Ronald O. Pitner

Understanding tobacco use among urban African American adolescents living in public housing communities: a test of problem behavior theory.

This study was guided by Jessor and Jessors problem behavior theory (PBT) to test the relative effects of personality, perceived environment and behavior system variables on urban teen tobacco use. A sample of 518 urban African American youth residing in public housing communities in three large U.S. cities was utilized. Our results provide partial support for PBT in this study. Personality system variables (i.e., positive attitudes toward tobacco use, and depressive affect, cause and outcome indicators) and behavior system variables (i.e., delinquent behaviors) significantly predicted adolescent tobacco use. Depressive effect and cause indicators were stronger than depressive outcome indicators in predicting the extent of tobacco use. Additionally, age positively moderated the impact of positive attitudes about tobacco use on the extent of adolescent tobacco use. However, perceived environment system variables (e.g., exposure to delinquent peers) did not predict such use. This study suggests that PBT may aid in understanding adolescent tobacco use. Implications for practice and future inquiry are discussed.

Exploring the Dynamics of Middle-Aged and Older Adult Residents' Perceptions of Neighborhood Safety

This study examined what variables best predict concerns about neighborhood safety among middle-aged and older adults. Eighty-five participants were selected from a Midwestern urban area. Participants completed a 22-item questionnaire that assessed their perceptions of neighborhood safety and vigilance. These items were clustered as: (a) community care and vigilance, (b) safety concerns, (c) physical incivilities, and (d) social incivilities. Police crime data were also used in the analyses. Our findings suggest that aspects of the broken window theory, collective efficacy, and place attachments play a role in affecting residents perceptions of neighborhood safety.

Spatial Dimensions of Social Capital

The neighborhood context affects social capital, yet scholars do not adequately account for the dynamic nature of the social spaces people occupy in measuring social capital. Research has focused on neighborhood effects as though the neighborhood space is fixed across all inhabitants without regard for the ways individuals define their neighborhoods considering their own spatial location and social interactions. Using a neighborhood–level social capital measure, we examine the relationship between cognitive neighborhood boundaries and social capital in residents (N = 135) of two public housing communities in a Southern urban city. As collective efficacy (bonding social capital) increased so too did the predicted size of ones cognitive neighborhood. GIS maps demonstrated that participant boundaries included areas of commerce and services necessary to build and maintain social capital. Larger cognitive neighborhoods suggest one may interact with a wider array of people to achieve instrumental and expressive returns despite the high–poverty neighborhood context.

A Dedicated Diversity Course or an Infusion Model? Exploring Which Strategy Is More Effective in Social Work Pedagogy

ABSTRACT The Council on Social Work Education requires schools of social work to meet diversity and social justice competencies. Many MSW programs meet these standards by having either a dedicated diversity and social justice course, or by using some form of diversity and social justice curricular infusion. The current study explored which of these strategies is more effective. Two-hundred and eighty-six MSW students participated in this quasi-experimental design (diversity-83; infusion-97; no diversity/no infusion-106), and were assessed on multiple indices of cultural responsiveness and social justice awareness. Our findings were mixed, but indicated that a dedicated diversity and social justice course is effective at increasing students cultural responsiveness and social justice awareness. Implications for social work pedagogy are discussed.

Implementing a Community Empowerment Center to Build Capacity for Developing, Implementing, and Sustaining Interventions to Promote Community Health

AbstractThe Community Empowerment Center used a community-engaged approach to build capacity among residents to develop and implement interventions focused on creating a healthier environment. The Center partnered with residents living in a public housing community and adjacent low-income neighborhood and provided support through a mini-grant program. A six-session training program guided community members in mini grant development; 25 individuals attended at least one session. Six grant proposals were submitted; three were awarded

When Identifying Health Disparities as a Problem Is a Problem: Pedagogical Strategies for Examining Racialized Contexts

12,000 each for intervention implementation. Findings offer a model for engaging residents from low-resource settings in intervention development, implementation, and sustainability for community health promotion.n

Purchased Behavioral Health Care Received by Military Health System Beneficiaries in Civilian Medical Facilities, 2000–2014

The current study presents a critical discussion on community responses to health disparity research and the need for utilizing pedagogical strategies to prepare students to understand and address health disparities in racialized contexts. Qualitative research methods were used to examine community responses to media stories on two health disparity research projects, and four themes emerged: naming health disparities is a tool for dividing, structural racism does not exist, naming of health disparities is a political act, and health disparities exist because of individual-level deficiencies. The implications for teaching students about racial health disparities are presented and discussed.

Effective Treatments of Late-Life Depression in Long-Term Care Facilities: A Systematic Review.

