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Zaccheo SK, Marrone G, Pandey LR, Deuba K. The impact of border crossing and imprisonment on injection practices and risk of HIV and hepatitis C infection among men who inject drugs in Nepal. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 119:104145. [PMID: 37549595 DOI: 10.1016/j.drugpo.2023.104145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND In Nepal, personal drug use is criminalized and among people who inject drugs (PWID), the majority of whom are men, movement across the border with India for drug procurement and use is common. Using a risk environment approach, this study examined associations between border crossing and imprisonment with respect to HIV, HCV and injection risk behavior among men who inject drugs in Nepal. METHODS This cross-sectional study analyzed data from 1345 participants from 14 districts across Nepal. Explanatory variables were prior imprisonment and past-month border crossing to procure or use drugs. We used multivariable logistic regression to evaluate associations between these variables and HIV, HCV, HIV/HCV co-infection and past-month injection risk behavior among PWID. RESULTS Over half of participants reported prior imprisonment (34.6% prior to past year, 21.6% within past year) and Indo-Nepal border crossing in the past year to use or buy drugs (31.2% sometimes, 20.8% often); over one quarter of participants (29.6%) reported both. Imprisonment prior to the past year was associated with higher odds of all outcome variables: HIV (adjusted odds ratio (aOR) 2.44, 95% confidence interval (CI) 1.29-4.59), HCV (aOR 1.51, 95% CI 1.08-2.09), HIV/HCV co-infection (aOR 3.12, 95% CI 1.58-6.14) and injection risk behavior (aOR 1.64, 95% CI 1.20-2.25). Past-year border crossing to procure or use drugs was associated with HCV (aOR 2.06, 95% CI 1.42-2.98) and injection risk behavior (aOR 1.47, 95% CI 1.04-2.10), with larger effect sizes among PWID who reported both border crossing as well as history of imprisonment. CONCLUSION Imprisonment and border crossing were associated with injection risk behavior and disease outcomes. These findings indicate a need to implement cross-border disease surveillance and harm reduction initiatives in the Indo-Nepal border region and in Nepali prisons.
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Affiliation(s)
- Sonia K Zaccheo
- Department of Global Public Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Gaetano Marrone
- Department of Global Public Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Lok Raj Pandey
- National Centre for AIDS and STD Control (NCASC), Ministry of Health and Population, Kathmandu, Nepal
| | - Keshab Deuba
- Department of Global Public Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden; National Centre for AIDS and STD Control (NCASC), Global Fund Programs, Kathmandu, Nepal.
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Wade NE, Sullivan RM, Tapert SF, Pelham WE, Huestis MA, Lisdahl KM, Haist F. Concordance between substance use self-report and hair analysis in community-based adolescents. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:76-84. [PMID: 36812240 PMCID: PMC10757802 DOI: 10.1080/00952990.2023.2164931] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/20/2022] [Accepted: 01/01/2023] [Indexed: 02/24/2023]
Abstract
Background: Accurate drug use identification through subjective self-report and toxicological biosample (hair) analysis are necessary to determine substance use sequelae in youth. Yet consistency between self-reported substance use and robust, toxicological analysis in a large sample of youth is understudied.Objectives: We aim to assess concordance between self-reported substance use and hair toxicological analysis in community-based adolescents.Methods: Hair results by LC-MS/MS and GC-MS/MS and self-reported past-year substance use from an Adolescent Brain Cognitive Development (ABCD) Study subsample (N = 1,390; ages 9-13; 48% female) were compared. The participants were selected for hair selection through two methods: high scores on a substance risk algorithm selected 93%; 7% were low-risk, randomly selected participants. Kappa coefficients the examined concordance between self-report and hair results.Results: 10% of youth self-reported any past-year substance use (e.g. alcohol, cannabis, nicotine, and opiates), while a mostly non-overlapping 10% had hair results indicating recent substance use (cannabis, alcohol, non-prescription amphetamines, cocaine, nicotine, opiates, and fentanyl). In randomly selected low-risk cases, 7% were confirmed positive in hair. Combining methods, 19% of the sample self-reported substance use and/or had a positive hair sample. Kappa coefficient of concordance between self-report and hair results was low (kappa = 0.07; p = .007).Conclusions: Hair toxicology identified substance use in high-risk and low-risk ABCD cohort subsamples. Given low concordance between hair results and self-report, reliance on either method alone would incorrectly categorize 9% as non-users. Multiple methods for characterizing substance use history in youth improves accuracy. Larger representative samples are needed to assess the prevalence of substance use in youth.
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Affiliation(s)
- Natasha E. Wade
- Department of Psychiatry, University of California, San Diego, USA
| | - Ryan M. Sullivan
- Department of Psychology, University of Wisconsin-Milwaukee, USA
| | - Susan F. Tapert
- Department of Psychiatry, University of California, San Diego, USA
| | | | - Marilyn A. Huestis
- Institute of Emerging Health Professions, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Frank Haist
- Department of Psychiatry, University of California, San Diego, USA
- Center for Human Development, University of California, San Diego, USA
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3
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Broman MJ, Bista S, Broman CL. Recanting substance use over time. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2087778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Michael J. Broman
- School of Social Work, Wayne State University, Detroit, Michigan, USA
| | | | - Clifford L. Broman
- Department of Sociology, Michigan State University, East Lansing, Michigan, USA
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Braverman ER, Dennen CA, Gold MS, Bowirrat A, Gupta A, Baron D, Roy AK, Smith DE, Cadet JL, Blum K. Proposing a “Brain Health Checkup (BHC)” as a Global Potential “Standard of Care” to Overcome Reward Dysregulation in Primary Care Medicine: Coupling Genetic Risk Testing and Induction of “Dopamine Homeostasis”. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095480. [PMID: 35564876 PMCID: PMC9099927 DOI: 10.3390/ijerph19095480] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 12/27/2022]
Abstract
In 2021, over 100,000 people died prematurely from opioid overdoses. Neuropsychiatric and cognitive impairments are underreported comorbidities of reward dysregulation due to genetic antecedents and epigenetic insults. Recent genome-wide association studies involving millions of subjects revealed frequent comorbidity with substance use disorder (SUD) in a sizeable meta-analysis of depression. It found significant associations with the expression of NEGR1 in the hypothalamus and DRD2 in the nucleus accumbens, among others. However, despite the rise in SUD and neuropsychiatric illness, there are currently no standard objective brain assessments being performed on a routine basis. The rationale for encouraging a standard objective Brain Health Check (BHC) is to have extensive data available to treat clinical syndromes in psychiatric patients. The BHC would consist of a group of reliable, accurate, cost-effective, objective assessments involving the following domains: Memory, Attention, Neuropsychiatry, and Neurological Imaging. Utilizing primarily PUBMED, over 36 years of virtually all the computerized and written-based assessments of Memory, Attention, Psychiatric, and Neurological imaging were reviewed, and the following assessments are recommended for use in the BHC: Central Nervous System Vital Signs (Memory), Test of Variables of Attention (Attention), Millon Clinical Multiaxial Inventory III (Neuropsychiatric), and Quantitative Electroencephalogram/P300/Evoked Potential (Neurological Imaging). Finally, we suggest continuing research into incorporating a new standard BHC coupled with qEEG/P300/Evoked Potentials and genetically guided precision induction of “dopamine homeostasis” to diagnose and treat reward dysregulation to prevent the consequences of dopamine dysregulation from being epigenetically passed on to generations of our children.
