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Jaguga F, Aalsma MC, Enane LA, Turissini M, Kwobah EK, Apondi E, Barasa J, Kosgei G, Olando Y, Ott MA. A qualitative pilot study exploring the acceptability of a peer provider delivered substance use brief intervention from the perspective of youth in Kenya. Subst Abuse Treat Prev Policy 2025; 20:6. [PMID: 39934864 PMCID: PMC11817832 DOI: 10.1186/s13011-025-00639-9] [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] [Received: 08/19/2024] [Accepted: 02/01/2025] [Indexed: 02/13/2025] Open
Abstract
BACKGROUND Substance use disorders are prevalent among youth in sub-Saharan Africa (SSA), yet treatment resources are scarce. Peer provider delivered brief interventions (BIs) represent an affordable and potentially scalable strategy for addressing youth substance use disorders. The goal of this study is to assess the acceptability of a peer provider delivered substance use BI from the perspective of youth in Kenya. METHODS We conducted qualitative semi-structured interviews with youth participants (n = 25) to explore acceptability of a substance use BI. Youth were participants in a two-arm mixed-methods pilot randomized controlled trial (RCT) investigating the feasibility of a peer provider delivered single-session substance use BI for youth aged 15-24 years with moderate-risk substance use. The semi-structured interviews were conducted three months after the BI was delivered and were guided by the Theoretical Framework of Acceptability (TFA). Qualitative data were analyzed through thematic analysis. RESULTS We interviewed 25 of 38 participants in the BI arm, 18 males and 7 females; 15 were ages 18-24 years, and 10 ages 15-17 years. Affective attitude: Most youth reported that they enjoyed the session content and enjoyed interacting with the peer provider. Burden: Most youth felt that it was easy to understand the session and participate in it. Perceived effectiveness: Most of the youth perceived the intervention to be effective in helping them reduce substance use and improve their well-being. Ethicality: All youth perceived that the counselling session fit in with their goals and values. Intervention coherence: Most youth understood the overall goal of the intervention. They reported that the goal of the intervention was to help youth stop substance use, and to bring about behavior change. Opportunity costs: Some youth reported that they had to forgo other activities to attend the session, such as work, school, sports, gaming, visiting family, or house chores. Self-efficacy: Most youth felt confident about being able to cut down or stop using substances following the intervention. CONCLUSION AND RECOMMENDATIONS Our findings indicate that the peer provider delivered single-session substance use BI was acceptable to youth. The youth recommended that follow-up sessions be provided to ensure sustained behavior change. This study supports the utility of the TFA in exploring acceptability of a substance use intervention from the perspective of young people. TRIAL REGISTRATION NCT05545904 Registration date 16/09/2022 Registry ClinicalTrials.gov https//clinicaltrials.gov/study/NCT05545904.
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Affiliation(s)
- Florence Jaguga
- Moi Teaching & Referral Hospital Department of Alcohol and Drug Abuse Rehabilitative Services, PO BOX 3-30100, Eldoret, Kenya.