Abstract Introduction Behavioral health conditions are a significant concern for the U.S. military and the Military Health System (MHS) because of decreased military readiness and increased health care utilization. Although MHS beneficiaries receive direct care in military treatment facilities, a disproportionate majority of behavioral health treatment is purchased care received in civilian facilities. Yet, limited evidence exists about purchased behavioral health care received by MHS beneficiaries. This longitudinal study (1) estimated the prevalence of purchased behavioral health care and (2) identified patient and visit characteristics predicting receipt of purchased behavioral health care in acute care facilities from 2000 to 2014. Materials and Methods Medical claims with Major Diagnostic Code 19 (mental disorders/diseases) or 20 (alcohol/drug disorders) as primary diagnoses and TRICARE as the primary/secondary payer were analyzed for MHS beneficiaries (n = 17,943) receiving behavioral health care in civilian acute care facilities from January 1, 2000, to December 31, 2014. The primary dependent variable, receipt of purchased behavioral health care, was modeled for select mental health and substance use disorders from 2000 to 2014 using generalized estimating equations. Patient characteristics included time, age, sex, and race/ethnicity. Visit types included inpatient hospitalization and emergency department (ED). Time was measured in days and visits were assumed to be correlated over time. Behavioral health care was described by both frequency of patients and visit type. The University of South Carolina Institutional Review Board approved this study. Results From 2000 to 2014, purchased care visits increased significantly for post-traumatic stress disorder, adjustment, anxiety, mood, bipolar, tobacco use, opioid/combination opioid dependence, nondependent cocaine abuse, psychosocial problems, and suicidal ideation among MHS beneficiaries. The majority of care was received for mental health disorders (78.8%) and care was most often received in EDs (56%). Most commonly treated diagnoses included mood, tobacco use, and alcohol use disorders. ED visits were associated with being treated for anxiety (excluding post-traumatic stress disorder; Adjusted odds ratio [AOR]: 9.14 [95% confidence interval (CI): 8.26, 10.12]), alcohol use disorders (AOR = 1.67 [95% CI: 1.53, 1.83]), tobacco use (AOR = 1.16 [95% CI: 1.06, 1.26]), nondependent cocaine abuse (AOR = 5.47 [95% CI: 3.28, 9.12]), nondependent mixed/unspecified drug abuse (AOR = 7.30 [95% CI: 5.11, 10.44]), and psychosis (AOR = 1.38 [95% CI: 1.20, 1.58]). Compared with adults age 60 yr and older, adolescents (ages 12–17 yr), and adults under age 60 yr were more likely to be treated for suicidal ideation, adjustment, mood, bipolar, post-traumatic stress disorder, nondependent cocaine, and mixed/unspecified drug abuse. Adults under age 60 yr also had increased odds of being treated for tobacco use disorders, alcohol use disorders, and opioid/combination opioid dependence compared with adults age 60 yr and older. Conclusions Over the past 15 yr, purchased behavioral health care received by MHS beneficiaries in acute care facilities increased significantly. MHS beneficiaries received the majority of purchased behavioral health care for mental health disorders and were treated most often in the ED. Receiving behavioral health care in civilian EDs raises questions about access to outpatient behavioral health care and patient-centered care coordination between civilian and military facilities. Given the influx of new Veterans Health Administration users from the MHS, findings have implications for military, veteran, and civilian facilities providing behavioral health care to military and veteran populations.

Examining the Relationship Between Diversity Exposure and Students’ Color-Blind Racial Attitudes and Awareness of Racial Oppression

Purpose: The purpose of this study was to identify effective treatment to manage the depression of older residents. Methods: Using Klein and Bloom’s criteria, we analyzed the number of subjects, designs and methodologies, residential types, intervention types and duration of treatment, standardized measures, and findings. Data searches were conducted to classify empirical studies and to review empirical literature published from 2007 to 2014. A systematic research synthesis of 25 articles was conducted to investigate how various treatments affected depression among older residents. Results: The results show that antidepressant medication treatment appears less efficacious in treating less severe depression. Discussion: These findings reveal that minor depression should be treated initially with a nonpharmacologic intervention to avoid unnecessary medication risks. The findings further suggest the need for more comprehensive analyses of longitudinal research and the need for more studies that examine the combination of medication and psychotherapy for depressed older adults.

Making neighborhoods safer: Examining predictors of residents' concerns about neighborhood safety

ABSTRACT This cross-sectional study surveyed graduate-level social work and undergraduate psychology students (N = 409) at a large university to explore the association of diversity exposure (diversity of undergraduate institution, diversity of childhood neighborhood, previous diversity courses), and color-blind racial attitudes and awareness of racial oppression. White students scored significantly higher on level of color-blind racial attitudes compared to racial/ethnic minorities. Students who attended predominantly White undergraduate institutions had greater awareness of racial oppression than students who attended racially balanced or institutions comprised exclusively of one racial/ethnic group other than White. Understanding how diversity exposure influences color-blind racial attitudes and awareness of racial oppression will better inform multicultural training and curricular delivery.