseline sexual risk behavior, marijuana use, and depression, and their sexual risk behavior over four follow-up time points. Results indicated support for the longitudinal model, with female truants having higher depression scores, and showing stronger relationships between baseline depression and future engagement in sexual risk behavior, than male truants. Findings suggest that incorporating strategies to reduce depression and marijuana use may decrease youth sexual risk behavior.

School truancy is a serious concern in the U.S., with far-reaching negative consequences. Truancy has been positively associated with substance use and delinquent behavior; however, research is limited. Consequently, the Truancy Brief Intervention Project was established to treat and prevent substance use and other risky behaviors among truants. This article examines whether the Brief Intervention program is more effective in preventing future delinquency over a 12-month follow-up period, than the standard truancy program. Results indicate the Brief Intervention was marginally significant in effecting future delinquency among truants, compared to the standard truancy program. Future implications of this study are discussed.

The National Criminal Justice Drug Abuse Treatment Studies research program conducted cluster randomized trials to test an organizational process improvement strategy for implementing evidence-based improvements in HIV services for preventing, detecting, and/or treating HIV for individuals under correctional supervision. Nine research centers conducted cluster randomized trials in which one correctional facility used a modified Network for Improvement of Addiction Treatment (NIATx) change team approach to implementing improved HIV services and the other facility used their own approach to implement the improved HIV services. This paper examines whether the intervention increased the perceived value of HIV services among staff of correctional and community HIV organizations. Baseline and follow-up measures of the perceived acceptability, feasibility, and organizational support for implementing HIV service improvements were collected from correctional, medical, and community HIV treatment staff. Results indicated that the perceived acceptability and feasibility of implementing HIV services improved among staff in the facilities using the modified NIATx change team approach as compared to staff in the comparison facilities.

Research indicates at-risk youth are more likely to experience emotional and psychological problems. Young people who are often truant from school represent a group of at-risk youth, but one for which mental health issues are understudied. This study examined heterogeneity of mental health problems among a sample of 300 truant adolescents using latent class analysis (LCA). LCA indicated the sample of truants was best represented by four latent subgroups of youth with: low mental health problems; high depression, low mania; high mania, low depression; and high depression and mania. These subgroups were examined in relation to socio-demographic and psychosocial measures at baseline and after truancy offenses. Results indicated general and unique differences in these covariates across the four latent classes. Service and practice implications of better understanding mental health issues of truant youth are discussed.

Two major dynamics characterize the field of substance misuse behavioral science research in recent decades. First, assessments of the outcomes of prevention and treatment services have shown increasing conceptual and methodological sophistication, but, in general, have not kept pace with new developments in biostatistics and multivariate analyses. Second, funding for richer, more informed evaluation efforts to assess the efficacy, cost benefits, and longer term outcomes of these services has declined significantly. These two processes are creating a growing crisis in the field. Researchers, program administrators, and legislative bodies at the state and federal levels have each contributed to this crisis. A significant restructuring of what we do and when (appropriate timing), their underpinnings (theoretical, empirical, stakeholder agendas and goals, etc.) and how we do it, and the ongoing availability and accessibility of relevant human and non-human resources, amongst other considerations, is needed. Although this Op-Ed piece prevents full discussion of these issues, as someone who has been involved in this field for many years, I feel several key issues need to be addressed

Overview Substance use and substance use disorders are highly prevalent among youth under juvenile justice (JJ) supervision, and related to delinquency, psychopathology, social problems, risky sex and sexually transmitted infections, and health problems. However, numerous gaps exist in the identification of behavioral health (BH) problems and in the subsequent referral, initiation and retention in treatment for youth in community justice settings. This reflects both organizational and systems factors, including coordination between justice and BH agencies. Methods and results This paper presents a new framework, the Juvenile Justice Behavioral Health Services Cascade (“Cascade”), for measuring unmet substance use treatment needs to illustrate how the cascade approach can be useful in understanding service delivery issues and identifying strategies to improve treatment engagement and outcomes for youth under community JJ supervision. We discuss the organizational and systems barriers for linking delinquent youth to BH services, and explain how the Cascade can help understand and address these barriers. We provide a detailed description of the sequential steps and measures of the Cascade, and then offer an example of its application from the Juvenile Justice – Translational Research on Interventions for Adolescents in the Legal System project (JJ-TRIALS), a multi-site research cooperative funded by the National Institute on Drug Abuse. Conclusion As illustrated with substance abuse treatment, the Cascade has potential for informing and guiding efforts to improve behavioral health service linkages for adolescent offenders, developing and testing interventions and policies to improve interagency and cross-systems coordination, and informing the development of measures and interventions for improving the implementation of treatment in complex multisystem service settings. Clinical Trials Registration number – NCT02672150

With numerous HIV service gaps in prisons and jails, there has been little research on HIV stigma attitudes among correctional staff. Such attitudes may undermine HIV services for inmates at risk of or infected with HIV. This HIV stigma attitudes survey among 218 correctional staff in 32 US facilities (1) provides an overview of staff’s stigma attitudes, (2) reports psychometric analyses of domains in Earnshaw and Chaudoir’s HIV Stigma Framework (HSF), and (3) explores differences in stigma attitudes among different staff types. Overall, correctional and medical staff expressed non stigmatizing attitudes toward people living with HIV/AIDS, but perceived that stigma and discrimination exist in others. Factor analyses revealed a three factor structure capturing two mechanisms of the HSF (prejudice, discrimination). Few factor score differences were found by staff type or setting. Implications for correctional HIV services and future research on HIV stigma attitudes are discussed.

