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LaRose JG, Gorin AA, Garcia K, Hayes JF, Tate DF, Espeland MA, Lewis CE, Perdue L, Robichaud E, Hatley K, Wing RR. Life events and stress among young adults in weight gain prevention trial. Health Psychol 2023; 42:314-324. [PMID: 37141017 PMCID: PMC10167549 DOI: 10.1037/hea0001282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Young adults (YAs) are at high risk for weight gain and show high variability in treatment response. Life events and high perceived stress are common in YAs and could drive less favorable outcomes. The goal was to examine whether life events and stress were related to program engagement and weight outcomes in a weight gain prevention trial for YAs. METHOD Secondary analysis from the Study of Novel Approaches to Weight Gain Prevention (SNAP), a randomized clinical trial (N = 599, 18-35 years, BMI 21-30 kg/m²). Both intervention arms received 10 in-person sessions over 4 months, with long-term contact via web and SMS. Participants completed the CARDIA life events survey and Cohen Perceived Stress Scale-4 at 0 and 4 months; weight was objectively measured at 0, 4 months, and 1, 2, 3, and 4 years. RESULTS Participants who experienced more life events prior to study entry had lower session attendance (p < .01) and retention (p < .01), although no differences in weight outcomes were observed (p = .39). Baseline perceived stress followed a similar pattern. Participants who experienced more life events and higher perceived stress during the initial in-person program (0-4 months) appeared to experience less favorable weight outcomes long-term (p = .05 for life events, p = .04 for stress). Very few associations differed by treatment arm. CONCLUSIONS Experiencing more life events and stress was negatively associated with program engagement and may impair long-term weight outcomes for YAs. Future work should consider identifying YAs at highest risk and tailoring interventions to better meet their needs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Jacqueline F. Hayes
- Weight Control and Diabetes Research Center at the Miriam Hospital
- Alpert Medical School of Brown University
| | - Deborah F. Tate
- University of North Carolina at Chapel Hill
- UNC Lineberger Comprehensive Cancer Center
| | | | | | | | - Erica Robichaud
- Weight Control and Diabetes Research Center at the Miriam Hospital
| | | | - Rena R. Wing
- Weight Control and Diabetes Research Center at the Miriam Hospital
- Alpert Medical School of Brown University
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Self-control or Flourishing? A Thematic Analysis of Experiences of Alcohol Users of the Rediscovery Process. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-021-00520-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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3
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Young AM, Lancaster KE, Bielavitz S, Elman MR, Cook RR, Leichtling G, Freeman E, Estadt AT, Brown M, Alexander R, Barrie C, Conn K, Elzaghal R, Maybrier L, McDowell R, Neal C, Lapidus J, Waddell EN, Korthuis PT. Peer-based Retention Of people who Use Drugs in Rural Research (PROUD-R 2): a multisite, randomised, 12-month trial to compare efficacy of standard versus peer-based approaches to retain rural people who use drugs in research. BMJ Open 2022; 12:e064400. [PMID: 35705346 PMCID: PMC9204453 DOI: 10.1136/bmjopen-2022-064400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 06/01/2022] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Rural communities bear a disproportionate share of the opioid and methamphetamine use disorder epidemics. Yet, rural people who use drugs (PWUD) are rarely included in trials testing new drug use prevention and treatment strategies. Numerous barriers impede rural PWUD trial engagement and advancing research methods to better retain rural PWUD in clinical trials is needed. This paper describes the Peer-based Retention Of people who Use Drugs in Rural Research (PROUD-R2) study protocol to test the effectiveness of a peer-driven intervention to improve study retention among rural PWUD. METHODS AND ANALYSIS The PROUD-R2 study is being implemented in 21 rural counties in three states (Kentucky, Ohio and Oregon). People who are 18 years or older, reside in the study area and either used opioids or injected any drug to get high in the past 30 days are eligible for study inclusion. Participants are allocated in a 1:1 ratio to two arms, stratified by site to assure balance at each geographical location. The trial compares the effectiveness of two retention strategies. Participants randomised to the control arm provide detailed contact information and receive standard retention outreach by study staff (ie, contacts for locator information updates, appointment reminders). Participants randomised to the intervention arm are asked to recruit a 'study buddy' in addition to receiving standard retention outreach. Study buddies are invited to participate in a video training and instructed to remind their intervention participant of follow-up appointments and encourage retention. Assessments are completed by intervention, control and study buddy participants at 6 and 12 months after enrolment. ETHICS AND DISSEMINATION The protocol was approved by a central Institutional Review Board (University of Utah). Results of the study will be disseminated in academic conferences and peer-reviewed journals, online and print media, and in meetings with community stakeholders. TRIAL REGISTRATION NUMBER NCT03885024.
