Commitment language as a predictor of alcohol and marijuana use outcomes among adolescents in school -based group treatment

Despite widespread recognition of the problem of adolescent alcohol and other drug (AOD) abuse, research on its most common treatment modality, group work, is lacking. This research gap is alarming given that outcomes range from positive to potentially iatrogenic. This study sought to identify change mechanisms and/or treatment factors that are observable within group treatment sessions and that may predict AOD use outcomes. This NIH (F31 DA 020233-01A1) study evaluated 108, 10-19 year olds and the 19 school-based treatment groups to which they were previously assigned (R01 AA10246; PI: Wagner). Associations between motivational interviewing (MI) based change talk variables, group leader MI skills, and alcohol and marijuana use outcomes up to 12-months following treatment were evaluated. Treatment session audio recordings and transcripts (1R21AA015679-01; PI: Macgowan) were coded using a new discourse analysis coding scheme for measuring group member change talk (Amrhein, 2003). Therapist MI skills were similarly measured using the Motivational Interviewing Treatment Integrity instrument. Group member responses to commitment predicted group marijuana use at the 1-month follow up. Also, group leader empathy was significantly associated with group commitment for marijuana use at the middle and ending stages of treatment. Both of the above process measures were applied in a group setting for the first time. Building upon MI and social learning theory principles, group commitment and group member responses to commitment are new observable, in-session, process constructs that may predict positive and negative adolescent group treatment outcomes. These constructs, as well as the discourse analysis method and instruments used to measure them, raise many possibilities for future group work process research and practice.

Psychosocial variables associated with the co-occurrence of risky sexual behavior with alcohol consumption among university students

This study examined the association of theoretically guided and empirically identified psychosocial variables on the co-occurrence of risky sexual behavior with alcohol consumption among university students. The study utilized event analysis to determine whether risky sex occurred during the same event in which alcohol was consumed. Relevant conceptualizations included alcohol disinhibition, self-efficacy, and social network theories. Predictor variables included negative condom attitudes, general risk taking, drinking motives, mistrust, social group membership, and gender. Factor analysis was employed to identify dimensions of drinking motives. Measured risky sex behaviors were (a) sex without a condom, (b) sex with people not known very well, (c) sex with injecting drug users (IDUs), (d) sex with people without knowing whether they had a STD, and (e) sex with using drugs. A purposive sample was used and included 222 male and female students recruited from a major urban university. Chi-square analysis was used to determine whether participants were more likely to engage in risky sex behavior in different alcohol use contexts. These contexts were only when drinking, only when not drinking, and when drinking or not. The chi-square findings did not support the hypothesis that university students who use alcohol with sex will engage in riskier sex. These results added to the literature by extending other similar findings to a university student sample. For each of the observed risky sex behaviors, discriminant analysis methodology was used to determine whether the predictor variables would differentiate the drinking contexts, or whether the behavior occurred. Results from discriminant analyses indicated that sex with people not known very well was the only behavior for which there were significant discriminant functions. Gender and enhancement drinking motives were important constructs in the classification model. Limitations of the study and implications for future research, social work practice and policy are discussed. ^

Teachers' knowledge, awareness, and pedagogy of global education in secondary schools