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Affiliation(s)
- Eric R. Braverman
- The Kenneth Blum Institute on Behavior & Neurogenetics, Austin, TX 78701, USA; (E.R.B.); (C.A.D.)
| | - Catherine A. Dennen
- The Kenneth Blum Institute on Behavior & Neurogenetics, Austin, TX 78701, USA; (E.R.B.); (C.A.D.)
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA;
- Department of Psychiatry, Tulane School of Medicine, New Orleans, LA 70112, USA;
| | - Abdalla Bowirrat
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA;
| | - David Baron
- Division of Addiction Research & Education, Center for Psychiatry, Medicine & Primary Care (Office of Provost), Western University Health Sciences, Pomona, CA 91766, USA;
| | - A. Kenison Roy
- Department of Psychiatry, Tulane School of Medicine, New Orleans, LA 70112, USA;
| | - David E. Smith
- Department of Cellular and Molecular Pharmacology, University of California San Francisco, San Francisco, CA 94158, USA;
| | - Jean Lud Cadet
- The Molecular Neuropsychiatry Research Branch, NIH National Institute on Drug Abuse, Baltimore, MD 21224, USA;
| | - Kenneth Blum
- The Kenneth Blum Institute on Behavior & Neurogenetics, Austin, TX 78701, USA; (E.R.B.); (C.A.D.)
- Division of Addiction Research & Education, Center for Psychiatry, Medicine & Primary Care (Office of Provost), Western University Health Sciences, Pomona, CA 91766, USA;
- Correspondence:
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5
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Substance use onset in high-risk 9-13 year-olds in the ABCD study. Neurotoxicol Teratol 2022; 91:107090. [PMID: 35341934 PMCID: PMC9623820 DOI: 10.1016/j.ntt.2022.107090] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 03/16/2022] [Accepted: 03/21/2022] [Indexed: 01/02/2023]
Abstract
AIM A key aim of the Adolescent Brain Cognitive Development℠ (ABCD) Study is to document substance use onset, patterns, and sequelae across adolescent development. However, substance use misreporting can obscure accurate drug use characterization. Hair toxicology provides objective historical substance use data but is rarely used in studies of youth. Here, we compare objective hair toxicology results with self-reported substance use in high-risk youth. METHODS A literature-based substance use risk algorithm prioritized 696 ABCD Study® hair samples from 677 participants for analysis at baseline, and 1 and 2-year follow-ups (spanning ages 9-13). Chi-square and t-tests assessed differences between participants' demographics, positive and negative hair tests, risk-for-use algorithm scores, and self-reported substance use. RESULTS Hair testing confirmed that 17% of at-risk 9-13 year-olds hair samples had evidence of past 3-month use of one (n = 97), two (n = 14), three (n = 2), or four (n = 2) drug classes. After considering prescribed medication and self-reported substance use, 10% had a positive test indicating substance use that was not reported. Participants with any positive hair result reported less sipping of alcohol (p < 0.001) and scored higher on the risk-for-use algorithm (p < 0.001) than those with negative toxicology results. CONCLUSIONS 10% of hair samples from at-risk 9-13 year-olds tested positive for at least one unreported substance, suggesting underreporting in high-risk youth when participating in a research study. As hair testing prioritized youth with risk characteristics, the overall extent of underreporting will be calculated in future studies. Nonetheless, hair toxicology was key to characterizing substance use in high-risk youth.
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Broman MJ, Bista S, Broman CL. Inconsistency in Self-Reporting the Use of Substances over Time. Subst Use Misuse 2022; 57:1356-1364. [PMID: 35724237 DOI: 10.1080/10826084.2022.2083168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The reliability of reporting the use of substances has important implications for researchers, policymakers, treatment providers, and other stakeholders. Recanting, defined as endorsing use of a particular substance initially and later denying it, threatens such reliability. Methods: Data from the National Longitudinal Study of Adolescent to Adult Health are utilized. This is a longitudinal nationally representative study of the U.S. individuals who have participated in five waves of interviews, starting in adolescence in 1994 and 1995 (Wave 1) and ending with the most recent wave (2016-2019) where respondents were aged 33-44 (Wave 5). Results: We found substantial recanting across years. From 2 to 17% of respondents recant over time. Misuse of prescription drugs is the most commonly recanted substance use behavior, at 16.8%. After this, alcohol use, and smoking are the most recanted substances. Race-ethnicity and education have a widespread association with recanting the various substances, and age and gender are also of importance. Conclusion: In the present study, we examined the issue of recanting of substance use over duration of up to 18 years. This extends the previous work on recanting by examining this phenomenon over a considerably longer period of time. We found substantial recanting across years, and that race-ethnicity and education are of significance in association with recanting.
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Affiliation(s)
- Michael J Broman
- School of Social Work, Wayne State University¸ Detroit, Michigan, USA
| | - Shikha Bista
- MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Clifford L Broman
- Department of Sociology, Michigan State University, East Lansing, Michigan, USA
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Dembo R, Wareham J, Schmeidler J, Wolff J. Assessing the Validity of Self-Reports of Marijuana Use among Adolescents Entering the Juvenile Justice System: Gender Differences. Subst Use Misuse 2022; 57:145-156. [PMID: 34766537 DOI: 10.1080/10826084.2021.1995757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective: Scant research exists on the validity of self-reported marijuana use using biological assays among adolescents involved in the juvenile justice system. This exploratory study examined gender (sex) differences in underreporting of marijuana use and the impact of age, race/ethnicity, living situation, depression, family problems, sexual risk behaviors, previous drug treatment, and juvenile justice placement. Methods: Self-reports of past year marijuana use were validated with urinalysis, and those testing positive for marijuana use were selected for study. The sample was 256 females and 885 males, aged 12 to 18, entering an urban juvenile assessment center in a southeastern U.S. state between 2017 and 2019. Results: Results indicated significant differences in marijuana underreporting (tested positive but self-reported no use), with 37% of females and 55% of males underreporting use. For males, Hispanic ethnicity, African American race, sexually transmitted infection (STI), and secure detention placement increased the odds of underreporting, while having an incarcerate parent and previous drug treatment decreased the odds. For females, number of sexual partners decreased the odds of underreporting of marijuana use. Conclusion: These findings imply use of collateral information, such as urine tests, as a recommendation for juvenile justice intake to corroborate self-reports and guide risk assessment.
