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Monari EN, Booth R, Forchuk C, Csiernik R. Experience of Family Members of Relatives With Substance Use Disorders: An Integrative Literature Review. Creat Nurs 2024:10784535241252169. [PMID: 38758032 DOI: 10.1177/10784535241252169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Background: Substance use disorders (SUDs) present substantial challenges for family members living with or supporting relatives with SUDs. This review explores existing literature on family members' experiences with relatives with SUDs and their support needs. Method: An integrative review was conducted by searching literature in the Cumulative Index of Nursing and Allied Health, PubMed, PsycINFO, ProQuest, and Scopus databases. Results: Five themes were generated based on analysis of 26 empirical studies: (a) family members' and caregivers' experiences of SUDs; (b) impact of SUDs-related aggressive/violent behaviors on families; (c) dilemmas faced by family members; (d) culture and family stigma related to SUDs; and (e) factors contributing to SUDs, challenges, and support needs. The review highlighted barriers to seeking support due to stigma and guilt, underscoring the need for structured support programs. Conclusions: This review sheds light on the challenges faced by family members with relatives suffering from SUDs and emphasizes the crucial need for structured support programs. The findings provide insights for developing initiatives to address the social and trauma-induced needs of family members and to establish support resources for them.
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Affiliation(s)
- Esther N Monari
- School of Nursing, Memorial University of Newfoundland, Canada
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2
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Amponsah EB, Abdullah A, Eltigani B, Cluver LD. Risk and Protective Factors of Commercial Sexual Exploitation of Children and Adolescents in sub-Saharan Africa: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241241021. [PMID: 38554071 DOI: 10.1177/15248380241241021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/01/2024]
Abstract
Commercial sexual exploitation of children (CSEC) has emerged as a critical child protection and public health concern in recent years. While the phenomenon is prevalent globally, its impact is compounded in sub-Saharan Africa owing to the cultural and socioeconomic challenges that leave many households in the region vulnerable. The present study synthesized existing evidence using the socioecological model as a guiding framework to assess the risk and protective factors associated with CSEC in sub-Saharan Africa. A protocol for the study was published in PROSPERO (CRD42022331832) with pre-specified inclusion and exclusion criteria. Studies were screened and extracted from eight databases: PsycINFO, Scopus, Web of Science, PROQUEST (Social Science Premium), PubMed, CINAHL, EMBASE, and MEDLINE via Ovid. After an initial screening of 4,377 papers, seven studies were found eligible for the final review. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide for reporting systematic reviews. Included studies were appraised and rated using the Cambridge Quality Checklist and GRADE. Findings revealed risk factors, including adverse childhood experience and victimization, females aged 16 years and older, school dropouts, technology influence, child and parental alcohol use, and separation from caregivers. On the other hand, protective factors such as the number of female adolescents in a household, frequent health screening in schools, children being in school, and high parental monitoring were found to be associated with a lower risk of CSEC. Based on these findings, we recommend that interventions in sub-Saharan Africa adopt a holistic approach that addresses identified risk factors while harnessing protective factors to combat CSEC effectively.
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Affiliation(s)
| | | | | | - Lucie D Cluver
- University of Oxford, Oxford, UK
- University of Cape Town, Cape Town, South Africa
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3
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McGovern R, Smart D, Alderson H, Fouweather T, Kaner E. Promoting Alcohol Reduction in Non-Treatment Seeking parents (PAReNTS): a pilot feasibility cluster randomized controlled trial of brief alcohol interventions with parents in contact with child safeguarding services. Alcohol Alcohol 2024; 59:agad076. [PMID: 37950898 PMCID: PMC10783945 DOI: 10.1093/alcalc/agad076] [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: 08/23/2023] [Revised: 10/10/2023] [Accepted: 10/23/2023] [Indexed: 11/13/2023] Open
Abstract
Many parents who come into contact with early help and children's social care services are risky drinkers. This study aimed to investigate the feasibility and acceptability of conducting a trial of brief alcohol interventions within this setting. We conducted a three-arm pilot feasibility cluster randomised controlled trial in the North-East of England. The additive interventions were: i) screening and a healthy lifestyle leaflet (control); ii) brief advice; iii) extended brief intervention. The trial was later reduced to two-arm due to the extended brief intervention being infeasible. Of the 1769 parents that were approached, 429 consented to be screened (24%), the majority were eligible to participate (n = 415; 97%), 147 of which (35%) scored ≥5 on the AUDIT-C screening tool. There were 108 parents (74%) who consented to participate in the trial (n = 50 control; n = 58 brief advice). Follow-up rates at 6 and 12-months were 61% and 43%. The TLFB30 was found to be a suitable tool to measure the primary outcome of heavy episodic drinking. Qualitative data showed that parents and practitioners largely found trial procedures to be acceptable, however, care should be taken when discussing alcohol risk with parents in this setting. Most of the a-priori success criteria were met in this pilot feasibility trial. The findings suggest that it may be feasible to conduct a two-arm randomised controlled trial of brief alcohol interventions to parents in contact with early help and social care. The TLFB30 was found to be a suitable tool to measure the primary outcome of heavy episodic drinking.
