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Adolescent girls’ stress responses as prospective predictors of self-injurious thoughts and behaviors: A person-centered, multilevel study
- Jason José Bendezú, Casey D. Calhoun, Megan W. Patterson, Abigail Findley, Karen D. Rudolph, Paul Hastings, Matthew K. Nock, Mitchell J. Prinstein
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- Journal:
- Development and Psychopathology / Volume 34 / Issue 4 / October 2022
- Published online by Cambridge University Press:
- 25 March 2021, pp. 1447-1467
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Adolescent risk for self-injurious thoughts and behaviors (STBs) involves disturbance across multiple systems (e.g., affective valence, arousal regulatory, cognitive and social processes). However, research integrating information across these systems is lacking. Utilizing a multiple-levels-of-analysis approach, this person-centered study identified psychobiological stress response profiles and linked them to cognitive processes, interpersonal behaviors, and STBs. At baseline, adolescent girls (N = 241, Mage = 14.68 years, Range = 12–17) at risk for STBs completed the Trier Social Stress Test (TSST), questionnaires, and STB interviews. Positive affect (PA), negative affect (NA), and salivary cortisol (SC) were assessed before and after the TSST. STBs were assessed again during 3, 6, and 9 month follow-up interviews. Multitrajectory modeling of girls’ PA, NA, and SC revealed four profiles, which were compared on cognitive and behavioral correlates as well as STB outcomes. Relative to normative, girls in the affective distress, hyperresponsive, and hyporesponsive subgroups were more likely to report negative cognitive style (all three groups) and excessive reassurance seeking (hyporesponsive only) at baseline, as well as nonsuicidal self-injury (all three groups) and suicidal ideation and attempt (hyporesponsive only) at follow-up. Girls’ close friendship characteristics moderated several profile–STB links. A synthesis of the findings is presented alongside implications for person-centered tailoring of intervention efforts.
3572 The Flint Community’s Action Plan to Rebuild Trust and Encourage Resiliency During the Post Water Crisis Phase
- Karen D. Calhoun, Kent Key, E. Yvonne Lewis, Susan J Woolford, E. Hill DeLoney, Jennifer Carerra, Joe Hamm, Ella Greene-Moton, Patricia Piechowski, Kaneesha Wallace, Elder Sarah Bailey
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- Journal:
- Journal of Clinical and Translational Science / Volume 3 / Issue s1 / March 2019
- Published online by Cambridge University Press:
- 26 March 2019, p. 96
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OBJECTIVES/SPECIFIC AIMS: o To review the community’s recommendations on how to rebuild trust in the Flint community. o To review effective community engagement strategies utilized with the Flint Special Projects for project conceptualization, participant recruitment, data analysis, project oversight, and dissemination. METHODS/STUDY POPULATION: The study population includes nearly two hundred residents representing seniors, youth and diverse ethnicities recruited to participate in eleven focus group meetings. The population also represents the general public who attended informational meetings in Flint, Michigan to learn about the crisis and allow residents to voice their opinions and concerns during the onset of the crisis. The project is a mixed methods community based participatory research effort that utilized community decision making in all phases of the effort such as pre-conception, implementation, dissemination and advocacy to encourage the community’s recommendations are adopted at policy and institutional responsiveness levels. It includes three community engaged research efforts: (project 1) A qualitative analysis of community sentiment provided during 17 recorded legislative, media and community events, and (projects 2-3) two mixed methods efforts utilizing purposive sampling of stakeholders whose voice may not have been heard. RESULTS/ANTICIPATED RESULTS: The project presents a qualitative analysis of the community’s voice during the onset of the man-made disaster when the community first became aware of the emergency manager’s plans to switch the water source. It also reflects current perspectives of community voice since the projects are scheduled to end late February 2019. Findings from a trust measure administered to nearly two hundred residents will be presented, along with a qualitative analysis of focus group findings among segments of the population (seniors, youth, and diverse ethnicities) who may have been left out of narratives on the water crisis. Finally, the project will compare empowerment and resiliency approaches being utilized in Flint, Michigan to recover from the disaster with other approaches grounded in literature and theory. DISCUSSION/SIGNIFICANCE OF IMPACT: Communities of color often experience social determinants of health which negatively impact their health, well-being and human rights. Some Flint citizens are experiencing negative health consequences (i.e., rashes, brain and behavioral sequelle, fertility, etc.) as a result of the disaster, and are uncertain of health outcomes in the future. This is the first project to rigorously document and analyze levels of trust and mistrust in the city of Flint since the water disaster occurred. The qualitative research will guide future clinical research that will benefit this traumatized community experiencing high levels of mistrust (i.e., government, elected officials, etc.). The community engaged methodology involved residents and study participants in all phases of the project including project oversight, validating and analyzing data, and dissemination. This methodology will contribute to existing literature and theory on community based participatory research, community engaged research, team science and citizen science. The approaches empowered a call to action among residents, for example, seniors who attended two senior focus group sessions shared “they are hopeful and have a purpose,” resulting in the creation of a council (with officers) at their housing complex to advocate for the well-being of seniors during the recovery process. Recruitment methodologies were extremely successful due to resident level trust in community leaders and community partner organizations. Finally, the project’s examination of approaches encouraging empowerment and resiliency will provide lessons learned for other communities challenged with crisis.
