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Armoon B, Lesage A, Mohammadi R, Khoshnazar Z, Varnosfaderani MR, Hosseini A, Fotovvati F, Mohammadjani F, Khosravi L, Beigzadeh M, Griffiths MD. Perceived Unmet Need for Care and Barriers to Care Among Individuals with Mental Health Issues: A Meta-analysis. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2025:10.1007/s10488-025-01446-x. [PMID: 40314899 DOI: 10.1007/s10488-025-01446-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2025] [Indexed: 05/03/2025]
Abstract
Unmet needs refer to the gap between the health services individuals require and what they receive. Individuals with mental health issues often face barriers preventing them from accessing the care they need. A meta-analysis was conducted to estimate the pooled prevalence of unmet needs for care and barriers to care among individuals with mental health issues. The databases PubMed, Scopus, Web of Science, and Cochrane Library were searched for relevant studies published from December 1, 1985 to August 1, 2024. Following the screening process, 204 included studies remained for meta-analysis. Individuals with mental health issues reported significant pooled prevalence rate of unmet care needs over the past year, with the most common being related to work/occupation (43%), dental care (41%), counseling (40%), social intervention (37%), mental health (34%), physical health needs (33%), skills training (32%), social network (32%), psychological distress (31%), information (27%), intimate relationships (27%), benefits (26%), harm reduction (25%), psychotic symptoms (24%), housing (24%), money and food (21%), education (20%), sexual expression (19%), home care (16%), safety (15%), self-care (15%), telephone support (9%), and child care (8%). The pooled prevalence rates of barriers to accessing care were motivational (38%), structural (37%), financial (31%), and stigmatization (25%). The findings indicated that patients with substance use disorders experienced a significantly higher prevalence of unmet care needs and barriers to accessing care compared to those with mental health disorders and homeless individuals. The results showed that unmet care needs were highest among those in established adulthood, while harm reduction was more common among adolescents and emerging adults. Physical health and food needs were most prevalent among midlife adults. Barriers to care were most common among adolescents and emerging adults, except for structural barriers, which were most frequent among midlife adults. To address the unmet employment needs of Individuals with mental health issues, comprehensive training in essential skills is recommended. Enhancing dentists' mental health understanding and fostering collaboration among healthcare providers is crucial. Government-funded, low-barrier service models for substance use disorder patients is suggested to enhance accessibility and effectiveness, while improving health service affordability and acceptability is essential.
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Affiliation(s)
- Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.
| | - Alain Lesage
- Centre de Recherche de l'Institut, Universitaire en santé mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Rasool Mohammadi
- School of Health and Nutrition, Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Zahedeh Khoshnazar
- Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Aida Hosseini
- Student Research Committee, Saveh University of Medical Sciences, Saveh, Iran
| | - Fatemeh Fotovvati
- Student Research Committee, Saveh University of Medical Sciences, Saveh, Iran
| | | | - Leila Khosravi
- Student Research Committee, Saveh University of Medical Sciences, Saveh, Iran
| | - Mehran Beigzadeh
- Student Research Committee, Saveh University of Medical Sciences, Saveh, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
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Patel EU, Rudolph JE, Feder KA, Zhu X, Astemborski J, Lau B, Kirk GD, Mehta SH, Genberg BL. Drug treatment and support service utilization amidst the COVID-19 pandemic among people who inject drugs in Baltimore, Maryland: An interrupted time-series analysis, 2015-2022. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2025; 138:104746. [PMID: 40037106 PMCID: PMC11970212 DOI: 10.1016/j.drugpo.2025.104746] [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: 09/20/2024] [Revised: 02/14/2025] [Accepted: 02/16/2025] [Indexed: 03/06/2025]
Abstract
BACKGROUND The COVID-19 pandemic prompted many structural and social changes including adaptations to drug treatment policies and provision (e.g., take-home methadone flexibilities and telehealth services), but their collective impact on drug treatment use among people who inject drugs in the US remains unclear. This study characterized trends in drug treatment and support service utilization before and during the pandemic among current and former people who inject drugs in Baltimore, Maryland. METHODS An interrupted time-series analysis was conducted using longitudinal survey data collected between December 2015 and November 2022 among 780 participants in the AIDS Linked to the IntraVenous Experience (ALIVE) study-a community-based cohort of adults who have injected drugs in Baltimore (n = 7036 semi-annual person-visits). Average marginal changes in service utilization were estimated following logistic regression with generalized estimating equations. RESULTS At participants' first pre-pandemic visit, 46.8 % attended group counseling/support group services, 13.5 % were prescribed buprenorphine, and 38.8% were prescribed methadone. After the onset of the pandemic, there was an immediate reduction in attending group services (-13.4 % [95%CI = -17.8 %, -8.9 %]) and a change in the trajectory of attendance (difference in quarterly percentage point change [QPPC] comparing before vs. during the pandemic = -0.9 % [95 %CI = -1.6 %, -0.1 %]). In contrast, there was a small immediate increase in buprenorphine use (2.3 % [95 %CI = 0.1 %, 4.6 %]) and no change in its trajectory (QPPC difference = -0.1 % [95 %CI = -0.6 %, 0.3 %]) after the pandemic's onset. A declining trajectory in methadone use before the pandemic accelerated during the pandemic, but this change was not statistically significant (QPPC difference = -0.5 % [95 %CI = -1.2 %, 0.2 %]). When prescribed buprenorphine/methadone during the pandemic, 28.8 % reported engagement in telehealth services (50.0 % for buprenorphine; 16.7 % for methadone). CONCLUSION There were pandemic-related disruptions in group-based support service utilization. Meanwhile, service adaptations may have blunted the pandemic's impact on buprenorphine and methadone treatment, suggesting adaptive systems have the potential to optimize treatment delivery. Nonetheless, the observed declines in methadone treatment uptake warrant investigation.
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Affiliation(s)
- Eshan U Patel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Jacqueline E Rudolph
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kenneth A Feder
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Xianming Zhu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jacqueline Astemborski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bryan Lau
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Gregory D Kirk
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shruti H Mehta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Becky L Genberg
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Chiappini S, Sampogna G, Ventriglio A, Menculini G, Ricci V, Pettorruso M, Volpe U, Martinotti G. Emerging strategies and clinical recommendations for the management of novel depression subtypes. Expert Rev Neurother 2025; 25:443-463. [PMID: 40013928 DOI: 10.1080/14737175.2025.2470973] [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: 10/31/2024] [Accepted: 02/19/2025] [Indexed: 02/28/2025]
Abstract
INTRODUCTION The phenomenology of depression is characterized by a wide array of emotional, cognitive, and physical symptoms that significantly disrupt an individual's life. Societal changes, driven by technological advancements, economic pressures, environmental concerns including climate change, and shifting cultural norms, have influenced how depression manifests and is understood. These developments have led to the identification of new depression subtypes, highlighting the need for personalized treatment approaches based on individual symptoms and underlying causes. AREAS COVERED The authors provide a comprehensive narrative review of the literature on managing novel depression subtypes, focusing on both pharmacological and non-pharmacological treatments. Specifically, scenarios recorded were related to i) depression in adolescents and young adults; ii) depression and social disconnection; iii) depression and alcohol/substance use disorder; iv) depression and gender dysphoria; v) depression, stressful events, and other environmental factors. EXPERT OPINION In the novel depression subtypes discussed, individualized treatment approaches tailored to the individual's specific circumstances are necessary. While selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs) remain the cornerstone of treatment for many forms of depression, atypical antidepressants such as trazodone, and emerging therapies like ketamine, neuromodulation techniques, and personalized psychotherapy offer hope for those with complex or treatment-resistant presentations.
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Affiliation(s)
- Stefania Chiappini
- Psychiatry Department, UniCamillus International University of Medical Sciences, Rome, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giulia Menculini
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Valerio Ricci
- San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy
| | - Umberto Volpe
- Section of Psychiatry, Department of Neurosciences/DIMSC, Università Politecnica Delle Marche, Ancona, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy
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Tam CC, Young SD, Harrison S, Li X, Litwin AH. Theory-Based Social Media Intervention for Nonmedical Use of Prescription Opioids in Young Adults: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2025; 14:e65847. [PMID: 40139213 PMCID: PMC11982775 DOI: 10.2196/65847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Revised: 02/17/2025] [Accepted: 02/18/2025] [Indexed: 03/29/2025] Open
Abstract
BACKGROUND The nonmedical use of prescription opioids (NMUPO) in young adults in the United States is concerning and is robustly influenced by many psychosocial factors. Given the advantages of flexibility, wide coverage, and real-time responses and assessment, using social media appears to be a promising and innovative approach to delivering psychosocial intervention to young adults. However, few theory-based social media interventions are available for NMUPO targeting this at-risk population. OBJECTIVE Guided by the information-motivation-behavioral skills model, the proposed research aims to address critical gaps by theoretically exploring psychosocial content associated with NMUPO among young adults via formative assessment. These findings will then be used to develop and evaluate the feasibility and preliminary efficacy of a peer-led social media intervention to reduce NMUPO among young adults. METHODS The proposed study will comprise serial research activities. First, formative research will be conducted through semistructured interviews among 30 young adults engaged in NMUPO. Qualitative data will be synthesized using a pragmatic approach for identifying psychosocial content associated with NMUPO. Second, qualitative findings will be used for developing a peer-led social media intervention to reduce NMUPO among young adults by integrating promising psychotherapy principles and incorporating them with well-trained recovery coaches. Third, the social media intervention will be evaluated through a 12-week randomized controlled trial among 70 young adults (n=35, 50% in the intervention group and control group) engaged in NMUPO via mixed methods, including pre- and postintervention surveys, social media paradata (eg, time-series reactions to posts) collection, and ecological momentary assessment during the intervention. The control group will not receive an intervention but will complete the pre- and postintervention surveys. The primary outcomes will be feasibility, usability, and acceptability, while the secondary outcomes will be psychosocial and behavioral measures, such as past-3-month NMUPO, intention, psychological distress, self-efficacy, resilience, and coping strategies. RESULTS The proposed study was funded in May 2024. Social media campaigns have received responses from a total of 379 individuals, with 24 (6.3%) identified as eligible. As of February 10, 2025, we have completed formative interviews with 8 eligible participants. CONCLUSIONS The proposed study will be one of the first efforts to develop and deliver a theory-based peer-led intervention on social media, incorporating empirical findings on the psychosocial mechanism of NMUPO. The findings of the proposed study will provide valuable insights into opioid risk reduction for young adults through an innovative approach. If the tested trial is found to be feasible, the proposed study will contribute to future scaled-up and fully powered psychosocial interventions among young adults and other key populations at risk for NMUPO. TRIAL REGISTRATION ClincialTrials.gov NCT06469749; https://clinicaltrials.gov/study/NCT06469749. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/65847.
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Affiliation(s)
- Cheuk Chi Tam
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
| | - Sean D Young
- School of Medicine and Informatics, University of California, Irvine, Irvine, CA, United States
| | - Sayward Harrison
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
- Department of Psychology, University of South Carolina, Columbia, SC, United States
| | - Xiaoming Li
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
| | - Alain H Litwin
- School of Health Research, Clemson University, Greenville, SC, United States
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
- Prisma Health, Greenville, SC, United States
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Holborn T, Schifano F, Smith E, Deluca P. The Use of Novel Stimulants in ADHD Self-Medication: A Mixed Methods Analysis. Brain Sci 2025; 15:292. [PMID: 40149813 PMCID: PMC11940814 DOI: 10.3390/brainsci15030292] [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: 01/15/2025] [Revised: 03/04/2025] [Accepted: 03/07/2025] [Indexed: 03/29/2025] Open
Abstract
BACKGROUND Numerous individuals suffer from attentional issues, such as ADHD. While medication is considered the first-line treatment, it is unavailable to some. As a result, certain individuals are choosing to self-medicate with novel stimulants, a phenomenon that remains poorly understood. We aimed to investigate which NPSs are being used to self-medicate ADHD, evaluate their perceived effectiveness, and explore the experiences and motivations of those self-medicating. METHODS Data from respondents (n = 225) (mean age [SD] = 29.5 ± 9.6; male = 83%; female = 12%; non-binary = 5%) were collected via an online survey, with nine participants (mean age = 31.4; male = 5; female = 1; non-binary = 3) undertaking further semi-structured interviews and the data being investigated using a framework analysis. RESULTS The most-used NPSs were 4F-MPH and 2-FMA. Some individuals perceived self-medication to be more effective than conventional treatment (p < 0.001). A framework analysis identified the following themes surrounding novel stimulant self-medication: (1) the use of NPS stimulants as a stopgap between treatments; (2) poor access to ADHD treatment; (3) a lack of openness and confidence in psychiatrists and healthcare providers. CONCLUSION Novel stimulants are being used when access to ADHD treatment is poor. Interventions should aim to reduce long treatment wait times and issues surrounding geographical access. Careful consideration should be given before denying stimulant medication to individuals with co-occurring substance use and psychiatric comorbidity. Individuals desire a more patient-centred ADHD treatment with broader pharmacotherapies.
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Affiliation(s)
- Tayler Holborn
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London SE5 8AF, UK; (T.H.)
| | - Fabrizio Schifano
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Emma Smith
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London SE5 8AF, UK; (T.H.)
| | - Paolo Deluca
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London SE5 8AF, UK; (T.H.)
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Nagra H, Mines RA, Dana Z. Exploring the Impact of Digital Peer Support Services on Meeting Unmet Needs Within an Employee Assistance Program: Retrospective Cohort Study. JMIR Hum Factors 2025; 12:e68221. [PMID: 39998863 PMCID: PMC11897672 DOI: 10.2196/68221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2024] [Revised: 01/09/2025] [Accepted: 01/28/2025] [Indexed: 02/27/2025] Open
Abstract
BACKGROUND The World Health Organization estimates that 1 in 4 people worldwide will experience a mental disorder in their lifetime, highlighting the need for accessible support. OBJECTIVE This study evaluates the integration of digital peer support (DPS) into an employee assistance program (EAP), testing 3 hypotheses: (1) DPS may be associated with changes in EAP counseling utilization within a 5-session model; (2) DPS users experience reduced sadness, loneliness, and stress; and (3) DPS integration generates a positive social return on investment (SROI). METHODS The study analyzed EAP utilization within a 5-session model using pre-post analysis, sentiment changes during DPS chats via natural language processing models, and SROI outcomes. RESULTS Among 587 DPS chats, 432 (73.6%) occurred after business hours, emphasizing the importance of 24/7 availability. A matched cohort analysis (n=72) showed that DPS reduced therapy sessions by 2.07 per participant (P<.001; Cohen d=1.77). Users' messages were evaluated for sentiments of sadness, loneliness, and stress on a 1-10 scale. Significant reductions were observed: loneliness decreased by 55.04% (6.91 to 3.11), sadness by 57.5% (6.84 to 2.91), and stress by 56.57% (6.78 to 2.95). SROI analysis demonstrated value-to-investment ratios of US $1.66 (loneliness), US $2.50 (stress), and US $2.58 (sadness) per dollar invested. CONCLUSIONS Integrating DPS into EAPs provides significant benefits, including increased access, improved emotional outcomes, and a high SROI, reinforcing its value within emotional health support ecosystems.