| | - Matthew C Aalsma
- Division of Child Health Services Research, Department of Pediatrics, Indiana University, Indianapolis, IN, USA
| | - Leslie A Enane
- The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Matthew Turissini
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Edith Kamaru Kwobah
- Moi Teaching & Referral Hospital Directorate of Mental Health and Rehabilitative Services, PO BOX 3-30100, Eldoret, Kenya
| | - Edith Apondi
- Department of Child Health and Pediatrics, Moi Teaching & Referral Hospital, PO BOX 3-30100, Eldoret, Kenya
| | - Julius Barasa
- Academic Model Providing Access to Healthcare, PO BOX 4606, Eldoret, Kenya
| | - Gilliane Kosgei
- Academic Model Providing Access to Healthcare, PO BOX 4606, Eldoret, Kenya
| | - Yvonne Olando
- National Authority for the Campaign against Alcohol and Drug Abuse, P.O. Box 10774 - 00100, Nairobi, Kenya
| | - Mary A Ott
- The Arnhold Institute for Global Health and the Departments of Global Health and Health Systems Design and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Moore SK, Boggis JS, Gauthier PR, Lambert-Harris CA, Hichborn EG, Bell KD, Saunders EC, Montgomery L, Murphy EI, Turner AM, Agosti N, McLeman BM, Marsch LA. Technology-Based Interventions for Substance Use Treatment Among People Who Identify as African American or Black, Hispanic or Latino, and American Indian or Alaska Native: Scoping Review. J Med Internet Res 2024; 26:e53685. [PMID: 39626234 PMCID: PMC11653051 DOI: 10.2196/53685] [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] [Received: 10/18/2023] [Revised: 04/21/2024] [Accepted: 10/11/2024] [Indexed: 12/29/2024] Open
Abstract
BACKGROUND In the United States, racial and ethnic disparities in substance use treatment outcomes are persistent, especially among underrepresented minority (URM) populations. Technology-based interventions (TBIs) for substance use treatment show promise in reducing barriers to evidence-based treatment, yet no studies have described how TBIs may impact racial or ethnic health equity. OBJECTIVE This study explored whether TBIs in substance use treatment research promote health equity among people who identify as African American or Black, Hispanic or Latino, and American Indian or Alaska Native through their inclusion in research. We explored whether research that includes the aforementioned groups consciously considers race and/or ethnicity beyond including these populations as participants. METHODS We conducted a scoping review of 5 electronic databases to identify TBIs in substance use treatment studies published in English between January 2000 and March 2021. Studies were included if ≥50% of participants identified as African American or Black, Hispanic or Latino, or American Indian or Alaska Native when combined. Included studies were evaluated for conscious consideration of race and ethnicity in at least one manuscript section. Finally, we conducted a critical appraisal of each study's potential to facilitate insights into the impact of a TBI for members of specific URM groups. RESULTS Of 6897 titles and abstracts screened and 1158 full-text articles assessed for eligibility, nearly half (532/1158, 45.9%) of the full-text articles were excluded due to the absence of data on race, ethnicity, or not meeting the aforementioned demographic eligibility criteria. Overall, 110 studies met the inclusion criteria. Study designs included 39.1% (43/110) randomized trials, and 35.5% (39/110) feasibility studies. In total, 47.3% (52/110) of studies used computer-based interventions, including electronic screening, brief interventions, and referrals to treatment, whereas 33.6% (37/110) used interactive voice response, ecological momentary assessment or interventions, or SMS text messaging via mobile phones. Studies focused on the following substances: alcohol or drugs (45/110, 40.9%), alcohol alone (26/110, 23.6%), opioids (8/110, 7.3%), cannabis (6/110, 5.5%), cocaine (4/110, 3.6%), and methamphetamines (3/110, 2.7%). Of the studies that consciously considered race or ethnicity (29/110, 26.4%), 6.4% (7/110) explicitly considered race or ethnicity in all manuscript sections. Overall, 28.2% (31/110) of the studies were critically appraised as having a high confidence in the interpretability of the findings for specific URM groups. CONCLUSIONS While the prevalence of TBIs in substance use treatment has increased recently, studies that include and consciously consider URM groups are rare, especially for American Indian or Alaska Native and Hispanic or Latino groups. This review highlights the limited research on TBIs in substance use treatment that promotes racial and ethnic health equity and provides context, insights, and direction for researchers working to develop and evaluate digital technology substance use interventions while promoting health equity.
