@article{cramer_montanaro_vansickle_cacace_zabelski_smith_franks_grover_cunningham_2022, title={A psychometric assessment of the Military Suicide Attitudes Questionnaire (MSAQ)}, volume={317}, ISSN={["1872-7123"]}, url={https://doi.org/10.1016/j.psychres.2022.114849}, DOI={10.1016/j.psychres.2022.114849}, abstractNote={Suicide rates remain high among military populations. Stigmatizing beliefs about suicide contribute to the problem of heightened suicide risk as a deterrent for help-seeking. Measurement of military suicide stigma is therefore an important gap in the literature as a necessity toward the development of military suicide prevention programming. This paper assessed the factor structure, reliability, and validity of the Military Suicide Attitudes Questionnaire (MSAQ). Study 1 featured secondary analysis of a suicide risk dataset from active duty treatment-seeking military personnel (N = 200). Study 2 was a secondary analysis of a statewide assessment of Army National Guard service members' beliefs about mental health and suicide (N =1116). Factor analyses results collectively supported a four-factor Military Suicide Attitudes Questionnaire (MSAQ) structure: discomfort, unacceptability, support, and empathic views. Subscale reliabilities ranged from 0.77 to 0.83 across samples. Unacceptability and support displayed significant negative correlations with psychological distress. Men displayed more negative suicide-related beliefs compared to women counterparts. Discomfort and unacceptability beliefs displayed significant positive associations with perceived barriers to care. The final short version of the MSAQ is an efficient, multi-dimensional measure of military suicide-related beliefs. The instrument can be used for public health assessment and program evaluation in military settings.}, journal={PSYCHIATRY RESEARCH}, author={Cramer, Robert J. and Montanaro, Erika and VanSickle, Marcus and Cacace, Sam and Zabelski, Sasha and Smith, Emily L. and Franks, Michael and Grover, Shawna and Cunningham, Craig A.}, year={2022}, month={Nov} }
 @article{cacace_simons-rudolph_dubljevic_2022, title={Morality, Risk-Taking and Psychopathic Tendencies: An Empirical Study}, volume={13}, ISSN={["1664-1078"]}, DOI={10.3389/fpsyg.2022.834734}, abstractNote={Research in empirical moral psychology has consistently found negative correlations between morality and both risk-taking, as well as psychopathic tendencies. However, prior research did not sufficiently explore intervening or moderating factors. Additionally, prior measures of moral preference (e.g., sacrificial dilemmas) have a pronounced lack of ecological validity. This study seeks to address these two gaps in the literature. First, this study used Preference for Precepts Implied in Moral Theories (PPIMT), which offers a novel, more nuanced and ecologically valid measure of moral judgment. Second, the current study examined if risk taking moderates the relationships between psychopathic tendencies and moral judgment. Results indicated that models which incorporated risk-taking as a moderator between psychopathic tendencies and moral judgment were a better fit to the data than those that incorporated psychopathic tendencies and risk-taking as exogenous variables, suggesting that the association between psychopathic tendencies and moral judgment is influenced by level of risk-taking. Therefore, future research investigating linkages between psychopathic tendencies and moral precepts may do well to incorporate risk-taking and risky behaviors to further strengthen the understanding of moral judgment in these individuals.}, journal={FRONTIERS IN PSYCHOLOGY}, author={Cacace, Sam and Simons-Rudolph, Joseph and Dubljevic, Veljko}, year={2022}, month={Mar} }
 @article{cacace_smith_desmarais_alders_2022, title={Locale Matters: Regional Needs of U.S. Military Service Members and Veterans}, volume={10}, url={https://doi.org/10.1080/21635781.2021.1990813}, DOI={10.1080/21635781.2021.1990813}, abstractNote={Abstract Military service members (MSM) and veterans make up nearly 10% of the U.S. population. They face unique challenges and require unique assistance related to community services and resources. However, little has been done to determine the specific needs within this population, particularly with regard to “locale” or “geographically-specific” military population needs. This study used a mixed-methods approach to investigate geographically-specific needs in the MSM and veteran populations residing in one southeastern state, collecting both qualitative focus group data and secondary quantitative data. The qualitative data was gathered from focus groups (15 veterans and leaders from military-service organizations) and the quantitative data was gathered from client requests from a regional network of military and veteran-serving organizations (N = 4,328). Thematic analysis of focus group transcripts shows, from the organizational side, a lack of availability, understanding, education, and advertising of resources. The client call data showed that MSM and veterans who live in higher population locales were more likely to experience longer wait times to achieve needs resolution when compared to the smaller locale group (β = 0.0000606, t(4,226) = 14.49, p < .0001, R2 = 0.047). Follow-up investigations should examine the importance of regional differences in professional branding and information dissemination practices maintained by organizations serving the MSM and veteran populations in this locale, with the goal of finding how to communicate more effectively and efficiently with their target audience(s). These future efforts should include comparing data with other regions and national data sets to further understand locale specific needs.