In 1979, the Florida State Board of Education approved the teaching of global education in the state of Florida. The purpose of this study was to examine the factors that contributed to teachers' global knowledge, global mindedness, and pedagogy in global education. The Hanvey model of teaching from a global perspective was the theoretical framework for the study. ^ A total of 90 secondary teachers from Miami-Dade County Public Schools were randomly selected and placed in three groups: Globally Oriented Social Studies Program (GOSSE), Non-Globally Oriented Social Studies Program (non-GOSSE), and Teachers Who Teach Other Subjects (TWTOS). Seven teachers, two of whom team-taught a class, were selected for classroom observations and interviews. A mixed methods design that combined quantitative and qualitative data was used. ANOVA and Chi square techniques were used to determine whether the factors that contributed to teachers' global knowledge and global mindedness differ among groups. Classroom observations and interviews were conducted to determine whether the instructional strategies differ among the seven selected teachers. ^ The findings of the study show that teachers who were trained in teaching from a global perspective differed in their global knowledge and used more appropriate instructional strategies than teachers who were not trained in teaching global perspectives. There was no significant difference in the combined global knowledge of the non-GOSSE and TWTOS groups when compared with the GOSSE group. There was no significant difference in the combined global knowledge of the GOSSE and non-GOSSE groups when compared with the TWTOS group. There was no significant difference among the teachers in their global mindedness. Observation and interview data indicate that current events, role-playing, simulations, open-ended discussion, debates, and projects were the predominant instructional strategies used by globally trained teachers. Cable networks, Internet, magazines, and newspapers were found to be the dominant tools for teaching global education. ^ This study concluded that teachers who were trained in globally oriented programs had more global knowledge than teachers who were not. It is recommended that teacher education programs should incorporate a global perspective in the preparation of social studies teachers, with particular attention to developing their global attitudes. ^

Relations between acculturation and alcohol use among international students

In the current study, 226 international students attending Florida International University responded to an Web-based questionnaire that assessed self-reported scores for: acculturation, acculturative stress, alcohol use patterns, perceived peer alcohol use, and perceived injunctive social norms for alcohol use. The purpose of the study was to evaluate structural relations among this set of variables using Structural Equation Modeling (SEM) via AMOS 17.0. The results of SEM analyses documented acceptable fit of a model which hypothesized that relations between acculturation and alcohol use variables are mediated partially by acculturative stress, perceived peer alcohol use, and perceived injunctive social norms. While significant path coefficients were documented for paths between (a) acculturation and acculturative stress and (b) acculturative stress and alcohol use, the coefficients had negative signs, contrary to existing studies investigating these relations among immigrant youth. While paths between (a) perceived peer alcohol use or (b) perceived injunctive social norms and participants’ alcohol use were significant, path coefficients between acculturation and either (a) perceived peer alcohol use or (b) perceived injunctive social norms were not statistically significant. In addition, multiple-group comparisons suggested that social support had a significant moderating influence on several significant paths in the structural model. Specifically, international students reporting higher social support reported lower scores for acculturative stress and alcohol use, in contrast to their counterparts who reported lower scores for social support.

The development of rubrics to measure undergraduate students' global awareness and global perspective: A validity study

Higher education institutions across the United States have developed global learning initiatives to support student achievement of global awareness and global perspective, but assessment options for these outcomes are extremely limited. A review of research for a global learning initiative at a large, Hispanic-serving, urban, public, research university in South Florida found a lack of instruments designed to measure global awareness and global perspective in the context of an authentic performance assessment. This quasi-experimental study explored the development of two rubrics for the global learning initiative and the extent to which evidence supported the rubrics' validity and reliability. One holistic rubric was developed to measure students' global awareness and the second to measure their global perspective. The study utilized a pretest/posttest nonequivalent group design. Multiple linear regression was used to ascertain the rubrics' ability to discern and compare average learning gains of undergraduate students enrolled in two global learning courses and students enrolled in two non-global learning courses. Parallel pretest/posttest forms of the performance task required students to respond to two open-ended questions, aligned with the learning outcomes, concerning a complex case narrative. Trained faculty raters read responses and used the rubrics to measure students' global awareness and perspective. Reliability was tested by calculating the rates of agreement among raters. Evidence supported the finding that the global awareness and global perspective rubrics yielded scores that were highly reliable measures of students' development of these learning outcomes. Chi-square tests of frequency found significant rates of inter-rater agreement exceeding the study's .80 minimum requirement. Evidence also supported the finding that the rubrics yielded scores that were valid measures of students' global awareness and global perspective. Regression analyses found little evidence of main effects; however, post hoc analyses revealed a significant interaction between global awareness pretest scores and the treatment, the global learning course. Significant interaction was also found between global perspective pretest scores and the treatment. These crossover interactions supported the finding that the global awareness and global perspective rubrics could be used to detect learning differences between the treatment and control groups as well as differences within the treatment group.