3578 Partnership Development: A learning community to advance institutional responsiveness to the opioid crisis in the city of Detroit and Wayne, County, Michigan
- Karen D. Calhoun, Laura Gultekin, Nikita Buckhoy, Tinetra Burns, Zachary Rowe, Lisa Braddix, Madiha Tariq, Patricia Piechowski, Donald R. Vereen, Jr., Dwight Vaughter, Kanzoni Asabigi
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- Journal:
- Journal of Clinical and Translational Science / Volume 3 / Issue s1 / March 2019
- Published online by Cambridge University Press:
- 26 March 2019, pp. 92-93
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OBJECTIVES/SPECIFIC AIMS: Facilitate relationships and partnership development to address the opioid crisis in Detroit and Wayne County Contribute to real-time conversations on opioid epidemic policy and practice to identify and build consensus on research questions Apply findings from each learning community session to policy briefs to better inform policymakers, providers and consumers; and advocate for institutional responsiveness METHODS/STUDY POPULATION: The study population utilizes a purposive sampling approach to intentionally organize relationships and partnership development. For example, participants registered for the December 2018 session, “Detroit/Wayne County Opioid Crisis Learning Community Series: Data Session,” include representation from school-based health clinics, community and faith-based organizations, health systems, city and county level public health, addiction/recovery organizations, law enforcement, academia and citizens. The team feels this approach ensures and builds diverse, team science perspectives and regional collaboration. The Detroit Area Mental Health Leadership Team formed in 2015 at a retreat held by the University of Michigan’s Clinical and Translational Science Initiative attended by nearly 100 community-academic partners. Mental health, stigma and suicide were identified as community priorities by participants who attended the summit. A mental health workgroup formed and later expanded its membership to strengthen diverse perspectives. The team immediately designed and administered a survey amongst its partners creating the following priorities and focus: substance abuse interventions, healthcare access, and consumer awareness of mental health issues/available resources. Since data, policy and service are common threads to design interventions, the partnership decided to facilitate dialogue and discussion from the community on special topics related to the crisis, and share the community’s recommendations on how to address them. The learning community series was designed as a bi-lingual format for sharing and expression. Deliberative democracy encourages inclusion of voices, interests and opinions often not heard or included in decision-making processes; driving the project’s purposive sampling approach. Institutional responsiveness and advocacy for adoption of the community’s recommendations will occur through strategic policy briefs summarizing each learning community session and the entire series. A dissemination plan will be utilized to encourage the policy briefs reach appropriate audiences for capacity building and institutional responsiveness. The learning community series will provide 5 sessions on data (impacting adolescents, emerging adults, and 20-mid 30 year-old adults), recovery/law enforcement, prescribing, and marijuana. The session topics arose from earlier assessment conducted by the Detroit Area Mental Health Leadership Team. RESULTS/ANTICIPATED RESULTS: A response to the opioid crisis should address community priorities identified through data, research and community input. Community providers should have access to real-time data and research to develop appropriate interventions and institutional responsiveness. Equally important is the need for legislators and others impacting resource allocation to hear from the community on priorities they feel should be addressed, and to better understand the need for new types of data and information to drive service delivery, policy and resources to address the crisis. The learning community series will focus on describing the epidemic and building infrastructure to collaborate, and share data and information to strengthen advocacy and responsiveness to address the crisis. We feel this will enable more efficient programming to strengthen service delivery that captures life experiences from those who directly interface with individuals impacted by the crisis. DISCUSSION/SIGNIFICANCE OF IMPACT: There is limited knowledge and consensus on types of data and information to effectively describe the opioid crisis. For example, data and information connecting gateway drugs such as marijuana with more hardcore drugs (i.e., opioids and heroin) is not available; community-based providers have limited access to what research says about the crisis; and local public and community providers are dependent upon the state for surveillance data. Individuals dealing with addiction and recovery often need immediate attention. A gap in access to services exists depending on types of insurance. For example, Medicaid and some HMOs require an assessment before clients can seek treatment, resulting in uncompensated care among providers to immediately address patients need. Access to healthcare is a longstanding issue in medically underserved communities. The impact of the crisis varies geographically in communities and regions due to cultural and ethnic differences, yet data and information on these differences is not readily available. Cultural competency and sensitivity is often an issue in medically underserved areas because stakeholders may feel professionals providing services do not relate to them effectively. Finally, the community does not understand the economic impact of the crisis. These issues make it difficult for community advocates and providers to work with elected officials, providers and others on the opioid crisis because they do not have the data and informed required to effectively flush out a hypothesis and form solutions. Information captured in the learning community series (i.e., presentations by experts, facilitated discussion and personal testimony) will be summarized in a policy brief after each session and the entire series. Recommendations and priorities from the community will be shared with providers, policymakers, the business community, consumers and others to provide community input on problem solving approaches, new interventions, types of data not currently available that should be captured, and other important strategies and information to address the crisis. This information will also encourage designing research questions to guide developing new community engaged and community based participatory research to address the crisis. Finally, utilizing a purposive approach in participant recruitment will encourage partnership development from a team science and capacity building perspective.