}, journal={Military Behavioral Health}, publisher={Informa UK Limited}, author={Cacace, Sam and Smith, Emily and Desmarais, Sarah and Alders, Elizabeth}, year={2022}, month={Jul}, pages={1–14} }
 @article{cacace_smith_cramer_meca_desmarais_2021, title={Military self-stigma as a mediator of the link between military identity and suicide risk}, volume={34}, ISSN={["1532-7876"]}, url={https://doi.org/10.1080/08995605.2021.1994329}, DOI={10.1080/08995605.2021.1994329}, abstractNote={ABSTRACT US military Veterans are at greater risk for suicide than those who have never served in the US military. Recent federal calls include the need to investigate military-specific suicide risk and protective factors among military-affiliated populations. To date, no study has examined the link between military identity, self-stigma, and suicide risk. The current study used a nationally representative sample of post-Vietnam US military Veterans (N = 1,461) in order to determine relationships between military identity, self-stigma, and suicide risk. Idealism (OR = 0.86) with less odds of elevated suicide risk, whereas individualism (OR = 1.15) and military self-stigma (OR = 1.39) were associated with increased odds of elevated suicide risk. Military self-stigma was found to mediate the relationship between military identity components and suicide risk. Implications for conceptualization of military Veteran identity, suicide prevention, and future research are discussed.}, number={2}, journal={MILITARY PSYCHOLOGY}, publisher={Informa UK Limited}, author={Cacace, Sam and Smith, Emily J. and Cramer, Robert J. and Meca, Alan and Desmarais, Sarah L.}, year={2021}, month={Dec} }
 @article{v. volpe_schorpp_cacace_benson_banos_2021, title={State- and Provider-Level Racism and Health Care in the US}, volume={61}, ISSN={["1873-2607"]}, url={http://www.scopus.com/inward/record.url?eid=2-s2.0-85111904550&partnerID=MN8TOARS}, DOI={10.1016/j.amepre.2021.03.008}, abstractNote={Introduction This study examines the associations between state-level and provider sources of racism and healthcare access and quality for non-Hispanic Black and White individuals. Methods Data from 2 sources were integrated: (1) data from the Association of American Medical Colleges’ Consumer Survey of Health Care Access (2014–2019), which included measures of self-reported healthcare access, healthcare quality, and provider racial discrimination and (2) administrative data compiled to index state-level racism. State-level racism composite scores were calculated from federal sources (U.S. Census, Department of Labor, Department of Justice). The data set comprised 21,030 adults (n=2,110 Black, n=18,920 White) who needed care within the past year. Participants were recruited from a national panel, and the survey employed age–insurance quotas. Logistic and linear regressions were conducted in 2020, adjusting for demographic, geographic, and health-related covariates. Results Among White individuals, more state-level racism was associated with 5% higher odds of being able to get care and 6% higher odds of sufficient time with provider. Among Black individuals, more state-level racism was associated with 8% lower odds of being able to get care. Provider racial discrimination was also associated with 80% lower odds of provider explaining care, 77% lower odds of provider answering questions, and 68% lower odds of sufficient time with provider. Conclusions State-level racism may engender benefits to healthcare access and quality for White individuals and may decrease access for Black individuals. Disparities may be driven by both White advantage and Black disadvantage. State-level policies may be the actionable levers of healthcare inequities with implications for preventive medicine.}, number={3}, journal={AMERICAN JOURNAL OF PREVENTIVE MEDICINE}, author={V. Volpe, Vanessa and Schorpp, Kristen M. and Cacace, Sam C. and Benson, G. Perusi and Banos, Noely C.}, year={2021}, month={Sep}, pages={338–347} }
 @article{dubljevic_cacace_desmarais_2022, title={Surveying Ethics: a Measurement Model of Preference for Precepts Implied in Moral Theories (PPIMT)}, volume={13}, ISSN={["1878-5166"]}, url={https://doi.org/10.1007/s13164-021-00530-z}, DOI={10.1007/s13164-021-00530-z}, number={1}, journal={REVIEW OF PHILOSOPHY AND PSYCHOLOGY}, author={Dubljevic, Veljko and Cacace, Sam and Desmarais, Sarah L.}, year={2022}, month={Mar}, pages={197–214} }
