Journal of the Society for Social Work and Research, 2020
Objective: This research reexamines common conceptualizations of ethnic identity as a relatively ... more Objective: This research reexamines common conceptualizations of ethnic identity as a relatively stable, dispositional-like construct—in contrast to constructionist theories that emphasize the contextual, situational, and transitory nature of ethnic identity—and integrates the two frameworks. Method: Two studies investigate Latinx ethnic identity in middle school youth in inner-city New York, NY. The first study consisted of in-depth interviews with 27 Latinx youths and their mothers. The second study was a two-wave longitudinal study of 800 youths with a 6-month interval between interviews. All participants self-identified as Dominican or Puerto Rican. Results: Results reinforce the need to integrate dispositional and constructionist perspectives and to represent expressions of ethnic identity as having stable facets, transitory facets, and unique facets that can have little relation to underlying feelings about pride/insertion. Conclusions: The unique and transitory facets of manifest expressions of ethnic identity are more prevalent than those representing stable, dispositional-like feelings of ethnic identity. Conceptual and methodological approaches to ethnic identity will benefit by including constructionist perspectives on the construct and the measurement strategies to assess it.
The International journal on drug policy, Jul 1, 2017
Working-class educational paths tend to be associated with elevated drinking. Little research has... more Working-class educational paths tend to be associated with elevated drinking. Little research has examined whether disproportionate alcohol use among vocationally oriented youth begins before or after the start of their vocational education. The present study analyzes a large sample of Russian middle-school students (N=1269; mean age=14.9), comparing the patterns of drinking among middle-schoolers oriented towards vocational educational, and their peers who do not plan a vocational education path. Results suggest that the orientation towards vocational education is associated with disproportionately high alcohol involvement among Russian middle-school students, even before they enter vocational schools. We studied if such difference could be partially explained by how youth orient towards extracurricular activities: discretionary peer time in risky contexts, reading for pleasure, working for pay, and religious activities. Reading demonstrated the strongest (negative) association wit...
Background Urologic chronic pelvic pain syndrome (UCPPS) encompasses several common, costly, diag... more Background Urologic chronic pelvic pain syndrome (UCPPS) encompasses several common, costly, diagnoses including interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome that are poorly understood and inadequately treated with conventional medical therapies. Behavioral strategies, recommended as a first-line treatment for managing symptoms, are largely inaccessible, time and labor intensive, and technically complex. The Easing Pelvic Pain Interventions Clinical Research Program (EPPIC) is a clinical trial examining the efficacy of low-intensity cognitive behavioral therapy (Minimal Contact CBT or MC-CBT) for UCPPS and its durability 3 and 6 months post treatment. Additional aims include characterizing the operative processes (e.g., cognitive distancing, context sensitivity, coping flexibility, repetitive negative thought) that drive MC-CBT-induced symptom relief and pre-treatment patient variables that moderate differential response. Methods U...
ImportanceStudies linking the quality of parent-adolescent relationships with young adult health ... more ImportanceStudies linking the quality of parent-adolescent relationships with young adult health outcomes could inform investments to support these complex relationships.ObjectiveTo evaluate whether consistently measured, modifiable characteristics of parent-adolescent relationships are associated with young adult health across multiple domains.Design, Setting, and ParticipantsThis cohort study used data from waves I (1994-1995; ages 12-17 years) and IV (2008-2009; ages 24-32 years) of the US National Longitudinal Study of Adolescent to Adult Health. Of 20 745 adolescents enrolled in wave I, 15 701 of 19 560 who were eligible completed wave IV (response rate, 80.3%). Data analyses were conducted from February 2019 to November 2020.ExposuresParental warmth, parent-adolescent communication, time together, relationship and communication satisfaction, academic expectations, and maternal inductive discipline as reported at wave I by adolescent participants.Main Outcomes and MeasuresWave ...