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Affiliation(s)
- Richard Dembo
- Criminology Department, University of South Florida, Tampa, FL, USA
| | - Jennifer Wareham
- Criminology and Criminal Justice Department, Wayne State University, Detroit, MI, USA
| | - James Schmeidler
- Psychiatry Department, Mt. Sinai Medical Center, New York, NY, USA
| | - Jessica Wolff
- Agency for Community Treatment Services, Inc., Tampa, FL, USA
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8
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Preliminary Evidence for Cannabis and Nicotine Urinary Metabolites as Predictors of Verbal Memory Performance and Learning Among Young Adults. J Int Neuropsychol Soc 2021; 27:546-558. [PMID: 34261558 PMCID: PMC8288450 DOI: 10.1017/s1355617721000205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Verbal memory deficits are linked to cannabis use. However, self-reported episodic use does not allow for assessment of variance from other factors (e.g., cannabis potency, route of consumption) that are important for assessing brain-behavior relationships. Further, co-occurring nicotine use may moderate the influence of cannabis on cognition. Here we utilized objective urinary measurements to assess the relationship between metabolites of cannabis, 11-nor-9-carboxy-∆9-tetrahydrocannabinol (THCCOOH), and nicotine (cotinine) on verbal memory in young adults. METHOD Adolescents and young adults (n = 103) aged 16-22 completed urinary drug testing and verbal memory assessment (RAVLT). Linear regressions examined the influence of THCCOOH and cotinine quantitative concentrations, and their interaction, on RAVLT scores, controlling for demographics and alcohol. Cannabis intake frequency was also investigated. Secondary analyses examined whether past month or recency of use related to performance, while controlling for THCCOOH and cotinine concentrations. RESULTS THCCOOH concentration related to both poorer total learning and long delay recall. Cotinine concentration related to poorer short delay recall. Higher frequency cannabis use status was associated with poorer initial learning and poorer short delay. When comparing to self-report, THCCOOH and cotinine concentrations were negatively related to learning and memory performance, while self-report was not. CONCLUSIONS Results confirm the negative relationship between verbal memory and cannabis use, extending findings with objective urinary THCCOOH, and cotinine concentration measurements. No moderating relationship with nicotine was found, though cotinine concentration independently associated with negative short delay performance. Findings support the use of both urinary and self-report metrics as complementary methods in substance use research.
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9
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Shadloo B, Baheshmat S, Rostam-Abadi Y, Shakeri A, Gholami J, Rahimi-Movaghar A. Comparison of self-reported substance use with biological testing among treatment-seeking patients with opioid use disorder. J Subst Abuse Treat 2021; 134:108555. [PMID: 34210569 DOI: 10.1016/j.jsat.2021.108555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/06/2021] [Accepted: 06/14/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Several factors may influence the validity of self-report. In this study, we aimed to assess the validity of self-reported drug use compared to urine testing among treatment-seeking patients with opioid use disorder (OUD). METHODS This cross-sectional study recruited 293 patients with OUD, referred to the Iranian National Center for Addiction Studies (INCAS) clinic, from November 2015 to June 2017. The study compared self-reported opioid use in the past 72 h with the results of urinalysis, using immunoassay technique. We estimated sensitivity, negative predictive value, percent agreement, positive percent agreement, and Cohen's kappa statistics for those with OUD. RESULTS The sensitivity of self-reported opioid use was 85.9%. Percent agreement, positive percent agreement, and Cohen's Kappa statistics between self-reported opioid use and urine testing for morphine in the first month were 88.5%, 78.1%, and 77.0, respectively. Multilevel logistic regression showed that longer treatment duration (OR = 1.21, 95%CI: 1.07-1.37, p-value = 0.002) was significantly associated with the agreement of self-reported opioid use with urine testing. CONCLUSION Self-report can be used as a reliable method for monitoring treatment adherence combined with random urine tests.
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Affiliation(s)
- Behrang Shadloo
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, No. 486, South Karegar Ave., Tehran 1336616357, Iran.
| | - Shahab Baheshmat
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine (SATiM), Tehran University of Medical Sciences, Tehran, Iran; Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.
| | - Yasna Rostam-Abadi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.
| | - Atena Shakeri
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.
| | - Jaleh Gholami
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, No. 486, South Karegar Ave., Tehran 1336616357, Iran.
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.
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De Los Reyes A, Drabick DAG, Makol BA, Jakubovic RJ. Introduction to the Special Section: The Research Domain Criteria’s Units of Analysis and Cross-Unit Correspondence in Youth Mental Health Research. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 49:279-296. [DOI: 10.1080/15374416.2020.1738238] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | | | - Bridget A. Makol
- Department of Psychology, University of Maryland at College Park
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11
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Zuckermann AME, Qian W, Battista K, Jiang Y, de Groh M, Leatherdale ST. Factors influencing the non-medical use of prescription opioids among youth: results from the COMPASS study. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1736669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Alexandra M. E. Zuckermann
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
- Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Wei Qian
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Katelyn Battista
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Ying Jiang
- Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Margaret de Groh
- Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Scott T. Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
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12
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Palamar JJ, Le A, Acosta P, Cleland CM. Consistency of self-reported drug use among electronic dance music party attendees. Drug Alcohol Rev 2019; 38:798-806. [PMID: 31523872 DOI: 10.1111/dar.12982] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 08/07/2019] [Accepted: 08/07/2019] [Indexed: 12/30/2022]
Abstract
INTRODUCTION AND AIMS Longitudinal studies have found that recanting of drug use is common. We investigate the extent to which individuals in a high-risk population-electronic dance music (EDM) party attendees-provide inconsistent reports of drug use. DESIGN AND METHODS Nine hundred and thirty-three EDM party attendees were intercept-surveyed before entering randomly selected parties in 2017. A quarter (n = 236) completed the optional follow-up survey (63.1% of those providing an email address to be contacted for follow up). We compared self-reported past-year drug use on baseline and follow-up surveys (mean = 3.6 days post-baseline) among those who completed both. Predictors for providing discordant responses were also examined. RESULTS About 42.4% provided a discordant response between surveys, but discord regarding reported use of individual drugs (measured in changes in absolute percentage) ranged from 0.0% to 5.1%. At follow up, prevalence of reported use of LSD decreased (by 3.8%, P = 0.013) and prevalence of reported use of shrooms also decreased (by 5.1%, P = 0.005); however, test-retest reliability was strong or almost perfect for all 17 drugs (κ range: 0.88-1.00). Those reporting the use of a higher number of drugs at baseline were at increased risk of providing discordant responses. Those surveyed outside of festivals were less likely to provide more discordant responses than those surveyed outside of nightclubs. DISCUSSION AND CONCLUSIONS Although reporting of drug use was very reliable in this high-risk population, inconsistent self-reported use of some drugs was still common. Research is needed to determine how to acquire more accurate responses in this population at the point of recruitment without relying on follow-up surveys.