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Affiliation(s)
- Sarah K Moore
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Jesse S Boggis
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Phoebe R Gauthier
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Chantal A Lambert-Harris
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Emily G Hichborn
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Kathleen D Bell
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Elizabeth C Saunders
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - LaTrice Montgomery
- College of Medicine, University of Cincinnati, Cincinatti, OH, United States
| | - Eilis I Murphy
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Avery M Turner
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Nico Agosti
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Bethany M McLeman
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
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Colonna R, Tucker P, Mandich A, Alvarez L. Developing a mobile-based brief intervention to reduce cannabis-impaired driving among youth: An intervention mapping approach. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 134:104626. [PMID: 39476788 DOI: 10.1016/j.drugpo.2024.104626] [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: 07/04/2024] [Revised: 10/01/2024] [Accepted: 10/16/2024] [Indexed: 12/06/2024]
Abstract
Behaviour change interventions delivered via smartphones have the potential to reduce youth cannabis use and driving under the influence of cannabis (DUIC). Countless smartphone applications (either downloadable or web-based) are available to help reduce substance use and impaired driving. However, most are developed without evidence-based content and theory, and many have poor user engagement. This study aims to: (1) describe the systematic development and theoretical foundations of a youth DUIC smartphone intervention, and (2) describe the pre-testing among a sample of youth and adult cannabis educators (prior to efficacy testing). A 6-step Intervention Mapping approach was utilized to combine theory, evidence, and user feedback to develop and implement the 'High Alert' intervention. This evidence-based and iterative process entailed: (1) conducting a needs assessment, (2) identifying intervention objectives, which map on the following DUIC determinants: knowledge, attitudes, risk perception, perceived norms, and self-efficacy, (3) selecting intervention theory and design, (4) developing of the intervention, (5) implementation, and (6) evaluation. Application of Intervention Mapping resulted in a smartphone web-based application that could support reductions in cannabis use and DUIC. The 'High Alert' intervention was created to include four modules with contents focusing on educating youth on the dangers and legal risks of DUIC, limiting risky situations, avoiding riding with an impaired driver, planning a safe ride home, and promoting safer cannabis use. Future research will test the efficacy of the intervention in reducing risky cannabis use and DUIC among youth.
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Affiliation(s)
- Robert Colonna
- Health and Rehabilitation Sciences, Western University, London, ON, Canada.
| | - Patricia Tucker
- School of Occupational Therapy, Western University, London, ON, Canada; Lawson Health Research Institute, London, ON, Canada; Children's Health Research Institute, London, ON, Canada
| | - Angela Mandich
- School of Occupational Therapy, Western University, London, ON, Canada
| | - Liliana Alvarez
- School of Occupational Therapy, Western University, London, ON, Canada
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Balán IC, Marone RO, Barreda V, Naar S, Wang Y. Integration of an Electronic Screening, Brief Intervention, and Referral to Treatment Program Into an HIV Testing Program to Reduce Substance Use and HIV Risk Behavior Among Men Who Have Sex With Men: Protocol for Intervention Development and a Pilot Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e56683. [PMID: 38483463 PMCID: PMC10979339 DOI: 10.2196/56683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Men who have sex with men (MSM) are disproportionally affected by HIV and drug and alcohol use; however, few effective HIV prevention interventions for MSM who use substances exist. Screening, Brief Intervention, and Referral to Treatment is an early intervention for non-treatment-seeking individuals with problematic substance use and for timely referral to treatment for those with substance use disorders. Electronic screening and brief interventions (e-SBIs) reduce implementation challenges. An e-SBI tailored for MSM at the time of HIV testing might be particularly opportune to strengthen their motivation to reduce substance use and HIV risk behavior. OBJECTIVE This study aims to develop a tailored e-SBI program to reduce substance use and HIV risk behavior among MSM seeking HIV testing at Nexo Asociación Civil, our community partners in Argentina (primary); assess the feasibility and acceptability of integrating the e-SBI into the Nexo HIV testing program (primary); assess the feasibility and acceptability of implementing an adapted Men's Health Project (MHP) at Nexo (secondary); and finally, explore preliminary