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Affiliation(s)
| | | | - Zara Dana
- Supportiv, Berkeley, CA, United States
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Michaud T, Puga T, Archer R, Theye E, Zagurski C, Estabrooks P, Dai HD. Enhancing Text Message Support With Media Literacy and Financial Incentives for Vaping Cessation in Young Adults: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2025; 14:e60527. [PMID: 39983103 PMCID: PMC11890145 DOI: 10.2196/60527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 09/26/2024] [Accepted: 12/23/2024] [Indexed: 02/23/2025] Open
Abstract
BACKGROUND The persistent high prevalence of e-cigarette use among young adults remains a significant public health concern, with limited evidence and guidance on effective vaping cessation programs targeting this population. OBJECTIVE This study aims to outline the study design and protocol of a pilot randomized controlled trial aimed at investigating feasibility and assessing whether media literacy education or financial incentives enhance the effectiveness of evidence-based text message support in promoting vaping abstinence among young adult e-cigarette users. METHODS The pilot study uses a 4-arm (1:1:1:1) randomized controlled trial design to assess the potential impact of different combinations of media literacy education, financial incentives, and text message support on vaping abstinence over a 3-month period. The first month serves as a preparatory phase for quitting, followed by 2 months focused on abstinence. A total of 80 individuals, aged 19-29 years, who have used e-cigarettes within the past 30 days, have internet access, and express interest in quitting vaping within the next 30 days, will be enrolled. Eligible individuals will be randomized into one of the four study groups: (1) Text Message, (2) Media Literacy, (3) Financial Incentive, and (4) Combined. All participants, regardless of group assignment, will receive text message support. Participants will be followed for 12 weeks, with abstinence status assessed at week 12, as well as during remote check-ins at weeks 6, 8, and 10. Feasibility measures include recruitment rate, reach, engagement, and retention. Other outcomes of interest include self-reported 7-day abstinence and changes in nicotine dependence and media literacy scores. Exit interviews will be conducted with those who complete the study to explore facilitators of and barriers to participation and engagement in vaping cessation, which will inform future program refinement and uptake. RESULTS Recruitment for the study commenced in December 2023 and concluded in August 2024. A total of 40 participants were randomized into these groups: 9 for Text Message, 11 for Media Literacy, 10 for Financial Incentive, and 10 for the Combined group. The final assessment was completed in November 2024, and analyses are currently ongoing. CONCLUSIONS The findings from this trial could provide valuable insights into the design and uptake of vaping cessation strategies among the young adult population. TRIAL REGISTRATION ClinicalTrials.gov NCT05586308; https://clinicaltrials.gov/study/NCT05586308. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/60527.
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Affiliation(s)
- Tzeyu Michaud
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
- Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Troy Puga
- Department of Orthopaedic Surgery, Medical City Denton, Denton, TX, United States
| | - Rex Archer
- College of Osteopathic Medicine, Kansas City University, Kansas city, MO, United States
| | - Elijah Theye
- Office of the Dean, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Cleo Zagurski
- Health Administration and Policy Program, Creighton University, Omaha, NE, United States
| | - Paul Estabrooks
- Department of Health and Kinesiology, College of Health, University of Utah, Salt Lake City, UT, United States
| | - Hongying Daisy Dai
- Office of the Dean, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
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Janson S, Mushy SE, McPherson M, Mhando F, Jennings Mayo-Wilson L, Iseselo MK, Saleem H, Kamwela J, Issango J, Knox J, Mbita G, Madut DB, Ostermann J, Thielman N, Mwasa B, Conserve DF. Exploring perceptions of the services offered in Tanzanian sober houses: a mixed- methods study among service users and providers. BMC Health Serv Res 2025; 25:253. [PMID: 39953582 PMCID: PMC11829410 DOI: 10.1186/s12913-025-12384-7] [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: 02/20/2024] [Accepted: 02/05/2025] [Indexed: 02/17/2025] Open
Abstract
BACKGROUND In Tanzania, residential treatment centers for alcohol and other drugs, locally known as "sober houses," play a critical role in the treatment of people living with a substance use disorder (SUD), but little is known about the services they offer and service users' and providers' perceptions of those services. We aimed to address these gaps in knowledge and to better understand where evidence-based interventions may be able to address gaps in service provision. MATERIALS AND METHODS This study used a mixed-methods approach across four sober houses in Dar es Salaam, Tanzania. We conducted 48 semi-structured interviews with a sub-sample of sober house service users (n = 38) and service providers (n = 10). Eighty-six (86) service users also completed a written survey to capture demographic information and assess knowledge of HIV and willingness to use HIV preventive care. All interviews were audio-recorded, translated into English, and then coded according to constructs developed with the Recovery Capital Framework. Following coding, a thematic analysis was conducted for the qualitative data using the framework developed by Braun and Clarke. RESULTS Service users were generally positive about the treatment they were receiving but identified gaps in health service provision related to HIV, as well as a lack of preparation to address the employment-related challenges they face in the community after completing treatment. Service providers largely agreed with users' perceptions of needs and identified a lack of clinical personnel in sober houses and funding challenges as barriers to meeting these needs. CONCLUSION Sober houses provide treatment services to Tanzanians with SUD that service users largely view as positive. This evaluation identified employment challenges after treatment completion and gaps related to HIV care in the sober house. Further research is needed to investigate how interventions can be adapted to the sober house setting to meet these needs.
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Affiliation(s)
- Samuel Janson
- The George Washington University Milken Institute School of Public Health, Washington, DC, USA.
| | - Stella E Mushy
- Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Mecca McPherson
- Temple University College of Public Health, Philadelphia, PA, USA
| | - Frank Mhando
- University of Johannesburg, Johannesburg, South Africa
| | | | - Masunga K Iseselo
- Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Haneefa Saleem
- The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jerome Kamwela
- Tanzania Commission for AIDS (TACAIDS), Dar Es Salaam, Tanzania
| | - Jumanne Issango
- Tanzania Commission for AIDS (TACAIDS), Dar Es Salaam, Tanzania
| | - Justin Knox
- Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Deng B Madut
- Duke University School of Medicine, Durham, NC, USA
| | | | | | - Betuel Mwasa
- Benjamin Mkapa Foundation, Dar Es Salaam, Tanzania
| | - Donaldson F Conserve
- The George Washington University Milken Institute School of Public Health, Washington, DC, USA
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Choi S, Choi J, O'Grady M, Renteria D, Oules C, Liebmann E, Lincourt P, Jordan AE, Neighbors CJ. Patient experiences in outpatient substance use disorder treatment: A qualitative study exploring both clinical and non-clinical contexts. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2025; 169:209581. [PMID: 39557341 PMCID: PMC11769759 DOI: 10.1016/j.josat.2024.209581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 11/01/2024] [Accepted: 11/14/2024] [Indexed: 11/20/2024]
Abstract
BACKGROUND Addressing the persistent treatment gap in substance use disorder (SUD) remains a critical challenge, with only 13 % of Americans with SUDs receiving necessary treatment. We explored the complexities of engaging in SUD treatment from patients' perspectives and aims to provide a comprehensive understanding of their treatment experiences. METHODS We conducted semi-structured interviews with 34 patients who had been attending outpatient SUD clinics in New York State for 6 or less months. Participants were recruited from seven clinics using purposive sampling. Interviews were conducted between June and August 2022. We conducted thematic analysis of coded data to explore patients' experiences and preferences while navigating their treatment journeys. RESULTS Critical elements for a positive treatment experience included cultural humility, confidentiality, consistency, trust, peer counselors with SUD experience, a strong sense of connection, and addressing needs beyond clinical settings. These included assistance with housing and employment, participation in external clinic events, and access to amenities like coffee and snacks. Participants favored holistic treatment approaches integrating mental health and involving peer recovery counselors. However, participants also identified ineffective aspects, including rigid and generic approaches, stigmatizing attitudes, and challenges related to communities and environmental influences. CONCLUSION The study highlights the multifaceted nature of outpatient SUD treatment, emphasizing the integration of patient-centered, holistic, and culturally competent approaches. Tailoring interventions to individual circumstances and acknowledging the diverse needs of patients are imperative for effective healthcare practices.
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Affiliation(s)
- Sugy Choi
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America.
| | - Jasmin Choi
- New York University School of Global Public Health, New York, NY, United States of America
| | - Megan O'Grady
- UCONN, Health United States of America, Farmington, CT, United States of America
| | - Diego Renteria
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America
| | - Crissy Oules
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America
| | - Eddie Liebmann
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America
| | - Pat Lincourt
- New York State Office of Addiction Services and Supports (OASAS), New York, NY, United States of America
| | - Ashly E Jordan
- New York State Office of Addiction Services and Supports (OASAS), New York, NY, United States of America
| | - Charles J Neighbors
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America
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Brockdorf AN, Tilstra-Ferrell EL, Danielson CK, Moreland AD, Rheingold AA, Salim SR, Gilmore AK, Siciliano RE, Smith DW, Hahn CK. Characterizing Engagement with Web-Based Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Traumatic Stress and Substance Misuse After Interpersonal Violence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2025; 22:190. [PMID: 40003416 PMCID: PMC11855337 DOI: 10.3390/ijerph22020190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2024] [Revised: 01/17/2025] [Accepted: 01/27/2025] [Indexed: 02/27/2025]
Abstract
Screening, brief intervention, and referral to treatment (SBIRT) is a widely used public health approach for delivering early intervention for substance misuse. SBIRT adaptations that incorporate content on interpersonal violence and posttraumatic stress disorder (PTSD) symptoms may be warranted, as experiences of interpersonal violence are prevalent and associated with greater substance misuse; however, more research is needed to refine the delivery of PTSD-substance use content within the SBIRT model. This study examined clinical data collected as part of a web-based SBIRT developed for co-occurring substance misuse and PTSD symptoms after interpersonal violence to characterize the clinical symptoms and responses of adults presenting to agencies serving intimate partner and sexual violence survivors. The respondents (N = 52) completed self-report measures during the SBIRT tool to personalize the recommendations, as well as motivational enhancement exercises. Descriptive statistics were conducted. The results underscored high rates of probable PTSD, substance use, and trauma-related motives for substance use. The respondents were ready to change their substance use on average after receiving personalized feedback. Many expressed values related to trauma recovery and self-empowerment, perceived these values as useful for substance use reduction, and set goals to seek mental health services or reduce their drinking quantity. The findings point to several clinical targets for integrated PTSD-substance misuse interventions for interpersonal violence survivors.
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Affiliation(s)
- Alexandra N. Brockdorf
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA; (E.L.T.-F.); (C.K.D.); (A.D.M.); (A.A.R.); (S.R.S.); (R.E.S.); (D.W.S.); (C.K.H.)
| | - Emily L. Tilstra-Ferrell
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA; (E.L.T.-F.); (C.K.D.); (A.D.M.); (A.A.R.); (S.R.S.); (R.E.S.); (D.W.S.); (C.K.H.)
| | - Carla K. Danielson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA; (E.L.T.-F.); (C.K.D.); (A.D.M.); (A.A.R.); (S.R.S.); (R.E.S.); (D.W.S.); (C.K.H.)
| | - Angela D. Moreland
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA; (E.L.T.-F.); (C.K.D.); (A.D.M.); (A.A.R.); (S.R.S.); (R.E.S.); (D.W.S.); (C.K.H.)
| | - Alyssa A. Rheingold
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA; (E.L.T.-F.); (C.K.D.); (A.D.M.); (A.A.R.); (S.R.S.); (R.E.S.); (D.W.S.); (C.K.H.)
| | - Selime R. Salim
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA; (E.L.T.-F.); (C.K.D.); (A.D.M.); (A.A.R.); (S.R.S.); (R.E.S.); (D.W.S.); (C.K.H.)
- Department of Psychiatry and Behavioral Sciences, Stanford University, 291 Campus Drive, Li Ka Shing Building, Stanford, CA 94305, USA
| | - Amanda K. Gilmore
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA;
| | - Rachel E. Siciliano
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA; (E.L.T.-F.); (C.K.D.); (A.D.M.); (A.A.R.); (S.R.S.); (R.E.S.); (D.W.S.); (C.K.H.)
| | - Daniel W. Smith
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA; (E.L.T.-F.); (C.K.D.); (A.D.M.); (A.A.R.); (S.R.S.); (R.E.S.); (D.W.S.); (C.K.H.)
| | - Christine K. Hahn
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA; (E.L.T.-F.); (C.K.D.); (A.D.M.); (A.A.R.); (S.R.S.); (R.E.S.); (D.W.S.); (C.K.H.)
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Salonen D, O’Donnell A, Jackson K, Hulse S, Crosbie J, Swiers R, Tasker F, Muldowney G, Pickford A, Christie-de Jong F, Kaner E, Holland EJ. Building Connections and Striving to Build Better Futures: A Qualitative Interview Study of Alcohol Recovery Navigators' Practice in the North East of England, UK. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2025; 22:111. [PMID: 39857564 PMCID: PMC11765025 DOI: 10.3390/ijerph22010111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2024] [Revised: 01/08/2025] [Accepted: 01/10/2025] [Indexed: 01/27/2025]
Abstract
To address the holistic and continuity of care needs of people who attend North East hospitals frequently for alcohol-related reasons, Recovery Navigator (Navigator) roles were introduced into Alcohol Care Teams in six hospitals in the North East of England, UK, in 2022. The Navigators aimed to provide dedicated holistic support to patients experiencing alcohol harms, starting whilst in the hospital with the potential to continue this beyond discharge. This qualitative study explores the contributions that the Navigators make towards integrated alcohol care. Twenty-five semi-structured interviews were undertaken with 7 patients, 1 carer, and 17 staff. We used reflexive thematic analysis and applied the concept of continuity of care and Self-Determination Theory. The findings suggest that all of the participants value Navigators having dedicated time to work with patients to address their social needs, that patients benefit from having someone who provides relational support and is 'gently persistent', and that most of the Navigators have good relationships with community providers and have supported the transition of patients to these services. Staff recognise the challenges of holistic alcohol care in hospitals, and the support of the Alcohol Care Teams and Navigators is seen as invaluable. Navigators help to address gaps in the provision of holistic support for patients who experience significant health inequalities.
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Affiliation(s)
- Domna Salonen
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; (D.S.); (A.O.); (K.J.); (E.K.)
| | - Amy O’Donnell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; (D.S.); (A.O.); (K.J.); (E.K.)
| | - Katherine Jackson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; (D.S.); (A.O.); (K.J.); (E.K.)
| | - Sarah Hulse
- North East North Cumbria Integrated Care Board, Sunderland SR5 3XB, UK; (S.H.); (J.C.); (R.S.); (A.P.)