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Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University School of Medicine, New York, USA.,Center for Drug Use and HIV/HCV Research, NYU College of Global Public Health, New York, USA
| | - Austin Le
- Department of Population Health, New York University School of Medicine, New York, USA.,New York University College of Dentistry, New York, USA
| | - Patricia Acosta
- Department of Population Health, New York University School of Medicine, New York, USA
| | - Charles M Cleland
- Department of Population Health, New York University School of Medicine, New York, USA.,Center for Drug Use and HIV/HCV Research, NYU College of Global Public Health, New York, USA
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Cordova D, Mendoza Lua F, Muñoz-Velázquez J, Street K, Bauermeister JA, Fessler K, Adelman N, Neilands TB, Boyer CB. A multilevel mHealth drug abuse and STI/HIV preventive intervention for clinic settings in the United States: A feasibility and acceptability study. PLoS One 2019; 14:e0221508. [PMID: 31437240 PMCID: PMC6705861 DOI: 10.1371/journal.pone.0221508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 08/08/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Drug abuse and sexually transmitted infections (STIs), including the human immunodeficiency virus (HIV), remain significant public health concerns in the United States. Youth are at disproportionate risk of drug use and STIs/HIV, yet interventions aimed at improving STI and HIV testing and reducing STI/HIV risk behaviors through technology-based engagement in clinic settings are limited. The purpose of this study was to examine the feasibility and acceptability of Storytelling 4 Empowerment (S4E), a multilevel mobile-health drug abuse and STI/HIV preventive application (app) for clinic settings. We also explored uptake of STI/HIV testing among youth immediately post-intervention. METHOD Employing community-based participatory research principles and a multi-method research design, we developed a clinician-facing app, and examined the feasibility and acceptability of S4E among clinicians (n = 6) and youth (n = 20) in an urban youth-centered community health clinic. S4E aimed to improve clinician-youth risk communication and youths' drug use and STI/HIV knowledge, self-efficacy, and refusal skills. We also explored youths' uptake of STI and HIV testing. Quantitative data were analyzed by computing mean scores and proportions, and qualitative analyses followed the tenets of content analysis. RESULTS Among eligible participants, 86.9% of youth and 85.7% of clinicians enrolled in the study, suggesting the feasibility of recruiting participants from the targeted clinic. Most clinicians identified as non-Hispanic white (83%) and female (66.7%). Among the youth, 70% identified as non-Hispanic white, followed by 30% African American, and 50% identified as female with a mean age of 19.6 (SD = 1.5, Range = 16-21). The quantitative findings suggest that the acceptability of S4E is high, as indicated by the Client Satisfaction Questionnaire (mean score = 25.2, SD: 4.8). Immediately post-intervention, all youth who reported past 90-day condomless sex or having never been tested for STIs or HIV in their lifetime, were tested for both STIs and HIV. Qualitative themes revealed four overarching themes, including S4E: (1) faciliated timely, targeted, and tailored prevention and risk reduction strategies; (2) shaped clinician and youth communication and interaction during the clinic visit; (3) may have improved uptake of STI/HIV testing and increased STI/HIV knowledge and self-efficacy; and (4) had high feasibiliy and acceptability among youth and clninicans. CONCLUSIONS Findings suggest the feasibility and acceptability of S4E in an urban community-based health clinic setting. A next important step is to examine the efficacy of S4E in a randomized controlled trial design.
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Affiliation(s)
- David Cordova
- University of Michigan School of Social Work, Ann Arbor, Michigan, United States of America
| | - Frania Mendoza Lua
- University of Chicago School of Social Service Administration, Chicago, Illinois, United States of America
| | - Jaime Muñoz-Velázquez
- University of Michigan School of Social Work, Ann Arbor, Michigan, United States of America
| | - Katie Street
- University of Michigan School of Social Work, Ann Arbor, Michigan, United States of America
| | - Jose A. Bauermeister
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, United States of America
| | - Kathryn Fessler
- The Corner Health Center, Ypsilanti, Michigan, United States of America
| | - Nicole Adelman
- The Corner Health Center, Ypsilanti, Michigan, United States of America
| | | | - Torsten B. Neilands
- University of California, San Francisco, California, United States of America
| | - Cherrie B. Boyer
- University of California, San Francisco, California, United States of America
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Palamar JJ, Le A. Underreporting of drug use on a survey of electronic dance music party attendees. ADDICTION RESEARCH & THEORY 2019; 28:321-327. [PMID: 33162873 PMCID: PMC7643632 DOI: 10.1080/16066359.2019.1653860] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 07/29/2019] [Accepted: 08/06/2019] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Skip-logic is commonly used on electronic surveys in which programs provide follow-up questions to affirmative responses and skip to the next topic in response to non-affirmative responses. While skip-logic helps produce data without contradictory responses, erroneous non-affirmative reports can lead to loss of accurate information. We examined the extent to which type-in drug use responses contradict unreported use in a survey of a high-risk population-electronic dance music (EDM) party attendees. DESIGN We surveyed 1029 EDM party-attending adults (ages 18-40) using time-spacing sampling in 2018. We examined the extent to which reporting of recent drug use via type-in responses occurred after past-year use of the same drugs were unreported earlier on the same survey. Changes in prevalence of use and predictors of providing discordant responses were examined. RESULTS 3.6% of participants typed in names of drugs they had used that they did not report using earlier on the survey. Changes in prevalence were not significant when correcting contradictory responses, but prevalence of past-year cocaine use increased from 23.3% to 24.3%. Those with a college degree were at lower odds for providing a discordant response (aOR = 0.13, p = .019). Females (aOR = 2.82, p = .022), those earning ≥$1000 per week (aOR = 11.03, p = .011), and those identifying as gay/lesbian (aOR = 5.20, p = .032) or bisexual or other sexuality (aOR = 15.12, p < .001) were at higher odds of providing a discordant response. CONCLUSIONS Electronic surveys that query drug use can benefit from follow-up (e.g. open-ended) questions not dependent on previous responses, as they may elicit affirmative responses underreported earlier in the survey.
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Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Austin Le
- Department of Population Health, New York University School of Medicine, New York, NY, USA
- New York University College of Dentistry, New York, NY, USA
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Cárdenas LE, Stormshak EA. Measuring Daily Activity of Emerging Adults: Text Messaging for Assessing Risk Behavior. JOURNAL OF CHILD AND FAMILY STUDIES 2019; 28:315-324. [PMID: 31105417 PMCID: PMC6519739 DOI: 10.1007/s10826-018-1267-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We evaluated the validity of the use of an SMS text messaging survey for measuring daily life activity in a sample of emerging adults. Short Message Service (SMS) text messaging is a prevalent form of everyday communication in the lives of emerging adults, yet there is limited research on the use of automated text messaging as a data collection method in clinical research. Study participants were 274 ethnically diverse emerging adults (54.4% female, baseline age = 17-21 years), and constructs included alcohol use, substance use, school activity, peer interaction, mood, and interaction with parents. Participants responded to "bursts" that included multiple surveys during the course of 2 weeks, 6 months apart (a total of 13 texting surveys). Most of the questions were strongly associated across bursts. Findings revealed response stability for participating subjects across the 6 months and across the texting and self-report survey methodologies. Paired sample t-tests indicated that participants reported differently across data methodologies, which suggests that some data collection methodologies are best suited for certain types of constructs, such as alcohol consumption. Study results encapsulate the daily life of emerging adults and highlight the importance of evaluating the validity of SMS text messaging as a potential data collection device in future research.
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Recanting of Previous Reports of Alcohol Consumption within a Large-Scale Clustered Randomised Control Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019; 20:844-851. [PMID: 30637672 PMCID: PMC6647483 DOI: 10.1007/s11121-019-0981-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The aim of this study was to examine the extent of recanting (inconsistencies in reporting of lifetime alcohol use) and its impact on the assessment of primary outcomes within a large-scale alcohol prevention trial. One hundred and five post-primary schools in were randomised to receive either the intervention or education as normal. Participants (N = 12,738) were secondary school students in year 8/S1 (mean age 12.5) at baseline. Self-report questionnaires were administered at baseline (T0) and at T1 (+ 12 months post-baseline), T2 (+ 24 months) and T3 (+ 33 months). The primary outcomes were (i) heavy episodic drinking (consumption of ≥ 6 units in a single episode in the previous 30 days for males and ≥ 4.5 units for females) assessed at T3 and (ii) the number of alcohol-related harms experienced in the last 6 months assessed at T3. Recanting was defined as a negative report of lifetime alcohol consumption that contradicted a prior positive report. Between T1 and T3, 9.9% of students recanted earlier alcohol consumption. Recanting ranged from 4.5 to 5.3% across individual data sweeps. While recanting was significantly associated (negatively) with both primary outcomes, the difference in the rate of recanting across trial arms was small, and adjusting for recanting within the primary outcome models did not impact on the primary outcome effects. Males were observed to recant at a greater rate than females, with a borderline small-sized effect (V = .09). While differential rates of recanting have the potential to undermine the analysis of prevention trial outcomes, recanting is easy to identify and control for within trial primary outcome analyses. Adjusting for recanting should be considered as an additional sensitivity test within prevention trials. Trial Registration: ISRCTN47028486 (http://www.isrctn.com/ISRCTN47028486). The date of trial registration was 23/09/2011, and school recruitment began 01/11/2011.