 @article{cacace_2020, title={Be all that you can be: Building a cohesive model for military identity in early-career and veteran U.S. military service members}, volume={7}, ISSN={2375-8899}, number={1}, journal={Journal of Behavioral and Social Sciences}, author={Cacace, S.C.}, year={2020}, pages={12–22} }
 @book{desmarais_cacace_smith_eckard-allen_preisler_hope_wade_bradford_2020, place={Raleigh, NC}, title={NC Child Welfare Family Leadership Model: SFY 2020 process and impact evaluation report}, journal={Annual evaluation report prepared for the Division of Social Services}, institution={NC Department of Health and Human Services}, author={Desmarais, S.L. and Cacace, S.C. and Smith, E.L. and Eckard-Allen, K.R. and Preisler, J.J. and Hope, E. and Wade, C.E. and Bradford, K.L.}, year={2020}, month={May} }
 @article{evans_widman_javidi_adams_cacace_prinstein_desmarais_2020, title={Preliminary Evaluation of a Prescription Opioid Misuse Prevention Program Among Rural Middle School Students}, volume={45}, ISSN={0094-5145 1573-3610}, url={http://dx.doi.org/10.1007/s10900-020-00899-5}, DOI={10.1007/s10900-020-00899-5}, abstractNote={Adolescent opioid misuse, addiction, and overdose have emerged as national health crises. Nearly 17% of high school students have misused prescription opioids. The purpose of this study was to evaluate the reach and acceptability of a widely-used prescription opioid misuse prevention program, This Is (Not) About Drugs© (TINAD), and its preliminary efficacy at improving opioid misuse knowledge, opioid misuse attitudes, self-efficacy to avoid opioid misuse, and intentions to misuse opioids. Participants were 576 7th grade students (Mage = 11.8; 51% boys; 39% Hispanic, 31% White, 20% Black) from a rural county in the southeastern U.S. All participants received the TINAD program and completed pretest and immediate posttest assessments. The program was school-based and implemented in collaboration with school teachers and administrators. Over 91% of all eligible students in the school district participated in the TINAD program. Most participants found the program acceptable-over 83% of students liked the program. Approximately 9% of participants reported prior misuse of prescription opioids. After participating in TINAD, students self-reported higher knowledge and self-efficacy as well as safer attitudes. However, there was no change in intentions to misuse opioids in the future. Effects of the program were consistent across gender, socioeconomic status, race/ethnicity, and previous opioid misuse. TINAD is acceptable and shows promise for improving opioid-related cognitions. However, more rigorous experimental and longitudinal research is needed to understand whether TINAD reduces opioid misuse over time. Given the limited research on adolescent opioid misuse prevention, this study lays the ground work for future randomized control trials.}, number={6}, journal={Journal of Community Health}, publisher={Springer Science and Business Media LLC}, author={Evans, Reina and Widman, Laura and Javidi, Hannah and Adams, Elizabeth Troutman and Cacace, Sam and Prinstein, Mitchell J. and Desmarais, Sarah L.}, year={2020}, month={Aug}, pages={1139–1148} }
 @article{cunningham_cramer_cacace_franks_desmarais_2020, title={The Coping Self-Efficacy Scale: Psychometric properties in an outpatient sample of active duty military personnel}, volume={32}, ISSN={0899-5605 1532-7876}, url={http://dx.doi.org/10.1080/08995605.2020.1730683}, DOI={10.1080/08995605.2020.1730683}, abstractNote={ABSTRACT Active duty military service members endure a unique constellation of stressors while deployed or at home. Yet, assessment of protective factors against these stressors among active duty service members represents an under studied area. The present study advances the assessment of protective factors through the psychometric evaluation of the Coping Self-Efficacy Scale (CSES) in a clinical sample of military service members in mental health or substance abuse treatment (n = 200). Cross-sectional data were drawn from military medical records and a supplemental self-report questionnaire. Data extracted included demographic (e.g., sex, age), military characteristics (e.g., rank, years in service), physical health and mental health (e.g., anxiety, depression), and coping self-efficacy. Findings suggest a 3-factor (i.e., problem-focused coping, thought-stopping, and getting social support) CSES structure with acceptable internal consistency. Further, there were small-to-moderate associations with physical and mental health outcomes, providing evidence of construct validity. There were few significant associations with military-related characteristics. Finally, controlling for covariates, thought-stopping beliefs explained unique variance in suicide-related behaviors. Together, findings support the use of the CSES to measure coping-related beliefs in military service members. Recommendations are offered for future research and practice with active duty service members.}, number={3}, journal={Military Psychology}, publisher={Informa UK Limited}, author={Cunningham, Craig A. and Cramer, Robert J. and Cacace, Sam and Franks, Michael and Desmarais, Sarah L.}, year={2020}, month={Mar}, pages={261–272} }