PURPOSE:In response to the increasing numbers of older, frail and dying persons in Western prisons and associated healthcare costs, awareness of the need of high-quality peer care in correctional facilities is growing. This paper aims to describe perceptions and experiences of male and female peer caregivers in two US prisons regarding their roles. DESIGN/METHODOLOGY/APPROACH:Data were collected via focus groups with peer caregivers (n = 15) incarcerated in two US state prisons and examined using thematic analysis. FINDINGS:Three themes were identified: "motivation and benefits", "challenges and costs" and "learning" associated with caregiving. The findings point to differences between male and female caregivers' motivation to perform the roles. While male peer caregivers in the sample appeared to be motivated by issues related to identity, masculinity and religious beliefs, female peer caregivers cited the value of meaningful relationships. However, there were several similarities between male and female's daily experiences and learning needs, and both groups enjoyed intrinsic and extrinsic rewards associated with their roles. ORIGINALITY/VALUE:To the best of the authors' knowledge, this is the first paper to conjointly describe male and female peer caregiver views and experiences of caring for older persons or persons with life-limiting illness. Findings underscore the need for more research aimed at making explicit the varying benefits of peer caregiving behind bars, as well as policies ensuring increased training for peer caregivers and correctional staff.

PURPOSE:The purpose of this study is to investigate the prevalence of chronic illness, multimorbidity, mental illness and comorbidity among older adults incarcerated in a Mid-South state prison system. DESIGN/METHODOLOGY/APPROACH:This study used a cross-sectional descriptive design, gathering data through face-to-face interviews with older adults (n = 499) incarcerated in five state prisons in Kentucky. FINDINGS:Uncovered was a substantial prevalence of chronic diseases and mental health disorders among older adults incarcerated in a Mid-South state prison system. Specifically, hypertension was reported by 65.5% of the participants, arthritis by 52.3% and diabetes by 23%. In terms of mental health, significant findings included that 34% of the older adult population scored above the threshold for major depression, and over one-third met the criteria for post-traumatic stress disorder. RESEARCH LIMITATIONS/IMPLICATIONS:Constrained by its cross-sectional design, the study may not reflect changes in chronic and mental health conditions over time. The predominantly white demographic of the Kentucky state prison system limits the generalizability of findings to more racially diverse populations. PRACTICAL IMPLICATIONS:Findings highlight the need for integrated health-care models within prison systems to address the complex, coexisting chronic and mental health conditions among older inmates. SOCIAL IMPLICATIONS:These findings illuminate the substantial social implications of inadequate health care for aging incarcerated persons, revealing a pressing public health issue within correctional facilities. ORIGINALITY/VALUE:The study highlights the often-overlooked demographic of older adults within the correctional system, particularly within a specific geographical region of the Mid-South, which is known for its higher disease prevalence. It contributes valuable insights into the multimorbidity and comorbidity of chronic and mental health conditions among incarcerated older adults.

Background: To identify the mental health care needs of resettled refugees, researchers have studied the perspectives of mental health service providers but have paid limited attention to the perspectives of individuals who work directly in resettlement agencies or in agencies that exclusively provide services to promote refugees’ self-sufficiency and integration—the refugee resettlement workforce—who routinely provide support, make referrals, and coordinate mental health care. To better inform programming and service delivery, this qualitative case study focuses on the perspectives of the resettlement workforce. Methods: Focus group interviews conducted with 48 refugee resettlement workforce members were analyzed for their perspectives on refugee mental health needs and care. Results: Thematic analysis revealed that their perspectives centered on barriers to (i.e., resettlement challenges, notions about mental illness, stigma associated with mental illness, inadequate access to mental health care, and limited technology literacy) and facilitators of (i.e., promoting mental health literacy, addressing stigma, providing specific and targeted training, mental health coordination, allies, and building programming capacity) refugee mental health care. A set of recommendations to minimize barriers and promote facilitators is presented. Conclusions: These findings corroborate previous research and inform the practices, programs, and policies that should be developed and implemented to support refugees’ mental health wellbeing, self-sufficiency, and community integration post-resettlement.