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Affiliation(s)
- April M Young
- Epidemiology, University of Kentucky, Lexington, Kentucky, USA
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky, USA
| | - Kathryn E Lancaster
- Division of Epidemiology, Ohio State University College of Public Health, Columbus, Ohio, USA
| | | | - Miriam R Elman
- Oregon Health & Science University, Portland, Oregon, USA
| | - Ryan R Cook
- Oregon Health & Science University, Portland, Oregon, USA
| | | | - Edward Freeman
- Department of Epidemiology, University of Kentucky, Lexington, Kentucky, USA
| | | | | | - Rhonda Alexander
- Department of Epidemiology, University of Kentucky, Lexington, Kentucky, USA
| | - Caiti Barrie
- Oregon Health & Science University, Portland, Oregon, USA
| | - Kandi Conn
- Department of Epidemiology, University of Kentucky, Lexington, Kentucky, USA
| | - Rhody Elzaghal
- Oregon Health & Science University, Portland, Oregon, USA
| | - Lisa Maybrier
- Department of Epidemiology, University of Kentucky, Lexington, Kentucky, USA
| | | | - Cathy Neal
- The Ohio State University, Columbus, Ohio, USA
| | - Jodi Lapidus
- Oregon Health & Science University, Portland, Oregon, USA
| | - Elizabeth N Waddell
- OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, Oregon, USA
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Jake-Schoffman DE, Brown SD, Baiocchi M, Bibeau JL, Daubenmier J, Ferrara A, Galarce MN, Hartogensis W, Hecht FM, Hedderson MM, Moran PJ, Pagoto SL, Tsai AL, Waring ME, Kiernan M. Methods-Motivational Interviewing Approach for Enhanced Retention and Attendance. Am J Prev Med 2021; 61:606-617. [PMID: 34544560 PMCID: PMC9302384 DOI: 10.1016/j.amepre.2021.04.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 03/15/2021] [Accepted: 04/02/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Suboptimal and differential participant engagement in randomized trials-including retention at primary outcome assessments and attendance at intervention sessions-undermines rigor, internal validity, and trial conclusions. METHODS First, this study describes Methods-Motivational Interviewing approach and strategies for implementation. This approach engages potential participants before randomization through interactive, prerequisite orientation sessions that illustrate the scientific rationale behind trial methods in accessible language and use motivational interviewing to diffuse ambivalence about participation. Then, this study examines the potential improvements in retention (proportion of participants assessed at follow-up visits) and attendance (e.g., mean percentage of intervention sessions attended, percentage of participants who attended 0 sessions) in 3 randomized weight-management trials that quickly added prerequisite orientations to their protocols following early signs of suboptimal or differential participant engagement (Supporting Health by Integrating Nutrition and Exercise [2009-2013, n=194]; Get Social [2016-2020, n=217]; GestationaL Weight Gain and Optimal Wellness [2014-2018, n=389]). Using a pre-post analytical design, adjusted estimates from regression models controlling for condition and assessment timepoint (analyses from 2020) are reported. RESULTS After adding prerequisite orientations, all 3 trials attained higher participant engagement. Retention at assessments was 11.4% and 17.3% higher (Get Social and Supporting Health by Integrating Nutrition and Exercise, respectively). Mean percentage of attendance at intervention sessions was 8.8% higher (GestationaL Weight Gain and Optimal Wellness), and 10.1% fewer participants attended 0 intervention sessions (Get Social). Descriptively, all the remaining retention and attendance outcomes were consistently higher but were nonsignificant. Across the trials, adding prerequisite orientations did not impact the proportion of eligible participants enrolled or the baseline demographics. CONCLUSIONS The Methods-Motivational Interviewing approach shows promise for increasing the rigor of randomized trials and is readily adaptable to in-person, webinar, and conference call formats. TRIAL REGISTRATION All 3 trials are registered at www.clinicaltrials.gov (Supporting Health by Integrating Nutrition and Exercise: NCT00960414; Get Social: NCT02646618; and GestationaL Weight Gain and Optimal Wellness: NCT02130232).