IMPORTANCE Adolescent well care visits provide opportunities for clinicians to facilitate parenta... more IMPORTANCE Adolescent well care visits provide opportunities for clinicians to facilitate parentadolescent communication (PAC) to reduce pregnancy, sexually transmitted infections, and alcoholrelated harm among adolescents. OBJECTIVE To test the effect of brief parent-targeted interventions delivered in primary care settings on PAC about sexual and alcohol use behaviors. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial conducted at a primary care pediatric practice from January 4, 2016, to April 10, 2017. Adolescents who were scheduled for a well care visit were recruited, along with their parent or guardian. Data analyses continued through April 30, 2018. INTERVENTIONS During well care visits, parents in sexual health intervention and alcohol prevention intervention groups received coaching to discuss written intervention materials encouraging PAC about sex or alcohol, respectively, with their adolescent within 2 weeks, followed by a brief clinician endorsement. After 2 weeks, parents received a follow-up telephone call. Control group parents received usual care. MAIN OUTCOMES AND MEASURES Participants were surveyed 4 months after the well care visit. Parent-reported and adolescent-reported quality of PAC was measured using the 20-item Parent-Adolescent Communication Scale, in which a higher score indicates better PAC; and frequency of PAC about sex or alcohol was measured using a 4-point Likert-type scale with 1 indicating not at all or never, and 4 indicating a lot or often. RESULTS Of 196 parent-adolescent dyads assessed for eligibility, 118 (60.2%) were eligible to participate. These 118 dyads were randomized to 1 of 3 groups: (1) sexual health intervention (n = 38 [32.2%]); (2) alcohol prevention intervention (n = 40 [33.9%]); and control (n = 40 [33.9%]); 104 parents (88.1%) and 99 adolescents (83.9%) completed the study. Parents included 112 women (94.9%) and had a mean (SD) age of 45.8 (6.9) years. Adolescents included 60 girls (50.9%); 67 adolescents (56.8%) were aged 14 years, and 51 adolescents (43.2%) were aged 15 years. Participant race/ethnicity reflected that of the practice (63 black adolescents [53.4%]; 46 white adolescents [38.9%]; 111 non-Hispanic adolescents [94.1%]). At baseline, 15 adolescents (12.7%) reported a history of sexual behavior and 16 adolescents (13.6%) reported a history of alcohol use. Intention-totreat analyses found that 4 months after the intervention, adolescents in the sexual health intervention group reported a higher mean frequency score for PAC about sex compared with those (continued) Key Points Question Can parent-targeted interventions delivered within primary care settings affect parent-adolescent communication about sexual health and alcohol use? Findings This randomized clinical trial included 118 parent-adolescent dyads and found that brief parent-targeted interventions in primary care pediatric settings were acceptable, were feasible, and significantly increased adolescentreported frequency of parentadolescent communication about sexual health and alcohol use. Meaning Delivering parent-targeted interventions in primary care settings may be an important strategy for influencing parent-adolescent communication and adolescent behaviors and improving health outcomes.
Examining the sources of health communication that young adults with mental health challenges rec... more Examining the sources of health communication that young adults with mental health challenges receive regarding service use is critical to curbing the societal concern of unmet mental health needs of this population. Semistructured interviews were conducted with 59 young adults, all of whom were diagnosed with a mood disorder and used public mental health services and additional public systems of care during childhood. Thematic analysis was utilized. Of the 59 participants, 45 nominated at least one supportive adult, with a total of 97 relationships analyzed. Results indicate that the majority of messages came from informal supports (e.g., family) who spoke positively about mental health services. Fewer messages came from formal supports (e.g., professionals). Messages included statements surrounding beliefs toward services, social norms (approval and disapproval), self-efficacy, and image considerations around using services. These findings can suggest ways that mental health service engagement interventions can leverage communication from informal supports. Future research can explore what messages young adults find most influential in persuading them to use mental health care consistently and the relationship between messages and health behavior.