findings on substance use and sexual risk reduction outcomes (exploratory). METHODS This mixed methods study has 2 stages. During stage 1 (development), we will use the User Centered Rapid App Design process consisting of focus groups (n=16), individual interviews (n=24), and a pilot deployment of the e-SBI (n=50) to iteratively develop the e-SBI. Quantitative and qualitative assessments at each step will inform the revision of the e-SBI. Furthermore, we will use the assessment, decision, administration, production, topic experts, integration, training, testing framework to adapt MHP. During stage 2 (pilot randomized controlled trial [RCT]), we will randomize 200 MSM coming to Nexo for HIV testing. They will complete a baseline assessment and then their assigned intervention (e-SBI vs screening only) and will be followed-up for 6 months. We will also conduct in-depth interviews with up to 45 participants: 15 participants from either study condition who entered or completed MHP or other substance abuse treatment and 15 from each arm who met the criteria for MHP but did not request it. RESULTS The study began recruitment in October 2022, and the stage-1 pilot study is near completion. Preliminary findings from stage 1 show high e-SBI acceptability. Data analysis of the stage-1 pilot is now beginning. The stage-2 pilot RCT will be launched in March 2024, with all data collection completed by May 2025. CONCLUSIONS This study will allow us to assess the acceptability and feasibility of e-SBI implementation during HIV testing encounters. We will also build the necessary research infrastructure for a subsequent RCT to assess the efficacy of e-SBIs in reducing substance use and HIV sexual risk behavior among MSM in this setting. TRIAL REGISTRATION ClinicalTrials.gov NCT05542914; https://tinyurl.com/yyjj64dm. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/56683.
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Affiliation(s)
- Iván C Balán
- Center for Translational Behavioral Science, Department of Behavioral Science and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, United States
| | | | | | - Sylvie Naar
- Center for Translational Behavioral Science, Department of Behavioral Science and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, United States
| | - Yuxia Wang
- Center for Translational Behavioral Science, Department of Behavioral Science and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, United States
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Ceprnja D, Chipchase L, Liamputtong P, Gupta A. "We are not there yet": perceptions, beliefs and experiences of healthcare professionals caring for women with pregnancy-related pelvic girdle pain in Australia. BMC Pregnancy Childbirth 2023; 23:682. [PMID: 37735360 PMCID: PMC10512538 DOI: 10.1186/s12884-023-06000-x] [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: 03/26/2023] [Accepted: 09/14/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Pregnancy-related pelvic girdle pain (PPGP) is a common condition worldwide. Women report being unprepared about PPGP, and state they receive little recognition and support from healthcare professionals. Situated within the Common-Sense Model and Convergent Care Theory, this study sought to gain a conceptual understanding of the perceptions, beliefs and experiences of healthcare professionals who provide routine care for women with PPGP in Australia. METHODS A qualitative research design, using individual, semi-structured interviews with purposive sampling of healthcare professionals (N=27) consisting of doctors (N=9), midwives (N=9) and physiotherapists (N=9). Most participants were female (22/27) with a range of professional experience. An interview guide consisting of open-ended questions was used with a flexible and responsive approach. Thematic analysis was performed where interview data were transcribed, coded, grouped into meaningful categories and then constructed into broad themes. RESULTS Four themes were identified: 1. Identity and impact of PPGP; 2. What works well?; 3. What gets in the way?; and 4. Quality care: What is needed? Healthcare professionals recognised PPGP as a common and disabling condition, which created a large impact on a woman's life during pregnancy. Stepped-level care, including education and physiotherapy intervention, was seen to be helpful and led to a positive prognosis. Barriers at patient, clinician and organisation levels were identified and led to consequences for women with PPGP not receiving the care they need. CONCLUSION This study elucidates important implications for health care delivery. Acknowledging that PPGP is a common condition causing difficulty for many women, healthcare professionals identified strong teamwork and greater clinical experience as important factors in being able to deliver appropriate healthcare. Whilst healthcare professionals reported being committed to caring for women during pregnancy, busy workloads, attitudes towards curability, and a lack of formal education were identified as barriers to care. The findings suggest timely access, clear referral pathways and an integrated approach are required for best care practice for women with PPGP. A greater emphasis on the need for multidisciplinary models of care during pregnancy is evident.
