Emily A. Hennessy

Estimating the Difference Between Published and Unpublished Effect Sizes A Meta-Review

Practitioners and policymakers rely on meta-analyses to inform decision making around the allocation of resources to individuals and organizations. It is therefore paramount to consider the validity of these results. A well-documented threat to the validity of research synthesis results is the presence of publication bias, a phenomenon where studies with large and/or statistically significant effects, relative to studies with small or null effects, are more likely to be published. We investigated this phenomenon empirically by reviewing meta-analyses published in top-tier journals between 1986 and 2013 that quantified the difference between effect sizes from published and unpublished research. We reviewed 383 meta-analyses of which 81 had sufficient information to calculate an effect size. Results indicated that published studies yielded larger effect sizes than those from unpublished studies ( d ¯ = 0.18, 95% confidence interval [0.10, 0.25]). Moderator analyses revealed that the difference was larger in meta-analyses that included a wide range of unpublished literature. We conclude that intervention researchers require continued support to publish null findings and that meta-analyses should include unpublished studies to mitigate the potential bias from publication status.

Recovery capital: a systematic review of the literature

Abstract Background: Recovery from a substance use disorder involves various supports addressing multiple interrelated factors. Recovery capital (RC) is a lens that could help identify distinct areas of assets that could be enhanced and barriers to be addressed in individuals’ recovery processes. The aim of this study is to conduct a systematic review of the literature to map the existing RC research and theoretical evidence base and to provide readers and potential users of the construct areas for further attention. Methods: Using systematic search methods, a literature search on RC was conducted. Articles were reviewed and relevant data was extracted and synthesized. Results: Searches resulted in 38 reports representing 35 unique studies. Samples ranged from 4–703 participants (4885 total) and were described as male (M = 60.9%) and white (M = 72.1%). Sample age ranged 17.3–70 years (37.2 ± 64.61 years). RC has been studied in a range of diverse adult populations and many factors have been studied within its primary domains. Yet, authors are inconsistent in their use and reporting of RC conceptualization and efforts to quantify RC through a scale have not been rewarded with uptake in the research community. Conclusions: Future researchers should consistently use key RC domains. Measurements of RC largely lack attention to community-level factors and should be further explored. RC should also be explored among specific populations, especially among youth and with particular attention to culture and intersectionality.

Recovery high schools: Effect of schools supporting recovery from substance use disorders

ABSTRACT Background: Recovery high schools (RHSs) provide post-treatment education and recovery support for young people with substance use disorders (SUDs). This is the first quasi-experimental outcome study to determine RHS effectiveness relative to students in non-RHSs. Objectives: To examine effects of RHS attendance on academic and substance use outcomes among adolescents treated for SUDs 6 months after recruitment to the study. Methods: A quasi-experimental design comparing outcomes for adolescents with treated SUDs who attended RHSs for at least 28 days versus a propensity-score balanced sample of students with treated SUDs who did not attend RHSs. The sample included 194 adolescents (134 in RHSs, 60 in non-RHSs) enrolled in Minnesota, Wisconsin, or Texas schools (M age = 16; 86% White; 49% female). Multilevel linear regression models were used to examine the effect of RHS attendance on students’ outcomes, after adjusting for a range of potential confounders. Results: Adolescents attending RHSs were significantly more likely than non-RHS students to report complete abstinence from alcohol, marijuana, and other drugs at the 6-month follow-up (OR = 4.36, p = .026), significantly lower levels of marijuana use (d = −0.51, p = .034) and less absenteeism from school (d = −0.56, p = .028). Conclusion: These results indicate that RHSs have significantly beneficial effects on substance use and school absenteeism after 6 months for adolescents treated for SUDs.

A Review of Meta-Analysis Packages in R

Meta-analysis is a statistical technique that allows an analyst to synthesize effect sizes from multiple primary studies. To estimate meta-analysis models, the open-source statistical environment R is quickly becoming a popular choice. The meta-analytic community has contributed to this growth by developing numerous packages specific to meta-analysis. The purpose of this study is to locate all publicly available meta-analytic R packages. We located 63 packages via a comprehensive online search. To help elucidate these functionalities to the field, we describe each of the packages, recommend applications for researchers interested in using R for meta-analyses, provide a brief tutorial of two meta-analysis packages, and make suggestions for future meta-analytic R package creators.