Journal of the Society for Social Work and Research, 2018
We describe randomized explanatory trials (RETs), a framework for evaluating interventions to pre... more We describe randomized explanatory trials (RETs), a framework for evaluating interventions to prevent adolescent problem behaviors. The approach maps intervention components onto hypothesized mediators of program effects and then uses structural equation modeling to evaluate whether the program changed those mediators and if assumptions of mediator relevance are viable. We review and explain key concepts related to theoretical issues of choosing and conceptualizing mediators, mapping structural relations among mediators, considering cascading effects, and incorporating theories of treatment duration and decay. We also explore methodological issues, including the choice of time intervals between assessments, the use of instrumental variables, methods for dealing with measurement error, and sample-size planning. In addition, we discuss analytic issues including use of structural equation modeling rather than ANOVA, ANCOVA and logistic/OLS regression; how to handle large numbers of mediators; incorporating covariates; use of per-protocol vs. intent-to-treat analyses; quantifying and testing mediation; and use of causal inference approaches to mediation. Because RETs can identify program components that are successful in bringing about change and why—providing more useful evaluations than outcome-only designs—we argue that RETs rather than randomized controlled trials should be the gold standard for program evaluation.
The present study examined cognitive and attitudinal factors relevant to binge‐drinking tendencie... more The present study examined cognitive and attitudinal factors relevant to binge‐drinking tendencies in a college sample. Results indicate that positive expectations about binge‐drinking activities were related to binge‐drinking tendencies. Binge‐drinking tendencies were also negatively related to expectations regarding nonbinge‐drinking alternatives. General attitudes toward drinking and normative influences were found to have complex influences on binge‐drinking tendencies involving indirect, direct, and moderated effects. The findings are discussed with respect to developing prevention programs.
Background Medical gender affirmation (i.e., hormone use) is one-way transgender (trans) people a... more Background Medical gender affirmation (i.e., hormone use) is one-way transgender (trans) people affirm their gender and has been associated with health benefits. However, trans people face stigmatization when accessing gender-affirming healthcare, which leads some to use non-prescribed hormones (NPHs) that increase their risk for poor health. Purpose We examined whether healthcare policy stigma, as measured by state-level trans-specific policies, was associated with NPHs use and tested mediational paths that might explain these associations. Because stigmatizing healthcare policies prevent trans people from participation in healthcare systems and allow for discrimination by healthcare providers, we hypothesized that healthcare policy stigma would be associated with NPHs use by operating through three main pathways: skipping care due to anticipated stigma in healthcare settings, skipping care due to cost, and being uninsured. Methods We conducted analyses using data from the 2015 U.S...
We examine unequal access to the law among industrial workers in the export processing plants of ... more We examine unequal access to the law among industrial workers in the export processing plants of the central highlands of Guatemala. Through qualitative interviews with 40 workers and a three-wave panel survey in four communities, we elicited perspectives on labor conditions and legal protections as perceived by workers. The workers, mostly young, indigenous women, are caught in the apparent fragmentation of transnational circuits of production through outsourcing, flexibilization strategies, and layers of removed accountability. Workers are subjected to discrimination and inequality before the law. This is facilitated by global regimes that allow corporations to create separate realms of responsibility by relying on contractors and subcontractors that renegotiate national and international laws with states. The nature of global regimes is such that new forms of activism and participation, including transnational networks of workers and consumers, are needed to provide protections and equal access to rights to a vulnerable, young, and mostly indigenous workforce.
The article addresses the system of tribal justice and the rule of power in the Occupied Palestin... more The article addresses the system of tribal justice and the rule of power in the Occupied Palestinian Territories as two key obstacles to the enforcement of the rule of law and governance. The article presents the legal grounds for the involvement of tribesmen in resolving disputes among citizens outside the rule of law. It goes on to analyze the role and interest of the executive authority in encouraging the involvement of tribes while the authority continues to interfere in the affairs of the official judiciary in both functional and structural terms. It also explores a number of illegal legislative and regulatory interventions made by the president of the executive authority with the effect of undermining official institutions supporting good governance and transparency. The article finds that it is impossible to enforce the rule of law in the Occupied Palestinian Territories as a result of existing practices that are difficult to change without renewing constitutional legitimacy by referring to the people as the source of authority for criminalizing any act contrary to or impeding the rule of law, or impeding or encroaching on the jurisdiction of the official judiciary.