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Gjerde H, Gjersing L, Baz-Lomba JA, Bijlsma L, Salgueiro-González N, Furuhaugen H, Bretteville-Jensen AL, Hernández F, Castiglioni S, Johanna Amundsen E, Zuccato E. Drug Use by Music Festival Attendees: A Novel Triangulation Approach Using Self-Reported Data and Test Results of Oral Fluid and Pooled Urine Samples. Subst Use Misuse 2019; 54:2317-2327. [PMID: 31398072 DOI: 10.1080/10826084.2019.1646285] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Self-reported data are commonly used when investigating illicit substance use. However, self-reports have well-known limitations such as limited recall and socially desirable responding. Mislabeling or adulteration of drugs on the illicit market may also cause incorrect reporting. Objectives: We aimed to examine what could be gained in terms of illicit drug use findings among music festival attendees when including biological sample test results in the assessment. Methods: We included 651 attendees at three music festivals in Norway from June to August 2016. Self-reported drug use was recorded using questionnaires, and samples of oral fluid were analyzed to detect use of illicit drugs. In addition, we analyzed samples of pooled urine from portable toilets at each festival. Results: All methods identified cannabis, MDMA, and cocaine as the most commonly used drugs. Overall, 6.6% of respondents reported use of illicit substances during the previous 48 hours. Oral fluid testing identified a larger number of drug users as 12.6% tested positive for illicit drugs. In oral fluid testing, we identified ketamine and three new psychoactive substances (NPS) that had not been reported on the questionnaire. In pooled urine testing, we identified amphetamine and three additional NPS that were neither reported used nor found in oral fluid samples. Conclusions/Importance: Drug testing of biological samples proved to be an important supplement to self-reports as a larger number of illicit substances could be detected.
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Affiliation(s)
- Hallvard Gjerde
- Section of Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
| | - Linn Gjersing
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Lubertus Bijlsma
- Research Institute for Pesticides and Water, University Jaume I, Castellón, Spain
| | | | - Håvard Furuhaugen
- Section of Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
| | | | - Félix Hernández
- Research Institute for Pesticides and Water, University Jaume I, Castellón, Spain
| | - Sara Castiglioni
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Ellen Johanna Amundsen
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Ettore Zuccato
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
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Gjerde H, Gjersing L, Furuhaugen H, Bretteville-Jensen AL. Correspondence between Oral Fluid Drug Test Results and Self-Reported Illicit Drug Use among Music Festival Attendees. Subst Use Misuse 2019; 54:1337-1344. [PMID: 30860932 DOI: 10.1080/10826084.2019.1580295] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Use of illicit substances is often under-reported. Testing positive in oral fluid provides an objective confirmation of recent intake. OBJECTIVES To examine the agreement between oral fluid test results and self-reported substance use among music festival attendees, and factors associated with reporting past 48 h drug use among users identified by drug testing. METHODS One thousand three hundred nine participants were recruited from six music festivals in Norway (June-August 2016). They completed a questionnaire and provided oral fluid samples analyzed for amphetamines, MDMA, tetrahydrocannabinol (cannabis), and cocaine. Additionally, their blood alcohol levels were measured. RESULTS Overall, 5.5% reported use of amphetamines, cannabis, cocaine, and/or MDMA during past 48 h in the questionnaire, whereas 10.8% tested positive in oral fluid. Only 16.7% of identified cocaine users and 31.1% of identified MDMA users reported past 48 h cocaine or MDMA use, respectively. Higher proportions of identified cannabis and amphetamine users reported past 48 h use (53.8% and 55.6%, respectively). Multivariable logistic regression analysis showed that among participants who tested positive, those reporting weekly illicit substance use (Adjusted Odds Ratio [AOR] 30.6; 95% Confidence Interval [CI] 6.3-147.9), and using such substances when younger than 18 years (AOR 5.0; 95% CI 1.9-13.4) were more likely to report past 48 h use. Conclusions/Importance: Oral fluid testing appears to be an important tool when studying illicit substance use among music festival attendees, as significant under-reporting was observed. Among those testing positive, regular, and experienced users were more likely to report recent use, compared to less regular and experienced users.
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Affiliation(s)
- Hallvard Gjerde
- a Section of Drug Abuse Research, Department of Forensic Sciences , Oslo University Hospital , Oslo , Norway
| | - Linn Gjersing
- b Department of Alcohol, Tobacco and Drugs , Norwegian Institute of Public Health , Oslo , Norway
| | - Håvard Furuhaugen
- a Section of Drug Abuse Research, Department of Forensic Sciences , Oslo University Hospital , Oslo , Norway
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Murphy SM, Rosenman R. The "Real" Number of Washington State Adolescents Using Marijuana, and Why: A Misclassification Analysis. Subst Use Misuse 2019; 54:89-96. [PMID: 30362862 PMCID: PMC6379127 DOI: 10.1080/10826084.2018.1496454] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Although causality is difficult to establish, the regular use of marijuana has been associated with many adverse physiological and sociological consequences. There is considerable concern regarding marijuana use among adolescents, as the likelihood of adverse consequences increases significantly for this age group. The most comprehensive data for identifying risk factors for adolescent marijuana use is typically self-report, which may be over- or under-reported for a variety of reasons, including stigmatization, peer-pressure, or fear of being discovered. OBJECTIVES To identify the prevalence of adolescent marijuana use in Washington State, and the associated risk and protective factors, while controlling for and estimating the extent of misreporting, and its determinants. METHOD Data came from the 2014 Washington State Healthy Youth Survey. We accounted for missingness using chained multivariate imputation equations, resulting in 33,320 complete observations. Our model was estimated using a maximum likelihood multiple regression designed to control for systematic misclassification in binary dependent variables. RESULTS Approximately 12% of Washington adolescents claimed to have used marijuana in the past 30 days. Our estimates indicate this figure is likely closer to 18%. Determinants of use included use of other substances, gender, age, and measures of deviant social influences, personality/attitude, school and family bonds, bullying, and acquisition ease. Determinants of misreporting included use of other substances, gender, parental education, and family bonds. CONCLUSIONS Failing to control for misreporting considerably underestimates the prevalence of marijuana use among adolescents. Our model allows us to better identify at-risk adolescents and inform focused prevention efforts.
