Research

St. Joseph County (Indiana) drug court: Participants’ and stakeholders’ views on how to improve graduation rates for individuals who have opioid use disorders

Drug courts have been an important part of the criminal justice system since 1989. They continue to expand throughout the United States because nearly three decades of evidence has shown that they are more effective at reducing criminal recidivism than other interventions, such as traditional probation. However, little is known about how drug courts serve participants who have opioid use disorders and how those participants view the program. Furthermore, there are no known qualitative studies that have explored the use of medication-assisted treatments (MATs) in drug courts, and the National Association of Drug Court Professionals (NADCP) has suggested that some drug courts are unwilling to allow participants on MATs, despite evidence of their effectiveness at reducing or eliminating opioid use, decreasing or eliminating criminality, and improving functioning and overall quality of life. The St. Joseph County (Indiana) drug court, for example, until recently, did not allow participants to use methadone or buprenorphine/naloxone (Suboxone). Moreover, a 2016 program evaluation of the St. Joseph County (Indiana) drug court, led by Dr. John Gallagher, found that participants who had opioid use disorders were less likely to graduate than participants who had other substance use disorders. This qualitative study contributes to the existing knowledge base by facilitating individual interviews with participants, who have an opioid use disorder, and stakeholders of the St. Joseph County (Indiana) drug court. Stakeholders will include the drug court judge, prosecuting attorneys, defense attorneys, social workers, treatment providers, and case managers, to name a few. The individual interviews will be guided by a phenomenological approach with the goal of developing an in-depth understanding of drug court from participants’ and stakeholders’ experiences in drug court, with a focus on the use of MATs in treating opioid use disorders. This study will explore what interventions are perceived as most helpful in treating opioid use disorders, identifying the barriers to treating opioid use disorders, and participants’ lived experiences with utilizing MATs to support their recovery. This study is timely, especially because our country is experiencing negative consequences related to opioids, such as increased rates of overdoses and deaths. Additionally, this will be the first known qualitative study to explore participants’, who have opioid use disorders, experiences in drug court and stakeholders’ views on the use of MATs in treating opioid use disorders. Last, the long-term objective of this study is to secure larger grants to complete a statewide evaluation of all Indiana drug courts.

Attitudes and decision-making process related to advance care planning (ACP) among Korean American older adults

This pilot project is developed to explores attitudes and decision-making process related to advance care planning (ACP) among Korean American older adults. ACP refers to a health care decision-making process that involves learning about, discussing and planning for end-of-life- care in the event that one is incapable of making a reasoned decision. Engagement in ACP is crucial because of its positive relationship with quality end-of-life care. With an increasing number of ethnic minority older adults in the U.S., there is a growing concern regarding ethnic/racial disparities in engagement in ACP. Culture could provide a unique context to form attitudes toward and prepare for end-of-life and thus, it is important to build culturally competent knowledge to effectively promote ACP for ethnic minority groups. Korean Americans, one of the fastest growing ethnic minority populations, consistently report low levels of engagement in and lack of knowledge of ACP. However, prior research has provided very limited evidence regarding ACP among this population. The aim of the study is to explore how Korean Americans view and engage in ACP. Non-experimental qualitative design will be employed. Focus group interviews will be conducted with Korean American older adults living in community using a semi-structured interview guide. The proposed pilot study would generate preliminary evidence to develop culturally tailored intervention programs to promote ACP among KAs.

The 8% Solution

The 8% Solution is an intervention approach developed and implemented in Orange County, California. Researchers found that 8% of juvenile court cases consumed more than 50% of judicial resources. Recognizing the importance of the “8% problem,” the court, along with a team of community professionals, implemented the 8% Solution. The 8% Solution targeted first time offenders at risk for chronic recidivism. Marion County Family Court officials have anecdotally identified a number of similar problems. However, the juvenile court system has no formal mechanism to identify youth at greatest risk for continuing court involvement. Using data available from the court, the proposed study will replicate the initial phase of the 8% Solution by identifying and characterizing factors that increase risk of continued court involvement for first time youthful offenders. The long term objective of this work are to: a) assist the court in developing a mechanism for identifying at-risk youth, b) provide preliminary data to inform development of a major grant application, and c) provide data to inform implementation of the 8% Solution intervention phase.

Exploring violence against street children in Bangladesh: A cross-sectional study

Street children are a group of extremely vulnerable and underprivileged children who are mostly visible in the street and public places of urban areas in developing countries and are engaged in informal economic activities in order to make a living for themselves and their families. Unfortunately, violence against street children is a common phenomenon in Bangladesh. Their homeless status, livelihood efforts under a precarious informal economy, and overnight stay in public places increase the odds of abuse. Only a few qualitative studies have explored some aspects of children’s abuse experiences. There is little systematic knowledge that helps us to understand the prevalence and magnitude of this victimization and to inform practice and policy efforts to protect these children. Against this background, my present study, intends to accomplish two primary objectives: a) develop a validated scale of abuse focusing on street children in developing countries; and, b) measure various abuse experiences of street children in Bangladesh to inform research and policy. This study has been built on my three previous research projects on street children in Bangladesh. Data from my last qualitative project on street children’s social networks provided evidence that street children, in general, encounter multiple types of abuses. I plan to pilot it in Bangladesh and replicate in other South Asian countries through collaboration with local researchers.

Search for Meaning

PTSD is a critical mental health problem among military veterans. Although there are effective and available PTSD-specific treatments, many are reluctant to engage in, or drop out of, treatment. As a result, there is a need for additional treatment options and in particular, options that do not emphasize detailed verbal processing of the trauma. Spirituality has been shown to be a helpful resource for dealing with a variety of trauma related events and there is evidence that spiritual beliefs can be an important factor in how veterans/military personnel cope following trauma. However, it is common for veterans to experience spiritual/religious struggles following trauma such as a weakening of beliefs, loss of meaning, increased feelings of guilt, difficulty forgiving, and moral and ethical challenges (i.e., moral injury). There have been few clinical interventions tested to address the spiritual/existential wounds from combat trauma that have been documented in the literature. To address this gap, an intervention titled “Search for Meaning” (SFM) was created through the collaborative efforts of a VA chaplain and mental health practitioners.

We intend to collect pilot data that could provide preliminary indication about the effectiveness of the SFM program, as well as develop a facilitator manual for the SFM program.

Attracting/hiring/retaining women in the building trades through the inclusion of mentoring curricula in union apprenticeship programs

This proposal explores creating or enhancing an existing mentoring component in union apprenticeship programs for the purpose of attracting/hiring/retaining women in the building trades and would act a springboard for a national study of women in apprenticeships. The inclusion of a mentoring component in joint apprenticeship programs would not only help provide the needed support women find nonexistent in the male-dominated building trades where they are often the target of bullying, intimidation, and sexual harassment in uncomfortable and unsafe workplaces but contribute to “best practices” (Moir, 2011) to retain women in trades. Providing mutual support in a one-on-one mentoring relationship for women facing these workplace challenges has been shown to reduce the number of women leaving the construction industry (Mccormack, 1998) and foster career-related and psychosocial benefits such as “organizational rewards in the form of promotions, increased financial security, and increased job satisfaction and commitment” (Hegstad, 1999, p. 387).