- North of England Commissioning Support (NECS), Durham DH1 3YG, UK
| | - James Crosbie
- North East North Cumbria Integrated Care Board, Sunderland SR5 3XB, UK; (S.H.); (J.C.); (R.S.); (A.P.)
- South Tyneside and Sunderland NHS Foundation Trust, Sunderland SR4 7TP, UK
| | - Ryan Swiers
- North East North Cumbria Integrated Care Board, Sunderland SR5 3XB, UK; (S.H.); (J.C.); (R.S.); (A.P.)
- South Tyneside and Sunderland NHS Foundation Trust, Sunderland SR4 7TP, UK
| | - Fiona Tasker
- ReCoCo-Newcastle Recovery College, Newcastle upon Tyne NE1 6UF, UK; (F.T.); (G.M.)
| | - Gemma Muldowney
- ReCoCo-Newcastle Recovery College, Newcastle upon Tyne NE1 6UF, UK; (F.T.); (G.M.)
| | - Anna Pickford
- North East North Cumbria Integrated Care Board, Sunderland SR5 3XB, UK; (S.H.); (J.C.); (R.S.); (A.P.)
- North of England Commissioning Support (NECS), Durham DH1 3YG, UK
| | - Floor Christie-de Jong
- School of Medicine, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland SR1 3SD, UK;
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; (D.S.); (A.O.); (K.J.); (E.K.)
| | - Emma-Joy Holland
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; (D.S.); (A.O.); (K.J.); (E.K.)
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Ngo TP, Cuffaro T, Santos GM. Syndemic conditions associated with hazardous alcohol consumption among sexual minority men in San Francisco. DRUG AND ALCOHOL DEPENDENCE REPORTS 2024; 13:100297. [PMID: 39619334 PMCID: PMC11605325 DOI: 10.1016/j.dadr.2024.100297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2024] [Accepted: 11/01/2024] [Indexed: 03/28/2025]
Abstract
Background Hazardous alcohol consumption (HAC) is prevalent among sexual minority men (SMM). Using syndemic theory, this study aimed to identify the number of syndemic conditions, including their combinations, and their association with HAC among SMM in San Francisco. Method We conducted a secondary analysis of cross-sectional data from 246 SMM who consume alcohol. Syndemic factors included multiple substance use, depressive symptoms, HIV/STI status, and houselessness. We conducted a multivariable logistic regression to estimate the odds of HAC associated with increasing syndemic conditions. We further examined which combinations of three syndemic factors were associated with the highest odds for HAC. Results The average age was 40.7; participants were predominantly White (33.3 %) and Black/African American (29.7 %) and graduated from high school (92.7 %). The prevalence of HAC increased with the number of syndemic conditions: 13.6 % with none, 30.9 % with one, 51.9 % with two, 65.1 % with three, and 69.2 % with four conditions. A significant log-linear trend was observed, with two syndemic conditions increasing the odds of HAC over fivefold (AOR=5.05, 95 % CI=1.68-15.15), and three and four syndemic conditions increasing the odds by more than eightfold (AOR=8.82, 95 % CI=2.74-28.39; AOR=8.55, 95 % CI=2.26-32.28). The combination of depressive symptoms, HIV/STI status, and houselessness tripled the odds for HAC (OR=3.07, 95 % CI=1.34-7.04). Conclusion HAC was associated with increasing syndemics, and specific conditions (depression, HIV/STI, and houselessness) had the greatest odds of HAC. These findings underscore the need for comprehensive screening and integrated interventions targeting these co-occurring conditions to reduce HAC in this population.
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Affiliation(s)
- Thye Peng Ngo
- National Clinician Scholars Program at University of California, San Francisco, San Francisco, CA, United States
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, United States
| | - Taylor Cuffaro
- School of Nursing, University of California, San Francisco, San Francisco, CA, United States
| | - Glenn-Milo Santos
- School of Nursing, University of California, San Francisco, San Francisco, CA, United States
- Division of Prevention Science, School of Medicine, University of California, San Francisco, CA, United States
- Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States
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Kang JH, Lee KH, Huh SJ, Shin SH, Kim IH, Hwang IG, Koo DH, Lee D, Koh SJ, Seo S, Lee GJ, Chun SH, Ji JH, Oh SY, Choi JW, Go SI. Efficacy of transdermal buprenorphine patch for managing withdrawal symptoms in patients with cancer physically dependent on prescription opioids. Oncologist 2024; 29:e1593-e1603. [PMID: 39028339 PMCID: PMC11546621 DOI: 10.1093/oncolo/oyae176] [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: 03/08/2024] [Accepted: 06/20/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND The physical dependence on prescription opioids among cancer survivors remains an under-investigated area, with a scarcity of well-designed prospective studies. METHODS This single-arm, phase-2 clinical trial in Korea assessed the efficacy and safety of a transdermal buprenorphine patch (TBP) in managing physical dependence on prescription opioids in cancer survivors, as confirmed through the DSM-5 criteria or psychiatric consultation for opioid withdrawal. This study involved a 4-phase treatment protocol of screening, induction/stabilization, discontinuation, and monitoring. The primary outcome was the rate of successful opioid discontinuation, as measured by a negative urine-drug screening at 8 weeks. Key secondary outcomes included the resumption of prescribed opioids, changes in both the Clinical Opioid Withdrawal Scale (COWS) and morphine equivalent daily dose (MEDD), and assessments related to the psychological and physiological aspects of dependence and safety. RESULTS Thirty-one participants were enrolled. In the intention-to-treat population, the success rate of opioid discontinuation was 58%, with only 2 participants experiencing a resumption of prescribed opioids. Significant reductions were observed in MEDD, which decreased from 98 to 26 mg/day (P < .001), and COWS scores, which decreased from 5.5 to 2.8 (P < .001). Desire to use opioids reduced from 7.0 to 3.0 on a 10-point numeric rating scale (P < .001). Toxicities related to TBP were mild and manageable, without severe precipitated withdrawal symptoms. CONCLUSION TBP may be considered as an alternative therapeutic option in cancer survivors physically dependent on prescription opioids, especially where sublingual formulations are unavailable.
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Affiliation(s)
- Jung Hun Kang
- Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Kyung Hee Lee
- Department of Hematology-Oncology, Yeungnam University College of Medicine, Daegu, Korea
| | - Seok Jae Huh
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Seong-Hoon Shin
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Il Hwan Kim
- Division of Oncology, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - In Gyu Hwang
- Division of Hematology/Oncology, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Dong-Hoe Koo
- Division of Hematology/Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dongyun Lee
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Su-Jin Koh
- Department of Hematology and Oncology, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Korea
| | - Seyoung Seo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Guk Jin Lee
- Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Sang Hoon Chun
- Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Jun Ho Ji
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Sung Yong Oh
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Jung Woo Choi
- Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Se-Il Go
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
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Dumbrell J, Carver H, Foster R, Pauly B, Steele W, Roy M, Parkes T. Navigating transitions into, through, and beyond peer worker roles: insider insights from the Supporting Harm Reduction through Peer Support (SHARPS) study. Harm Reduct J 2024; 21:191. [PMID: 39468544 PMCID: PMC11514757 DOI: 10.1186/s12954-024-01109-4] [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: 06/04/2024] [Accepted: 10/14/2024] [Indexed: 10/30/2024] Open
Abstract
BACKGROUND Peer workers are individuals who draw on their personal experiences in a professional capacity to support clients. Existing research on the role of peer workers in mental health, homelessness, and substance use services has primarily focused on their impact on client outcomes. This paper describes the development of peer workers as they transition into, through, and beyond this role. Utilising data from the Supporting Harm Reduction through Peer Support (SHARPS) study, where Peer Navigators supported people experiencing homelessness and substance use challenges, this paper explores the sense-making involved in an intensive peer support worker role, adaptation to organisational culture, and engagement with opportunities for professional advancement. METHODS Semi-structured interviews with three Peer Navigators were conducted by two SHARPS study researchers at four time points in 2018 and 2019 corresponding with the beginning, middle, and end of the intervention. These data were analysed along with entries from the three Peer Navigators' reflective diaries. Analysis followed a multi-stage approach to thematic analysis utilising both inductive and deductive processes. The Peer Navigators' personal reflections have also been incorporated into the recommendations. RESULTS The foundational training provided to the Peer Navigators before taking up their role helped to ensure readiness and build confidence. This training illuminated the dynamics of supporting individuals with complex health and social challenges. Integrating into diverse organisational environments, the Peer Navigators adapted to new professional expectations and consistently advocated for harm reduction and psychologically informed approaches, sometimes encountering resistance from other professionals. Establishing effective relationships with participants and professionals was essential and involved dealing with challenges such as overcoming personal biases and navigating systemic obstacles. the Peer Navigators benefitted from the specially designed training to support career progress with personal and professional development opportunities which enabled successful transitions beyond the SHARPS study. CONCLUSIONS Pre-work training, coupled with support and adherence to key principles, enabled the Peer Navigators to integrate effectively into diverse organisations. Quality relationships were vital in achieving client outcomes and supporting the professional growth of the Peer Navigators. These findings are important for services employing peer workers and underscore the importance of a commitment to training and continuing professional development.
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Affiliation(s)
- Josh Dumbrell
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK.
| | - Hannah Carver
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK
| | - Rebecca Foster
- School of Applied Sciences, Edinburgh Napier University, 9 Sighthill Court, Edinburgh, UK
| | - Bernie Pauly
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Wez Steele
- Scottish Drugs Forum, 91 Mitchell Street, Glasgow, UK
| | - Michael Roy
- New Vision Bradford, Humankind, Pelican House, 10 Currer Street, Bradford, UK
| | - Tessa Parkes
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK
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Dana Z, Nagra H, Kilby K. Role of Synchronous, Moderated, and Anonymous Peer Support Chats on Reducing Momentary Loneliness in Older Adults: Retrospective Observational Study. JMIR Form Res 2024; 8:e59501. [PMID: 39453688 PMCID: PMC11549579 DOI: 10.2196/59501] [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: 04/13/2024] [Revised: 06/06/2024] [Accepted: 09/03/2024] [Indexed: 10/26/2024] Open
Abstract
BACKGROUND Older adults have a high rate of loneliness, which contributes to increased psychosocial risk, medical morbidity, and mortality. Digital emotional support interventions provide a convenient and rapid avenue for additional support. Digital peer support interventions for emotional struggles contrast the usual provider-based clinical care models because they offer more accessible, direct support for empowerment, highlighting the users' autonomy, competence, and relatedness. OBJECTIVE This study aims to examine a novel anonymous and synchronous peer-to-peer digital chat service facilitated by trained human moderators. The experience of a cohort of 699 adults aged ≥65 years was analyzed to determine (1) if participation, alone, led to measurable aggregate change in momentary loneliness and optimism and (2) the impact of peers on momentary loneliness and optimism. METHODS Participants were each prompted with a single question: "What's your struggle?" Using a proprietary artificial intelligence model, the free-text response automatched the respondent based on their self-expressed emotional struggle to peers and a chat moderator. Exchanged messages were analyzed to quantitatively measure the change in momentary loneliness and optimism using a third-party, public, natural language processing model (GPT-4 [OpenAI]). The sentiment change analysis was initially performed at the individual level and then averaged across all users with similar emotion types to produce a statistically significant (P<.05) collective trend per emotion. To evaluate the peer impact on momentary loneliness and optimism, we performed propensity matching to align the moderator+single user and moderator+small group chat cohorts and then compare the emotion trends between the matched cohorts. RESULTS Loneliness and optimism trends significantly improved after 8 (P=.02) to 9 minutes (P=.03) into the chat. We observed a significant improvement in the momentary loneliness and optimism trends between the moderator+small group compared to the moderator+single user chat cohort after 19 (P=.049) and 21 minutes (P=.04) for optimism and loneliness, respectively. CONCLUSIONS Chat-based peer support may be a viable intervention to help address momentary loneliness in older adults and present an alternative to traditional care. The promising results support the need for further study to expand the evidence for such cost-effective options.
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Affiliation(s)
- Zara Dana
- Supportiv, Berkeley, CA, United States
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16
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Tillson M, Annett J, Staton M, Schneider JA, Oser CB. Social support networks of incarcerated women with opioid use disorder: Differences associated with jail-based substance use treatment. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 165:209457. [PMID: 39067766 PMCID: PMC11347120 DOI: 10.1016/j.josat.2024.209457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 05/15/2024] [Accepted: 07/11/2024] [Indexed: 07/30/2024]
Abstract
INTRODUCTION Social support is a critical factor for women's engagement with substance use treatment and recovery, particularly for women with criminal-legal system involvement. However, less is known about the social support networks of incarcerated women, particularly as a function of service engagement. Thus, this paper aims to describe the structure, composition, and function of social support networks of women with opioid use disorder (OUD) incarcerated in jails; and compare network differences between women receiving jail-based substance use treatment and non-treatment participants. METHODS As part of a larger clinical trial under the NIDA-funded Justice Community Opioid Innovation Network (JCOIN), staff conducted an egocentric social network inventory with women who were randomly selected from eight jails in Kentucky, screened for OUD, and consented (N = 445). Women were asked to name people (alters) who provided them with support in the past 90 days and respond to questions about alters who were named. Bivariate comparisons examined differences in social networks among women who were currently receiving jail-based treatment (29.9 %, n = 133) and those who were incarcerated, but not receiving treatment (70.1 %, n = 312). RESULTS On average, women's social support networks consisted of 2.4 alters (range 1-9). Compared to women with OUD who were not receiving treatment, those in treatment were significantly more likely to name at least one alter who was in recovery (57.9 % vs. 43.9 %, p = .007) and less likely to name a partner (21.8 % vs. 37.8 %, p = .001) or someone who had recently used opioids (9.8 % vs. 24.7 %, p < .001). On average, women in treatment also felt significantly closer to their alters (4.70 vs. 4.55 out of 5, p = .021) and rated alters as fulfilling more types of social support functions (5.54 vs. 5.18 out of 6, p < .001) and recovery support functions (2.83 vs. 2.70 out of 3, p = .016). CONCLUSION Results suggest that women participating in jail-based substance use treatment reported more positive social support network attributes, including network function and composition. Future research should assess longitudinal changes in networks and associated differences in recovery outcomes as women are released to the community.
