The influence of gender on perceived treatment need among a community sample of substance users

Purpose: Most individuals do not perceive a need for substance use treatment despite meeting diagnostic criteria for substance use disorders and they are least likely to pursue treatment voluntarily. There are also those who perceive a need for treatment and yet do not pursue it. This study aimed to understand which factors increase the likelihood of perceiving a need for treatment for individuals who meet diagnostic criteria for substance use disorders in the hopes to better assist with more targeted efforts for gender-specific treatment recruitment and retention. Using Andersen and Newman's (1973/2005) model of individual determinants of healthcare utilization, the central hypothesis of the study was that gender moderates the relationship between substance use problem severity and perceived treatment need, so that women with increasing problems due to their use of substances are more likely than men to perceive a need for treatment. Additional predisposing and enabling factors from Andersen and Newman's (1973/2005) model were included in the study to understand their impact on perceived need. Method: The study was a secondary data analysis of the 2010 National Survey on Drug Use and Health (NSDUH) using logistic regression. The weighted sample consisted of a total 20,077,235 American household residents (The unweighted sample was 5,484 participants). Results of the logistic regression were verified using Relogit software for rare events logistic regression due to the rare event of perceived treatment need (King & Zeng, 2001a; 2001b). Results: The moderating effect of female gender was not found. Conversely, men were significantly more likely than women to perceive a need for treatment as substance use problem severity increased. The study also found that a number of factors such as race, ethnicity, socioeconomic status, age, marital status, education, co-occurring mental health disorders, and prior treatment history differently impacted the likelihood of perceiving a need for treatment among men and women. Conclusion: Perceived treatment need among individuals who meet criteria for substance use disorders is rare, but identifying factors associated with an increased likelihood of perceiving need for treatment can help the development of gender-appropriate outreach and recruitment for social work treatment, and public health messages.

The Influence of Gender on Perceived Treatment Need among a Community Sample of Substance Users

Purpose: Most individuals do not perceive a need for substance use treatment despite meeting diagnostic criteria for substance use disorders and they are least likely to pursue treatment voluntarily. There are also those who perceive a need for treatment and yet do not pursue it. This study aimed to understand which factors increase the likelihood of perceiving a need for treatment for individuals who meet diagnostic criteria for substance use disorders in the hopes to better assist with more targeted efforts for gender-specific treatment recruitment and retention. Using Andersen and Newman’s (1973/2005) model of individual determinants of healthcare utilization, the central hypothesis of the study was that gender moderates the relationship between substance use problem severity and perceived treatment need, so that women with increasing problems due to their use of substances are more likely than men to perceive a need for treatment. Additional predisposing and enabling factors from Andersen and Newman’s (1973/2005) model were included in the study to understand their impact on perceived need. Method: The study was a secondary data analysis of the 2010 National Survey on Drug Use and Health (NSDUH) using logistic regression. The weighted sample consisted of a total 20,077,235 American household residents (The unweighted sample was 5,484 participants). Results of the logistic regression were verified using Relogit software for rare events logistic regression due to the rare event of perceived treatment need (King & Zeng, 2001a; 2001b). Results: The moderating effect of female gender was not found. Conversely, men were significantly more likely than women to perceive a need for treatment as substance use problem severity increased. The study also found that a number of factors such as race, ethnicity, socioeconomic status, age, marital status, education, co-occurring mental health disorders, and prior treatment history differently impacted the likelihood of perceiving a need for treatment among men and women. Conclusion: Perceived treatment need among individuals who meet criteria for substance use disorders is rare, but identifying factors associated with an increased likelihood of perceiving need for treatment can help the development of gender-appropriate outreach and recruitment for social work treatment, and public health messages.

The effects of required/sequenced preparatory courses on academic success and retention at a community college

This dissertation had two purposes: first, to analyze how required sequenced college preparatory courses in mathematics, reading, and writing affect students' academic success and, second, to add to a theoretical model for predicting student retention at a community college. Grade point average, number of degree credits earned, and re-enrollment rate were measured as determinants of academic success. The treatment group had a significantly higher grade point average than the control group. There was no significant difference in the number of degree credits earned or re-enrollment rate for the groups. A series of logistic regressions used the independent variables E-ASSET scores in math, reading, and writing; number of college prep areas required; credits earned; grade point average; students' status; academic restrictions/required course sequencing; sex; race; and socio-economic status to determine the predictor variables for retention. The academic variable that showed the greatest potential as a predictor for retention was grade point average. Overall, receiving financial aid was the greatest predictor for re-enrollment. For a financial aid recipient the odds of re-enrollment were 2.70 times more likely than if no financial aid was received.

