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Purpose – The purpose of this chapter is to provide a comprehensive overview of the substance use disparities among American Indian/Alaska Native (AI/AN) youth, the contributing factors to these disparities, proven and promising approaches through strengths-based methods, barriers to implementation of prevention and treatment efforts, and future recommendations for effective programs and research.

Approach – We have conducted a thorough literature review of relevant research studies, as well as a review of government, tribal, and community-based curricula and resources. This review of programs is not exhaustive but provides several examples of best practices in the field and suggestions for future directions.

Social implications – We strongly advocate that to accurately explore the true etiology of substance abuse and to respond to the concerns that AI/AN have prioritized, it is necessary to utilize a strengths-based approach and draw upon traditional AI/AN perspectives and values, and active community participation in the process. More specifically, prevention and treatment programs should use methods that incorporate elders or intergenerational approaches; foster individual and family skills-building; promote traditional healing methods to recognize and treat historical, cultural, and intergenerational and personal trauma; focus on early intervention; and tailor efforts to each Native nation or community.

Value – Ultimately, to reduce substance abuse disparities in AI/AN youth, we must find better ways to merge traditional Native practices with western behavioral health to ensure cultural competency, as well as to develop mechanisms to effect system- and policy-level changes that reduce barriers to care and promote the well-being of AI/AN youth, families, and communities.

Purpose: In the current work, we provide a portrait of heavy alcohol use, cigarette smoking, mental health, and suicide ideation by sexual orientation among a large sample of US adults aged 25 years and older.

Design/methodology/approach: We produce a repository of information on sexual orientation, substance use, mental well-being, and suicide ideation for adults aged 25 years and older using Behavioral Risk Factor Surveillance System (BRFSS) surveys for nine US states from 2011 to 2018. We establish baseline differences on these outcomes for gay, lesbian, and bisexual (GLB), relative to heterosexual, adults and then use regression techniques to adjust the estimates for important sociodemographic, socioeconomic, and relationship status variables.

Findings: Disparities by sexual orientation across substance use, mental health, and suicide ideation are concerning, some alarmingly so. Bisexuals, particularly women, face pronounced challenges across outcomes. Sexual minority men and women report significantly more poor mental health days and much higher odds of suicide ideation. To illustrate, gay men, lesbians, and bisexual men and women, relative to their heterosexual counterparts, have odds of seriously contemplating taking their own lives that are two to four times higher even after adjusting for relevant controls.

Originality/value: Existing knowledge connecting GLB identity and mental well-being has focused largely on adolescent and young adults. We provide a representative study on older adult differences across four different behavioral health outcomes by sexual orientation. The scale of the disparities we report here, and their implications for overall well-being across groups, deserves national attention and action.

This is the second in a series of papers focused on alcohol and substance abuse rehabilitation centers. Centers face the ongoing challenge of validating outcomes to meet the burden of evidence for insurance companies. In the first paper, data mining was used to establish baseline patterns in treatment success rates, for the Futures: Palm Beach Rehabilitation Center, that have a direct impact on a client’s ability to receive insurance coverage for treatment programs. In this paper, we examine 2016 outcomes and report on facility efficacy, alumni progression and sobriety, and forecast treatment success rates (short and long term) in support of client insurability. Data collection has been standardized and includes admissions data, electronic medical records data, satisfaction survey data, post-discharge survey data, Centers for Disease Control (CDC) data, and demographic data. Clustering, partitioning, ANOVA, stepwise regression and stepwise Logistic regression are applied to the data to determine statistically significant drivers of treatment success.

Students with emotional and behavioral disorders (EBD) who display aggression necessitate effective interventions for reducing highly disruptive behavior, while keeping learning environments safe and secure for all students and staff. In this chapter, we describe the merits of cognitive-behavioral interventions (CBIs) in school settings to reduce student aggression and other destructive and maladaptive behavior and to promote student success and lifelong learning. To that end, we first explore three theoretical frameworks for aggression: the general aggression model, social learning theory, and social information processing, each of which examines the role of environment, cognition, and behavior as foundational to the occurrence of aggression. Synthesizing these theories assists in the development and implementation of CBIs in classroom settings. We then describe the CBI approach to teaching students cognitive and behavioral strategies to reduce problematic behaviors and increase the use of more pro-social alternatives, and ultimately generalize learned skills to a variety of social situations. A brief history of CBIs is explored, followed by a discussion of several meta-analyses establishing CBI's effectiveness in decreasing aggression across a variety of venues and populations. We then focus on social problem solving as an example of a cognitive-behavioral approach and describe the Tools for Getting Along curriculum as an example of a school-based CBI. At the end of the chapter, we explain some limitations of CBIs in schools and delineate future research needs.

The COVID-19 crisis has jolted the hotel landscape profoundly and sector's usual resistance to innovative efforts is gone. Ecologically innovative (green) hotels are now expected to set the benchmark in protecting the environment and mitigating human health hazards. The need for this study stems from the fact that eco-innovative (green) hotels need not only be established and promoted, but also accepted or adopted by guests. Existing studies have mostly relied on customer's pro-environmental attitude, knowledge, and a selective list of green hotel attributes in order to predict green hotel visit intentions. The objective of this study is to provide a comprehensive list of environmental and human health attributes that are likely to influence guest's decision to visit a green hotel. One of the first studies to utilize the diffusion of innovation (DOI) theory in sustainable hospitality research, this qualitative study identifies 27 key green hotel's perceived attributes. Examining the guest's expected green hotel attributes would help managers make their green efforts more effective and attract potential guests who have not yet stayed at green hotels.

Purpose – Reality TV shows that feature embodied “transformations” are popular, including Intervention, a program that depicts therapeutic recovery from addiction to “health.” The purpose of this chapter is to address the ways whiteness constitutes narratives of addiction on Intervention.

Methodology – This analysis uses a mixed methodology. I conducted a systematic analysis of nine (9) seasons of one hundred and forty-seven (147) episodes featuring one hundred and fifty-seven individual “addicts” (157) and logged details, including race and gender. For the qualitative analysis, I watched each episode more than once (some, I watched several times) and took extensive notes on each episode.

Findings – The majority of characters (87%) are white, and the audience is invited to gaze through a white lens that tells a particular kind of story about addiction. The therapeutic model valorized by Intervention rests on neoliberal regimes of self-sufficient citizenship that compel us all toward “health” and becoming “productive” citizens. Such regimes presume whiteness. Failure to comply with an intervention becomes a “tragedy” of wasted whiteness. When talk of racism erupts, producers work to re-frame it in ways that erase systemic racism.

Social implications – The whiteness embedded in Intervention serves to justify and reinforce the punitive regimes of controlling African American and Latina/o drug users through the criminal justice system while controlling white drug users through self-disciplining therapeutic regimes of rehab.

Originality – Systematic studies of media content consistently find a connection between media representations of addiction and narratives about race, yet whiteness has rarely been the critical focus of addiction.

Since its resurrection during the 1980s, comparative-historical sociology has been repeatedly critiqued on two fronts. Quantitative methodologists have argued that its “causal inferences” are unreliable due to its “small n.” And methodological individualists have argued its explanatory accounts are unacceptable because they do not specify “microfoundations.” But these critiques are built on faulty foundations, namely, a regularity theory of causation and a reductionist social ontology. In this article, I propose an alternative foundation derived from Critical Realism: a production theory of causation and an emergentist account of social structure.