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Affiliation(s)
- Martha Tillson
- University of Kentucky Center on Drug and Alcohol Research, Lexington, KY, USA.
| | - Jaxin Annett
- University of Kentucky Center on Drug and Alcohol Research, Lexington, KY, USA
| | - Michele Staton
- University of Kentucky Center on Drug and Alcohol Research, Lexington, KY, USA; University of Kentucky College of Medicine, Department of Behavioral Science, Lexington, KY, USA
| | - John A Schneider
- University of Chicago, Departments of Medicine and Public Health Sciences, Chicago, IL, USA
| | - Carrie B Oser
- University of Kentucky Center on Drug and Alcohol Research, Lexington, KY, USA; University of Kentucky College of Arts and Sciences, Department of Sociology, Lexington, KY, USA; University of Kentucky Center for Health Equity Transformation, Lexington, KY, USA
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Fitzgerald C, Webb C, McNally C. Lift Yourself Up: The Short-Term Associations Between Strength Training and Mood States and the Longer Term Development of Physical Capital and "Grit" Among People Recovering From Substance Use Disorders. Health Promot Pract 2024; 25:845-854. [PMID: 38686654 DOI: 10.1177/15248399241245051] [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] [Indexed: 05/02/2024]
Abstract
Mind Body Connect is a charity that delivers community-based physical exercise (PE) classes to people in recovery from substance use disorders. This study aimed to identify the contribution that strength training played in the development of positive short- and long-term psychological attributes for people recovering from substance use disorders by assessing (a) the short-term associations between participation in group exercise classes (N = 43, t = 2,940) and (b) the prospective long-term association between strength development and individuals' self-assessed level of "grit" among participants for whom strength training became a habitual activity (N = 13, median 8 weeks supported training). Participants completed demographic, Profile of Mood States-Adapted Short Form, and Short Grit Scale questionnaires before and after each strength training session over a period of 45 noncompulsory training sessions between February 2020 and March 2021. Weekly training logs recording the weight lifted were normalized into a measure of physical capital development. Short-term associations were tested using multilevel regression models predicting change in mean Grit score with interactions for gender; long-term associations were assessed through the use of latent growth models. We found that training sessions were associated with weak to moderate reductions (β = -0.112 to -0.533) in many negative mood states but elevated fatigue (β MEN = 1.071, β WOMEN = 0.397). Latent growth in recorded strength was strongly associated with latent growth in self-assessed grit (β = 0.674). The findings suggest that PE classes and supported long-term strength training may assist with the development of recovery capital.
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18
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Yusay CTC. To be visible yet remain unseen: An interpretative phenomenological analysis of embodied drug use and recovery of Filipinas. JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:950-970. [PMID: 39139087 DOI: 10.1002/jcop.23140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 07/25/2024] [Accepted: 07/30/2024] [Indexed: 08/15/2024]
Abstract
The experience of drug use is a gendered and culturally embodied phenomenon. This qualitative study aims to unpack the lived experiences of 16 urban, poor, Filipina mothers who used drugs. In-depth interviews were conducted. Data was analyzed using interpretative phenomenological analysis (IPA). Their experiences were divided into drug initiation and recovery. Key findings show embodied experiences of initiation through starting use, losing control, and navigating through public and private spaces of drug use. Their experiences of drug recovery revolved around decoupling relations, avoiding drug use spaces, and healing their strained home. Theoretically, this study contributes to enriching the analytical underpinnings of IPA through a gendered and embodied perspective. In terms of practical implications, findings point to the need for a gender-conscious approach in intervention design and implementation in the community setting considering the life space of Filipinas who use drugs.
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Affiliation(s)
- Camille Therese C Yusay
- Department of Psychology, Ateneo de Manila University, Quezon City, Philippines
- University Research Co LLC, Bethesda, Maryland, USA
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Sun C, Li H, Wang X, Shao Y, Huang X, Qi H, Zhang Z, Su G. Self-control as mediator and social support as moderator in stress-relapse dynamics of substance dependency. Sci Rep 2024; 14:19852. [PMID: 39191931 PMCID: PMC11349877 DOI: 10.1038/s41598-024-70884-8] [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: 03/13/2024] [Accepted: 08/22/2024] [Indexed: 08/29/2024] Open
Abstract
Substance Use Disorders (SUDs) present a significant challenge to global public health, with prolonged drug use not only impairing individual health but also hindering social development. Despite various interventions aimed at addressing drug abuse and dependence, a high relapse rate remains a prominent issue. In light of this, this study aims to explore the impact of perceived stress on the relapse of individuals with SUDs, as well as the mediating role of self-control and the moderating role of social support, in hopes of providing new perspectives for interventions to reduce the risk of relapse among individuals with SUDs. By utilizing a convenience sampling method, 420 male individuals with SUDs were recruited from detoxification centers in Guangxi, China. They completed questionnaires on perceived stress, self-control, social support, and tendencies towards relapse. A total of 401 valid datasets were obtained and analyzed using the SPSS Process plugin to conduct a moderated mediation model analysis. Results: (1) Perceived stress had a positive impact on the relapse of individuals with SUDs, (2) Self-control played a partial mediating role between perceived stress and the relapse, (3) The direct effect of perceived stress on the relapse and its first half of the indirect effect were moderated by social support. The research emphasize the critical importance of learning stress management strategies, enhancing self-control, and receiving comprehensive social support in the prevention and treatment of substance dependence. By strengthening self-control and social support as both internal and external resources, the likelihood of relapse among individuals with SUDs can be reduced, contributing to more effective and comprehensive drug rehabilitation strategies.
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Affiliation(s)
- Chao Sun
- School of Psychology, Beijing Sport University, Beijing, 100084, China
| | - Haojie Li
- School of Exercise and Health, Shanghai University of Sport, Shanghai, 200438, China
| | - Xiaojun Wang
- China Wushu School, Beijing Sport University, Beijing, 100084, China.
| | - Yongcong Shao
- School of Psychology, Beijing Sport University, Beijing, 100084, China.
| | - Xuetong Huang
- China Wushu School, Beijing Sport University, Beijing, 100084, China
| | - Huanhuan Qi
- China Wushu School, Beijing Sport University, Beijing, 100084, China
| | - Zhuolin Zhang
- China Wushu School, Beijing Sport University, Beijing, 100084, China
| | - Guobai Su
- Department of Physical Education, Tianjin Medical University, Tianjin, 300070, China.
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Ma Q, Whipple CR, Kaynak Ö, Saylor E, Kensinger WS. Somebody to Lean on: Understanding Self-Stigma and Willingness to Disclose in the Context of Addiction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1044. [PMID: 39200654 PMCID: PMC11354585 DOI: 10.3390/ijerph21081044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 08/02/2024] [Accepted: 08/05/2024] [Indexed: 09/02/2024]
Abstract
Substance use self-stigma is a barrier to treatment and can negatively impact individuals' well-being and treatment engagement. Given the mixed findings in previous research and the limited specific investigation into the concept of self-stigma within the context of opioid misuse, examining factors associated with self-stigma in the context of opioid use disorder (OUD) is warranted. The current study examines the influence of individual-level factors (race, sex, urban/rural status, support group attendance) on self-stigma and willingness to disclose opioid use. Data for this study were from a larger study of OUD-related stigma among adults in Pennsylvania, U.S. The current study included participants who indicated a personal past or current history with OUD were included (n = 84). Exploratory factor analysis and multiple indicators, multiple causes (MIMIC) model were used to explore the associations between demographic factors (i.e., sex, age, race/ethnicity, urban/rural status), attendance at mutual support groups, and self-stigma factors. Results indicated that sex and attendance at mutual support groups significantly predicted levels of self-stigma. Women and individuals with no previous experience attending mutual support groups endorsed lower levels of self-stigma. Additionally, attendance at mutual support groups predicted willingness to self-disclose past and present opioid use. Individuals who reported no history of attending mutual support groups demonstrated less willingness to disclose past and present OUD use compared to participants who were support group attendees. The current research findings enhance the understanding of OUD-related self-stigma by examining its relationship with individual-level factors, disclosure, and attendance to mutual support groups. The results offer insights into the influence of sex and support group attendance on self-stigma and disclosure. These findings have significant clinical implications for developing future interventions and promoting health policy changes.
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Affiliation(s)
| | | | - Övgü Kaynak
- School of Behavioral Sciences and Education, Penn State University, Harrisburg, Middletown, PA 17057, USA; (Q.M.); (C.R.W.); (E.S.); (W.S.K.)
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21
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Emery H, Matthews A, Duggan M. "A little bit of hope goes a long way": Exploring the role of peer workers in alcohol and other drug rehabilitation services. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 163:209408. [PMID: 38763216 DOI: 10.1016/j.josat.2024.209408] [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: 11/22/2023] [Revised: 03/11/2024] [Accepted: 05/14/2024] [Indexed: 05/21/2024]
Abstract
INTRODUCTION Peer workers operating within health care settings can offer unique perspectives based on their own lived experience. Within alcohol and other drug (AOD) rehabilitation services, the potential value of peer work is becoming increasingly recognised. This qualitative study aimed to evaluate a newly implemented peer worker program located across three rehabilitation services in Tasmania, Australia. METHODS Online interviews were conducted with eight clients, seven peer workers, and five non-peer worker employees with varied experience with peer worker programs. All interviews were audio-recorded and transcribed verbatim. RESULTS Guided by an overarching exploratory-descriptive methodological framework, thematic analysis generated three overarching themes: 1) Enhancing and supporting client experiences (what peer workers did in their role to improve client experiences, 2) Changing experiences with AOD rehabilitation (the unique benefits and changes that peer work brings to AOD rehabilitation services) and 3) Finding organizational value (how defining peer work and the feasibility of the peer worker role was challenged by different organizational factors). Overall, peer work was viewed as a positive addition to all rehabilitation services that was able to enhance client experiences through various mechanisms, such as by sharing their own stories, assisting with understanding, and creating safety. Peer work was also able to create change in AOD services, by instilling hope and reducing stigma. However, ongoing challenges with defining the peer worker role in a way that offers organizational recognition and financial security remain. CONCLUSION Peer workers offer a unique and valuable perspective when working within rehabilitation services. Through their own lived experience peer workers were able to support clients and assist them in their recovery. These findings highlight the potential benefit of peer work programs within AOD rehabilitation services.
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Affiliation(s)
- Holly Emery
- School of Psychological Sciences, University of Tasmania, Launceston, Australia.
| | - Allison Matthews
- School of Psychological Sciences, University of Tasmania, Hobart, Australia.
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Mussared J, Oni HT, Gregory TJ, Fernandes A, Mazzacano A, Kadarusman D, Fraser S. An In-Home Withdrawal Service for individuals with low-to-moderate substance dependence: implementation and program evaluation. Aust J Prim Health 2024; 30:PY23231. [PMID: 39094011 DOI: 10.1071/py23231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 07/17/2024] [Indexed: 08/04/2024]
Abstract
Background Sonder's In-Home Withdrawal Service (IHWS) has been providing a unique home-based, multidisciplinary, wraparound withdrawal option for people with low-to-moderate levels of substance dependence since September 2019. This paper provides an evaluation of the service's overall impact on reducing substance use among clients through the delivery of this innovative service model. The evaluation explores the acceptability and feasibility of the service via client, stakeholder, and staff perspectives. Methods A mixed-method design was used to evaluate the IHWS. Descriptive analysis of quantitative data was conducted using clinical assessments from client records and online feedback surveys. Qualitative data from client, staff, and stakeholder feedback surveys were analysed thematically. Results Overall, 1166 referrals were received over the lifespan of the service, and a data set of 96 clients was included in the analysis. Self-reported measures showed that most clients decreased their substance use (89%), improved their psychological health status (75%), improved their physical health (65%), improved their quality of life (69%), and improved their understanding and ability to manage their alcohol and other drugs (AOD) use (84%). Client feedback suggests the service is providing a unique option for AOD withdrawal. Stakeholders commend the service's home-based setting, multidisciplinary and person-centred approach to care, and recommended expansion of the service to increase access for clients and reduce demand on inpatient settings. Conclusions The IHWS is having a significant impact in reducing substance use and highlights the need for increased access to holistic approaches to withdrawal. This includes pre- and post-withdrawal support and the inclusion of multidisciplinary teams, and engaging lived experience practitioners. A focus on funding primary-based services is required to meet the rising costs of tertiary-based care and to better meet the needs of consumers.
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Affiliation(s)
- James Mussared
- School of Public Health, University of Adelaide, Adelaide, SA 5005, Australia; and Sonder Care, Edinburgh North, SA 5113, Australia
| | | | | | | | | | | | - Sarah Fraser
- Sonder Care, Edinburgh North, SA 5113, Australia
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23
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Drazdowski TK, Castedo de Martell S, Sheidow AJ, Chapman JE, McCart MR. Leveraging Parents and Peer Recovery Supports to Increase Recovery Capital in Emerging Adults With Polysubstance Use: Protocol for a Feasibility, Acceptability, and Appropriateness Study of Launch. JMIR Res Protoc 2024; 13:e60671. [PMID: 39037768 DOI: 10.2196/60671] [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: 05/17/2024] [Revised: 06/26/2024] [Accepted: 06/27/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Emerging adults (aged 18-26 years) are the most at-risk yet underserved age group among people with substance use disorder, especially rural emerging adults, and polysubstance use is common. Recovery capital is lower among emerging adults than older adults, and evidence-based treatments are typically unavailable or not developmentally tailored, especially in rural areas. Both supportive parents (or parental figures) and peer recovery support services (PRSS) can be leveraged to better support these emerging adults. Previous research indicates parents can be engaged to deliver contingency management (CM), an extensively researched evidence-based intervention for substance use. OBJECTIVE This protocol describes a funded pilot of Launch, a novel, scalable service package that pairs web-based coaching for parents to deliver CM for emerging adults (CM-EA) at home and in-person PRSS with educational and vocational goal setting. Specifically, this protocol describes feasibility, acceptability, and appropriateness testing (implementation-related outcomes) and steps taken to prepare for a future large-scale trial of Launch. METHODS Upon the recruitment of 48 emerging adult and parent pairs from sites serving primarily rural clients, participants will be randomized into 1 of 3 conditions for this randomized controlled trial: virtual parent coaching to deliver CM-EA, in-person PRSS for emerging adults, or both sets of services. Emerging adult eligibility includes polysubstance use, a substance use disorder, and availability of a consenting parent. Emerging adults will be interviewed at baseline and 6 months about substance use, quality of life, recovery capital, parental relationship, and Launch implementation-related outcomes (6-month follow-up only). Parents, peer workers delivering PRSS, and parent CM-EA coaches will be interviewed about implementation-related outcomes at the end of the study period. Peer workers and CM-EA coaches will be asked to complete checklists of services delivered after each session. Finally, payers and providers will be interviewed for additional insights into Launch implementation and to identify key outcomes of Launch. Data analysis for emerging adult outcomes will be primarily descriptive, but parent CM-EA training adherence will be assessed using nested mixed-effects regression models of repeated measures. RESULTS Launch is currently ongoing, with funding received in August 2023, and is expected to end in September 2025, with data analysis and results in December 2026. Participants are expected to begin enrolling in June 2024. CONCLUSIONS While this pilot is limited by the small sample size and restriction to emerging adults with an involved parent, this is mitigated by the study's strengths and is appropriate for the pilot stage. Launch uses an innovative combination of existing strategies to generate better outcomes for emerging adults while remaining scalable. This pilot will provide insights into the feasibility and acceptability of Launch from the perspectives of service recipients, providers, and payers to inform a larger-scale effectiveness trial. TRIAL REGISTRATION ClinicalTrials.gov NCT06414993; https://clinicaltrials.gov/study/NCT06414993. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/60671.