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Affiliation(s)
- Danielle E Jake-Schoffman
- Department of Health Education & Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida.
| | - Susan D Brown
- Division of Research, Kaiser Permanente Northern California, Oakland, California; Department of Internal Medicine, University of California, Davis, Sacramento, California
| | - Michael Baiocchi
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, California
| | - Jessica L Bibeau
- Department of Allied Health Sciences, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, Connecticut
| | - Jennifer Daubenmier
- The Institute for Holistic Health Studies, San Francisco State University, San Francisco, California
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Maren N Galarce
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Wendy Hartogensis
- UCSF Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California
| | - Frederick M Hecht
- UCSF Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California
| | - Monique M Hedderson
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Patricia J Moran
- UCSF Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California
| | - Sherry L Pagoto
- Department of Allied Health Sciences, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, Connecticut
| | - Ai-Lin Tsai
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Molly E Waring
- Department of Allied Health Sciences, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, Connecticut
| | - Michaela Kiernan
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California
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Greer TL, Walker R, Rethorst CD, Northrup TF, Warden D, Horigian VE, Silverstein M, Shores-Wilson K, Stotts AL, Trivedi MH. Identifying and responding to trial implementation challenges during multisite clinical trials. J Subst Abuse Treat 2020; 112S:63-72. [PMID: 32220413 PMCID: PMC9746284 DOI: 10.1016/j.jsat.2020.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/31/2020] [Accepted: 02/08/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The National Drug Abuse Treatment Clinical Trials Network (CTN) was initiated by the National Institute on Drug Abuse (NIDA) in 2000 with the aim of improving substance use treatment and reducing the time between the discovery of effective treatments and their implementation into clinical practice. While initial trials were conducted almost exclusively in specialty addiction treatment settings, the CTN began evolving strategically in 2010 to conduct research in general medical settings, including healthcare systems, primary care settings, emergency departments, and pharmacies, to broaden impact. The advantages of a research network like the CTN is not only the collective content expertise that investigators contribute to the network, but the collective experience gained by conducting studies in the network and then applying those lessons to future studies. OBJECTIVE To summarize trial implementation challenges encountered, and the process by which solutions were identified and implemented, within one of the last early-phase CTN Stage II behavioral intervention studies conducted in a specialty addiction treatment setting. METHOD AND RESULTS We describe the implementation of the CTN-0037 STimulant Reduction Intervention using Dosed Exercise (STRIDE) trial. Issues encountered during study implementation are categorized into four major areas, described in terms useful to future study teams: 1) study team infrastructure challenges, 2) participant- and site- level challenges, 3) intervention-related challenges, and 4) longitudinal study design challenges. Potential consequences of identified problems and the solutions developed to manage these problems are discussed within the context of these four areas. We propose how to extend these implementation lessons and apply them in other healthcare settings to expand the CTN. CONCLUSIONS Effective study management allows for flexible, collaborative solutions to expected and unexpected obstacles to study success. Implementation strategies derived from the first 15 to 20 years of CTN studies are a result of working with providers and participants, and the ongoing collaboration among CTN investigators and network staff. Timely identification and response to problems during study implementation are critical to the success of a trial, regardless of its design. We believe a collaborative approach to identifying and responding to study implementation challenges will increase the likelihood of successful adoption of relevant, efficacious interventions. As the CTN continues to expand, the wealth of successful trial implementation strategies developed during the first 20 years of the CTN need to be applied and adapted to studies in broader network settings, and considered in conjunction with more formalized implementation science processes that are currently available.