Journal of the Society for Social Work and Research, 2020
Objective: This research reexamines common conceptualizations of ethnic identity as a relatively ... more Objective: This research reexamines common conceptualizations of ethnic identity as a relatively stable, dispositional-like construct—in contrast to constructionist theories that emphasize the contextual, situational, and transitory nature of ethnic identity—and integrates the two frameworks. Method: Two studies investigate Latinx ethnic identity in middle school youth in inner-city New York, NY. The first study consisted of in-depth interviews with 27 Latinx youths and their mothers. The second study was a two-wave longitudinal study of 800 youths with a 6-month interval between interviews. All participants self-identified as Dominican or Puerto Rican. Results: Results reinforce the need to integrate dispositional and constructionist perspectives and to represent expressions of ethnic identity as having stable facets, transitory facets, and unique facets that can have little relation to underlying feelings about pride/insertion. Conclusions: The unique and transitory facets of manifest expressions of ethnic identity are more prevalent than those representing stable, dispositional-like feelings of ethnic identity. Conceptual and methodological approaches to ethnic identity will benefit by including constructionist perspectives on the construct and the measurement strategies to assess it.
The International journal on drug policy, Jul 1, 2017
Working-class educational paths tend to be associated with elevated drinking. Little research has... more Working-class educational paths tend to be associated with elevated drinking. Little research has examined whether disproportionate alcohol use among vocationally oriented youth begins before or after the start of their vocational education. The present study analyzes a large sample of Russian middle-school students (N=1269; mean age=14.9), comparing the patterns of drinking among middle-schoolers oriented towards vocational educational, and their peers who do not plan a vocational education path. Results suggest that the orientation towards vocational education is associated with disproportionately high alcohol involvement among Russian middle-school students, even before they enter vocational schools. We studied if such difference could be partially explained by how youth orient towards extracurricular activities: discretionary peer time in risky contexts, reading for pleasure, working for pay, and religious activities. Reading demonstrated the strongest (negative) association wit...
Background Urologic chronic pelvic pain syndrome (UCPPS) encompasses several common, costly, diag... more Background Urologic chronic pelvic pain syndrome (UCPPS) encompasses several common, costly, diagnoses including interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome that are poorly understood and inadequately treated with conventional medical therapies. Behavioral strategies, recommended as a first-line treatment for managing symptoms, are largely inaccessible, time and labor intensive, and technically complex. The Easing Pelvic Pain Interventions Clinical Research Program (EPPIC) is a clinical trial examining the efficacy of low-intensity cognitive behavioral therapy (Minimal Contact CBT or MC-CBT) for UCPPS and its durability 3 and 6 months post treatment. Additional aims include characterizing the operative processes (e.g., cognitive distancing, context sensitivity, coping flexibility, repetitive negative thought) that drive MC-CBT-induced symptom relief and pre-treatment patient variables that moderate differential response. Methods U...
ImportanceStudies linking the quality of parent-adolescent relationships with young adult health ... more ImportanceStudies linking the quality of parent-adolescent relationships with young adult health outcomes could inform investments to support these complex relationships.ObjectiveTo evaluate whether consistently measured, modifiable characteristics of parent-adolescent relationships are associated with young adult health across multiple domains.Design, Setting, and ParticipantsThis cohort study used data from waves I (1994-1995; ages 12-17 years) and IV (2008-2009; ages 24-32 years) of the US National Longitudinal Study of Adolescent to Adult Health. Of 20 745 adolescents enrolled in wave I, 15 701 of 19 560 who were eligible completed wave IV (response rate, 80.3%). Data analyses were conducted from February 2019 to November 2020.ExposuresParental warmth, parent-adolescent communication, time together, relationship and communication satisfaction, academic expectations, and maternal inductive discipline as reported at wave I by adolescent participants.Main Outcomes and MeasuresWave ...