Latinos/as are the largest ethnic group in the U.S. and are a continuous source of population growth. Therefore, their health and quality of life are important public health concerns. Acculturation is an important determinant of health for Latinos/as. However, few studies examine models identifying determinants of acculturation along with its relationship to other social and health behaviors. The current study uses social network data from a sample of crowdsourced recruited Latinos/as (N = 300) to examine a structural model between network acculturation, psychological acculturation, social capital, help-seeking, and quality of life (QoL). The model posits several paths through which social networks (i.e., network acculturation) relate to acculturation and other model variables. Directly, network acculturation was found to be significantly related to Latino/a enculturation (−0.83, p = 0.002) and White American Acculturation (0.47, p = 0.003). Latino/a enculturation was related to help-seeking (0.21, p = 0.029) and social capital (0.36, p < 0.001), while White American acculturation was only related to social capital (0.35, p = 0.003). Social capital demonstrated a robust relationship with help-seeking (0.48, p = 0.004) and QoL (0.96, p = 0.003). The findings suggest that determinants of acculturation (i.e., network acculturation) are meaningful contributors to psychological acculturation and other variables relating to Latino/as’ QoL.

Negative social exchange has been the primary framework for understanding negative interactions in social relationships that adversely affect health and well-being. Using classic content analysis, this study explores whether inquiries about interpersonal stress within one’s relationships elicit descriptions of negative social exchange and whether the types of stressful experiences reported by young and middle-aged adults (N = 298) reflect the negative social exchange categories depicted in previous research. The current study furthers our understanding of the composition of these adults’ negative social exchange networks and describes interpersonal stressors across close and peripheral relationships. Our analysis indicates that among young and middle-aged adults, a large portion of negative social exchange was associated with close relationships and included experiencing misdeeds and violation of relationship norms, misdirected control and undermining, rejection and neglect, and failed social support. Among responses categorized as “others,” stressors were associated with personal relationships, work, third parties, school, children, and health. Negative social exchange is often associated with psychological distress and has the potential to become chronic. Despite its importance, several ambiguities remain, especially when examining the experiences of adults between the ages of 18 and 59. Findings from this study describe the composition of negative social exchange networks and reveal the nuanced differences in negative social exchange among young and middle-aged adults that further help characterize their experiences with relationships.

Perceived stress is strongly related to a person's mental health and risk for disease and disability. Negative social exchange is a pervasive source of negative interaction that influences a person's stress perceptions. Using an egocentric network design (N = 277), the current study explores the relationship between the intensity, frequency, and duration of negative social exchange and perceptions of stress among young (ages 18-35) and middle adults (ages 36-55). The final models explained 35% and 43% of the variance in measures of stress. Findings from the study support previous research suggesting that networks of negative relationships are related to a person's psychological health.

Acculturation is essential because of its relationship to important health outcomes for Latinxs. Yet, little agreement exists on how acculturation is best measured. The present study updated and examined the psychometric properties of a previously validated acculturation measure by testing two competing factor structures and the construct and criterion validity using other available proxies. In addition, the present study focused on establishing low-burden scales to replace proxy measures in acculturation and health research. The present study used a crowdsourced population identifying as Latino/a/x or Hispanic (N = 298) between the ages of 18 and 65, who were fluent in English and living in the United States. Overall, the domain model of the Latinx Enculturation Dimension Domain (non-normed fit index [NNFI] = .98, relative fit index = .97, Tucker-Lewis index = .99, incremental fit index = .99, and comparative fit index = .99) and the White American Acculturation Dimension Domain (NNFI = .93, relative fit index = .89, Tucker-Lewis index = .91, incremental fit index = .95, and comparative fit index = .95) scales demonstrated the more robust factor structure compared to the bidimensional models. All alphas for the domain subscales were above .70, except for the language domain of the White American Acculturation Dimension Domain. Overall, the Latin Enculturation Dimension and White American Dimension Domains demonstrated the ability to distinguish between generational status groups and measure differences in Spanish use and Latinx and White American relationships among Latinxs living in traditional and nontraditional resettlement communities. While the four-item versions of each scale demonstrated promise, only the Latin Enculturation Dimension Domain-4 consistently demonstrated adequate psychometric properties. Additional research is required to establish the validity of the shortened versions of each scale.

Latinx young adults encounter several negative social determinants that compromise their well-being. The movement of Latinx into the Southeastern United States marked a significant change in immigration, transforming communities across the region. Attempts to achieve cultural fit through acculturation have come at a high cost for Latinx young adults, influencing their mental health and well-being. Many of these poor mental health outcomes have been associated with negative interactions across Latinx young adults' social networks. Using an egocentric social network design, the present study examines networks of stressful relationships (i.e., negative relationship networks) among a college-enrolled sample (N = 211) of Latinx young adults. Findings indicate that Latinx enculturation, White American acculturation, and Latinx and White American homophily were positively associated, while network stress intensity and structural holes were negatively associated with Latinx young adults' well-being. These findings underscore the importance of social relationships as predictors of stress and well-being, as well as their potential for forming social convoys through interconnected social networks.