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Affiliation(s)
- Tess K Drazdowski
- Lighthouse Institute, Chestnut Health Systems, Bloomington, IL, United States
| | | | - Ashli J Sheidow
- Lighthouse Institute, Chestnut Health Systems, Bloomington, IL, United States
| | - Jason E Chapman
- Lighthouse Institute, Chestnut Health Systems, Bloomington, IL, United States
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24
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McFadden D, Davidson G, Butler M. Social support and trauma experiences of imprisoned men in Northern Ireland. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2024; 95:102005. [PMID: 38964262 DOI: 10.1016/j.ijlp.2024.102005] [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: 03/04/2024] [Revised: 06/20/2024] [Accepted: 06/23/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Social Support has multiple benefits for health and mental wellbeing. Its existence, and the extent to which it can be beneficial, is dependent upon the context in which it is provided, and the recipients' view of it. Social support has long been established as a 'buffer' to the negative impact of stressful life experiences. Trauma can negatively impact upon social support, reducing the extent of social networks and ability of some trauma experienced individuals to sustain extensive social support networks. However, some trauma experiences can also strengthen social relationships. Imprisoned men are disproportionately likely to have experienced a traumatic event when compared with the general population. Past research has found that traumatic events can lead to a decrease in social support among imprisoned men but more research is needed to understand the variations in perceived social support experienced by imprisoned men and to determine how different types of trauma may be related to perceived social support. METHOD A cross-sectional survey of 384 adult men detained in the Northern Ireland Prison Service was conducted between November 2022 and January 2023. The survey collected data on the men's demographics, mental health, substance use, and criminal history. Respondents were also asked to complete a Trauma History Questionnaire (THQ) and the Multi-dimensional Scale of Perceived Social Support (MSPSS). Regression analysis was then used to investigate the possible associations between individual characteristics, different types of trauma experiences and perceived social support. RESULTS Most types of trauma experiences were not associated with lower levels of perceived social support. Only those who had experienced crime related trauma were more likely to report lower levels of social support. Older imprisoned men and those using substances were more likely to report lower levels of perceived social support, while those who had served a sentence of less than one year reported higher levels of perceived social support. DISCUSSION Crime related trauma experiences were found to be associated with lower levels of perceived social support. There were no significant findings around perceived social support and any of the other trauma types i.e. physical, sexual and general disaster experiences. Trauma informed policy responses should be cognisant of this, as those with experiences of crime related victimisation are less likely to have the social support needed to buffer against future trauma experiences. The findings demonstrate that some individuals experience lower levels of perceived social support and several factors are associated with this including age, time served and substance use history. This will potentially impact upon them during release and affect their reintegration into society. Specific policies aimed at these groups should be considered to prevent them from experiencing a lack of support and any accompanying adversity upon release.
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Affiliation(s)
- Daniel McFadden
- School of Social Sciences, Education & Social Work, 6. College Park, Queen's University Belfast, UK.
| | - Gavin Davidson
- School of Social Sciences, Education & Social Work, 6. College Park, Queen's University Belfast, UK
| | - Michelle Butler
- School of Social Sciences, Education & Social Work, 6. College Park, Queen's University Belfast, UK
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Maurage P, Boudehent C, Ferrié L, Cabé N, Pitel AL. Are we just talking in circles? Impact of psychoeducation on disease knowledge and relapse in severe alcohol use disorder. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:1383-1394. [PMID: 38811340 DOI: 10.1111/acer.15375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/02/2024] [Accepted: 05/03/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Psychoeducation constitutes a routine therapeutic practice in most treatment settings for severe alcohol use disorder (sAUD). This technique is considered an efficient way to help patients to learn more about their disease and achieve therapeutic objectives. However, this approach capitalizes on three untested assumptions: namely, that (1) patients with sAUD possess insufficient knowledge about sAUD at treatment entry; (2) patients with sAUD have the cognitive resources to learn new information and benefit from psychoeducation; and (3) psychoeducation positively impacts clinical outcomes. METHODS We tested these assumptions in two experimental studies. In the first experiment in 66 recently detoxified patients with sAUD and 102 matched healthy controls, we measured baseline knowledge on sAUD through self-reported questionnaires, determined whether an up-to-date psychoeducation program can improve this knowledge, explored the role of cognitive abilities in such learning, and established the impact of psychoeducation on relapse rates. In a second experiment in 23 patients and 17 healthy controls, we examined whether the increased knowledge following psychoeducation is alcohol specific, and whether the motivation to change influences the relation between psychoeducation and clinical outcomes. RESULTS At treatment entry, patients with sAUD presented with more sAUD-related knowledge than healthy controls, and were able to increase this knowledge following psychoeducation, independently of their cognitive status. However, psychoeducation did not impact either the motivation to change or relapse rates. CONCLUSIONS Psychoeducation can increase patients' knowledge about sAUD, but it does not increase the likelihood of abstinence or controlled low consumption after discharge. Thus, clinicians should question whether psychoeducation should occupy a central position in the therapeutic programs and reconsider what can be expected from psychoeducation in terms of achieving therapeutic objectives.
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Affiliation(s)
- Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Céline Boudehent
- Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
- UNICAEN, INSERM, U1237, PhIND « Physiopathology and Imaging of Neurological Disorders », Neuropresage Team, Cyceron, Normandie Univ, Caen, France
| | - Louise Ferrié
- Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Nicolas Cabé
- Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
- UNICAEN, INSERM, U1237, PhIND « Physiopathology and Imaging of Neurological Disorders », Neuropresage Team, Cyceron, Normandie Univ, Caen, France
| | - Anne-Lise Pitel
- UNICAEN, INSERM, U1237, PhIND « Physiopathology and Imaging of Neurological Disorders », Neuropresage Team, Cyceron, Normandie Univ, Caen, France
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Urbina T, Balasundaram M, Coughlin M, Sorrells K, Toney-Noland C, Day C. The Why and How of Family-Centered Care. Neoreviews 2024; 25:e393-e400. [PMID: 38945966 DOI: 10.1542/neo.25-7-e393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/18/2023] [Accepted: 01/09/2024] [Indexed: 07/02/2024]
Abstract
Although the Accreditation Council for Graduate Medical Education states that neonatal-perinatal medicine fellows must demonstrate an understanding of the emotional impact of admission to the NICU on a family, few curricula are in place to teach this important competency. Family-centered care (FCC) in the NICU is an approach to health care that focuses on decreasing mental and emotional trauma for families while empowering them to reclaim their role as caregivers. FCC is deeply rooted in trauma-informed care and is crucial during transition periods throughout the NICU admission. In this article, we provide a review of FCC and trauma-informed care and how to use these approaches at different stages during an infant's hospitalization. We also discuss parent support networks and how to integrate FCC into an existing NICU practice.
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Affiliation(s)
- Theresa Urbina
- Department of Pediatrics, Uniformed Services University of Health Services, Bethesda, MD
| | - Malathi Balasundaram
- Division of Neonatology, Department of Pediatrics, Stanford Medicine Children's Health, Standford, CA
| | | | | | | | - Colby Day
- Division of Neonatology, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY
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Lardier DT, Gilmore-Powell K, Morton CM, Peterson NA, Borys S. Peer Recovery Specialists and Referrals to Treatment: Clinical Correlates Among Patients of an Opioid Overdose Recovery Program in New Jersey. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:493-505. [PMID: 38469829 DOI: 10.1177/29767342241235765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
BACKGROUND Peer recovery programs increase recovery support and treatment engagement among individuals with opioid use disorder. Peer recovery specialists (PRS) are critical in the cascade of care of treating addiction and related conditions. Work remains to help identify the benefits of PRS, particularly time spent with a PRS as a clinical indicator associated with referral to substance use treatment services. Gaps in the literature do not consider the nested hierarchical intercorrelations of opioid recovery data within multiple emergency departments. PURPOSE The current study examined demographic and clinical correlates with referral to substance use treatment services including prior engagement within an opioid overdose recovery program, mental health diagnosis, the number of naloxone administrations, prior overdoses, and hospital-level variability of PRS time associated with treatment referrals. METHOD This study used data collected by providers among patients who engaged in an opioid overdose recovery program. Data were collected between January 2016 and September 2020. Generalized linear mixed effect multilevel regression analyses tested the associations on clinical referral to substance use services. RESULTS A total of 5655 patients participated in the study (male: 68.91%; age: mean = 37.75 ± 12.43; White non-Hispanic: 62.48%). Significant individual-level associations were identified between demographic and clinical variables and referral to substance use treatment services. At the hospital level, recovery specialist time spent with the patient also showed a positive and significant association with referral to substance use treatment services. CONCLUSION The cross-level interaction effect displayed that any period of time spent with PRS played an important role for those patients with a greater number of prior overdoses on referral to treatment. Results provide important information on the role of PRS in the cascade of care, as well as the time spent with those in this role for both individuals with varying number of prior overdoses.
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Affiliation(s)
- David T Lardier
- Department of Psychiatry and Behavioral Sciences, Division of Community Behavioral Health, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Kristen Gilmore-Powell
- Center for Prevention Science and the Northeast and Caribbean Prevention Technology Transfer Center, School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | - Cory M Morton
- Center for Prevention Science and the Northeast and Caribbean Prevention Technology Transfer Center, School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | - N Andrew Peterson
- Center for Prevention Science and the Northeast and Caribbean Prevention Technology Transfer Center, School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | - Suzanne Borys
- Office of Planning, Research, Evaluation and Prevention, New Jersey Division of Mental Health and Addiction Services, Hamilton, NJ, USA
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28
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Peart A, Horn F, Petukhova R, Barnett A, Lubman DI. Web-Based Forums for People Experiencing Substance Use or Gambling Disorders: Scoping Review. JMIR Ment Health 2024; 11:e49010. [PMID: 38885012 PMCID: PMC11217707 DOI: 10.2196/49010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 03/08/2024] [Accepted: 04/26/2024] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND For people experiencing substance use or gambling disorders, web-based peer-supported forums are a space where they can share their experiences, gather around a collective goal, and find mutual support. Web-based peer support can help to overcome barriers to attending face-to-face meetings by enabling people experiencing addiction to seek support beyond their physical location and with the benefit of anonymity if desired. Understanding who participates in web-based peer-supported forums (and how), and the principles underpinning forums, can also assist those interested in designing or implementing similar platforms. OBJECTIVE This study aims to review the literature on how people experiencing substance use or gambling disorders, and their family, friends, and supporters, use and participate in web-based peer-supported forums. Specifically, we asked the following research questions: (1) What are the characteristics of people who use web-based peer-supported substance use or gambling-focused forums? (2) How do people participate in web-based peer-supported forums? (3) What are the key principles reportedly underpinning the web-based peer-supported forums? (4) What are the reported outcomes of web-based peer-supported forums? METHODS Inclusion criteria for our scoping review were peer-reviewed primary studies reporting on web-based addiction forums for adults and available in English. A primary search of 10 databases occurred in June 2021, with 2 subsequent citation searches of included studies in September 2022 and February 2024. RESULTS Of the 14 included studies, the majority of web-based peer-supported forums reported were aimed specifically for, or largely used by, people experiencing alcohol problems. Results from the 9 studies that did report demographic data suggest forum users were typically women, aged between 40 years and early 50 years. Participation in web-based peer-supported forums was reported quantitatively and qualitatively. The forums reportedly were underpinned by a range of key principles, mostly mutual help approaches and recovery identity formation. Only 3 included studies reported on outcomes for forum users. CONCLUSIONS Web-based peer-supported forums are used by people experiencing addiction in a number of ways, to share information and experiences, and give and receive support. Seeking web-based support offers an alternative approach to traditional face-to-face support options, and may reduce some barriers to engaging in peer support.
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Affiliation(s)
- Annette Peart
- Eastern Health Clinical School, Monash University, Richmond, Victoria, Australia
| | - Freya Horn
- Eastern Health Clinical School, Monash University, Richmond, Victoria, Australia
| | - Rachel Petukhova
- Eastern Health Clinical School, Monash University, Richmond, Victoria, Australia
| | - Anthony Barnett
- Eastern Health Clinical School, Monash University, Richmond, Victoria, Australia
| | - Dan I Lubman
- Eastern Health Clinical School, Monash University, Richmond, Victoria, Australia
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29
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Hechanova MR, Tee MRC, Co TAC, Rañeses Iii BRM. Her village: experiences of drug-involved women in a female-only aftercare program in the Philippines. INTERNATIONAL JOURNAL OF PRISON HEALTH 2024; 20:156-171. [PMID: 38984605 DOI: 10.1108/ijoph-08-2023-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
PURPOSE Women are exposed to vulnerabilities that can lead to drug use or hinder recovery. However, there is a dearth of studies on recovery programs for women. This study aims to add to the literature by examining the feasibility of a women-only aftercare program for recovering users in the Philippines. DESIGN/METHODOLOGY/APPROACH The study used a mixed-method design with pre and post-program surveys used to measure changes in participants' recovery capital. Focused group discussions elicited participants' context, their reactions, perceived outcomes and suggestions on the program. FINDINGS Women in the program shared narratives of pain, trauma and abuse before treatment. Participants reported significant improvements in personal, community and family recovery capital dimensions. The program enabled personal growth in the form of new knowledge, skills and self-confidence. The women-only program also provided a safe space for women, to receive support from other women, community members and family. However, the women continue to face continuing challenges related to stigma and discrimination and a lack of livelihood opportunities. RESEARCH LIMITATIONS/IMPLICATIONS A limitation of the study was its small sample size and the lack of a control group. Another limitation was the variability in treatment received by the women, which could have affected overall outcomes. Future studies using a randomized control trial and longitudinal designs may provide more robust conclusions on the effectiveness of the program. PRACTICAL IMPLICATIONS Given punitive contexts, gender-sensitive and trauma-informed programs and services for women involved in drug use could potentially mitigate the abuse, stigma and vulnerabilities they experience. ORIGINALITY/VALUE This study contributes to the sparse literature on women-only aftercare, particularly in countries that criminalize drug use.