The effects of participation in an Internet -based project on the development of global knowledge, global mindedness, and global pedagogy among preservice social studies teachers

In order to prepare younger generations to live in a world characterized by interconnectedness, developing global and international perspectives for future teachers has been recommended by the National Council for the Social Studies and the National Council for the Accreditation of Teacher Education. The purpose of this study was to investigate the effects that participation in the International Communication and Negotiation Simulation (ICONS), an Internet-based communication project has on preservice social studies teachers' global knowledge, global mindedness, and global teaching strategies. ^ The study was conducted at a public university in South Florida. A combination of quantitative and qualitative approaches was employed. Two groups of preservice social studies teachers were chosen as participants: a control group composed of 14 preservice teachers who enrolled in a global education class in the summer semester of 1998 and an experimental group that included nine preservice teachers who took the same class in the fall semester of 1998. The summer class was conducted in a traditional format, which included lectures, classroom discussions, and student presentations. The fall class incorporated a five-week Internet-based communication project. The Global Mindedness Scale (Hett, 1993) and an adapted Test of Global Knowledge (ETS, 1981) were administered upon the completion of the class. ^ Contrasting case studies were utilized to investigate the impact of participation in the ICONS on the development of preservice teachers' global pedagogy. Four preservice teachers, two selected from each group were observed and interviewed to explore how they were infusing global perspectives into social studies curriculum and instruction during a 10-week student teaching internship in the spring semester of 1999. ^ This study had three major findings. First, preservice social studies teachers from the experimental group on average scored significantly higher than those from the control group on the global knowledge test. Second, no significant difference was found between the two groups in their mean scores on the Global Mindedness Scale. Third, all four selected preservice social studies teachers were infusing global perspectives into United States and world history curriculum and instruction during their student teaching internship. Using multiple resources was the common pedagogy. The two who participated in the ICONS were more aware of using the communication feature of the Internet and the web sites that reflect more international perspectives to facilitate teaching about the world. ^ Recommendations were made for further research and for preservice studies teacher education program development. ^

Investigating group processes in a positive youth development program for multi -problem youth

This study investigated group processes as potential mediators or moderators of positive development outcome and negative reduction intervention response by evaluating the utility of a group measure modified from a widely known measure of group impact found in the group therapy research literature. Four group processes were of primary interest, (1) Group Impact; (2) Facilitator Impact; (3) Skills Impact; and (4) Exploration Impact as assessed by the Session Evaluation Form (SEF). Outcome measures included the Personally Expressive Activities Questionnaire (PEAQ), Erikson Psycho-Social Index (EPSI) and the Zill Behavior Items, Behavior Problem Index (ZBI (BPI)). The sample consisted of 121 multi-ethnic participants drawn from four alternative high schools from the Miami-Dade County Public School system. Utilizing a Latent Growth Curve Modeling approach with Structural Equation Modeling (SEM) statistics, preliminary analyses were conducted to evaluate the psychometric properties of the SEF and its role in the mediation or moderation of intervention outcome. Preliminary results revealed evidence of a single higher order factor representing a "General" global reaction, which was hypothesized to be a "Positive Group Climate" construct to the program as opposed to the four distinct group processes that were initially hypothesized to affect outcomes. The results of the evaluation of the mediation or moderation role of intervention outcome of the single "General" global latent factor ("Positive Group Climate" construct) did not significantly predict treatment response on any of the outcome variables. Nevertheless, the evidence of an underlying "General" global latent factor ("Positive Group Climate" construct) has important future directions for research on positive youth development programs as well as in group therapy research.