2438 Community-based research networks: Providing infrastructure for clinical and translational research in the State of Michigan
- Meghan Spiroff, Patricia Piechowski, Karen D. Calhoun, Susan Goold, Ayse Buyuktur, Michael Klinkman, Elias M. Samuels, Zachary Rowe, Zachary Rowe, Friends of Parkside
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- Journal:
- Journal of Clinical and Translational Science / Volume 2 / Issue S1 / June 2018
- Published online by Cambridge University Press:
- 21 November 2018, pp. 65-66
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OBJECTIVES/SPECIFIC AIMS: As the sole Clinical and Translational Science Award (CTSA) site in Michigan, the Michigan Institute for Clinical & Health Research (MICHR) at the University of Michigan (UM) is working to develop community networks that drive clinical and translational research on community-identified health priorities. METHODS/STUDY POPULATION: These CBRNs will be modeled from successful work that has been accomplished in Jackson, MI where stakeholders from the local healthcare community, County Health Department, Health Improvement Organization, and grassroots community members created a Community of Solution to address the unmet behavioral health and social needs of community members. The CBRN’s will focus on identifying community health priorities by receiving input from community members in underserved communities using deliberative software called Choosing All Together (CHAT). RESULTS/ANTICIPATED RESULTS: In the fall of 2017, 3 focus groups were held in Northern Michigan to identify community health priorities. The top 5 community health priorities include; (1) mental wellness, (2) long-term illness, (3) alcohol and drugs, (4) air, water, and land, and (5) affording care. Additional focus groups are scheduled for the winter in 2 additional geographic areas. DISCUSSION/SIGNIFICANCE OF IMPACT: Future work for the creation of CBRNs includes building leadership groups comprised of clinicians, community leaders, public health leaders, health system leaders and researchers to inform the leadership groups of community-identified health priorities. In addition, the team is working to identify a platform to connect academic investigators across UM and community partners on shared research priorities in real time. In order to measure and map relationships within the networks, we are planning to utilize Social Network Analysis as an evaluation tool.
2447 Community voices first: A multi-method approach to shaping institutional response to Flint’s water crisis
- Karen D. Calhoun, Kent Key, E. Yvonne Lewis, Jennifer Carerra, Joseph Hamm, Susan Woolford, E. Hill De Loney, Ella Greene-Moten, Arlene Sparks, Don Vereen, Patricia Piechowski-Whitney, Kaneesha Wallace, Ismael Byers, Athena McKay, DeWaun Robinson, Jess Holzer, Vanessa De Danzine, Adam Paberzs, Meghan Spiroff, Erica Marsh
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- Journal:
- Journal of Clinical and Translational Science / Volume 2 / Issue S1 / June 2018
- Published online by Cambridge University Press:
- 21 November 2018, pp. 66-67
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OBJECTIVES/SPECIFIC AIMS: Explore perceptions of Flint stakeholders on the water crisis regarding trust and the capacity of faith and community-based organizations providing public health services to address community needs. Analyze the community’s voice shared at (1) 17 key community communications (community/congressional meetings and events), and (2) during 9 focus group sessions, in which residents, faith-based leadership and other stakeholders discuss issues and concerns on the Flint Water Crisis, and recommend ways to address them. Develop a framework that defines core theories, concepts and strategies recommended by the community to help rebuild trust and the quality of life in Flint, Michigan, and support other communities experiencing environmental stress. METHODS/STUDY POPULATION: Study population: faith-based leaders, seniors, youth, Hispanic/Latino and African American stakeholders, and others experiencing inequities in the city of Flint. Convene 9 focus group sessions (recorded and transcribed) to learn community perceptions on trust and ways to address it. Validate accuracy of the transcriptions with community consultants to reconcile any inaccurate information. Through a community engaged research (CEnR) process, review and analyze qualitative data from the 9 focus group sessions, and quantitative data from 2 surveys documenting (1) demographic backgrounds of focus group participants, and (2) their perceptions on trust and mistrust. Prepare a codebook to qualitatively analyze the focus group data summarizing community input on trust, mistrust, changes in service delivery among community and faith-based organizations, and ways to re-build trust in the city of Flint. Transcribe the community’s voice shared during 17 key events, identified by a team of