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Affiliation(s)
- Maria Regina Hechanova
- Philippine Office, University Research Co LLC, Bethesda, Maryland, USA and Department of Psychology, Ateneo de Manila University, Quezon City, Philippines
| | | | - Trixia Anne C Co
- Philippine Office, University Research Co LLC, Bethesda, Maryland, USA
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Patel EU, Grieb SM, Winiker AK, Ching J, Schluth CG, Mehta SH, Kirk GD, Genberg BL. Structural and social changes due to the COVID-19 pandemic and their impact on engagement in substance use disorder treatment services: a qualitative study among people with a recent history of injection drug use in Baltimore, Maryland. Harm Reduct J 2024; 21:91. [PMID: 38720307 PMCID: PMC11077846 DOI: 10.1186/s12954-024-01008-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 04/22/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Substance use disorder treatment and recovery support services are critical for achieving and maintaining recovery. There are limited data on how structural and social changes due to the COVID-19 pandemic impacted individual-level experiences with substance use disorder treatment-related services among community-based samples of people who inject drugs. METHODS People with a recent history of injection drug use who were enrolled in the community-based AIDS Linked to the IntraVenous Experience study in Baltimore, Maryland participated in a one-time, semi-structured interview between July 2021 and February 2022 about their experiences living through the COVID-19 pandemic (n = 28). An iterative inductive coding process was used to identify themes describing how structural and social changes due to the COVID-19 pandemic affected participants' experiences with substance use disorder treatment-related services. RESULTS The median age of participants was 54 years (range = 24-73); 10 (36%) participants were female, 16 (57%) were non-Hispanic Black, and 8 (29%) were living with HIV. We identified several structural and social changes due the pandemic that acted as barriers and facilitators to individual-level engagement in treatment with medications for opioid use disorder (MOUD) and recovery support services (e.g., support group meetings). New take-home methadone flexibility policies temporarily facilitated engagement in MOUD treatment, but other pre-existing rigid policies and practices (e.g., zero-tolerance) were counteracting barriers. Changes in the illicit drug market were both a facilitator and barrier to MOUD treatment. Decreased availability and pandemic-related adaptations to in-person services were a barrier to recovery support services. While telehealth expansion facilitated engagement in recovery support group meetings for some participants, other participants faced digital and technological barriers. These changes in service provision also led to diminished perceived quality of both virtual and in-person recovery support group meetings. However, a facilitator of recovery support was increased accessibility of individual service providers (e.g., counselors and Sponsors). CONCLUSIONS Structural and social changes across several socioecological levels created new barriers and facilitators of individual-level engagement in substance use disorder treatment-related services. Multilevel interventions are needed to improve access to and engagement in high-quality substance use disorder treatment and recovery support services among people who inject drugs.
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Affiliation(s)
- Eshan U Patel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Suzanne M Grieb
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Abigail K Winiker
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jennifer Ching
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Catherine G Schluth
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Shruti H Mehta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Gregory D Kirk
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Becky L Genberg
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
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Jennings LK, Lander L, Lawdahl T, McClure EA, Moreland A, McCauley JL, Haynes L, Matheson T, Jones R, Robey TE, Kawasaki S, Moschella P, Raheemullah A, Miller S, Gregovich G, Waltman D, Brady KT, Barth KS. Characterization of peer support services for substance use disorders in 11 US emergency departments in 2020: findings from a NIDA clinical trials network site selection process. Addict Sci Clin Pract 2024; 19:26. [PMID: 38589934 PMCID: PMC11003047 DOI: 10.1186/s13722-024-00453-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: 04/04/2023] [Accepted: 03/18/2024] [Indexed: 04/10/2024] Open
Abstract
INTRODUCTION Emergency departments (ED) are incorporating Peer Support Specialists (PSSs) to help with patient care for substance use disorders (SUDs). Despite rapid growth in this area, little is published regarding workflow, expectations of the peer role, and core components of the PSS intervention. This study describes these elements in a national sample of ED-based peer support intervention programs. METHODS A survey was conducted to assess PSS site characteristics as part of site selection process for a National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) evaluating PSS effectiveness, Surveys were distributed to clinical sites affiliated with the 16 CTN nodes. Surveys were completed by a representative(s) of the site and collected data on the PSS role in the ED including details regarding funding and certification, services rendered, role in medications for opioid use disorder (MOUD) and naloxone distribution, and factors impacting implementation and maintenance of ED PSS programs. Quantitative data was summarized with descriptive statistics. Free-text fields were analyzed using qualitative content analysis. RESULTS A total of 11 surveys were completed, collected from 9 different states. ED PSS funding was from grants (55%), hospital funds (46%), peer recovery organizations (27%) or other (18%). Funding was anticipated to continue for a mean of 16 months (range 12 to 36 months). The majority of programs provided "general recovery support (81%) Screening, Brief Intervention, and Referral to Treatment (SBIRT) services (55%), and assisted with naloxone distribution to ED patients (64%). A minority assisted with ED-initiated buprenorphine (EDIB) programs (27%). Most (91%) provided services to patients after they were discharged from the ED. Barriers to implementation included lack of outpatient referral sources, barriers to initiating MOUD, stigma at the clinician and system level, and lack of ongoing PSS availability due to short-term grant funding. CONCLUSIONS The majority of ED-based PSSs were funded through time-limited grants, and short-term grant funding was identified as a barrier for ED PSS programs. There was consistency among sites in the involvement of PSSs in facilitation of transitions of SUD care, coordination of follow-up after ED discharge, and PSS involvement in naloxone distribution.
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Affiliation(s)
- Lindsey K Jennings
- Department of Emergency Medicine, Medical University of South Carolina, 169 Ashley Avenue, MSC 300, Charleston, SC, 29425, USA.
| | - Laura Lander
- Department of Behavioral Medicine & Psychiatry, West Virginia University, Morgantown, WV, USA
| | - Tricia Lawdahl
- Faces and Voices of Recovery (FAVOR) Upstate, Greenville, SC, USA
| | - Erin A McClure
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Angela Moreland
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Jenna L McCauley
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Louise Haynes
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Timothy Matheson
- Center On Substance Use and Health, San Francisco Department of Public Health, San Francisco, CA, USA
| | | | - Thomas E Robey
- Providence Regional Medical Center Everett, Washington State University, Everett, WA, USA
| | - Sarah Kawasaki
- Departments of Psychiatry and Internal Medicine, Penn State Health, Hershey, PA, USA
| | - Phillip Moschella
- Department of Emergency Medicine, University of South Carolina School of Medicine, Greenville, SC, USA
| | - Amer Raheemullah
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Suzette Miller
- Mercy Health - St. Elizabeth Youngstown Hospital, Youngstown, OH, USA
| | - Gina Gregovich
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Deborah Waltman
- Deaconess Hospital, MultiCare Health System, Spokane, WA, USA
| | - Kathleen T Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kelly S Barth
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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Hya KM, Huang Z, Chua CMS, Shorey S. Experiences of men undergoing assisted reproductive technology: A qualitative systematic review. Int J Gynaecol Obstet 2024; 165:9-21. [PMID: 37694768 DOI: 10.1002/ijgo.15082] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/29/2023] [Accepted: 08/17/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Many infertile couples undergo assisted reproductive technology (ART) to increase pregnancy chances, with many of them experiencing psychosocial distress. Although research has been performed on women's experiences of ART, there is limited focus on men. OBJECTIVE This systematic review consolidated and synthesized men's experiences with ART to better understand their needs and challenges to support them. SEARCH STRATEGY Nine electronic databases were searched from the inception date until November 2022. SELECTION CRITERIA This review included published and unpublished primary studies with qualitative methodologies exploring men's experiences with ART. DATA COLLECTION AND ANALYSIS The screening of studies, methodological assessment, data extraction, and analysis were conducted by two reviewers independently. The data were thematically synthesized. MAIN RESULTS Fifteen studies were included. An overarching theme of "despair to destiny" was identified, with four synthesized themes: (1) "the roller coaster ride," (2) "what made it from bad to worse?", (3) "what kept men going?", and (4) "hopeful for the future." CONCLUSION Men undergoing ART experienced struggles, a transition of emotions, and a need for support as they attempted to cope with unknowns while remaining hopeful for future outcomes. There is a need for health care interventions and policies to address the issue to improve the well-being of male ART patients. Interventions should be tailored to the specific support groups that cater to the emotional and informational needs of male ART patients. Future research should focus on the influence of cultural sensitivities on men's ART experiences, to tailor support programs to address their psychological needs during ART.
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Affiliation(s)
- Kia Min Hya
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Zhongwei Huang
- NUS Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), Singapore, Singapore
- Undergraduate Medical Education, Department of Obstetrics & Gynaecology, YLLSoM, NUS, Singapore, Singapore
- Departments of Obstetrics & Gynaecology and Physiology, YLLSoM, NUS, Singapore, Singapore
- Department of Obstetrics & Gynaecology, National University Health Systems, Singapore, Singapore
| | - Crystal Min Siu Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Kim S, Lee I, Lee M, Champion JD. The effects and challenges of alcohol use disorder peer support service in South Korea: A focus group study. Int J Ment Health Nurs 2024; 33:159-165. [PMID: 37743562 DOI: 10.1111/inm.13230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/23/2023] [Accepted: 09/06/2023] [Indexed: 09/26/2023]
Abstract
Although alcohol use disorder (AUD) is associated with a high disease burden due to medical consequences, people with AUD often do not receive appropriate treatment or community health service support. Peer-support services, intended to bridge the gap between patients with AUD and mental health providers have produced successful results. However, the number of studies on peer supporters in South Korea, especially those with AUD, is limited. Therefore, research on the effectiveness or challenges faced by AUD peer supporters in Korea is required to meet the challenges posed by increases in the numbers and capabilities of peer supporters in the mental health field. This qualitative study (N = 13), included focus group interviews of AUD peer supporters (n = 7), and supervisors of peer supporters (n = 6). Focus group data were analysed using thematic analysis methods. These analyses identified themes including 'Life before AUD peer supporters: The moment of change', 'Effects of peer support services: Working as peer supporters changed our lives', 'Challenges of peer supporter services: Things experienced as a team' and 'Future directions: How we can improve peer support services'? Findings indicate that healthcare professionals, educated to maintain clear boundaries, are discouraged from disclosing personal information or developing personal relationships with patients. On the other hand, peer supporters discuss personal histories and prioritize personal connections. By acting as comrades, peer supporters have positive effects. By sharing their experiences, peer supporters formed appropriate relationships with AUD patients and families resulting in more active engagement in treatment programmes and increased numbers of patients receiving outpatient treatment.
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Affiliation(s)
- Soojeong Kim
- Department of Nursing, College of Medicine, Inha University, Incheon, South Korea
| | - Insuk Lee
- Department of Nursing, College of Medicine, Inha University, Incheon, South Korea
| | - Mihyong Lee
- Department of Nursing, College of Medicine, Inha University, Incheon, South Korea
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Stylianopoulos P, Hertner L, Heinz A, Kluge U, Schäfer I, Penka S. Good practice in reaching and treating refugees in addiction care in Germany - a Delphi study. BMC Public Health 2024; 24:30. [PMID: 38166874 PMCID: PMC10763166 DOI: 10.1186/s12889-023-17446-1] [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: 06/23/2023] [Accepted: 12/09/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Health and adequate access to health care are human rights. Refugees are at risk for substance abuse. Despite the known structural and personal risk factors for abuse, refugees in Germany continue to face barriers to adequate addiction prevention and care, which is a violation of the fundamental human right to health care. The question arises as to how barriers for refugees in reaching addiction services and care can be overcome. In the presented study, strategies for good practices to deconstruct these barriers were identified. METHOD A total of 21 experts participated in a three-round, consensus-oriented Delphi-Process. The experts represented five different fields: addiction care services, including specialized programs for women, refugee aid services, academia, policy-making and immigrants' self-help services. RESULTS The Delphi-Process generated 39 strategies of good practice summarized in 9 major categories: Care System, Framework Conditions, Multilingualism, Information and Education, Access, Service-Level, Employee-Level, Employee-Attitudes and Networking. CONCLUSION In order to guarantee human rights regarding health and adequate access to health care for refugees, institutional barriers limiting access to prevention and treatment programs for addictive disorders must be abolished. The identified good practice strategies for Germany, if widely implemented, could contribute to this aim. By opening up prevention and treatment facilities for refugees, other marginalized groups could also benefit. While some of the strategies need to be implemented at the institutional level, political steps are also required at the system level including, e.g. financing of adequate translation services.
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Affiliation(s)
- Panagiotis Stylianopoulos
- Department of Psychiatry and Neurosciences at the Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Corporate Member of the Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Laura Hertner
- Department of Psychiatry and Neurosciences at the Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Corporate Member of the Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Neurosciences at the Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Corporate Member of the Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Berlin Institute for Empirical Integration and Migration Research at the Humboldt Universität zu Berlin, Berlin, Germany
| | - Ulrike Kluge
- Department of Psychiatry and Neurosciences at the Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Corporate Member of the Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Berlin Institute for Empirical Integration and Migration Research at the Humboldt Universität zu Berlin, Berlin, Germany
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
| | - Simone Penka
- Department of Psychiatry and Neurosciences at the Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Corporate Member of the Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
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Scherzer C, Jiménez Muñoz P, Ramsey S, Carey KB, Ranney ML, Clark S, Rich J, Langdon KJ. Perceptions of medications, program settings, and drug use histories among individuals engaged in treatment for opioid use disorder. J Addict Dis 2024; 42:24-32. [PMID: 36325942 PMCID: PMC10154429 DOI: 10.1080/10550887.2022.2126273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: Nearly two million adults in the US currently live with an Opioid Use Disorder (OUD) diagnosis. Recent efforts have encouraged and facilitated widespread adoption of empirically supported medications for opioid use disorder (MOUD), yet MOUD and OUD behavioral health interventions remain dramatically underutilized. Fear of discrimination and judgment, compounded by systemic and regulatory barriers, hinder individuals' access to specialty treatment.Objectives: The goal of the current study was to (1) reveal how perspectives toward OUD treatment may differ across medication types, program settings, and drug use history; (2) address systemic and regulatory components that potentially foster and propagate positive or negative attributions to OUD; and (3) understand how experiences reduce patients' willingness to pursue and/or maintain long term treatment.Methods: Twenty-four adults engaged in buprenorphine treatment at two outpatient addiction treatment centers participated in in-depth, qualitative interviews between 2019 and 2020 in Providence, Rhode Island.Results: Thematic analysis revealed negative attributions toward OUD across all participants. Three key themes developed from the coding and analysis: (1) differential perceptions of therapeutic medications (2) negative perceptions of treatment programs and (3) perceptions of drugs and people who use drugs.Conclusions: Stigmatizing language remains a major public health issue that needs to be addressed to facilitate treatment for individuals for OUD and other drug use disorders. Incorporating strategies targeting labeling across medication types, program settings, and drug use may improve treatment outcomes by reducing the inaccurate beliefs surrounding OUD and connecting patients to evidence-based support.