Social relationships have been linked to various positive health and mental health outcomes. Research has shown that many social capital characteristics that support positive relationships may serve as the substrate for relationships associated with negative social exchange. The current paper reports on two cross-sectional egocentric social network studies (N = 57; N = 43). These studies examine the social capital characteristics of negative social exchange, instrumental, and emotional support networks among college-enrolled Latino/a young adults living in the Southeastern United States. Negative social exchange and support networks were primarily composed of family members, while friends occupied emotional and instrumental support networks. Collectively, these two studies indicate that as trust, relationship quality, frequency of interaction, and the length of time known were more strongly and consistently correlated within than across networks. Negative social exchange and support networks statistically differed in the reported level of trust and relationship quality, but only negative social exchange and emotional support networks differed in the length of time known. Findings from these two studies suggest that social capital characteristics may be present in relationships involving negative social exchange but differ in their quantity from those that provide different forms of support.

Introduction: Most studies have focused on the effects of the COVID-19 lockdown on social relationships. However, few studies have examined differences in health, social support, perceived stress, and quality of life (QoL) just prior to the COVID-19 pandemic in the United States (U.S.). Historically, marriage has been a protective factor that buffers psychological distress and enhances a person's QoL. Yet, it is unclear whether some relationship groups entered the pandemic with these protective benefits over others. Therefore, the current study examines differences between relationship status groups' subjective assessment of health, stress, and social support prior to the widespread effects of COVID-19 in the United States. Methods: In this study, data were used from a cross-sectional social network study completed just prior to the COVID-19 pandemic in the U.S. Individuals between the ages of 18 and 65 (N =284) years were recruited from a crowdsource platform to complete health, social support, and perceived stress measures. Results: Among the sample, 66% reported psychological QoL scores below 60, followed by social QoL (60%), environment QoL (48%), and physical QoL (39%). Bivariate results identify positive correlations between social support, social network size, and QoL domains. Conversely, perceived stress was negatively correlated with these variables. ANCOVA results indicate that those who were married reported significantly higher psychological (F3, 275 = 3.73, p = .012), social (F3, 275 = 16.50, p < .001), and environmental (F3, 275 = 6.03, p < .001) QoL and less stress (F3, 275 = 5.75, p < .001) than single or cohabiting individuals. However, those in a committed relationship (not cohabiting) did not substantially differ from those who were married. Discussion: Some groups entered the COVID-19 pandemic with greater protective benefits than others. In the current study, those who were married and in a committed relationship reported better QoL compared to other groups. Understanding the protective benefits experienced by particular groups may help policymakers, healthcare professionals, and service providers understand the full impact of the COVID-19 pandemic.

Psychometric exploration of the World Health Organization Quality of Life Questionnaire-BREF (WHOQOL-BREF, WHOQOL Group, 1998) is warranted. The role of life satisfaction in health and social outcomes, variations within and across populations surrounding quality of life, and the potential influence of social and political changes since the development of the measure beget assessment of the structural and construct validity of the WHOQOL-BREF in a general U.S. population. We examined the reliability, convergent and discriminant construct validity, and multiple-fit indexes of both first-order and second-order models of the measure using a convenience sample of U.S. adults obtained through Prolific (c) (n = 302). Mean scores were lower than scores reported among several inter-national and U.S. samples and reflect values parallel to that of unhealthy or patient populations. Fit indexes indicate the second-order model of the WHOQOL-BREF outperforms the first-order model (chi(2)/df = 485/242 = 2.00; NFI = .89; NNFI = .94; CFL = .94; and IFI = .94). Also, a large number of floor and ceiling effects were also observed indicating limitations with capturing respondents' life satisfaction and potential concerns with validity. Limitations related to response patterns are highlighted and recommendations for future research with underrepresented groups and the use of cognitive interviewing are indicated.