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Affiliation(s)
- Sean M Murphy
- a Weill Cornell Medical College , New York , New York , 10065 , USA
| | - Robert Rosenman
- b Washington State University , Pullman , Washington , 99164 , USA
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Ramos DDO, Daly M, Seidl-de-Moura ML, Jomar RT, Nadanovsky P. Inconsistent reports of risk behavior among Brazilian middle school students: National School Based Survey of Adolescent Health (PeNSE 2009/2012). CAD SAUDE PUBLICA 2017; 33:e00145815. [PMID: 28538791 DOI: 10.1590/0102-311x00145815] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 06/13/2016] [Indexed: 11/22/2022] Open
Abstract
This study assessed the consistency of self-reports of risk behavior (overall and within four specific domains: alcohol use, tobacco use, drug use, and sexual activity) in two editions of the Brazilian National School Based Survey of Adolescent Health (PeNSE): 2009 and 2012. The overall proportion of cases with at least one inconsistent response in the two editions was 11.7% (2.7% on the alcohol items, 2.1% for drug use, 4.3% for cigarette use, 3% for sexual activity) and 22.7% (12.8% on alcohol items, 2.5% for drug use, 4.3% for cigarette use, 4.1% for sexual activity), respectively. Such inconsistency was more prevalent among males, delayed students, those who reported having experimented with drugs, and those who did not have a cellphone. Because inconsistent responses were more prevalent among the students who claimed to have engaged in risky activities, removing inconsistent responders affected the estimated prevalence of all risk behaviors in both editions of the survey. This study supports the importance of performing consistency checks of self-report surveys, following the growing body of literature on this topic.
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Affiliation(s)
| | | | | | - Rafael Tavares Jomar
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Paulo Nadanovsky
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
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21
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Dembo R, Robinson RB, Barrett K, Winters KC, Ungaro R, Karas L, Belenko S, Wareham J. The Validity of Truant Youths' Marijuana Use and Its Impact on Alcohol Use and Sexual Risk Taking. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2015; 26:355-365. [PMID: 26478691 DOI: 10.1080/1067828x.2013.844089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Few studies investigating the validity of marijuana use have used samples of truant youth. In the current study, self-reports of marijuana use are compared with urine test results for marijuana to identify marijuana underreporting among adolescents participating in a longitudinal Brief Intervention for drug-involved truant youth. It was hypothesized that marijuana underreporting would be associated with alcohol underreporting and engaging in sexual risk behaviors. The results indicated marijuana underreporting was significantly associated with self-denial of alcohol use, but not associated with sexual risk behavior. Also, there was an age effect in marijuana use underreporting such that younger truant youth were more likely to underreport marijuana use, compared to older truant youth. Implications for policy and future research are discussed.
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Johnson TP. Sources of Error in Substance Use Prevalence Surveys. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:923290. [PMID: 27437511 PMCID: PMC4897110 DOI: 10.1155/2014/923290] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 10/13/2014] [Indexed: 11/17/2022]
Abstract
Population-based estimates of substance use patterns have been regularly reported now for several decades. Concerns with the quality of the survey methodologies employed to produce those estimates date back almost as far. Those concerns have led to a considerable body of research specifically focused on understanding the nature and consequences of survey-based errors in substance use epidemiology. This paper reviews and summarizes that empirical research by organizing it within a total survey error model framework that considers multiple types of representation and measurement errors. Gaps in our knowledge of error sources in substance use surveys and areas needing future research are also identified.
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Affiliation(s)
- Timothy P. Johnson
- Survey Research Laboratory, University of Illinois at Chicago, 412 S. Peoria Street, Chicago, IL 60607, USA
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Roberts SP, Siegel MB, DeJong W, Jernigan DH. A comparison between brand-specific and traditional alcohol surveillance methods to assess underage drinkers' reported alcohol use. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2014; 40:447-54. [PMID: 25062357 DOI: 10.3109/00952990.2014.938160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Adolescent alcohol consumption remains common and is associated with many negative health outcomes. Unfortunately, common alcohol surveillance methods often underestimate consumption. Improved alcohol use measures are needed to characterize the landscape of youth drinking. OBJECTIVES We aimed to compare a standard quantity-frequency measure of youth alcohol consumption to a novel brand-specific measure. METHODS We recruited a sample of 1031 respondents across the United States to complete an online survey. Analyses included 833 male and female underage drinkers ages 13-20. Respondents reported on how many of the past 30 days they consumed alcohol, and the number of drinks consumed on an average drinking day. Using our brand-specific measure, respondents identified which brands they consumed, how many days they consumed each brand, and how many drinks per brand they usually had. RESULTS Youth reported consuming significantly more alcohol (on average, 11 drinks more per month) when responding to the brand-specific versus the standard measure (p < 0.001). The two major predictors of the difference between the two measures were being a heavy episodic drinker (p < 0.001, 95% CI = 4.1-12.0) and the total number of brands consumed (p < 0.001, 95% CI = 2.0-2.8). CONCLUSION This study contributes to the field of alcohol and adolescent research first by investigating a potentially more accurate alcohol surveillance method, and secondly by promoting the assessment of alcohol use among adolescents vulnerable to risky alcohol use. Finally, our survey addresses the potential impact of alcohol marketing on youth and their subsequent alcohol brand preferences and consumption.
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Affiliation(s)
- Sarah P Roberts
- Boston University School of Public Health, Department of Community Health Sciences , Boston, MA and
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Discrimination, drugs, and alcohol among Latina/os in Brooklyn, New York: differences by gender. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2013; 24:367-73. [PMID: 23481289 DOI: 10.1016/j.drugpo.2013.01.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 01/10/2013] [Accepted: 01/28/2013] [Indexed: 11/22/2022]
Abstract
BACKGROUND Based on a stress-coping framework, the present study investigates the relationship between discrimination and substance use, and the moderating effects of gender. METHODS This cross-sectional study analyzes data from Latina/o young adults aged 18-25 (N = 401) from Brooklyn, New York. Multinomial logistic regression was used to test the association between discrimination and substance use. RESULTS Discrimination was significantly associated with increased odds of substance use adjusting for covariates (e.g. age, education). Gender was a moderator. Discrimination was associated with increased risk of alcohol/cannabis and hard drug use among young Latina women. However, discrimination was associated with decreased risk of alcohol/cannabis use and increased risk of hard drug use among young Latino men. CONCLUSION These findings suggest that discrimination is generally associated with risk for substance use, but further that the outcomes vary by gender. Future research should explore gender-specific dimensions of discrimination and their associations with other outcomes.
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Shillington AM, Woodruff SI, Clapp JD, Reed MB, Lemus H. Self-Reported Age of Onset and Telescoping for Cigarettes, Alcohol, and Marijuana Across Eight Years of the National Longitudinal Survey of Youth. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2012; 21:333-348. [PMID: 23284228 DOI: 10.1080/1067828x.2012.710026] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Smoking, drinking, and illicit drug use are leading causes of morbidity and mortality, both during adolescence as well as later in life. Although for some adolescents, substance use may last for only a brief period of experimentation, use of these substances in adolescence may have negative consequences. The determination of how well national and local policy and intervention efforts address teen substance use depends largely on the collection of valid and accurate data. Assessments of substance use rely heavily on retrospective self-report measures. The reliability and validity of self-reported substance use measures, however, may be limited by various sources of measurement error. This study utilizes four waves of data from the National Longitudinal Survey of Youth spanning eight years. Our wave-to-wave analyses examined the accuracy of self-reported age of onset for cigarette, alcohol and marijuana users. Findings indicate that approximately one-fourth of cigarette users, one-fifth of alcohol users and one-third of marijuana users reported their age of onset exactly the same across waves. Of those who reported the age of onset inaccurately, the error tended to be in the direction of reporting their age of onset as older at a latter wave relative to what was reported previously, known as forward telescoping. Results from multiple linear regression analyses showed that the single most consistent variable associated with telescoping was the number of years since the substance was first reported. Time since first report was the single consistent and strongly associated with telescoping in each wave-to-wave comparison for all three substances under study. Implications for policy and research are discussed.