community-academic stakeholders (i.e., UM Flint water course, congressional and community events, etc.), in which residents and other stakeholders discuss issues and concerns on the Flint Water Crisis, and recommend ways to address it. Qualitatively analyze the transcriptions, using a CEnR process to prepare a codebook on key themes from the community’s voice shared at these events, and recommendations on ways to address it. Compare and contrast findings between the two codebooks developed from (1) the focus group data and (2) qualitative analysis of community voice during public meetings and events. Synthesize this information into a framework of core theories, concepts and rebuilding strategies for Flint, Michigan. RESULTS/ANTICIPATED RESULTS: It is important to note many undocumented immigrant populations in Flint fear deportation and other consequences, hampering their ability to obtain service and provide community voice. Through our purposive sampling approach, we will hear from community voices not often included in narratives (i.e., seniors, youth, Hispanic/Latino residents). The presentation will present findings documenting levels of trust and mistrust in the city of Flint; and a framework of recommendations, core theories and concepts on ways to reduce, rebuild and eliminate stress that will be helpful to other communities experiencing distress. DISCUSSION/SIGNIFICANCE OF IMPACT: To our knowledge, levels of trust and mistrust in Flint have not been documented thus far. We will compare and contrast common themes presented by the community at public meetings and events with themes presented in our focus group effort on trust. Faith and community-based providers were among the first responders to the Flint Water Crisis. The effort will also share perceptions on changes in public health service delivery, and observations on preparedness for these roles that occurred among community and faith-based providers. Finally, the effort will (1) support the design of a research agenda, (2) define a framework of core theories, concepts and recommendations developed by the community to help rebuild trust in Flint, Michigan; and (3) support other communities addressing environmental distress.
Relational victimization, friendship, and adolescents' hypothalamic–pituitary–adrenal axis responses to an in vivo social stressor—ERRATUM
- Casey D. Calhoun, Sarah W. Helms, Nicole Heilbron, Karen D. Rudolph, Paul D. Hastings, Mitchell J. Prinstein
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- Development and Psychopathology / Volume 27 / Issue 3 / August 2015
- Published online by Cambridge University Press:
- 02 October 2014, pp. 945-946
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Relational victimization, friendship, and adolescents' hypothalamic–pituitary–adrenal axis responses to an in vivo social stressor
- Casey D. Calhoun, Sarah W. Helms, Nicole Heilbron, Karen D. Rudolph, Paul D. Hastings, Mitchell J. Prinstein
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- Development and Psychopathology / Volume 26 / Issue 3 / August 2014
- Published online by Cambridge University Press:
- 22 July 2014, pp. 605-618
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Adolescents' peer experiences may have significant associations with biological stress-response systems, adding to or reducing allostatic load. This study examined relational victimization as a unique contributor to reactive hypothalamic–pituitary–adrenal (HPA) axis responses as well as friendship quality and behavior as factors that may promote HPA recovery following a stressor. A total of 62 adolescents (ages 12–16; 73% female) presenting with a wide range of life stressors and adjustment difficulties completed survey measures of peer victimization and friendship quality. Cortisol samples were collected before and after a lab-based interpersonally themed social stressor task to provide measures of HPA baseline, reactivity, and recovery. Following the stressor task, adolescents discussed their performance with a close friend; observational coding yielded measures of friends' responsiveness. Adolescents also reported positive and negative friendship qualities. Results suggested that higher levels of adolescents' relational victimization were associated with blunted cortisol reactivity, even after controlling for physical forms of victimization and other known predictors of HPA functioning (i.e., life stress or depressive symptoms). Friendship qualities (i.e., low negative qualities) and specific friendship behaviors (i.e., high levels of responsiveness) contributed to greater HPA regulation; however, consistent with theories of rumination, high friend responsiveness in the context of high levels of positive friendship quality contributed to less cortisol recovery. Findings extend prior work on the importance of relational victimization and dyadic peer relations as unique and salient correlates of adaptation in adolescence.