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Affiliation(s)
- Tracy L. Greer
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute, The University of Texas Southwestern Medical Center, Dallas, Texas, 75390-9119, USA
| | - Robrina Walker
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute, The University of Texas Southwestern Medical Center, Dallas, Texas, 75390-9119, USA
| | - Chad D. Rethorst
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute, The University of Texas Southwestern Medical Center, Dallas, Texas, 75390-9119, USA
| | - Thomas F. Northrup
- Department of Family and Community Medicine, University of Texas Medical School at Houston, Houston, Texas, 77030, USA
| | - Diane Warden
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute, The University of Texas Southwestern Medical Center, Dallas, Texas, 75390-9119, USA
| | - Viviana E. Horigian
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, Florida, 33136, USA
| | | | - Kathy Shores-Wilson
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute, The University of Texas Southwestern Medical Center, Dallas, Texas, 75390-9119, USA
| | - Angela L. Stotts
- Department of Family and Community Medicine, University of Texas Medical School at Houston, Houston, Texas, 77030, USA
| | - Madhukar H. Trivedi
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute, The University of Texas Southwestern Medical Center, Dallas, Texas, 75390-9119, USA
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Lappan SN, Brown AW, Hendricks PS. Dropout rates of in-person psychosocial substance use disorder treatments: a systematic review and meta-analysis. Addiction 2020; 115:201-217. [PMID: 31454123 DOI: 10.1111/add.14793] [Citation(s) in RCA: 133] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/15/2019] [Accepted: 08/01/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND AIMS Relapse rates for psychosocial substance use disorder (SUD) treatments are high, and dropout is a robust predictor of relapse. This study aimed to estimate average dropout rates of in-person psychosocial SUD treatments and to assess predictors of dropout. DESIGN A comprehensive meta-analysis of dropout rates of studies of in-person psychosocial SUD treatment. Studies included randomized controlled trials (RCTs) and cohort studies. SETTING Studies conducted anywhere in the world that examined SUD treatment and were published from 1965 to 2016, inclusive. PARTICIPANTS/CASES One hundred and fifty-one studies, 338 study arms and 299 dropout rates including 26 243 participants. MEASUREMENTS Databases were searched for studies of SUD treatment that included an in-person psychosocial component. Meta-analyses and meta-regressions were conducted to estimate dropout rates and identify predictors of dropout, including participant characteristics, facilitator characteristics and treatment characteristics. Pooled estimates were calculated with random-effects analyses accounting for the hierarchical structure of study arms nested within studies. FINDINGS The average dropout rate across all studies and study arms was 30.4% [95% confidence interval (CI) = 27.2-33.8 and 95% prediction interval (PI) = 6.25-74.15], with substantial heterogeneity (I2 = 93.7%, P < 0.0001). Studies including a higher percentage of African Americans and lower-income individuals were associated with higher dropout rates. At intake, more cigarettes/day and a greater percentage of heroin use days were associated with lower dropout rates, whereas heavier cocaine use was associated with higher dropout rates. Dropout rates were highest for studies targeting cocaine, methamphetamines and major stimulants (broadly defined) and lowest for studies targeting alcohol, tobacco and heroin, although there were few studies on methamphetamines, major stimulants and heroin. Programs characterized by more treatment sessions and greater average session length were associated with higher dropout rates. Facilitator characteristics were not significantly associated with dropout. CONCLUSIONS On average, approximately 30% of participants drop out of in-person psychosocial SUD treatment studies, but there is wide variability. Drop-out rates vary with the treated population, the substance being targeted, and the characteristics of the treatment.