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Affiliation(s)
- Audrey M Shillington
- San Diego State University, School of Social Work, College of Health and Human Services, Center for Alcohol and Other Drug Studies and Services
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Reid MJ, Langford KH, Grung M, Gjerde H, Amundsen EJ, Morland J, Thomas KV. Estimation of cocaine consumption in the community: a critical comparison of the results from three complimentary techniques. BMJ Open 2012; 2:bmjopen-2012-001637. [PMID: 23144259 PMCID: PMC3533010 DOI: 10.1136/bmjopen-2012-001637] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES A range of approaches are now available to estimate the level of drug use in the community so it is desirable to critically compare results from the differing techniques. This paper presents a comparison of the results from three methods for estimating the level of cocaine use in the general population. DESIGN The comparison applies to; a set of regional-scale sample survey questionnaires, a representative sample survey on drug use among drivers and an analysis of the quantity of cocaine-related metabolites in sewage. SETTING 14 438 participants provided data for the set of regional-scale sample survey questionnaires; 2341 drivers provided oral-fluid samples and untreated sewage from 570 000 people was analysed for biomarkers of cocaine use. All data were collected in Oslo, Norway. RESULTS 0.70 (0.36-1.03) % of drivers tested positive for cocaine use which suggest a prevalence that is higher than the 0.22 (0.13-0.30) % (per day) figure derived from regional-scale survey questionnaires, but the degree to which cocaine consumption in the driver population follows the general population is an unanswered question. Despite the comparatively low-prevalence figure the survey questionnaires did provide estimates of the volume of consumption that are comparable with the amount of cocaine-related metabolites in sewage. Per-user consumption estimates are however highlighted as a significant source of uncertainty as little or no data on the quantities consumed by individuals are available, and much of the existing data are contradictory. CONCLUSIONS The comparison carried out in the present study can provide an excellent means of checking the quality and accuracy of the three measurement techniques because they each approach the problem from a different viewpoint. Together the three complimentary techniques provide a well-balanced assessment of the drug-use situation in a given community and identify areas where more research is needed.
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Affiliation(s)
| | | | - Merete Grung
- Norwegian Institute for Water Research, Oslo, Norway
| | | | | | - Jorg Morland
- Norwegian Institute of Public Health, Oslo, Norway
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Reid MJ, Langford KH, Mørland J, Thomas KV. Quantitative assessment of time dependent drug-use trends by the analysis of drugs and related metabolites in raw sewage. Drug Alcohol Depend 2011; 119:179-86. [PMID: 21737215 DOI: 10.1016/j.drugalcdep.2011.06.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 06/03/2011] [Accepted: 06/07/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Accurate and timely information on the scale and dynamics of drug consumption is important for assessing the needs of law enforcement and public health services in a community. AIMS This paper presents a detailed examination of a comprehensive sewage-sampling campaign for the purposes of increasing an understanding of the dynamics of drug-flows in sewage streams, and developing new methodology by which this technique can support traditional drug-use surveys. METHODS A total of 104 sewage samples were collected from a treatment plant servicing approximately 500000 people and analysed for levels of methamphetamine, cocaine and cocaine metabolites. Careful examination of the kinetics of drug-flow profiles was then performed in order to identify trends or patterns of use within the community. RESULTS Results were validated against identical measurements of pharmaceutical reference compounds. Consumption profiles for cocaine and methamphetamine were found to differ in terms of frequency and timing of use. The majority of cocaine consumption occurs during the evening hours and 45% of consumption of this drug occurs in weekend periods. The flow of methamphetamine in the sewage system appears more evenly spread throughout the week. CONCLUSIONS This result is consistent with both an extended excretion half-life and a pattern of use that is more evenly balanced across all days of the week. Comprehensive investigation in to the scale and kinetics of drug flow in a sewage stream can therefore provide valuable information, not only in terms of the volume of drug consumed, but also in terms of identifying differing usage-patterns over daily and weekly time-scales.
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Affiliation(s)
- Malcolm J Reid
- Norwegian Institute for Water Research, Gaustadalleen 21, NO-0349 Oslo, Norway.
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Cummings JR, Wen H, Druss BG. Racial/ethnic differences in treatment for substance use disorders among U.S. adolescents. J Am Acad Child Adolesc Psychiatry 2011; 50:1265-74. [PMID: 22115147 PMCID: PMC3249933 DOI: 10.1016/j.jaac.2011.09.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 08/11/2011] [Accepted: 09/14/2011] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study examined differences in treatment rates for substance use disorders (SUD) among adolescents of white, black, Hispanic, Asian, Native American/Alaska Native, and Native Hawaiian/Pacific Islander race/ethnicity. METHOD Eight years of cross-sectional data (2001-2008) were pooled from the National Survey on Drug Use and Health to derive a nationally representative sample of 144,197 adolescents (aged 12-17 years); 12,634 adolescents were identified with SUD in the previous year. Weighted probit regressions were estimated with year fixed effects to examine whether racial/ethnic minorities had lower rates of treatment in any setting, in medical settings (i.e., hospital, rehabilitation facility, mental health clinic, and/or doctor's office), and in self-help programs. Initial models controlled for demographics and health status. Additional models further adjusted for family income and health insurance status. RESULTS Among adolescents with SUD, unadjusted treatment rates ranged from 8.4% among blacks to 23.5% among Native Hawaiian/Pacific Islanders. After adjusting for demographics and health status, blacks (RD = -3.9%, 95% CI = -6.4%, -1.3%) and Hispanics (RD = -2.3%, 95% CI = -4.1%, -0.4%) were significantly less likely to receive SUD treatment than whites (adjusted treatment rate 10.7%). These differences were exacerbated after adjusting for family income and insurance status. Lower treatment rates for black and Hispanic adolescents persisted when examining SUD treatment rates in medical settings and self-help programs. Treatment rates for other racial/ethnic groups did not generally differ from whites. CONCLUSION Results highlight exceptionally low treatment rates for SUD among all adolescents, with blacks and Hispanics experiencing the lowest treatment rates across all racial/ethnic groups.
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Affiliation(s)
- Janet R Cummings
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Room 650, Atlanta, GA 30322, USA.
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Griffin BA, Ramchand R, Edelen MO, McCaffrey DF, Morral AR. Associations between abstinence in adolescence and economic and educational outcomes seven years later among high-risk youth. Drug Alcohol Depend 2011; 113:118-24. [PMID: 20797825 PMCID: PMC3025066 DOI: 10.1016/j.drugalcdep.2010.07.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2009] [Revised: 07/01/2010] [Accepted: 07/03/2010] [Indexed: 11/25/2022]
Abstract
AIM In this study, we investigated the relationship between abstinence and long-term educational and economic outcomes among a sample of high-risk youth. METHODS Multivariable regression models were used to estimate associations between abstinence and outcomes among a sample of 13-17 year-olds referred to group homes in Los Angeles in 1999-2000 and followed for 87 months afterwards. Abstinence was measured during the first year of the study. We considered differential effects based on the duration of abstinence (12 vs. 6 months) and type of abstinence (all substances vs. use of alcohol and/or marijuana) on three 87-month outcomes: having received a high-school diploma or equivalent by age 20, institutionalization in the past 90 days, and total legitimate income for the past 90 days. RESULTS Abstinence from all substances for 12 months was associated with positive long-term educational and economic outcomes relative to using any drug during the same time interval. Abstaining from all substances for 12 months was also associated with an increased likelihood of being a legitimate wage earner and decreased likelihood of being institutionalized relative to using only alcohol and/or marijuana during that time interval. No effect on long-term outcomes was seen among youth who abstained for only 6 months relative to those who used drugs during this interval, or for youth who used only alcohol and/or marijuana over 12 months vs. those who used other drugs during this interval. CONCLUSIONS The results presented here justify continued and expanded efforts to promote long periods of abstinence from all drugs for high-risk youth.