The relative influence of social support, rehabilitation program participation, and inmate preincarceration characteristics on incarcerated substance abusers' perceptions of adjustment to community reintegration

This dissertation identifies, examines, and assesses the relative influence of identified empirically and conceptually relevant variables on incarcerated substance abusers' expectations of postrelease adjustment. A purposive sampling procedure was used to recruit 101 male and female substance-abusing offenders participating in prison- and jail-based drug treatment programs in south Florida. A 92-item survey questionnaire was used to collect basic demographic data; measure inmate preincarceration characteristics, social support, and rehabilitation program participation; and record archival data. Regression equations were developed utilizing ten different measures of the participants' expectations of their postrelease adjustment. Two equations yielded statistically significant F ratios; maintaining a stable living and maintaining abstinence. Twenty-two percent of the variance in respondents' expectations of maintaining a stable living was explained by preincarceration characteristics, social support, and rehabilitation program participation (F = 1.89; df = 13,87; p $<$.05). The only significant predictor variable was perception of social support (b = $-$.05; t = $-$3.6; p $<$.001). Twenty-three percent of the variance in respondents' expectations of maintaining abstinence from substances was explained by preincarceration characteristics, social support, and rehabilitation program participation (F = 2; df = 13,87; p $<$.05). Once again, the only significant predictor variable was perception of social support. The results of the analyses indicate that social support was the only important variable for understanding these respondents' efficacy expectations of postrelease abstinence and stable living. The results of this investigation demonstrate the complexity of the social support variable for prisoners, and identify social support as a potential rehabilitative resource for substance-abusing inmates. The results of this investigation underscore the importance of continued, detailed empirical study in order to understand and clarify how social support, efficacy expectations, and actual postrelease performance interrelate for this population of offenders.

A study of the effects of a service-learning experience on student success at an urban community college

The purpose of this study was to explore the effects of a service-learning experience on student success as measured by class attendance, course completion, final course grades, and end-of-term evaluation data.^ Though many outcomes of service-learning experiences have been studied, including ethical values, self-esteem, student personal development, and career preparation, relatively few studies have been conducted on the effects of such experiences on academic achievement, and the studies that have been done have primarily studied students at traditional, four-year, residential universities.^ The study consisted of 286 students enrolled in six paired courses taught by five instructors at a community college in the Fall term 1996. One section of each pair (the control group) was taught using traditional subject matter and course materials and the other section of each pair (the treatment group) participated in a 20-hour required service-learning activity in addition to the regular course curriculum. The courses in the study included American History, Sociology, College Preparatory English, and Introduction to English Composition.^ The results of this study indicate that, overall, students who participated in a class in which service-learning was a requirement, achieved higher final course grades and reported greater satisfaction with the course, the instructor, the reading assignments, and the grading system, and the treatment section of one course pair had fewer absences. In addition, the faculty members reported that, in the treatment sections, class discussions were more stimulating, the sections seemed more vital in terms of student involvement, the students seemed more challenged academically, more motivated to learn, and seemed to exert more effort in the course. ^

The effect of cooperative learning on the attitudes toward science and the achievement of students in a non-science majors' general biology laboratory course at an urban community college

The purpose of this study was to evaluate the effect of cooperative learning strategies on students' attitudes toward science and achievement in BSC 1005L, a non-science majors' general biology laboratory course at an urban community college. Data were gathered on the participants' attitudes toward science and cognitive biology level pre and post treatment in BSC 1005L. Elements of the Learning Together model developed by Johnson and Johnson and the Student Team-Achievement Divisions model created by Slavin were incorporated into the experimental sections of BSC 1005L.^ Four sections of BSC 1005L participated in this study. Participants were enrolled in the 1998 spring (January) term. Students met weekly in a two hour laboratory session. The treatment was administered to the experimental group over a ten week period. A quasi-experimental pretest-posttest control group design was used. Students in the cooperative learning group (n$\sb1$ = 27) were administered the Test of Science-Related Attitudes (TOSRA) and the cognitive biology test at the same time as the control group (n$\sb2$ = 19) (at the beginning and end of the term).^ Statistical analyses confirmed that both groups were equivalent regarding ethnicity, gender, college grade point average and number of absences. Independent sample t-tests performed on pretest mean scores indicated no significant differences in the TOSRA scale two or biology knowledge between the cooperative learning group and the control group. The scores of TOSRA scales: one, three, four, five, six, and seven were significantly lower in the cooperative learning group. Independent sample t-tests of the mean score differences did not show any significant differences in posttest attitudes toward science or biology knowledge between the two groups. Paired t-tests did not indicate any significant differences on the TOSRA or biology knowledge within the cooperative learning group. Paired t-tests did show significant differences within the control group on TOSRA scale two and biology knowledge. ANCOVAs did not indicate any significant differences on the post mean scores of the TOSRA or biology knowledge adjusted by differences in the pretest mean scores. Analysis of the research data did not show any significant correlation between attitudes toward science and biology knowledge. ^