The influence of neurocognitive impairment, alcohol and other drug (AOD) use, and psychosocial factors on antiretroviral treatment adherence, service utilization and viral load among HIV-seropositive adults

Among people living with HIV (PLWH), adherence to antiretroviral therapy (ART) can be affected by problems of neurocognitive (NC) impairment, stress, alcohol and other drug (AOD) abuse, and other barriers. The aims of this research were to: (1) examine factors associated with NC impairment, (2) explore relationships between psychosocial variables with ART adherence and viral load (VL), and (3) evaluate the efficacy of an evidence-based intervention in improving ART adherence, increasing service utilization, and decreasing VL. The first study (n=370) was cross sectional and used structural equation modeling to test whether AOD use, years living with HIV, and time from HIV diagnosis to seeking care were associated with poorer NC functioning. The second study (n=246) used similar methods to test the hypothesis that stress, barriers to adherence, NC impairment, poor social support, and AOD use were related to lower VL mediated by ART adherence. The third study (n=243) evaluated an evidence-based, eight-session program to improve ART adherence, reduce VL, and increase service utilization in a randomized controlled trial. Study participants were PLWH living in South Florida, 18 to 60 years old, with a history of alcohol abuse enrolled from January 2009 through November 2012. Secondary analysis of available data showed: (1) scores on interference with executive functioning increased by 0.32 for each day of marijuana use and 1.18 for each year living with HIV, but no association was found between alcohol use and NC functioning; (2) each barrier to adherence was associated with a 10% decrease in adherence to ART and a 0.42 unit increase in VL (log10) and the relationship between barriers and VL was partially mediated by ART adherence; (3) participants in the evidence-based program were more likely than the comparison group to report an undetectable VL (OR=2.25, p<0.01) at 6 months, but not 3 months, post-intervention. Psychosocial factors affect VL, but ART adherence is essential in achieving an undetectable VL in PLWH.

Undergraduate Students’ Perceptions of Study Abroad and Their Level of Achievement of Global Learning Outcomes

This study expanded on current research on study abroad and global learning, using the Global Perspective Inventory (GPI), and conducted at Florida International University (FIU) in Miami, FL. The GPI assesses the holistic development of a global perspective in higher education within three domains and their respective FIU-determined equivalents: cognitive (global awareness), intrapersonal (global perspective), and interpersonal (global engagement). The main purpose of this study was to assess FIU’s undergraduate students’ perceptions of study abroad on their level of achievement of global awareness, global perspective, and global engagement. The secondary purpose was to determine how the students described their study abroad experience and achievement of global learning. The research design for this study consisted of parallel mixed methods. The quantitative component was an ex post facto with hypothesis design, using a pretest/posttest nonequivalent group methodology. FIU undergraduates (N=147) who studied abroad for one semester or more completed the GPI pre- and post-tests. Descriptive statistics and paired t-tests were conducted to compare the means. The interviews included 10 students, and were analyzed through Structural coding, Saldaña’s In Vivo coding, and Value coding. Quantitative analyses indicated positive changes in the students’ global awareness and global perspective. These analyses also showed that the FIU students achieved higher post-test means on all the domains of the GPI compared to other studies. Qualitative analyses showed that the students’ experiences incorporated all three global learning outcomes, most notably global awareness and perspective.

The Influence of Psychological Predictors and Cognitive Behavioral Stress Management Intervention on Antiretroviral Therapy (ART) Adherence Among HIV-Positive Female Haitian Alcohol Users