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Affiliation(s)
- Sara N Lappan
- Department of Health Behavior, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Andrew W Brown
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Peter S Hendricks
- Department of Health Behavior, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
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Chhatre S, Jefferson A, Cook R, Meeker CR, Kim JH, Hartz KM, Wong YN, Caruso A, Newman DK, Morales KH, Jayadevappa R. Patient-centered recruitment and retention for a randomized controlled study. Trials 2018; 19:205. [PMID: 29587805 PMCID: PMC5870194 DOI: 10.1186/s13063-018-2578-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 03/09/2018] [Indexed: 11/17/2022] Open
Abstract
Background Recruitment and retention strategies for patient-centered outcomes research are evolving and research on the subject is limited. In this work, we present a conceptual model of patient-centered recruitment and retention, and describe the recruitment and retention activities and related challenges in a patient-centered comparative effectiveness trial. Methods This is a multicenter, longitudinal randomized controlled trial in localized prostate cancer patients. Results We recruited 743 participants from three sites over 15 months period (January 2014 to March 2015), and followed them for 24 months. At site 1, of the 773 eligible participants, 551 (72%) were enrolled. At site 2, 34 participants were eligible and 23 (68%) enrolled. Of the 434 eligible participants at site 3, 169 (39%) enrolled. We observed that strategies related to the concepts of trust (e.g., physician involvement, ensuring protection of information), communication (e.g., brochures and pamphlets in physicians’ offices, continued contact during regular clinic visits and calling/emailing assessment), attitude (e.g., emphasizing the altruistic value of research, positive attitude of providers and research staff), and expectations (e.g., full disclosure of study requirements and time commitment, update letters) facilitated successful patient recruitment and retention. A stakeholders’ advisory board provided important input for the recruitment and retention activities. Active engagement, reminders at the offices, and personalized update letters helped retention during follow-up. Usefulness of telephone recruitment was site specific and, at one site, the time requirement for telephone recruitment was a challenge. Conclusions We have presented multilevel strategies for successful recruitment and retention in a clinical trial using a patient-centered approach. Our strategies were flexible to accommodate site-level requirements. These strategies as well as the challenges can aid recruitment and retention efforts of future large-scale, patient-centered research studies. Trial registration Clinicaltrials.gov, ID: NCT02032550. Registered on 22 November 2013.
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Affiliation(s)
- Sumedha Chhatre
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market St. Suite 4051, Philadelphia, PA, 19104, USA.
| | - Ashlie Jefferson
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ratna Cook
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Caitlin R Meeker
- Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | - Ji Hyun Kim
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Yu-Ning Wong
- Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | - Adele Caruso
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Diane K Newman
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Knashawn H Morales
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ravishankar Jayadevappa
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Corporal Michael J. Crescenz VAMC, Philadelphia, PA, USA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.,Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
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Lynch WJ, Abel J, Robinson AM, Smith MA. Exercise as a Sex-Specific Treatment for Substance Use Disorder. CURRENT ADDICTION REPORTS 2017; 4:467-481. [PMID: 29404264 PMCID: PMC5796660 DOI: 10.1007/s40429-017-0177-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Exercise is a promising treatment for substance use disorder that may reduce withdrawal symptoms and prevent relapse. In this review, we discuss recent evidence from clinical and preclinical studies for its efficacy, from a behavioral to a molecular level, in order to understand the exercise conditions that lead to beneficial effects. We also highlight the few recent findings of sex-specific differences. RECENT FINDINGS Clinical and preclinical findings show that exercise decreases withdrawal symptoms, including craving, in both males and females. Evidence from clinical studies support the efficacy of exercise to prevent relapse to smoking, although further research is needed to examine sex differences, establish long-term efficacy, and to determine if effects extend to other substance use disorders. Preclinical findings also support the potential utility of exercise to prevent relapse with evidence suggesting that its efficacy is enhanced in males, and mediated by blocking drug-induced adaptations that occur during early abstinence. SUMMARY Sex differences and timing of exercise availability during abstinence should be considered in future studies examining exercise as an intervention for relapse. A better understanding of the neurobiological mechanisms underlying the efficacy of exercise to reduce withdrawal symptoms and prevent relapse is needed to guide its development as a sex-specific treatment.
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Affiliation(s)
- Wendy J Lynch
- Associate Professor of Psychiatry and Neurobehavioral Sciences University of Virginia: P.O. Box 801402, Charlottesville, VA 22904 434-243-0580 (phone); 434-973-7031 (fax)
| | - Jean Abel
- Assistant Professor of Psychiatry and Neurobehavioral Sciences University of Virginia; P.O. Box 801402, Charlottesville, VA 22904-1402 434) 243-5767 (phone); 434-973-7031 (fax)
| | - Andrea M Robinson
- Postdoctoral Fellow of Psychology Davidson College: Box 7136 Davidson, NC 28035 704-894-3012 (phone); 704-894-2512 (fax)
| | - Mark A Smith
- Professor of Psychology Davidson College, Davidson, NC 28035 704-894-2470 (phone); 704-894-2512 (fax)
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