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Petróczi A, Aidman EV, Hussain I, Deshmukh N, Nepusz T, Uvacsek M, Tóth M, Barker J, Naughton DP. Virtue or pretense? Looking behind self-declared innocence in doping. PLoS One 2010; 5:e10457. [PMID: 20463978 PMCID: PMC2864761 DOI: 10.1371/journal.pone.0010457] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Accepted: 04/05/2010] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Social science studies of doping practices in sport rely predominantly on self-reports. Studies of psychoactive drug use indicate that self-reporting is characterised by under-reporting. Likewise doping practice is likely to be equally under-reported, if not more so. This calls for more sophisticated methods for such reporting and for independent, objective validation of its results. The aims of this study were: i) to contrast self-reported doping use with objective results from chemical hair analysis and ii) to investigate the influence of the discrepancy on doping attitudes, social projection, descriptive norms and perceived pressure to use doping. METHODOLOGY/PRINCIPAL FINDINGS A doping attitudes questionnaire was developed and combined with a response latency-based implicit association test and hair sample analysis for key doping substances in 14 athletes selected from a larger sample (N = 82) to form contrast comparison groups. Results indicate that patterns of group differences in social projection, explicit attitude about and perceived pressure to use doping, vary depending on whether the user and non-user groups are defined by self-report or objectively verified through hair analysis. Thus, self-confessed users scored higher on social projection, explicit attitude to doping and perceived pressure. However, when a doping substance was detected in the hair of an athlete who denied doping use, their self-report evidenced extreme social desirability (negative attitude, low projection and low perceived pressure) and contrasted sharply with a more positive estimate of their implicit doping attitude. CONCLUSIONS/SIGNIFICANCE Hair analysis for performance enhancing substances has shown considerable potential in validating athletes' doping attitude estimations and admissions of use. Results not only confirm the need for improved self-report methodology for future research in socially-sensitive domains but also indicate where the improvements are likely to come from: as chemical validation remains expensive, a more realistic promise for large scale studies and online data collection efforts is held by measures of implicit social cognition.
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Affiliation(s)
- Andrea Petróczi
- School of Life Sciences, Kingston University London, Kingston upon Thames, United Kingdom.
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Napper LE, Fisher DG, Johnson ME, Wood MM. The reliability and validity of drug users' self reports of amphetamine use among primarily heroin and cocaine users. Addict Behav 2010; 35:350-4. [PMID: 20053503 PMCID: PMC2821802 DOI: 10.1016/j.addbeh.2009.12.006] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Revised: 10/09/2009] [Accepted: 12/10/2009] [Indexed: 10/20/2022]
Abstract
Relatively few studies have addressed the psychometric properties of self-report measures of amphetamine use. This study examines the reliability and validity of the Risk Behavior Assessment's (RBA) lifetime and recent amphetamine-use questions. To evaluate validity, 4027 out-of-treatment primarily cocaine and heroin users provided urine samples that were compared to self-report data; to evaluate reliability, 218 completed the RBA at two time points, 48h apart. In the overall sample, self-reports demonstrated moderately high validity, with a 95% accuracy rate (kappa=.54). When analysis was restricted to recent amphetamine users validity was slightly lower (71.5% accuracy; kappa=.41). Test-retest data indicated good reliability for self-reports of ever having used amphetamine (kappa=.79), and amphetamine use in the past 30 days (.75
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Affiliation(s)
- Lucy E. Napper
- Center for Behavioral Research and Services, California State University, Long Beach, Long Beach, CA 90813
| | - Dennis G. Fisher
- Center for Behavioral Research and Services, California State University, Long Beach, Long Beach, CA 90813
| | - Mark E. Johnson
- Behavioral Health Research and Services, University of Alaska Anchorage, Anchorage, AK 99508
| | - Michele M. Wood
- Health Science Department, California State University, Fullerton, Fullerton, CA 92831
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A randomized controlled study of a web-based performance improvement system for substance abuse treatment providers. J Subst Abuse Treat 2010; 38:251-62. [PMID: 20116964 DOI: 10.1016/j.jsat.2010.01.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Revised: 11/30/2009] [Accepted: 01/04/2010] [Indexed: 11/22/2022]
Abstract
We report here the results of a randomized, controlled trial evaluating the efficacy of a semiautomated performance improvement system ("patient feedback") that enables real-time monitoring of patient outcomes in outpatient substance abuse treatment clinics. The study involved 118 clinicians working at 20 community-based outpatient substance abuse treatment clinics in the northeast United States. Ten clinics received 12 weeks of the patient feedback performance improvement intervention, and 10 clinics received no intervention during the 12 weeks. More than 1,500 patients provided anonymous ratings of therapeutic alliance, treatment satisfaction, and drug/alcohol use. There was no evidence of an intervention effect on the primary drug and alcohol use scales. There was also no evidence of an intervention effect on secondary measures of therapeutic alliance. Clinician-rated measures of organizational functioning and job satisfaction also showed no intervention effect. Possible insights from these findings and alternative methods of utilizing feedback reports to enhance clinical outcomes are proposed.
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Howard DL, Strobino D, Sherman SG, Crum RM. Timing of incarceration during pregnancy and birth outcomes: exploring racial differences. Matern Child Health J 2008; 13:457-66. [PMID: 18561009 DOI: 10.1007/s10995-008-0376-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2007] [Accepted: 06/05/2008] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine whether there are racial differences in the relation between the timing of incarceration during pregnancy and birth outcomes among incarcerated pregnant women. METHODS We examined the medical records associated with 360 infants born to pregnant inmates in Texas state prisons between January 1, 2002 and December 31, 2004. Weighted linear regression was used, within racial strata, to model gestational age at delivery, and infant birth weight, respectively, as functions of gestational age at maternal admission to prison. Models were adjusted for maternal age; gravidity; educational attainment; history of tobacco, substance, and alcohol use and the presence of any maternal chronic disease. RESULTS Among Whites there was a 360.8 g lower mean birth weight for infants born to women incarcerated during weeks 14-20 relative to infants born to women incarcerated during weeks 1-13 (p < 0.10). Among Blacks and Hispanics, incarceration after the first trimester was not associated with a significant decrease in infant birth weight relative to incarceration during the first trimester. White women entering prison during the first trimester delivered infants at higher gestational ages than White women entering in the second trimester but the opposite was the case for Hispanics. CONCLUSIONS The association between the quantity of exposure to prison during pregnancy and birth outcomes appears to be different for Blacks, Whites, and Hispanic women. Future studies of the effect of incarceration on pregnancy outcomes should attempt to uncover potential racial differences in trends by obtaining racially stratified results or by assessing interaction with race.
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Affiliation(s)
- David L Howard
- Medical Scientist Training Program, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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