Assessing the social determinants of health care costs for Medicaid-enrolled adolescents in Washington State using administrative data.

Objective: The study used administrative data to identify the social determinants that have the greatest impact on Medicaid expenditures in adolescence.

Data Sources: Data were compiled using the Washington State Department of Social and Health Services Integrated Client Databases, which link data from state systems including Medicaid claims and social services receipt.

Study Design: Medical system and behavioral health service costs of over 180 000 Medicaid-enrolled adolescents aged 12-17 were measured using integrated administrative data from Washington State.

Using State Administrative Data to Identify Social Complexity Risk Factors for Children.

Purpose: Screening for social determinants of health is challenging but critically important for optimizing child health outcomes. We aimed to test the feasibility of using an integrated state agency administrative database to identify social complexity risk factors and examined their relationship to emergency department (ED) use.

Methods: We conducted a retrospective cohort study among children younger than 18 years with Washington State Medicaid insurance coverage (N = 505,367).

Childhood adversity and behavioral health outcomes for youth: An investigation using state administrative data.

This study aimed to measure the relative contribution of adverse experiences to adolescent behavioral health problems using administrative data. Specifically, we sought to understand the predictive value of adverse experiences on the presence of mental health and substance abuse problems for youth receiving publicly funded social and health services. Medicaid claims and other service records were analyzed for 125,123 youth age 12-17 and their biological parents.

Impact of sexual orientation and co-occurring disorders on chemical dependency treatment outcomes.

Objective: The aims of this study were to compare client characteristics at admission to chemical dependency (CD) treatment by sexual orientation, examine sexual orientation as a predictor of co-occurring CD and mental health problems (hereafter referred to as co-occurring disorders [COD]), and to examine the effect of sexual orientation and COD on 1-year CD treatment outcomes (treatment completion, treatment reentry, and arrest) among men and women.

Method: This retrospective cohort study used 2004-2008 data from publicly funded CD treatment programs in Washington State (n = 69,525 clients). Bivariate comparisons were made using chi-square tests; logistic and Cox regressions were to estimate risk in multivariate analyses.

The impact of reported direct and indirect killing on mental health symptoms in Iraq war veterans.

This study examined the mental health impact of reported direct and indirect killing among 2,797 U.S. soldiers returning from Operation Iraqi Freedom.

History and implementation of the Fort Lewis Soldier Wellness Assessment Program (SWAP).

The Department of Defense mandates a health reassessment at 90 to 180 days following return from deployment. Essential components include a review of mental and physical health symptoms and follow-up referral. Fort Lewis developed a program that exceeds these basic requirements to provide additional screening and on-site services, including face-to-face visits with a credentialed mental health provider for all soldiers.

Impact of Access to Recovery services on alcohol/drug treatment outcomes.

The purpose of this study was to assess the impact of providing recovery support services to clients receiving publicly funded chemical dependency (CD) treatment through the Access to Recovery (ATR) Program in Washington State. Services included case management, transportation, housing, and medical. A comparison group composed of clients who received CD treatment only was constructed using a multistep procedure based on propensity scores and exact matching on specific variables.

Screening soldiers in outpatient care for mental health concerns.

Significant recent effort has been directed toward screening and describing military populations in relation to deployment. Missing from these recent efforts is information describing screened mental health symptoms for the population of active duty military that are seen for mental health services. This article presents mental health screening data for 2,882 soldiers seeking services at a military facility outpatient behavioral health clinic.

Relative impact of adverse events and screened symptoms of posttraumatic stress disorder and depression among active duty soldiers seeking mental health care.

Symptoms of depression and posttraumatic stress are among the most studied psychological difficulties among soldiers. Such symptoms have been linked to a history of adverse events among both civilians and combat veterans. There is a paucity of research on this topic that can be applied to an active duty clinical population.

Negative Affect and HIV Risk in Alcohol and Other Drug (AOD) Abusing Adolescent Offenders.

Various depressive symptoms have been linked to elevated levels of HIV risk across diverse adult populations in multiple studies. However, this link has been examined in a much more limited manner among adolescents, despite an exceedingly heightened risk of both HIV and negative affect in this age group. To address the current lack of clinically pertinent knowledge in this area, we analyzed baseline data from 256 male and 107 female inner city, culturally diverse adolescent offenders.

Audio-CASI vs interview method of administration of an HIV/STD risk of exposure screening instrument for teenagers.

Previous research conducted to examine the implications of using audio-computerized (A-CASI) procedures to gather sensitive sexual behaviour data has provided mixed results. The purpose of this study was to assess differences in the disclosure of HIV risk behaviours between subjects interviewed face to face and subjects interviewed using A-CASI procedures. An HIV/STD risk of exposure screening instrument was administered to 265 male and female adolescents in the juvenile justice system.

Impulsivity and HIV risk among adjudicated alcohol- and other drug-abusing adolescent offenders.

Although impulsivity is likely to be related to HIV risk--particularly in incarcerated substance-abusing youth--this area of research has been understudied. To investigate the relationship between impulsivity and various HIV/AIDS risk behaviors and attitudes, a sample of court-referred and incarcerated culturally diverse inner-city adolescents (males: N = 266; females: N = 111) were divided into high and low impulsive groups based on the Millon Adolescent Clinical Inventory Impulsivity Scale. Findings showed that compared to the less impulsive group, the highly impulsive adolescents reported more frequent marijuana and alcohol use in the last 3 months as well as a significantly higher proportion of unprotected sex when high on alcohol and marijuana, higher perceived susceptibility to HIV, more AIDS-related anxiety, greater HIV knowledge, less sexual self-efficacy, and less favorable sexual attitudes.