Risk factors that predict maladaptive outcomes among sexually abused girls presenting for services at a community agency

The purpose of this study was to determine which factors predicted maladaptive outcomes in sexually abused children. Key factors were aggregated into four categories: abuse characteristics risk factors, individual-level risk factors, family disruption risk factors, and social disruption risk factors. It was hypothesized that (a) individual-level risk factors (e.g., school performance, child alcohol/substance abuse) and (b) abuse characteristics risk factors (e.g., longer duration/frequency of abuse, use of force/threats of force, intrafamilial abuse) would predict higher levels of trauma symptoms. Furthermore, it was hypothesized that (a) family disruption risk factors (e.g., family alcohol/substance use, family psychopathology) and (b) social disruption risk factors (e.g., parental divorce, homelessness, witnessing homicide or violence) would moderate the impact of prior sexual abuse and predict higher levels of trauma symptoms. ^ The participants were 110 female children (5 to 18 years old) presenting for treatment for sexual abuse at a community agency (The Journey Institute) in Miami, Florida. This study conducted a retrospective analysis of an archival data set collected over a three-year period (1998–2001). The measures completed upon intake included The Journey Psychosocial Assessment and The Trauma Symptom Checklist for Children (TSCC; Briere, 1996). Using Pearson correlations and hierarchical multiple regression analysis, this study found that abuse characteristics risk factors and individual-level risk factors were predictive of maladaptive outcomes in this sample of sexually abused girls. However, no moderating effects were found for family disruption risk factors or social disruption risk factors. Therefore, the results of these analyses provided support for the contention that abuse characteristics and individual-level risk factors were appropriate targets for treatment for sexually abused girls. Moreover, limitations of this study, implications for treatment, and directions for future research were discussed. ^

Supplemental instruction, study habits, and the community college student

The purpose of this study was to demonstrate if the academic assistance program Supplemental Instruction (SI) facilitates the acquisition of effective study behaviors through strategies that transcend simple double-exposure to the course material. Its advocates claim it increases academic achievement using learner-centered knowledge and acquisition of effective study behaviors. SI sessions are specifically related to particular courses that students are taking. Sessions are facilitated by the SI leader who has taken the subject matter course in the past. Students review the content of the previous subject matter class using collaborative learning strategies coordinated by a SI leader. In addition, the SI leader models appropriate study behaviors in his or her interactions with the students. ^ An instructor at a large Florida community college who taught five classes of an Anatomy & Physiology I course (traditionally supported by SI) was identified. Two of the classes were randomly selected to participate in SI activities, and two classes were random chosen to participate in alternate, computer-based activities that dealt with the course content, but did not include work in developing students' study behaviors. These treatments were carried out over the course of an entire semester. Participation was mandatory. ^ Data were collected on two variables. Academic achievement in anatomy and physiology content was measured both pre- and post-treatment using an instructor developed examination. Student study behaviors were measured using pre- and post-treatment administration of the Study Behavior Inventory, a valid and reliable instrument that provides scores on three categories of study behaviors: (a) Academic self-efficacy, (b) Preparation for routine academic tasks, and (c) Preparation for long range academic tasks. Measures obtained at the end of the semester of treatment revealed no significant differences between the SI and alternative treatment groups in post-treatment achievement test score and the post-treatment scores on the three study behaviors categories when adjusted for pre-treatment scores. ^ These results suggest that the development of appropriate study behaviors requires more time than SI, as it is now implemented, can provide. In addition, results indicate that improved academic achievement may be attained through any number of means that include repeated exposure to course material. ^

The effect of instruction on the study behaviors and academic achievement of community college students