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Affiliation(s)
- Caroline Scherzer
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Paola Jiménez Muñoz
- Department of Psychiatry, Rhode Island Hospital, Providence, RI, United States
- Brown-Lifespan Center for Digital Health, Providence, RI, United States
| | - Susan Ramsey
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
- Department of Medicine, Alpert Medical School of Brown University, Providence, RI, United States
- Division of General Internal Medicine, Department of Medicine, Rhode Island Hospital, Providence, RI, United States
| | - Kate B Carey
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, United States
| | - Megan L Ranney
- Brown-Lifespan Center for Digital Health, Providence, RI, United States
- School of Public Health, Brown University, Providence, RI, United States
| | - Seth Clark
- Department of Psychiatry, Rhode Island Hospital, Providence, RI, United States
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
| | - Josiah Rich
- Department of Medicine and Epidemiology, Brown University, Providence, RI, United States
- Center for Prisoner Health and Human Rights, The Miriam Hospital, Providence, RI, United States
| | - Kirsten J Langdon
- Department of Psychiatry, Rhode Island Hospital, Providence, RI, United States
- Brown-Lifespan Center for Digital Health, Providence, RI, United States
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
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Lavoie MCC, Okui L, Blanco N, Stoebenau K, Magidson JF, Gokatweng G, Ikgopoleng K, Charurat ME, Ndwapi N. Feasibility and acceptability of peer-delivered interventions using mHealth for PrEP services among adolescent girls and young women in DREAMS program in Botswana. Glob Health Action 2023; 16:2231256. [PMID: 37462118 DOI: 10.1080/16549716.2023.2231256] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/26/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Adolescent girls and young women accounted for 25% of all new HIV infections despite representing only 10% of the population in Sub Saharan Africa. PEPFAR has launched the Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) initiative, a comprehensive HIV prevention program including PrEP services. Among adolescent girls and young women, PrEP adherence is currently sub-optimal. Tailored strategies for adolescent girls and young women to improve access and use of PrEP delivery are urgently needed to maximise its potential. Recommended interventions include peer-delivered interventions using mobile technology. However, data on the feasibility and acceptability of this approach is limited for SSA. OBJECTIVES We assessed the feasibility and perceived acceptability of providing mHealth peer-delivered interventions to support PrEP services among adolescent girls and young women in Botswana. METHODS This cross-sectional study included HIV-negative women aged 18-24 years old seeking health services at DREAMS-supported facilities. Participants completed a survey assessing the feasibility and perceived acceptability of the mHealth peer-delivered interventions, which included the Acceptability of Intervention Measure (AIM). Descriptive analyses were performed. RESULTS A total of 131 participated in the study. Overall, 89% owned a mobile phone (feasibility). There was no difference in cell phone ownership between participants from rural and urban settings. Among participants, 85% reported interest in participating in a mHealth peer-delivered intervention if it was available to them. Regarding perceived acceptability for mHealthpeer support groups for PrEP, the average score on the AIM was 3.8 out of 5 (SD = 0.8). CONCLUSION mHealthpeer-delivered interventions appear to be feasible and perceived acceptable among adolescent girls and young women in Botswana. This modality should be incorporated into PEPFAR's programmatic toolkit of implementation strategies to improve PrEP services.
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Affiliation(s)
- Marie-Claude C Lavoie
- Division of Global Health Sciences, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
- Center for International Health Education and Biosecurity (Ciheb), University of Maryland School of Medicine, Baltimore, MD, USA
| | - Lillian Okui
- Center for International Health, Education, and Biosecurity (Ciheb), Maryland Global Initiative Corporation, University of Maryland Baltimore, Gaborone, Botswana
| | - Natalia Blanco
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
- Center for International Health Education and Biosecurity (Ciheb), University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kirsten Stoebenau
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, USA
| | | | - Gadzikanani Gokatweng
- Botswana-University of Maryland School of Medicine Health Initiative (Bummhi), Gaborone, Botswana
| | - Kaizer Ikgopoleng
- Center for International Health, Education, and Biosecurity (Ciheb), Maryland Global Initiative Corporation, University of Maryland Baltimore, Gaborone, Botswana
| | - Manhattan E Charurat
- Division of Global Health Sciences, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
- Center for International Health Education and Biosecurity (Ciheb), University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ndwapi Ndwapi
- Botswana-University of Maryland School of Medicine Health Initiative (Bummhi), Gaborone, Botswana
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Sebola BR, Risenga PR. The support group impact on enhancing the self-worth of women who terminated a pregnancy in adolescence. S Afr Fam Pract (2004) 2023; 65:e1-e10. [PMID: 38197692 PMCID: PMC10784272 DOI: 10.4102/safp.v65i1.5707] [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: 01/03/2023] [Revised: 07/26/2023] [Accepted: 07/26/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Terminating a pregnancy can be a traumatic life event, resulting in negative emotions that can diminish women's self-worth. Support from different sources, including health support groups, could be beneficial in restoring a woman's self-worth. This article aimed to present findings on the impact of a support group intervention on the self-worth of women who terminated a pregnancy in adolescence. METHODS A qualitative, exploratory and descriptive approach, using in-depth, semi-structured interviews, was used to collect data. Thematic analysis guided the data analysis. RESULTS Five themes emerged from the data: reasons for joining the support group; enhanced emotional and physical wellbeing; self-forgiveness; spiritual growth and participants' voices. CONCLUSION Participants described why they needed to join the support group. It became clear that the intercession was effective in the short term as it enhanced participants' self-worth by encouraging them to accept themselves thereby altering their self-condemning emotions, replacing them with self-love.Contribution: The study recommends that a support group should be considered as a backup for women who terminated a pregnancy and have lost their self-worth.
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Affiliation(s)
- Botshelo R Sebola
- Department of Health Studies, School of Social Sciences, University of South Africa, Pretoria.
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Kirk MR, Dawkins AD, Wei X, Ajumobi O, Lee LC, Oman R, Woodard S, Wagner KD. What makes a peer? Characteristics of certified peer recovery support specialists in an emergency department-based intervention. PLoS One 2023; 18:e0289920. [PMID: 38060503 PMCID: PMC10703250 DOI: 10.1371/journal.pone.0289920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 07/28/2023] [Indexed: 12/18/2023] Open
Abstract
Providing brief interventions by certified peer recovery support specialists (CPRSS) in the emergency department (ED) following a drug related visit is a promising method of service engagement and has garnered national attention. This study examines CPRSS's perceptions of the qualities that enable them to deliver interventions in the ED. We conducted qualitative interviews with 14 CPRSSs working in EDs. Interview topics included how the participants became involved with CPRSS work, experiences working in the ED, how the ED differs from other settings, and what interactions with patients look like. Interviews were digitally recorded, transcribed, and analyzed for emerging categories. Three categories were identified relating to CPRSS work: (1) how they approach peer work, (2) inherent qualities required to do the work, regardless of the setting, and (3) context-specific skills required to do the work in the ED. When describing their approach to this work, participants talked about CPRSS work as their life calling and their passion. Participants also identified certain qualities that all CPRSS workers possess, regardless of the setting, including the ability to build rapport, strong listening skills, and a shared lived experience. Lastly, participants identified how specific hard and soft skills help them to navigate organizational and structural challenges in the ED. The unique conditions of the ED and the required qualities of a CPRSS should be considered when implementing an ED-based intervention.
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Affiliation(s)
- Mia R. Kirk
- School of Public Health, University of Nevada, Reno, Reno, Nevada, United States of America
| | - Ashley D. Dawkins
- School of Public Health, University of Nevada, Reno, Reno, Nevada, United States of America
| | - Xing Wei
- School of Public Health, University of Nevada, Reno, Reno, Nevada, United States of America
| | - Olufemi Ajumobi
- School of Public Health, University of Nevada, Reno, Reno, Nevada, United States of America
| | - Lisa C. Lee
- Roots to Wings Consulting, LLC, Reno, Nevada, United States of America
| | - Roy Oman
- School of Public Health, University of Nevada, Reno, Reno, Nevada, United States of America
| | - Stephanie Woodard
- Division of Public and Behavioral Health, Bureau of Behavioral Health, Wellness and Prevention, State of Nevada, Carson City, Nevada, United States of America
| | - Karla D. Wagner
- School of Public Health, University of Nevada, Reno, Reno, Nevada, United States of America
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Pebdani RN, Leon J, Won DS, deLeon RD, Dy CJ, Keslacy S. "Teaching somebody else makes you a better person:" A phenomenological exploration of the importance of informal peer support for individuals with spinal cord injury. Disabil Health J 2023; 16:101505. [PMID: 37541930 DOI: 10.1016/j.dhjo.2023.101505] [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: 02/27/2023] [Revised: 06/02/2023] [Accepted: 06/29/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND Peer support is widely recognized as an important aspect of health promotion for individuals with spinal cord injury (SCI). Reports indicate positive effects for the recipients of either informal and formal peer support. The experience can also be meaningful to the person(s) providing support, although the value to providers is not well studied. OBJECTIVE This study examines the experience of provision of and receipt of informal peer support for individuals with SCI through semi-structured interviews. METHODS Data were analysed using a qualitative phenomenological approach. 16 participants with SCI participated in the study. RESULTS Three main themes were developed, each describing different benefits of peer support from the perspective of both members of the peer support dyad. First, participants found personal satisfaction from using their own experiences to help others adjust to their disability. Participants also noted that they learned how to complete activities of daily living as well as how to be autonomous in travel from others with SCI. Finally, participants spoke of the intrinsic benefit in teaching others with SCI. CONCLUSIONS This study provides a novel understanding of the importance of informal peer support for individuals with SCI. Practitioners should provide opportunities for individuals with SCI to develop informal peer relationships with others who have sustained SCI.
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Affiliation(s)
- Roxanna N Pebdani
- Centre for Disability Research and Policy, University of Sydney, Sydney, Australia.
| | - Jesus Leon
- Department of Rehabilitation, Ingelwood, CA, United States
| | - Deborah S Won
- Department of Electrical and Computer Engineering, California State University, Los Angeles, CA, United States
| | - Ray D deLeon
- School of Kinesiology, California State University, Los Angeles, CA, United States
| | - Christine J Dy
- School of Kinesiology, California State University, Los Angeles, CA, United States
| | - Stefan Keslacy
- School of Kinesiology, California State University, Los Angeles, CA, United States
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Robinson N, Mahapatra A, Jean-Baptiste B, Mallard A, Yang A, Hollon SD, Ezawa ID. Cognitive Behavioral Immersion for Substance Use Disorders: A Feasibility and Pilot Study of a Peer-Based Coaching Program in the Metaverse. Games Health J 2023; 12:397-404. [PMID: 37294540 PMCID: PMC10541924 DOI: 10.1089/g4h.2022.0214] [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] [Indexed: 06/10/2023] Open
Abstract
Introduction: Cognitive Behavioral Immersion (CBI) is a novel cognitive-behavioral skills program delivered by lay coaches in the metaverse through immersive virtual reality technology. Objectives: The objective for this study was to run a feasibility and pilot study of CBI for individuals in recovery from a substance use disorder. Methods: Data from 48 participants were used and program usage was assessed. Participants were asked to complete questionnaires assessing affect, perceived online social support, and group therapy alliance throughout their participation in the program. Structured qualitative interviews were also conducted with a subset of participants (n = 11) to understand the feasibility of the novel program. Results: Participants experienced a significant increase in their positive affect and non-significant decrease in their negative affect during their most recently attended session. Participants also experienced a nonsignificant increase in online social support across their participation in the program. Structured qualitative interviews revealed eight primary themes, including both advantages (community, psychoeducational impact, immersion, comparability with other interventions, coping in the pandemic, and anonymity) and areas of improvement (challenges and technological usability) of the program. Conclusion: This study provides preliminary support for the feasibility and potential effects of CBI and its incorporation of lay coaches to lead cognitive-behavioral skills groups in the metaverse. Future research is encouraged to examine the feasibility and efficacy of this program for a broader array of clinical presentations.
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Affiliation(s)
- Noah Robinson
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Anjali Mahapatra
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | | | - Austin Mallard
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Aaron Yang
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Steven D. Hollon
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Iony D. Ezawa
- Department of Psychology, University of Southern California, Los Angeles, California, USA
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Chen Y, Yuan Y, Reed BG. Experiences of peer work in drug use service settings: A systematic review of qualitative evidence. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 120:104182. [PMID: 37683570 DOI: 10.1016/j.drugpo.2023.104182] [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: 06/16/2023] [Revised: 08/14/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND People with lived or living experiences of drug use and services have been increasingly incorporated into nonpeer-led mainstream organizational settings as a unique workforce. Despite the much discussed effectiveness of peer services in achieving measurable outcomes, limited attention has been given to the experiential aspects of peer work from the perspectives of peers, clients, or others involved. This systematic review synthesized qualitative evidence examining the experiences of peer work in nonpeer-led drug use service settings. It focused on the benefits of incorporating peers as a unique workforce, the challenges they face, and the organizational factors that influence their practices. METHODS A search of 15 databases identified 3,940 unique citations, 33 of which met inclusion criteria. Thematic analysis was utilized to synthesize their findings. RESULTS Foregrounding the uniqueness of peers' shared experience, studies have shown that incorporating peers into nonpeer-led settings can provide benefits at the client, organizational, and societal levels while promoting peers' personal and professional growth. The unique shared experience of peers can also present multidimensional challenges, such as triggering, boundary negotiation, and feelings of being trapped by their peer identity. To fully integrate peers into the system, organizations need to work with them to reconstruct organizational mission, culture, and structures in a way that recognizes and genuine commits to peers' unique values. CONCLUSION This review highlights the significance of understanding peer uniqueness for organizations to create nourishing conditions for peer services and calls for future research exploring context- and setting-specific peer roles and organizational enablers and barriers.
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Affiliation(s)
- Yun Chen
- School of Social Work, University of Michigan, 1080 S. University Avenue, Ann Arbor, MI, 48109, United States.
| | - Yeqing Yuan
- School of Social Work, College of Health, University of Alaska Anchorage, UAA Professional Studies Building, 2533 Providence Dr, Suite 234, Anchorage, AK 99508, United States
| | - Beth Glover Reed
- School of Social Work, University of Michigan, 1080 S. University Avenue, Ann Arbor, MI, 48109, United States
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Manning V, Roxburgh AD, Savic M. Piloting the integration of SMART Recovery into outpatient alcohol and other drug treatment programs. Addict Sci Clin Pract 2023; 18:52. [PMID: 37674227 PMCID: PMC10481580 DOI: 10.1186/s13722-023-00406-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 08/15/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Research suggests peer support groups can amplify and extend treatment effects and enhance long-term recovery from Alcohol and Other Drug (AOD) problems. However, they are rarely integrated into outpatient treatment programs, resulting in a missed opportunity for peer-to-peer learning, and increased connection to others social networks where people want to reduce or cease substance use. METHOD In this mixed-methods study, we examined the uptake, participant experiences and impacts of Self-Management and Recovery Training (SMART) when embedded in three public AOD treatment programs in a pilot program in Australia. Groups were delivered initially in-person but transitioned online during the COVID-19 pandemic. RESULTS A total of 75 SMART Recovery groups were run by the pilot sites, with an average attendance of 6.5 people per meeting. Among Participants (N = 31) who completed the survey, 94% reported benefits relating to substance use (i.e., reduction/ successful maintenance of abstinence), 71% reported improvements in their mental health and wellbeing, 74% reported improvements in their physical health, and 81% reported feeling better connected with others. In-depth qualitative interviews were conducted with 10 participants to explore their experiences. Thematic analysis revealed four themes: motivation to attend, active ingredients, views on the integration of SMART into formal AOD, and the advantages and disadvantages of online groups. CONCLUSION Taken together, these findings suggest embedding SMART Recovery in AOD treatment is a worthwhile endeavour. This was indicated by a good uptake and evidence of multiple and unique benefits to participants over and above their usual care, notably, better management of their AOD use, health, wellbeing, and sense of connection with others.