PurposeValid and reliable measurement is critical to the assessment and evaluation of health interventions. However, few scholars have examined the psychometric properties of "gold standard" measures in carceral settings, and no research has explored the reliability, validity and factor structure of the 26-item World Health Organization Quality of Life (WHOQOL) BREF among older adults incarcerated in prison, a large and growing population marked by substantial chronic and life-limiting illness. This study aims to examine the reliability, validity and factor structure of the WHOQOL-BREF. Design/methodology/approachSecondary data from a large-scale study with older adults (age 45+) incarcerated in a Midwestern state were used (N = 499). Floor and ceiling effects were examined, as was the reliability of the measure (Cronbach's alpha). The structural validity of a four-factor and second-order four-factor model of the WHOQOL-BREF was examined using confirmatory factor analysis. Model data fit was examined using chi-square, standardized root mean square residual, comparative fit indices, Akaike information criterion and the Bayesian Information Criterion. Pearson product-moment correlation coefficients were also used to assess validity. FindingsResults indicate adequate construct validity and reliability for the WHOQOL-BREF using the current sample. Model-data fit indexes also reveal adequate structure of the measure relative to other older adult samples. Non-random data and item exclusion are noteworthy limits, and future researchers are encouraged to co-conceptualize and operationalize life quality with older adults who are incarcerated. Originality/valueTo the best of the authors' knowledge, this is the first study to explore the psychometric properties of the WHOQOL-BREF among older adults incarcerated in prison.

Introduction: This paper describes implementation results as part of a larger three-arm, cluster randomized controlled trial that compared two curriculum interventions to prevent teen pregnancy with a control condition. The intervention of focus is an enhanced version of Reducing the Risk to Prevent Pregnancy, STD and HIV (Kirby, Barth, Leland, & Fetro, 1991; Langley et al., 2015), which is a comprehensive sex education program appropriate for youth ages 14-19. Method: In order to standardize the delivery of this teen pregnancy prevention education curriculum to high-risk youth across 39 presentations, in 23 different community-based organizations, by dyads involving 16 facilitators, researchers utilized two implementation frameworks to guide program delivery and developed several fidelity measurement tools to assess adherence, dosage, quality of intervention delivery, participant responsiveness, and program differentiation . Results: These efforts resulted in high fidelity to the curriculum. There also were high levels of youth engagement as indicated both by self-reports and observed by facilitators who created cohesive groups. Results also found that training quality, alliance with facilitators and group cohesion positively impacted attitude change and gains in knowledge. Discussion: Issues related to balancing adherence to evidence-based curricula and being responsive to youth needs are discussed.

The growth of the Latina/o population has been met with a backlash that has increased experiences of discrimination. Differences in gender, education, and acculturation often result in experiences of discrimination. Despite the importance of acculturation, few attempts have been made to understand the structural environment surrounding those experiences (i.e., social networks). Using ego network data, the current study examines the relationship between enculturation (a traditional indicator of acculturation), network language use, acculturative pressures, structural social support characteristics, and experiences of discrimination among a college-enrolled sample of Latinas/os (N = 139). Over half of respondents were female (61 %) with ages ranging from 18 to 63 and reported largely first (43 %) and second generational status (27 %). Findings indicate that pressure to acculturate was the strongest variable associated with experiences of discrimination. Network language use moderated by gender emerged over enculturation as more closely related to experiences of discrimination. The interaction term between gender and network language use revealed potentially different risk and protective factors for Latinas/os related to experiences of discrimination. Structural support variables associated with respondents' social networks appear to provide some protective value but do not attenuate the relationship between pressure to acculturate and experiences of discrimination. In the current study, ego networks proved useful in identifying factors related to experiences of discrimination. Future research should continue to explore the importance of a person's immediate social structure (i.e., ego networks) in protecting and exposing Latinas/os to harmful and health benefiting experiences.

Acculturation measures focus on the perceived composition of a person's social networks as a characteristic of cultural change but have not focused on specific social relationships as sources of evaluation. The current study explores network-derived indicators of acculturation and determines the viability of network acculturation as a related, but distinct, construct from enculturation. A first-order ego network electronic survey design was used to gather social network and traditional survey data from a sample of college-enrolled Latinxs using name generator and name interpreter questions. Findings indicate low but statistically significant correlations between network indicators of acculturation and enculturation as hypothesized. No group differences in network acculturation were observed between generational statuses despite demonstrated differences in psychological enculturation. The low but statistically significant relationships between enculturation and network acculturation suggest conceptually related but distinct indicators of acculturation. Latinx homophily was the strongest predictor of enculturation, revealing the importance of network characteristics.