The purpose of this study was twofold. It was designed to determine (a) the efficacy of an intervention designed to increase the frequencies of appropriate study behaviors on the part of community college students who were preparing for academic mathematics activities and (b) whether any increase in appropriate study behavior frequency was accompanied by increased academic achievement in college preparatory mathematics classes. A total of 126 Miami Dade College students participated in this study. Two developmental (remedial) mathematics classes were randomly assigned as the experimental group, and two others were assigned as the control group. All students also took a College Survival (SLS) class. The Study Behavior Inventory (SBI) and the Computerized Placement Test (CPT) were administered to the four classes. The SBI was used as a pre- and post-test. The SLS curriculum and classroom time were the same for both groups. However, students in the treatment groups received instruction designed to increase the frequency of effective study behaviors associated with the three factors identified in the SBI, while the students in the control group participated in activities that did not emphasize study behaviors. A series of analysis of covariance procedures were used to analyze four hypotheses. The first three hypotheses proposed that students who were instructed in the use of appropriate study behaviors would score higher on the three factors of the Study Behavior Inventory than those who were not. The fourth hypothesis proposed that a greater proportion of mathematics students who were instructed in the use of appropriate study behaviors would receive a passing grade in their course than students who were in the control group. The four hypotheses were tested at the .05 level of significance. This study revealed that students who received instruction in appropriate study behaviors scored higher in the use of appropriate study behaviors and in mathematics achievement than students who did not. Additional research is needed to investigate whether these effects would persist over time, or be found in subjects other than mathematics.

The effects of fertilization and simulated grazing on the community structure of a seagrass bed in South Florida

The importance of resource supply and herbivory in driving competitive interactions among species has been an important but contentious issue within ecology. These variables exhibit different effects on species competition when manipulated in isolation but interact when manipulated together. I tested the direct and interactive effects of nutrient addition and simulated grazing (clipping) on the competitive performance of primary producers and community structure of a seagrass bed in South Florida. One square meter experimental plots were established in a mixed seagrass meadow from August 2007 to July 2009. The experiment was a 3 x 3 factorial experiment: 3 fertility treatments: control, medium (2.4 mg N d−1 and 80 µg P day −1) and high (4.8 mg N d−1 and 160 µg P day−1) x 3 clipping intensities (0, 25% and 50 % biomass removal (G)) x 5 replicates for each treatment = 45 plots). Nutrient additions and simulated grazing were done every two months. Fertilization and simulated grazing decreased sexual reproduction in S. filiforme. Fertilization increased competitive dominance within the primary producers while simulated grazing counteracted this effect by removal of the dominant species. Fertilization ameliorated the negative impacts of simulated grazing while simulated grazing prevented competitive exclusion in the fertilized plots. Nutrient addition and simulated grazing both exerted strong control on plant performance and community structure. Neither bottom up nor top down influences was eliminated in treatments where both factors where present. The effects of fertilization on plant performance were marked under all clipping intensities indicating that the system is regulated by nutrient availability both in the presence or absence of grazers. Clipping effects were strong under both fertilized and unfertilized conditions indicating that the seagrass bed can be simultaneously under top-down control by grazers.

Nutrient effects on seagrass epiphyte community structure in Florida Bay

A field experiment was employed in Florida Bay investigating the response of seagrass epiphyte communities to nitrogen (N) and phosphorus (P) additions. While most of the variability in epiphyte community structure was related to uncontrolled temporal and spatial environmental heterogeneity, P additions increased the relative abundance of the red algae–cyanobacterial complex and green algae, with a concomitant decrease in diatoms. When N was added along with P, the observed changes to the diatoms and the red algae–cyanobacterial complex were in the same direction as P-only treatments, but the responses were decreased in magnitude. Within the diatom community, species relative abundances, species richness, and diversity responded weakly to nutrient addition. P additions produced changes in diatom community structure that were limited to summer and were stronger in eastern Florida Bay than in the western bay. These changes were consistent with well-established temporal and spatial patterns of P limitation. Despite the significant change in community structure resulting from P addition, diatom communities from the same site and time, regardless of nutrient treatment, remained more similar to one another than to the diatom communities subject to identical nutrient treatments from different sites and times. Overall, epiphyte communities exhibited responses to P addition that were most evident at the division level.