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Affiliation(s)
- Dragana Ceprnja
- School of Health Sciences, Western Sydney University, Sydney, Australia
- Physiotherapy Department, Westmead Hospital, Sydney, Australia
| | - Lucy Chipchase
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | | | - Amitabh Gupta
- School of Health Sciences, Western Sydney University, Sydney, Australia
- Physiotherapy Department, Westmead Hospital, Sydney, Australia
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Shah AQ, Noronha N, Chin-See R, Hanna C, Kadri Z, Marwaha A, Rambharack N, Ng JY. The use and effects of telemedicine on complementary, alternative, and integrative medicine practices: a scoping review. BMC Complement Med Ther 2023; 23:275. [PMID: 37533042 PMCID: PMC10394941 DOI: 10.1186/s12906-023-04100-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 07/21/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Telemedicine includes the delivery of health-care services and sharing of health information across distances. Past research has found that telemedicine can play a role in enhancing complementary, alternative, and integrative medicine (CAIM) while allowing the maintenance of cultural values and ancestral knowledge. This scoping review synthesized evidence regarding the use of telemedicine in the context of CAIM. METHODS Following Arksey and O'Malley's scoping review framework, CINAHL, PsycINFO, MEDLINE, EMBASE and AMED databases were searched systematically. The CADTH website was also searched for grey literature. Eligible articles included a CAIM practice or therapy offered through telemedicine, with no restrictions placed on the type of telemedicine technology used. Inductive thematic analysis was conducted to synthesise common themes among the included studies. RESULTS Sixty-two articles were included in this synthesis. The following themes emerged: 1) the practitioner view of CAIM delivered through telemedicine, 2) the patient view of CAIM delivered through telemedicine, and 3) the technological impacts of telemedicine delivery of CAIM. CONCLUSIONS Studies have shown that telemedicine delivery of CAIM is feasible, acceptable, and results in positive health outcomes. Some barriers remain such as the presence of chronic illness and morbidity, inability to form strong patient-provider relationships relative to face-to-face approaches, and technological difficulties. Future intervention research should focus on reducing such barriers, as well as explore which patient population would realize the greatest benefit from CAIM delivered via telemedicine, and the impact of interventions on providers and caregivers.
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Affiliation(s)
- Aimun Qadeer Shah
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Noella Noronha
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Robert Chin-See
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Christina Hanna
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Zeest Kadri
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Amn Marwaha
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Neetu Rambharack
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Jeremy Y Ng
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
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Gette JA, Regan T, Schumacher JA. Screening, brief intervention, and referral to treatment (SBIRT) for cannabis: A scoping review. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 146:208957. [PMID: 36880902 DOI: 10.1016/j.josat.2023.208957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/04/2022] [Accepted: 01/09/2023] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Screening, brief intervention, and referral to treatment (SBIRT) has been used to change substance use behavior. Despite cannabis being the most prevalent federally illicit substance, we have limited understanding of use of SBIRT for managing cannabis use. This review aimed to summarize the literature on SBIRT for cannabis use across age groups and contexts over the last two decades. METHODS This scoping review followed the a priori guide outlined by the PRISMA (Preferred Reporting Items for Scoping Reviews and Meta-Analyses) statement. We gathered articles from PsycINFO, PubMed, Sage Journals Online, ScienceDirect, and SpringerLink. RESULTS The final analysis includes forty-four articles. Results indicate inconsistent implementation of universal screens and suggest screens assessing cannabis-specific consequences and utilizing normative data may increase patient engagement. Broadly, SBIRT for cannabis demonstrates high acceptability. However, the impact of SBIRT on behavior change across various modifications to intervention content and modality has been inconsistent. In adults, patients with primary cannabis use are not engaging in recommended treatment at similar rates to other substances. Results also suggest a lack of research addressing referral to treatment in adolescents and emerging adults. DISCUSSION Based on this review, we offer several to improve each component of SBRIT that may increase implementation of screens, effectiveness of brief interventions, and engagement in follow-up treatment.