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Affiliation(s)
- Ruth McGovern
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom
| | - Deborah Smart
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom
| | - Hayley Alderson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom
| | - Tony Fouweather
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom
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Låftman SB, Magnusson C, Olsson G, Wahlström J, Modin B. Perceived problematic alcohol use in the family and adolescents' stress-related complaints: examining the buffering role of the school's degree of student focus as rated by its teachers. BMC Public Health 2023; 23:1754. [PMID: 37684584 PMCID: PMC10492349 DOI: 10.1186/s12889-023-16505-x] [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: 04/14/2023] [Accepted: 08/10/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND A non-negligible proportion of children grow up with problematic alcohol use in the family. Problematic familial drinking can be regarded as a stressor, and prior studies have consistently reported poorer mental health among adolescents who are exposed. However, it is also of relevance to identify modifiable protective factors which may buffer against stress-related ill-health in this group of adolescents. One context where such factors may be present is the school. The aim of this study is to examine the relationship between perceived problematic familial alcohol use and students' stress-related complaints, and specifically to explore if the school's degree of student focus can buffer against any such negative health consequences of problem drinking at home. METHODS Data were drawn from four separate surveys, the Stockholm School Survey (SSS) and the Stockholm Teacher Survey (STS) conducted in 2014 and 2016 among 7,944 students (~ 15-16 years) and 2,024 teachers in 147 Stockholm senior-level school units. Perceived problematic familial alcohol use was measured by one item in the SSS. Stress-related complaints were captured by co-occurring somatic complaints and psychological distress, and reported by students in the SSS. The school's student focus was measured by an index based on teachers' ratings of four items in the STS. A set of covariates at the student and the school level were also included. Two-level binary logistic and linear regression models were performed. RESULTS Perceived problematic familial alcohol use was linked with an increased likelihood of reporting co-occurring somatic complaints as well as psychological distress. Cross-level interactions revealed that the association between perceived problematic familial alcohol use and co-occurring somatic complaints was weaker among students attending schools with stronger teacher-rated student focus. Regarding psychological distress, the association was weaker for students attending schools with intermediate or strong teacher-rated student focus, compared with those attending schools with weaker teacher-rated student focus. CONCLUSIONS The findings provide support for the assumption that favourable conditions in schools can buffer against negative health consequences of problematic conditions in the family, thus serving a compensatory role.
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Affiliation(s)
- Sara Brolin Låftman
- Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, 10691 Stockholm, Sweden
| | - Charlotta Magnusson
- Swedish Institute for Social Research (SOFI), Stockholm University, 10691 Stockholm, Sweden
| | - Gabriella Olsson
- Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, 10691 Stockholm, Sweden
| | - Joakim Wahlström
- Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, 10691 Stockholm, Sweden
| | - Bitte Modin
- Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, 10691 Stockholm, Sweden
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Spencer L, Alderson H, Scott S, Kaner E, Ling J. 'The Addiction Was Making Things Harder for My Mental Health': A Qualitative Exploration of the Views of Adults and Adolescents Accessing a Substance Misuse Treatment Service. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5967. [PMID: 37297571 PMCID: PMC10253073 DOI: 10.3390/ijerph20115967] [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: 03/27/2023] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023]
Abstract
The relationship between substance use and mental health is complex, and both constitute a global public health burden. In the UK, the estimated annual financial costs of alcohol-related harm and illicit drug use are GBP 21.5 billion and GBP 10.7 billion, respectively. This issue is magnified in the North East of England, where treatment access is low and a large proportion of individuals experience socioeconomic deprivation. The present study aimed to explore the experiences of adults and adolescents accessing a substance misuse treatment service in the North East, in order to inform policy makers, commissioners, and providers of substance misuse treatment and prevention. Semi-structured qualitative interviews were conducted with an opportunistic sample of n = 15 adult participants (aged 18 years and over) and n = 10 adolescent participants (aged between 13 and 17 years). Interviews were audio-recorded, transcribed, anonymised, and analysed thematically. Five key themes were identified: (1) initiation of substance use, (2) early life experiences, (3) the bi-directional relationship of mental health and substance use, (4) cessation of substance use, and (5) accessing treatment. Future preventative interventions should focus on providing support to individuals who have been exposed to adverse childhood experiences, with treatment provision for individuals experiencing co-occurring mental health and substance use issues taking a more holistic approach.
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Affiliation(s)
- Liam Spencer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK (S.S.)
| | - Hayley Alderson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK (S.S.)
| | - Steph Scott
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK (S.S.)