BACKGROUND:Adults aged 55 or above represent a large and growing proportion of the US and international correctional populations and more physical and mental health problems than their non-incarcerated peers. Social capital represents the collective cognitive and network structure resources accessible through social relationships and may serve as a potential asset in carceral settings in the amelioration of depressive symptoms among older adults.METHOD:A sample of men drawn from a study of older adults in Kentucky prisons (n = 91) was used to meet the following aims: (1) explore relationships among cognitive and structural facets of social capital, chronic health conditions and depressive symptoms and (2) identify the role of social capital (viz. trust) alongside chronic health conditions as a determinant of depressive symptoms. We hypothesized that each indicator of social capital would relate negatively to depressive symptoms and that trust would emerge as most strongly associated with depressive symptoms.RESULTS:Bivariate correlations between depression and social capital variables related as we hypothesized. However, our hypotheses were only partially supported. Higher trust was correlated to fewer depressive symptoms (r = .21, p < .05) revealing a lighter side of trust in the correctional milieu but was unrelated to depression when controlling for variables. An interaction term in the final model indicated a different role for trust. Factors accounted for 64% of variance in depressive symptoms among older adults in a state prison (F(10, 80) = 14.25, p < .001). In this model, higher trust was related to depressive symptoms when included alongside additional measures of social capital, indicating that a darker side of this facet may exist within correctional settings.CONCLUSION:Many indicators of social capital (e.g., network size) demonstrated potentially protective benefits against depression, while trust revealed a more complex role related to chronic health conditions. Limited measures and the agnostic behavior of trust require attention by future researchers.

Background: Corrections-involved adults with a history of opioid use disorder are at elevated risk of opioid overdose following release from correctional settings. Increased opioid prescribing restrictions and monitoring during a time when heroin is becoming cheaper and ubiquitous means that adults who misused prescription opioids prior to incarceration may be reentering communities at greater risk for heroin exposure and use. Objectives: Determine risk factors of post-release heroin use among a sample of adults who participated in corrections-based drug treatment in Kentucky released between 2012 and 2017. Methods: Survey data obtained as part of an ongoing evaluation of corrections-based drug treatment were examined. Results: The final sample (N = 1,563) was majority male (80.9%). Nearly 11.0% reported past-year heroin use following their release. Depressive symptoms, polydrug use, and urban proximity were more common among participants reporting post-release heroin use. Heroin use 30 days prior to incarceration was associated with a 432.1% increase in odds of heroin use subsequent to incarceration. Post-release suicidal ideation increased odds of heroin use by 154.2%, whereas reporting satisfaction from social interactions decreased odds of use by nearly 60%. Post-release use of cocaine and diverted buprenorphine were associated with increased likelihood of heroin use during this time period, increasing odds by 469.1% and 265.9%, respectively. Residing in Central Appalachia subsequent to incarceration was associated with decreased likelihood of use. Conclusions: In this sample, post-release heroin use was associated with concerning features, such as polydrug use, lack of social satisfaction, and suicidal ideation. These features can serve as clear targets for clinical intervention.

Objectives: This research sought to describe the physical and psychological health and quality of life among older adult men incarcerated in a state prison and to examine the role of age and historical time between age cohorts. Methods: Survey responses from male respondents incarcerated in a medium-security prison (N = 186) were described using frequencies and descriptive statistics; chi-square and analysis of variance analyses were used to examine differences between age cohorts. Results: The average number of chronic health conditions for the sample was higher than those in similar samples; the proportion of older adults with four or more chronic conditions was 10% higher than the national average for adults age 65 or older. Depression and post-traumatic stress (PTS) symptom severity scores were higher than those found in community-based samples. Significant differences were identified between cohorts regarding physical (number of chronic conditions, F = 12.48, p < .01); functional impairment, F = 4.28, p < .05) and psychological health (PTS symptom severity, F = 3.16, p < .05). Conclusion: Policy and practice implications are discussed including the expansion of on- and off-site services for older adults in prisons, enhanced accessibility, and the use of grief counseling and stress management strategies.

Negative evaluative beliefs and other cognitive structures have been tied to psychological distress across various populations but have not been sufficiently incorporated into acculturation models. The current study examines the relationships between acculturation and various activating events and mediating sources of support related to negative evaluative beliefs among people of Mexican descent (N = 319). Overall, model variables explained 26% of the variance in negative evaluative beliefs. Acculturation, marital commitment, and social capital associated with friends were negatively related to negative evaluative beliefs. Conversely, single relationship status, marital reward value, psychosocial stressors, and bridging social capital were positively related, and likely serve as activating events for negative evaluative beliefs. Identifying mechanisms related to psychological distress as well as supportive structures may help in constructing interventions that will address the specific needs of different groups. Future research should continue to explore appraisal and associated beliefs in acculturation models to understand why acculturative experiences may become stressful.