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Affiliation(s)
- J A Gette
- Center for Alcohol and Substance Use Studies, Rutgers, the State University of New Jersey, Piscataway, NJ, United States of America.
| | - T Regan
- Department of Psychiatry, the University of Mississippi Medical Center, Jackson, MS, United States of America
| | - J A Schumacher
- Department of Psychiatry, the University of Mississippi Medical Center, Jackson, MS, United States of America
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McCoy L, Newman Carroll S, Walters K. "It's so Natural It Goes Hand in Hand": A Qualitative Study of Maternal Perceptions of Cannabis Use during Pregnancy. J Psychoactive Drugs 2022:1-8. [PMID: 35679475 DOI: 10.1080/02791072.2022.2080615] [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] [Indexed: 10/18/2022]
Abstract
As the market continues to embrace marijuana as a holistic product, perceptions about its uses are increasingly contradictory to public health recommendations. The purpose of this research was to qualitatively analyze the perceived risks and benefits of cannabis use during pregnancy via in-depth semi-structured interviews conducted with nine women. This research is intended to inform patient-provider interactions regarding cannabis use in prenatal clinical settings.
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Affiliation(s)
- Lillian McCoy
- Department of Public Health, Fort Lewis College, Durango, United States
| | - Sara Newman Carroll
- Department of Public Health, Fort Lewis College, Durango, United States.,Health Sciences Department, Eastern Connecticut State University, Willimantic, United States
| | - Kevin Walters
- Department of Psychology, Fort Lewis College, Durango, United States
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Colonna R, Alvarez L. Characteristics of mobile-based brief interventions targeting substance use among youth: a rapid review. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2051622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Robert Colonna
- Health and Rehabilitation Sciences Graduate Program, Western University, London, Ontario, Canada
| | - Liliana Alvarez
- School of Occupational Therapy, Western University, London, Ontario, Canada
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Dauber S, West A, Hammond C, Cohen I, Thrul J. Postpartum heavy episodic drinking: A survey to inform development of a text messaging intervention. Drug Alcohol Rev 2022; 41:182-187. [PMID: 34192391 PMCID: PMC8716644 DOI: 10.1111/dar.13341] [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: 02/16/2021] [Revised: 05/30/2021] [Accepted: 06/04/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Text messaging interventions (TMI) are promising for addressing heavy episodic drinking (HED) in non-treatment-seeking postpartum women. Their anonymous delivery can overcome fear of consequences that often prevents postpartum women from seeking treatment for HED. We assessed feasibility and acceptability of text messaging to inform the development of a tailored TMI for postpartum HED. METHODS We surveyed 165 postpartum women recruited via a national Qualtrics panel on their drinking behaviours, mobile technology use and TMI preferences. RESULTS Twenty-five percent of the sample (N = 41) were classified as heavy episodic drinkers, with significant drinking reported before, during and after pregnancy, supporting the need for intervention. Feasibility of text messaging was supported by nearly universal mobile phone ownership and text messaging. Attitudes and intervention preferences varied, with 30% of HEDs likely to participate in an intervention asking them to receive automated messages, and 46% likely to participate in an intervention that included live texting with a counsellor. Respondents were more likely to participate in a study that asked them to respond to messages about mood and stress (63%) than daily drinking behaviours (35%), and were most interested in a TMI that included live texting with a counsellor. Nearly half the sample endorsed fear of child removal as a significant barrier to participation. DISCUSSION AND CONCLUSIONS Findings support the feasibility of text messaging as an intervention approach for postpartum HEDs. Postpartum women may have unique concerns and preferences that differ from other groups of HEDs, making a user-centred design approach critical.