Purpose: Over half the HIV-infected persons in the Caribbean, the second most HIV-impacted region in the world, live in Haiti. Using secondary data from a parent study, this research assessed the effects of psychological and social factors on antiretroviral therapy (ART) adherence among Haitian, HIV-positive, female alcohol users. Theoretical Foundation and Research Questions: Using the Theory of Planned Behavior/Reasoned Action and the Information, Motivation, Behavior skills model as guiding theoretical frameworks, the study examined the effectiveness of an adapted cognitive behavioral stress management (CBSM-A) intervention in improving ART adherence. The effect of psychological factors (depression, anxiety, beliefs about medicine, and social support), social factors (stigma, relationship status, and educational attainment), and alcohol on adherence to ART was assessed. Methods: The sample consisted of 116 female ART patients who were randomly assigned to the CBSM-A intervention or the wait-list control group. Participants completed intervention sessions as well as pre- and post-test assessments. Analyses of variance, t-tests, and point biserial correlations were used to test hypotheses. Results: Surprisingly, ART adherence rates significantly decreased for both groups combined [F (1, 108) = 8.79, p = .004]; there was no significant difference between the intervention and control groups with regard to the magnitude of change between baseline and post assessment. On average, depression decreased significantly among participants in the CBSM-A group only [(t (62) = 5.54, p < .001)]. For both groups combined, alcohol use significantly decreased between baseline and post-assessment [(F (1, 78) = 34.70, p < .001)]; there was no significant difference between the intervention and control groups with regard to the magnitude of change between baseline and post-assessment. None of the variables were significantly correlated with ART adherence. Discussion: Adherence to ART did not improve in this sample, nor were any of the variables significantly associated with adherence. The findings suggest that additional supportive and psychological services may be needed in order to promote higher adherence to ART among HIV-positive females. More research may be needed on this sample; a focus on mental health issues, partner conflict, family and sexual history may allow for better targeting and more successful interventions.

Psychosocial variables associated with the co-occurance of risky sexual behavior with alcohol consumption among university students

This study examined the association of theoretically guided and empirically identified psychosocial variables on the co-occurrence of risky sexual behavior with alcohol consumption among university students. The study utilized event analysis to determine whether risky sex occurred during the same event in which alcohol was consumed. Relevant conceptualizations included alcohol disinhibition, self-efficacy, and social network theories. Predictor variables included negative condom attitudes, general risk taking, drinking motives, mistrust, social group membership, and gender. Factor analysis was employed to identify dimensions of drinking motives. Measured risky sex behaviors were (a) sex without a condom, (b) sex with people not known very well, (c) sex with injecting drug users (IDUs), (d) sex with people without knowing whether they had a STD, and (e) sex with using drugs. A purposive sample was used and included 222 male and female students recruited from a major urban university. Chi-square analysis was used to determine whether participants were more likely to engage in risky sex behavior in different alcohol use contexts. These contexts were only when drinking, only when not drinking, and when drinking or not. The chi-square findings did not support the hypothesis that university students who use alcohol with sex will engage in riskier sex. These results added to the literature by extending other similar findings to a university student sample. For each of the observed risky sex behaviors, discriminant analysis methodology was used to determine whether the predictor variables would differentiate the drinking contexts, or whether the behavior occurred. Results from discriminant analyses indicated that sex with people not known very well was the only behavior for which there were significant discriminant functions. Gender and enhancement drinking motives were important constructs in the classification model. Limitations of the study and implications for future research, social work practice and policy are discussed.

Relations Between Acculturation And Alcohol Use Among International Students

In the current study, 226 international students attending Florida International University responded to an Web-based questionnaire that assessed self-reported scores for: acculturation, acculturative stress, alcohol use patterns, perceived peer alcohol use, and perceived injunctive social norms for alcohol use. The purpose of the study was to evaluate structural relations among this set of variables using Structural Equation Modeling (SEM) via AMOS 17.0. The results of SEM analyses documented acceptable fit of a model which hypothesized that relations between acculturation and alcohol use variables are mediated partially by acculturative stress, perceived peer alcohol use, and perceived injunctive social norms. While significant path coefficients were documented for paths between (a) acculturation and acculturative stress and (b) acculturative stress and alcohol use, the coefficients had negative signs, contrary to existing studies investigating these relations among immigrant youth. While paths between (a) perceived peer alcohol use or (b) perceived injunctive social norms and participants’ alcohol use were significant, path coefficients between acculturation and either (a) perceived peer alcohol use or (b) perceived injunctive social norms were not statistically significant. In addition, multiple-group comparisons suggested that social support had a significant moderating influence on several significant paths in the structural model. Specifically, international students reporting higher social support reported lower scores for acculturative stress and alcohol use, in contrast to their counterparts who reported lower scores for social support.