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK (S.S.)
| | - Jonathan Ling
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland SR1 3SD, UK
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Appleseth HS, Moyers SA, Crockett-Barbera EK, Hartwell M, Arndt S, Croff JM. Language considerations for children of parents with substance use disorders. Subst Abuse Treat Prev Policy 2023; 18:28. [PMID: 37208692 PMCID: PMC10197365 DOI: 10.1186/s13011-023-00536-z] [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: 05/03/2023] [Indexed: 05/21/2023] Open
Abstract
Parents with substance use disorders are highly stigmatized by multiple systems (e.g., healthcare, education, legal, social). As a result, they are more likely to experience discrimination and health inequities [1, 2]. Children of parents with substance use disorders often do not fare any better, as they frequently experience stigma and poorer outcomes by association [3, 4]. Calls to action for person-centered language for alcohol and other drug problems have led to improved terminology [5-8]. Despite a long history of stigmatizing, offensive labels such as "children of alcoholics" and "crack babies," children have been left out of person-centered language initiatives. Children of parents with substance use disorders can feel invisible, shameful, isolated, and forgotten-particularly in treatment settings when programming is centered on the parent [9, 10]. Person-centered language is shown to improve treatment outcomes and reduce stigma [11, 12]. Therefore, we need to adhere to consistent, non-stigmatizing terminology when referencing children of parents with substance use disorders. Most importantly, we must center the voices and preferences of those with lived experience to enact meaningful change and effective resource allocation.
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Affiliation(s)
- Hannah S Appleseth
- Department of Psychology, Oklahoma State University, Stillwater, OK, 74074, USA.
| | - Susette A Moyers
- Oklahoma State University Center for Health Sciences, Tulsa, OK, 74107, USA
| | | | - Micah Hartwell
- Oklahoma State University Center for Health Sciences, Tulsa, OK, 74107, USA
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Tahlequah, OK, 74464, USA
| | - Stephan Arndt
- Editor Substance Abuse Treatment, Prevention and Policy, Departments of Psychiatry and Biostatistics, College of Medicine, JPP, University of Iowa, Iowa City, IA, 52240, USA
| | - Julie M Croff
- Oklahoma State University Center for Health Sciences, Tulsa, OK, 74107, USA
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Salonen D, McGovern R, Sobo-Allen L, Adams E, Muir C, Bourne J, Herlihy J, Tasker F, Hunter D, Kaner E. Being and becoming a father in the context of heavy drinking and other substance use—a qualitative evidence synthesis. DRUGS: EDUCATION, PREVENTION AND POLICY 2023. [DOI: 10.1080/09687637.2023.2167650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- D. Salonen
- Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - R. McGovern
- Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK
| | - L. Sobo-Allen
- School of Health, Leeds Beckett University - City Campus, Leeds, UK
| | - E. Adams
- Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK
| | - C. Muir
- Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK
| | - J Bourne
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - J. Herlihy
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - F. Tasker
- Changing Futures Northumbria, Newcastle upon Tyne, UK
| | - D. Hunter
- Changing Futures Northumbria, Newcastle upon Tyne, UK
| | - E. Kaner
- Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK
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McGovern R, Bogowicz P, Meader N, Kaner E, Alderson H, Craig D, Geijer-Simpson E, Jackson K, Muir C, Salonen D, Smart D, Newham JJ. The association between maternal and paternal substance use and child substance use, internalizing and externalizing problems: a systematic review and meta-analysis. Addiction 2023; 118:804-818. [PMID: 36607011 DOI: 10.1111/add.16127] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 12/06/2022] [Indexed: 01/07/2023]
Abstract
AIMS There is substantial evidence showing an association between parental substance use and child substance use and/or mental health problems. Most research focuses upon maternal substance use, with the influence of paternal substance use often being overlooked. We aimed to investigate the differential effects of maternal and paternal substance use upon children aged 0-18 years. METHODS We used systematic review methods to identify observational studies examining the association between either maternal or paternal substance use and child substance use and/or mental health problems. The odds ratio (OR) effect measure was used, for ease of computation. We used a random-effects model with the inverse variance method to meta-analyse the findings from eligible studies. RESULTS We included 17 unique studies with a total of 47 374 child participants. Maternal and paternal substance use were both associated with increased odds of child any drug use [OR = 2.09; 95% confidence interval (CI) = 1.53, 2.86; n = 12 349 participants; three studies and OR = 2.86; 95% CI = 1.25, 6.54; n = 5692 participants; three studies, respectively], child alcohol problem use (OR = 2.16; 95% CI = 1.73, 2.71; n = 7339 participants; four studies and OR = 1.70; 95% CI = 1.36, 2.12; n = 14 219 participants; six studies), child externalizing problems (OR = 1.81; 95% CI = 1.01, 3.22; n = 1748 participants; three studies and OR = 1.60; 95% CI = 1.18, 2.17; n = 2508 participants; six studies) and child internalizing problems (OR = 1.60; 95% CI = 1.25, 2.06; n = 1748 participants; three studies and OR = 1.42; 95% CI = 1.12, 1.81; n = 2248 participants; five studies). Child any alcohol use was associated with maternal substance use only (OR = 2.26; 95% CI = 1.08, 4.70; n = 28 691 participants; five studies). CONCLUSIONS Both maternal and paternal substance use are associated with child substance use and mental health problems.
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Affiliation(s)
- Ruth McGovern
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Paul Bogowicz
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Nick Meader
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Hayley Alderson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Dawn Craig
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Emma Geijer-Simpson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Katherine Jackson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Cassey Muir
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Domna Salonen
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Deborah Smart
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - James J Newham
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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