IMPORTANCE Adolescent well care visits provide opportunities for clinicians to facilitate parenta... more IMPORTANCE Adolescent well care visits provide opportunities for clinicians to facilitate parentadolescent communication (PAC) to reduce pregnancy, sexually transmitted infections, and alcoholrelated harm among adolescents. OBJECTIVE To test the effect of brief parent-targeted interventions delivered in primary care settings on PAC about sexual and alcohol use behaviors. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial conducted at a primary care pediatric practice from January 4, 2016, to April 10, 2017. Adolescents who were scheduled for a well care visit were recruited, along with their parent or guardian. Data analyses continued through April 30, 2018. INTERVENTIONS During well care visits, parents in sexual health intervention and alcohol prevention intervention groups received coaching to discuss written intervention materials encouraging PAC about sex or alcohol, respectively, with their adolescent within 2 weeks, followed by a brief clinician endorsement. After 2 weeks, parents received a follow-up telephone call. Control group parents received usual care. MAIN OUTCOMES AND MEASURES Participants were surveyed 4 months after the well care visit. Parent-reported and adolescent-reported quality of PAC was measured using the 20-item Parent-Adolescent Communication Scale, in which a higher score indicates better PAC; and frequency of PAC about sex or alcohol was measured using a 4-point Likert-type scale with 1 indicating not at all or never, and 4 indicating a lot or often. RESULTS Of 196 parent-adolescent dyads assessed for eligibility, 118 (60.2%) were eligible to participate. These 118 dyads were randomized to 1 of 3 groups: (1) sexual health intervention (n = 38 [32.2%]); (2) alcohol prevention intervention (n = 40 [33.9%]); and control (n = 40 [33.9%]); 104 parents (88.1%) and 99 adolescents (83.9%) completed the study. Parents included 112 women (94.9%) and had a mean (SD) age of 45.8 (6.9) years. Adolescents included 60 girls (50.9%); 67 adolescents (56.8%) were aged 14 years, and 51 adolescents (43.2%) were aged 15 years. Participant race/ethnicity reflected that of the practice (63 black adolescents [53.4%]; 46 white adolescents [38.9%]; 111 non-Hispanic adolescents [94.1%]). At baseline, 15 adolescents (12.7%) reported a history of sexual behavior and 16 adolescents (13.6%) reported a history of alcohol use. Intention-totreat analyses found that 4 months after the intervention, adolescents in the sexual health intervention group reported a higher mean frequency score for PAC about sex compared with those (continued) Key Points Question Can parent-targeted interventions delivered within primary care settings affect parent-adolescent communication about sexual health and alcohol use? Findings This randomized clinical trial included 118 parent-adolescent dyads and found that brief parent-targeted interventions in primary care pediatric settings were acceptable, were feasible, and significantly increased adolescentreported frequency of parentadolescent communication about sexual health and alcohol use. Meaning Delivering parent-targeted interventions in primary care settings may be an important strategy for influencing parent-adolescent communication and adolescent behaviors and improving health outcomes.
Examining the sources of health communication that young adults with mental health challenges rec... more Examining the sources of health communication that young adults with mental health challenges receive regarding service use is critical to curbing the societal concern of unmet mental health needs of this population. Semistructured interviews were conducted with 59 young adults, all of whom were diagnosed with a mood disorder and used public mental health services and additional public systems of care during childhood. Thematic analysis was utilized. Of the 59 participants, 45 nominated at least one supportive adult, with a total of 97 relationships analyzed. Results indicate that the majority of messages came from informal supports (e.g., family) who spoke positively about mental health services. Fewer messages came from formal supports (e.g., professionals). Messages included statements surrounding beliefs toward services, social norms (approval and disapproval), self-efficacy, and image considerations around using services. These findings can suggest ways that mental health service engagement interventions can leverage communication from informal supports. Future research can explore what messages young adults find most influential in persuading them to use mental health care consistently and the relationship between messages and health behavior.