Combination of 16S rRNA variable regions provides a detailed analysis of bacterial community dynamics in the lungs of cystic fibrosis patients

Chronic bronchopulmonary bacterial infections remain the most common cause of morbidity and mortality among patients with cystic fibrosis (CF). Recent community sequencing work has now shown that the bacterial community in the CF lung is polymicrobial. Identifying bacteria in the CF lung through sequencing can be costly and is not practical for many laboratories. Molecular techniques such as terminal restriction fragment length polymorphism or amplicon length heterogeneity-polymerase chain reaction (LH-PCR) can provide many laboratories with the ability to study CF bacterial communities without costly sequencing. The aim of this study was to determine if the use of LH-PCR with multiple hypervariable regions of the 16S rRNA gene could be used to identify organisms found in sputum DNA. This work also determined if LH-PCR could be used to observe the dynamics of lung infections over a period of time. Nineteen samples were analysed with the V1 and the V1_V2 region of the 16S rRNA gene. Based on the amplicon size present in the V1_V2 region, Pseudomonas aeruginosa was confirmed to be in all 19 samples obtained from the patients. The V1 region provided a higher power of discrimination between bacterial profiles of patients. Both regions were able to identify trends in the bacterial population over a period of time. LH profiles showed that the CF lung community is dynamic and that changes in the community may in part be driven by the patient's antibiotic treatment. LH-PCR is a tool that is well suited for studying bacterial communities and their dynamics.

The use of treatment process variables to differentiate between completers and dropouts for a guided self -change adolescent substance abuse intervention

This study documented differences between substance using adolescent participants who either completed or dropped out of a brief motivational intervention. Therapeutic alliance, working alliance and patient involvement were used to describe differences in treatment process ratings in a sample of majority Latino males who either (a) completed a adolescent substance abuse intervention called Alcohol Treatment Targeting Adolescents In Need (ATTAIN) or (b) dropped out after the first or second Guided Self-Change therapy session. Fifteen-minute segments were copied from the midpoint of previously recorded audio-tapes of Guided Self-Change therapy sessions. Raters were trained to a criterion level of interrater reliability for both the Working Alliance Inventory-Short and Vanderbilt Psychotherapy Process Scale. Correlations among Working Alliance Inventory- Short and Vanderbilt Psychotherapy Process Scale subscales reflected a general similarity in the assignment of ratings to client-therapist dyads. Findings underscore why these concepts are often used interchangeably in the treatment process literature. The Vanderbilt Psychotherapy Process Scale patient participation subscale demonstrated substantial empirical differentiation from overall therapeutic alliance. Discriminant function analysis demonstrated the Working Alliance Inventory-Short goal subscale and the Vanderbilt Psychotherapy Process Scale patient participation and therapist warmth and friendliness subscales as successful classifiers of groups of mostly Latino youth based on completion status. Follow-up logistic regression analyses confirmed major findings and successfully predicted group membership. Treatment process constructs can be used as clinical tools to identify participants who may be susceptible to dropping out of treatment services. Further investigation of treatment process may enhance understanding of the influence of alliance between clients and Guided Self-Change therapists. Investigating the role of treatment process as a critical component of brief motivational interventions for substance-using adolescents will inform both practitioners and researchers regarding the effectiveness of community-based substance abuse interventions for adolescents.

A study of the effects of a service-learning experience on student success at an urban community college

The purpose of this study was to explore the effects of a service-learning experience on student success as measured by class attendance, course completion, final course grades, and end-of-term evaluation data. Though many outcomes of service-learning experiences have been studied, including ethical values, self-esteem, student personal development, and career preparation, relatively few studies have been conducted on the effects of such experiences on academic achievement, and the studies that have been done have primarily studied students at traditional, four-year, residential universities. The study consisted of 286 students enrolled in six paired courses taught by five instructors at a community college in the Fall term 1996. One section of each pair (the control group) was taught using traditional subject matter and course materials and the other section of each pair (the treatment group) participated in a 20-hour required service- learning activity in addition to the regular course curriculum. The courses in the study included American History, Sociology, College Preparatory English, and Introduction to English Composition. The results of this study indicate that, overall, students who participated in a class in which service-learning was a requirement, achieved higher final course grades and reported greater satisfaction with the course, the instructor, the reading assignments, and the grading system, and the treatment section of one course pair had fewer absences. In addition, the faculty members reported that, in the treatment sections, class discussions were more stimulating, the sections seemed more vital in terms of student involvement, the students seemed more challenged academically, more motivated to learn, and seemed to exert more effort in the course.