‘Pickle or a cucumber?’ administrator and practitioner views of successful adolescent recovery

Abstract Introduction: Adolescent substance use disorders often involve a recurring cycle of treatment and relapse. The academic and practical definition of addition recovery for adults has been debated; yet, elements determining a successful adolescent recovery aside from abstinence have not been delineated. Thus, we sought to explore how practitioners and administrators define ‘success’ in recovery and how they foster youth progress toward success. Methods: Using a qualitative design, we purposively selected and visited treatment and recovery services sites and interviewed practitioners and administrators (N = 13). Sites included recovery high schools (N = 2), alternative peer groups (N = 4), and one treatment center. Two authors analyzed the data using the constant comparative method. Results: Success emerged from the interviews in three primary themes (1) factors demonstrating success, (2) progress that highlights success, and (3) factors enabling success and two subthemes (1) use of metaphors and (2) use of specific examples. A variety of factors and processes were discussed as indicators of success. Multiple practitioners stated that sobriety and length of abstinence were not the best success measures; yet, sobriety and education were mentioned most often. Conclusions: A key finding of this study, which has not been addressed in existing qualitative studies of youth recovery, is that the understanding of recovery was so diverse and multi-dimensional and provided a view of success beyond sobriety, highlighting the various facets from which practitioners must operate and address recovery. This demonstrates the need for researchers to carefully conceptualize how they operationalize adolescent recovery.

A Meta-Analysis Exploring the Relationship Between 12-Step Attendance and Adolescent Substance Use Relapse

This article describes results from a systematic review and meta-analysis of research exploring the relationship between adolescent 12-step program attendance and relapse after treatment. A systematic literature search was conducted resulting in 364 unduplicated abstracts to review. Four studies were eligible and were double-coded for variables. Outcome effect sizes were then analyzed in a random-effects model. The overall mean effect indicated beneficial results for adolescents who attended 12-step programs posttreatment. These findings support the clinical recommendation that adolescents attend 12-step programs, yet the findings highlight the need for future research among this population that clearly documents variables related to recovery outcomes.

Who attends recovery high schools after substance use treatment? A descriptive analysis of school aged youth

Recovery high schools (RHSs) are an alternative high school option for adolescents with substance use disorders (SUDs), designed to provide a recovery-focused learning environment. The aims of this study were to examine the characteristics of youth who choose to attend RHSs, and to compare them with local and national comparison samples of youth in recovery from SUDs who were not enrolled in RHSs. We conducted secondary analysis of existing data to compare characteristics of youth in three samples: (1) adolescents with SUDs who enrolled in RHSs in Minnesota, Texas, and Wisconsin after discharge from treatment (RHSs; n = 171, 51% male, 86% White, 4% African American, 5% Hispanic); (2) a contemporaneously recruited local comparison sample of students with SUDs who did not enroll in RHSs (n = 123, 60% male, 77% White, 5% African American, 12% Hispanic); and (3) a national comparison sample of U.S. adolescents receiving SUD treatment (n = 12,967, 73% male, 37% White, 15% African American, 30% Hispanic). Students enrolled in RHSs had elevated levels of risk factors for substance use and relapse relative to both the local and national comparison samples. For instance, RHS students reported higher rates of pre-treatment drug use, past mental health treatment, and higher rates of post-treatment physical health problems than adolescents in the national comparison sample. We conclude that RHSs serve a population with greater co-occurring problem severity than the typical adolescent in SUD treatment; programming offered at RHSs should attend to these complex patterns of risk factors. SUD service delivery policy should consider RHSs as an intensive recovery support model for the most high-risk students with SUDs.

International and Multicultural Perspectives on Youth Recovery

ABSTRACT This article introduces the special thematic issue, which includes multiple and diverse perspectives to illustrate how youth treatment and recovery from substance use/dependence/misuse is approached and studied internationally. Although treatment and recovery services are available to and in use by youth across the world, this introduction explains that there is a noticeable gap in literature documenting the continuum of care for this vulnerable population. This introductory piece presents a synopsis of the articles in the issue, which address group treatment and recovery supports internationally and multi-culturally from a youth treatment and recovery lens. The articles offer an integration of international and diverse adolescent recovery supports, including those in Canada, Norway and the United States, and add to the larger body of recovery literature.

Disparities in Youth Access to Substance Abuse Treatment and Recovery Services: How One Recovery School Initiative is Helping Students “Change Tracks”

ABSTRACT Recovery high schools are one aftercare support for adolescents in the United States following intervention for substance use disorders. Admission requirements for most recovery schools include completion of a formal treatment program; yet, there is a documented disparity in access to treatment and completion by race. This article presents a descriptive case study of recovery schools in Massachusetts to consider the relationships among treatment and recovery resources, disparities in accessing these resources, and steps schools can take to address these inequities, specifically through the example of the Changing Tracks program.