Journal of the Society for Social Work and Research, 2018
We describe randomized explanatory trials (RETs), a framework for evaluating interventions to pre... more We describe randomized explanatory trials (RETs), a framework for evaluating interventions to prevent adolescent problem behaviors. The approach maps intervention components onto hypothesized mediators of program effects and then uses structural equation modeling to evaluate whether the program changed those mediators and if assumptions of mediator relevance are viable. We review and explain key concepts related to theoretical issues of choosing and conceptualizing mediators, mapping structural relations among mediators, considering cascading effects, and incorporating theories of treatment duration and decay. We also explore methodological issues, including the choice of time intervals between assessments, the use of instrumental variables, methods for dealing with measurement error, and sample-size planning. In addition, we discuss analytic issues including use of structural equation modeling rather than ANOVA, ANCOVA and logistic/OLS regression; how to handle large numbers of mediators; incorporating covariates; use of per-protocol vs. intent-to-treat analyses; quantifying and testing mediation; and use of causal inference approaches to mediation. Because RETs can identify program components that are successful in bringing about change and why—providing more useful evaluations than outcome-only designs—we argue that RETs rather than randomized controlled trials should be the gold standard for program evaluation.
The present study examined cognitive and attitudinal factors relevant to binge‐drinking tendencie... more The present study examined cognitive and attitudinal factors relevant to binge‐drinking tendencies in a college sample. Results indicate that positive expectations about binge‐drinking activities were related to binge‐drinking tendencies. Binge‐drinking tendencies were also negatively related to expectations regarding nonbinge‐drinking alternatives. General attitudes toward drinking and normative influences were found to have complex influences on binge‐drinking tendencies involving indirect, direct, and moderated effects. The findings are discussed with respect to developing prevention programs.
Background Medical gender affirmation (i.e., hormone use) is one-way transgender (trans) people a... more Background Medical gender affirmation (i.e., hormone use) is one-way transgender (trans) people affirm their gender and has been associated with health benefits. However, trans people face stigmatization when accessing gender-affirming healthcare, which leads some to use non-prescribed hormones (NPHs) that increase their risk for poor health. Purpose We examined whether healthcare policy stigma, as measured by state-level trans-specific policies, was associated with NPHs use and tested mediational paths that might explain these associations. Because stigmatizing healthcare policies prevent trans people from participation in healthcare systems and allow for discrimination by healthcare providers, we hypothesized that healthcare policy stigma would be associated with NPHs use by operating through three main pathways: skipping care due to anticipated stigma in healthcare settings, skipping care due to cost, and being uninsured. Methods We conducted analyses using data from the 2015 U.S...
We examine unequal access to the law among industrial workers in the export processing plants of ... more We examine unequal access to the law among industrial workers in the export processing plants of the central highlands of Guatemala. Through qualitative interviews with 40 workers and a three-wave panel survey in four communities, we elicited perspectives on labor conditions and legal protections as perceived by workers. The workers, mostly young, indigenous women, are caught in the apparent fragmentation of transnational circuits of production through outsourcing, flexibilization strategies, and layers of removed accountability. Workers are subjected to discrimination and inequality before the law. This is facilitated by global regimes that allow corporations to create separate realms of responsibility by relying on contractors and subcontractors that renegotiate national and international laws with states. The nature of global regimes is such that new forms of activism and participation, including transnational networks of workers and consumers, are needed to provide protections and equal access to rights to a vulnerable, young, and mostly indigenous workforce.
The article addresses the system of tribal justice and the rule of power in the Occupied Palestin... more The article addresses the system of tribal justice and the rule of power in the Occupied Palestinian Territories as two key obstacles to the enforcement of the rule of law and governance. The article presents the legal grounds for the involvement of tribesmen in resolving disputes among citizens outside the rule of law. It goes on to analyze the role and interest of the executive authority in encouraging the involvement of tribes while the authority continues to interfere in the affairs of the official judiciary in both functional and structural terms. It also explores a number of illegal legislative and regulatory interventions made by the president of the executive authority with the effect of undermining official institutions supporting good governance and transparency. The article finds that it is impossible to enforce the rule of law in the Occupied Palestinian Territories as a result of existing practices that are difficult to change without renewing constitutional legitimacy by referring to the people as the source of authority for criminalizing any act contrary to or impeding the rule of law, or impeding or encroaching on the jurisdiction of the official judiciary.
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Papers by Liliana Goldin