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Affiliation(s)
| | - Allison West
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | | | - Ilana Cohen
- Johns Hopkins School of Medicine, Baltimore, USA
| | - Johannes Thrul
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, USA,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
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Gesterling L, Bradford H. Cannabis Use in Pregnancy: A State of the Science Review. J Midwifery Womens Health 2021; 67:305-313. [PMID: 34841645 DOI: 10.1111/jmwh.13293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/25/2022]
Abstract
With a growing number of states legalizing recreational use, cannabis consumption during pregnancy is increasing. Population-based data and rigorous studies examining the association of cannabis use in pregnancy with perinatal outcomes are limited, but trends include preterm prelabor rupture of membranes, placenta previa, and an increased length of hospital stay. Neonates of pregnant persons who used cannabis during their pregnancy can be at increased risk of low birth weight, preterm birth, neonatal intensive care unit admission, neurocognitive deficits, and infectious and neurologic morbidity and mortality. This state of the science review examines the prevalence of cannabis use in pregnancy, its pharmacodynamics and how that is influenced by pregnancy, and associated adverse perinatal and neonatal outcomes. Implications for health care providers caring for pregnant persons using cannabis, especially in legalized states, are discussed.
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Affiliation(s)
- Lisa Gesterling
- Nurse-Midwifery/Women's Health Nurse Practitioner Program, Georgetown University School of Nursing and Health Studies, Washington, DC
| | - Heather Bradford
- Nurse-Midwifery/Women's Health Nurse Practitioner Program, Georgetown University School of Nursing and Health Studies, Washington, DC
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Wouldes TA, Crawford A, Stevens S, Stasiak K. Evidence for the Effectiveness and Acceptability of e-SBI or e-SBIRT in the Management of Alcohol and Illicit Substance Use in Pregnant and Post-partum Women. Front Psychiatry 2021; 12:634805. [PMID: 34025470 PMCID: PMC8131659 DOI: 10.3389/fpsyt.2021.634805] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/17/2021] [Indexed: 12/12/2022] Open
Abstract
Alcohol and illicit psychoactive drug use during pregnancy have increased worldwide, putting women and their children's health and development at risk. Multiple drug use, comorbid psychiatric disorders, sexual and physical abuse are common in women who use alcohol and drugs during pregnancy. The effects on the mother include poor reproductive and life-long health, legal, family, and social problems. Additionally, the exposed child is at increased risk of long-term physical health, mental health, and developmental problems. The stigma associated with substance use during pregnancy and some clinicians' reticence to inquire about substance use means many women are not receiving adequate prenatal, substance abuse, and mental health care. Evidence for mHealth apps to provide health care for pregnant and post-partum women reveal the usability and effectiveness of these apps to reduce gestational weight gain, improve nutrition, promote smoking cessation and manage gestational diabetes mellitus, and treat depression and anxiety. Emerging evidence suggests mHealth technology using a public health approach of electronic screening, brief intervention, or referral to treatment (e-SBIRT) for substance use or abuse can overcome the typical barriers preventing women from receiving treatment for alcohol and drug use during pregnancy. This brief intervention delivered through a mobile device may be equally effective as SBIRT delivered by a health care professional in preventing maternal drug use, minimizing the effects to the exposed child, and providing a pathway to therapeutic options for a substance use disorder. However, larger studies in more diverse settings with women who have co-morbid mental illness and a constellation of social risk factors that are frequently associated with substance use disorders are needed.
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Affiliation(s)
- Trecia A. Wouldes
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Andi Crawford
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
- Te Ara Manapou, Parenting and Pregnancy Service, Hawke's Bay District Health Board, Hastings, New Zealand
| | - Suzanne Stevens
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
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