The issue of delinquency among truant youth is insufficiently documented in the literature. There is a need to elucidate this issue, and assess the efficacy of interventions to reduce this problem behavior. The present, NIDA-funded study addressed this gap by examining the impact of a Brief Intervention (BI), originally designed to address youth substance use, on their delinquent behavior over an 18-month follow-up period (for self-reported delinquency) and a 24-month follow-up period (for official record delinquency). A number of significant BI intervention effects with sizable effect sizes were found, as well as a number of marginally significant BI effects. In particular, significant reductions in arrest charges at 24-month follow-up for youth receiving BI services compared to controls were among the key findings of this study. Service delivery implications and directions for future analyses are discussed.

Based on problem-behavior theory (Jessor & Jessor, 1977), a second-order problem behavior model of delinquency, marijuana use, and risky sexual behavior over five waves was estimated among truant adolescents. The study also investigated the influence of the problem factor on future arrest charges and the effect of sociodemographics on problem behavior and future crime. Results confirm the existence of a second-order latent factor of problem behaviors. Problem behaviors predicted more future arrest charges. Age was related to problem behaviors and future arrest charges, and family income was related to problem behavior. Implications for future research and practice are discussed.

Baseline data collected in two brief intervention projects (BI-Court and Truancy Project) were used to assess similarities and differences in subgroups of at-risk youth. Classifications of these subgroups were based on their psychosocial characteristics (e.g., substance use). Multi-group latent class analysis (LCA) identified two BI-Court subgroups of youth, and three Truant subgroups. These classes can be viewed as differing along two dimensions, substance use involvement and emotional/behavioral issues. Equality tests of means across the latent classes for BI-Court and Truancy Project youths found significant differences that were consistent with their problem group classification. These findings highlight the importance of quality assessments and allocating appropriate services based on problem profiles of at-risk youth.

This study examined sociodemographic variation in the interrelationships between risky sexual practices, substance use, and arrest history. The sample consisted of 948 newly arrested juvenile offenders processed at a centralized intake facility in 2006. A series of confirmatory factor analysis and structural equation modeling techniques were used to (a) determine if risky sexual behavior, marijuana and cocaine use, and arrest history form a unidimensional latent factor, (b) examine the direct effect of age on the latent factor, and (c) compare the factor structure, as well as the effect of age on the latent factor, across four demographic subgroups based on race and gender. Important similarities, as well as differences, in the factor structure across the four groups were found. The results highlight the importance of accounting for sociodemographic factors when examining the association among adolescent problem behaviors.

Variations in drug use have been found across individual-level factors and community characteristics, and by type of drug used. Relatively little research, however, has examined this variation among juvenile offenders. Based on a sample of 924 newly arrested juvenile offenders, two multilevel logistic regression models predicting marijuana test result and cocaine test result were separately examined. The results highlighted a strong association between individual-level socio-demographic characteristics, most notably age and seriousness of arrest charge, and drug use. Residential stability was related to cocaine use, yet none of the community variables were related to marijuana use. These findings suggest that different risk factors are related to adolescent marijuana and cocaine use. The research implications of the findings are discussed.

This article examines the impact of sociodemographic characteristics and psychosocial factors on the probability and frequency of marijuana use and, for youths initiating use, on their frequency of use over four time points. The sample consists of 278 justice-involved youths completing at least one of three follow-up interviews as part of a National Institute on Drug Abuse (NIDA)–funded study. A two-part growth model was estimated to examine the probability of engaging in marijuana use and change in marijuana frequency of use over time. In addition, covariates for intervention status, gender, age, race, ethnicity, psychological functioning, alcohol use, and self-reported delinquency were included as baseline predictors in the model. The results of our two-part latent growth model reveal (1) a latent tendency to engage in marijuana use and a conditional, continuing decision on frequency of marijuana use, and (2) different patterns of relationships among age, psychosocial variables, and the probability and ...

We report the results of a parallel-process, latent growth model analysis examining the relationships between cocaine use and delinquent behavior among youths. The 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. The results of our analysis of the cocaine use and delinquency parallel-process model highlighted that these phenomena are mutually related experiences over time. Particularly noteworthy is the significant, positive relationship between cocaine trend and delinquency trend: as the rate of change in cocaine use increases, a corresponding change occurs in engaging in delinquent behavior. Implications for policy and intervention service needs are discussed.