Teachers' knowledge, awareness, and pedagogy of global education in secondary schools

Professor Mohammed K. Farouk, Major Professor In 1979, the Florida State Board of Education approved the teaching of global education in the state of Florida. The purpose of this study was to examine the factors that contributed to teachers' global knowledge, global mindedness, and pedagogy in global education. The Hanvey model of teaching from a global perspective was the theoretical framework for the study. A total of 90 secondary teachers from Miami-Dade County Public Schools were randomly selected and placed in three groups: Globally Oriented Social Studies Program (GOSSE), Non-Globally Oriented Social Studies Program (non-GOSSE), and Teachers Who Teach Other Subjects (TWTOS). Seven teachers, two of whom team-taught a class, were selected for classroom observations and interviews. A mixed methods design that combined quantitative and qualitative data was used. ANOVA and Chi square techniques were used to determine whether the factors that contributed to teachers' global knowledge and global mindedness differ among groups. Classroom observations and interviews were conducted to determine whether the instructional strategies differ among the seven selected teachers. The findings of the study show that teachers who were trained in teaching from a global perspective differed in their global knowledge and used more appropriate instructional strategies than teachers who were not trained in teaching global perspectives. There was no significant difference in the combined global knowledge of the non-GOSSE and TWTOS groups when compared with the GOSSE group. There was no significant difference in the combined global knowledge of the GOSSE and non- GOSSE groups when compared with the TWTOS group. There was no significant difference among the teachers in their global mindedness. Observation and interview data indicate that current events, role-playing, simulations, open-ended discussion, debates, and projects were the predominant instructional strategies used by globally trained teachers. Cable networks, Internet, magazines, and newspapers were found to be the dominant tools for teaching global education. This study concluded that teachers who were trained in globally oriented programs had more global knowledge than teachers who were not. It is recommended that teacher education programs should incorporate a global perspective in the preparation of social studies teachers, with particular attention to developing their global attitudes.

The Influence of Neurocognitive Impairment, Alcohol and other Drug (AOD) Use, and Psychosocial Factors on Antiretroviral Treatment Adherence, Service Utilization and Viral Load Among HIV-Seropositive Adults

Among people living with HIV (PLWH), adherence to antiretroviral therapy (ART) can be affected by problems of neurocognitive (NC) impairment, stress, alcohol and other drug (AOD) abuse, and other barriers. The aims of this research were to: (1) examine factors associated with NC impairment, (2) explore relationships between psychosocial variables with ART adherence and viral load (VL), and (3) evaluate the efficacy of an evidence-based intervention in improving ART adherence, increasing service utilization, and decreasing VL. The first study (n=370) was cross sectional and used structural equation modeling to test whether AOD use, years living with HIV, and time from HIV diagnosis to seeking care were associated with poorer NC functioning. The second study (n=246) used similar methods to test the hypothesis that stress, barriers to adherence, NC impairment, poor social support, and AOD use were related to lower VL mediated by ART adherence. The third study (n=243) evaluated an evidence-based, eight-session program to improve ART adherence, reduce VL, and increase service utilization in a randomized controlled trial. Study participants were PLWH living in South Florida, 18 to 60 years old, with a history of alcohol abuse enrolled from January 2009 through November 2012. Secondary analysis of available data showed: (1) scores on interference with executive functioning increased by 0.32 for each day of marijuana use and 1.18 for each year living with HIV, but no association was found between alcohol use and NC functioning; (2) each barrier to adherence was associated with a 10% decrease in adherence to ART and a 0.42 unit increase in VL (log10) and the relationship between barriers and VL was partially mediated by ART adherence; (3) participants in the evidence-based program were more likely than the comparison group to report an undetectable VL (OR=2.25, p Psychosocial factors affect VL, but ART adherence is essential in achieving an undetectable VL in PLWH.