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Affiliation(s)
- V Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Clayton, Australia
- Turning Point, Eastern Health, Box Hill, Australia
| | - A D Roxburgh
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Clayton, Australia.
- Turning Point, Eastern Health, Box Hill, Australia.
| | - M Savic
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Clayton, Australia
- Turning Point, Eastern Health, Box Hill, Australia
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Turuba R, Toddington C, Tymoschuk M, Amarasekera A, Howard AM, Brockmann V, Tallon C, Irving S, Mathias S, Henderson JL, Barbic S. "A peer support worker can really be there supporting the youth throughout the whole process": a qualitative study exploring the role of peer support in providing substance use services to youth. Harm Reduct J 2023; 20:118. [PMID: 37644488 PMCID: PMC10463579 DOI: 10.1186/s12954-023-00853-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 08/20/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Youth (ages 12-24) rarely access services and supports to address substance use concerns. Peer support can facilitate service engagement and has been associated with positive substance use recovery outcomes in adults, yet few studies have examined this role among youth specifically. As such, this qualitative study explored the role of peer support in providing substance use services to youth in British Columbia and how best to support them in their role. METHODS Participatory action research methods were used by partnering with youth who had lived/living experience of substance use, including peer support workers, to co-design the research protocol and materials. An initial focus group and subsequent interviews were held with 18 peer support workers who provide services to youth (ages 12-24) based on their own lived experience with mental health and/or substance use. The discussions were audio-recorded, transcribed verbatim, and analysed thematically using an inductive approach. RESULTS Peer support workers' core experiences providing substance use services to youth centred around supporting youth throughout the whole process. This was accomplished by meeting youth where they are at, providing individualized care, and bridging the gap between other services and supports. However, participants experienced multiple organizational barriers hindering their ability to support youth and stressed the importance of having an employer who understands the work you are doing. This involved having someone advocating for the peer support role to promote collaboration, empowering peers to set boundaries and define their own role, and providing adequate training and mentorship. Finally, peer support workers described how their lived experience bridges connection and de-stigmatization at the individual, organizational, and community level, which was unique to their role. CONCLUSIONS Peer support plays a unique role in youths' substance use journeys, given their own lived experience and flexibility within their role. However, their position is often misunderstood by employers and other service providers, leaving peers with inadequate support, training, and mentorship to do their job. The findings from this study call for improved integration of peer support into service environments, as well as standardized training that is in-depth and continuous.
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Affiliation(s)
- Roxanne Turuba
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.
- Providence Health Care, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
- Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada.
- Department of Occupational Science and Occupational Therapy, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada.
| | - Ciara Toddington
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
- Providence Health Care, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Miranda Tymoschuk
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
- Providence Health Care, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Anurada Amarasekera
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
- Providence Health Care, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Amanda Madeleine Howard
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
- Providence Health Care, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Violet Brockmann
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
- Providence Health Care, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Corinne Tallon
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
- Providence Health Care, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Sarah Irving
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
- Providence Health Care, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Steve Mathias
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
- Providence Health Care, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Providence Research, 1190 Hornby Street, 10th Floor, Vancouver, BC, V6Z 2K5, Canada
- Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada
- Centre for Health Evaluation Outcome Sciences, 588-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - J L Henderson
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8Th Floor, Toronto, ON, M5T 1R8, Canada
- Youth Wellness Hubs Ontario, 80 Workman Way, Toronto, ON, M4J 1H4, Canada
| | - Skye Barbic
- Foundry, 915-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada
- Providence Health Care, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Providence Research, 1190 Hornby Street, 10th Floor, Vancouver, BC, V6Z 2K5, Canada
- Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada
- Centre for Health Evaluation Outcome Sciences, 588-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
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Gichane MW, Camlin CS, Getahun M, Emenyonu N, Woolf-King S, Sanyu N, Katusiime A, Fatch R, Muyindike W, Hahn JA. Understanding Patients' Experiences with a Brief Alcohol Reduction Intervention among People Living with HIV in Uganda: A Qualitative Study. Subst Use Misuse 2023; 58:1714-1721. [PMID: 37551890 PMCID: PMC10538401 DOI: 10.1080/10826084.2023.2244066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Background: Brief alcohol reduction interventions for people living with HIV (PLWH) have resulted in mixed findings with some studies showing null or limited treatment effects. To better understand factors that may contribute to their success or failure, this qualitative study sought to explore participants' experiences in a randomized trial (RCT) of a brief counseling-based alcohol reduction intervention, including challenges that may have impeded alcohol reduction. Methods: We conducted in-depth semi-structured interviews with 24 PLWH engaging in unhealthy alcohol use, who were enrolled in an RCT to reduce alcohol consumption conducted in southwestern Uganda in 2019-2020 (NCT03928418). We used a collaborative thematic approach to analyze data from transcribed and translated audio recordings. Results: Perceived benefits of the intervention included increased awareness of alcohol use and its impact on personal finances, the relationship between alcohol use and violence, and a commitment to drinking reduction. Participants experienced several barriers to decreasing their alcohol use, including: prevailing social norms about alcohol use, lack of social support, and economic and social consequences of the COVID-19 pandemic. Conclusion: Factors in the immediate contexts of PLWH in low-income settings, including social norms influencing alcohol consumption and lack of social support, may impede the impact of alcohol reduction interventions, especially during times of stress such as the COVID-19 pandemic.
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Affiliation(s)
- Margaret W Gichane
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Carol S Camlin
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Monica Getahun
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Nneka Emenyonu
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Sarah Woolf-King
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Naomi Sanyu
- Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Anita Katusiime
- Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Robin Fatch
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Winnie Muyindike
- Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Judith A Hahn
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
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Subhani M, Enki DG, Knight H, Jones KA, Sprange K, Rennick-Egglestone S, Morling JR, Wragg A, Hutton C, Ryder SD. Does knowledge of liver fibrosis affect high-risk drinking behaviour (KLIFAD): an open-label pragmatic feasibility randomised controlled trial. EClinicalMedicine 2023; 61:102069. [PMID: 37448808 PMCID: PMC10336239 DOI: 10.1016/j.eclinm.2023.102069] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/13/2023] [Accepted: 06/13/2023] [Indexed: 07/15/2023] Open
Abstract
Background Early identification followed by effective behaviour interventions is pivotal to changing the natural history of alcohol-related liver disease. We examined the feasibility of using transient elastography based advice and alcohol recovery video stories (ARVS) to change drinking behaviour in community alcohol services. Methods A feasibility randomised control trial (RCT) was conducted in three community alcohol services. Adults 18+ years presenting with a primary alcohol problem were randomised (1:1) to receive either usual care (control group) or usual care and the KLIFAD Intervention, consisting of advice tailored to liver stiffness measure and access to ARVS (intervention group). Data were collected at baseline and six months. To establish definitive trial feasibility, recruitment and retention rates, study procedure safety and extent of effectiveness were measured (Start date: 02.10.2019, End date: 30.11.2022, ISRCTN.com: 16922410). Findings 382 service users were screened, 184 were randomised (intervention: 93, control: 91), and baseline data were collected for 128 (intervention: 71, control: 59). Six months follow-up data were available in 87 (intervention: 53, control: 34). Intervention compared to the control group had a longer duration of engagement with services (mean difference 8.6 days SD = 18.4), was more likely to complete the allocated treatment program and reduced or stop drinking (54.9% vs 43.9%) and reduce AUDIT category (71.7% vs 61.8%). There were no reported serious adverse reactions, one intervention group participant reported an increase in AUDIT category. Interpretation Integration of transient elastography in community alcohol services is feasible. It may improve engagement with services, retention in clinical trials and supplement the reduction in self-reported alcohol consumption. A definitive RCT is supported. Funding National Institute for Health and Care Research (NIHR201146).
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Affiliation(s)
- Mohsan Subhani
- Nottingham Digestive Diseases Centre (NDDC), School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - Doyo G. Enki
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Holly Knight
- Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham, UK
| | - Katy A. Jones
- Academic Unit of Mental Health and Clinical Neuroscience, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Kirsty Sprange
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | | | - Joanne R. Morling
- Nottingham Digestive Diseases Centre (NDDC), School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
- Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham, UK
| | - Andrew Wragg
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - Clare Hutton
- Patient and Public Involvement (PPI) Co-applicant, Nottingham, UK
| | - Stephen D. Ryder
- Nottingham Digestive Diseases Centre (NDDC), School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
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Deutsch AR, Chau E, Motabar N, Jalali MS. Grounding alcohol simulation models in empirical and theoretical alcohol research: a model for a Northern Plains population in the United States. SYSTEM DYNAMICS REVIEW 2023; 39:207-238. [PMID: 38107548 PMCID: PMC10723070 DOI: 10.1002/sdr.1738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 05/05/2023] [Indexed: 12/19/2023]
Abstract
The growing number of systems science simulation models for alcohol use (AU) are often disconnected from AU models within empirical and theoretical alcohol research. As AU prevention/intervention efforts are typically grounded in alcohol research, this disconnect may reduce policy testing results, impact, and implementation. We developed a simulation model guided by AU research (accounting for the multiple AU stages defined by AU behavior and risk for harm and diverse transitions between stages). Simulated projections were compared to historical data to evaluate model accuracy and potential policy leverage points for prevention and intervention at risky drinking (RD) and alcohol use disorder (AUD) stages. Results indicated prevention provided the greatest RD and AUD reduction; however, focusing exclusively on AUD prevention may not be effective for long-term change, given the continued increase in RD. This study makes a case for the strength and importance of aligning subject-based research with systems science simulation models.
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Affiliation(s)
- Arielle R Deutsch
- Avera Research Institute, Avera Health, Sioux Falls, SD, USA
- Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
| | | | - Nikki Motabar
- University of California Santa Barbara, Santa Barbara, CA, USA
| | - Mohammad S Jalali
- University of California Santa Barbara, Santa Barbara, CA, USA
- MGH Institute for Technology Assessment, Harvard Medical School, Boston, MA, USA
- Sloan School of Management, Massachusetts, Institute of Technology, Cambridge, MA, USA
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Zgierska AE, Hilliard F, Deegan S, Turnquist A, Goldstein E. Promoting research engagement among women with addiction: Impact of recovery peer support in a pilot randomized mixed-methods study. Contemp Clin Trials 2023; 130:107235. [PMID: 37211273 PMCID: PMC10330478 DOI: 10.1016/j.cct.2023.107235] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE The impact of involving peers on research engagement is largely unknown. The purpose of this pilot study, a part of a larger research, was to evaluate the impact of recovery peer involvement as a study team member on recruitment/retention of persons with lived experience of SUD during pregnancy and to assess participant perceptions about factors impacting engagement of this population and their children in research, especially brain magnetic resonance imaging (MRI). METHODS This study randomly assigned participants (1:1) to either Peer or Research Coordinator (RC) arms. Eligible participants were English-speaking adult, non-pregnant females with lived experience of substance use during pregnancy. Certified Peers were recruited word of mouth and completed study-specific training. The impact of trained, certified Peer versus RC on research engagement was assessed by between-arm comparison of retention rates. Quantitative and qualitative survey data on participant perceptions were summarized. RESULTS Thirty-eight individuals enrolled into the study (19 Peer, 19 RC). Peer versus RC had 7.2 times greater odds of completing Visit 2 (Fisher's exact test; 95%CI: 1.2, 81.8; p = 0.03). The majority (70.4%) of respondents identified being accompanied by a peer and getting a tour of the MRI facility/procedures as 'extremely' helpful for improving participant comfort and engagement in future studies. Motivators of future research engagement also included creating a trusting, supportive, non-judgmental research environment, and linkages to treatment and other services. CONCLUSION Findings support the notion that peers involved as research team members could boost research engagement among persons with substance use during pregnancy.
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Affiliation(s)
- Aleksandra E Zgierska
- Departments of Family and Community Medicine, Anesthesiology and Perioperative Medicine, and Public Health Sciences, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, United States of America.
| | - Florence Hilliard
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, 1100 Delaplaine Ct, Madison, WI 53715, United States of America.
| | - Shelbey Deegan
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, 1100 Delaplaine Ct, Madison, WI 53715, United States of America.
| | - Alyssa Turnquist
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, 1100 Delaplaine Ct, Madison, WI 53715, United States of America.
| | - Ellen Goldstein
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, 845 S Damen Ave, Chicago, IL 60612, United States of America.
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Mustapha SZ, Ahmad Y, Aziz NA, Abd Hamid SNF. Cure & Care 1Malaysia Clinics: Measuring the Effectiveness via Dyads Lens Involving Receivers and Providers. J Patient Exp 2023; 10:23743735231179070. [PMID: 37332831 PMCID: PMC10272645 DOI: 10.1177/23743735231179070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023] Open
Abstract
Drug treatment and rehabilitation programs are one of the initiatives to alleviate the global epidemic of drug addiction. The efforts were undertaken by everyone, particularly the government. However, the rising number of drug relapses among patients or clients ponders the effectiveness of the drug treatment and rehabilitation programs implemented in the country. This paper aims to study the drug relapse prevention initiatives and the effectiveness of the center in dealing with drug addiction issues. A case study of 4 drug treatment and rehabilitation centers, namely Cure & Care 1Malaysia Clinics in Selangor, Malacca, Penang, and Kelantan, was selected. In-depth interviews were conducted with 37 participants-26 clients and 11 providers, and the data were analyzed using thematic analysis and NVivo version 12. The findings indicate that relapse prevention initiatives are a signal for the effectiveness of the center to reduce drug relapse cases. The implementation of drug treatment and rehabilitation programs was effective based on key aspects consisting of (1) knowledge and life skills learned; (2) staff reception; (3) individual changes; and (4) client acceptance. Therefore, by experiencing relapse prevention activities, it helps to improve the effectiveness of the implementation of drug treatment and rehabilitation programs.
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Affiliation(s)
- Siti Zulaikha Mustapha
- Faculty of Administrative Science and Policy Studies, Universiti Teknologi MARA Kelantan, Machang, Malaysia
| | - Yarina Ahmad
- Faculty of Administrative Science and Policy Studies, Institute for Biodiversity and Sustainable Development, Universiti Teknologi MARA, Shah Alam, Malaysia
| | - Nur Amalina Aziz
- Faculty of Business and Management, Universiti Teknologi MARA Segamat, Malaysia
| | - Siti Nur Fathanah Abd Hamid
- Faculty of Administrative Science and Policy Studies, Institute for Biodiversity and Sustainable Development, Universiti Teknologi MARA, Shah Alam, Malaysia
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Garcia R. Understanding Alcohol Use Disorder. Nurs Clin North Am 2023; 58:133-140. [PMID: 37105649 DOI: 10.1016/j.cnur.2023.02.006] [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: 04/29/2023]
Abstract
Alcohol consumption has been a significant influence on varying social cultures for thousands of years. From its use in medicinal settings, social environments, industry, and more, alcohol has rooted itself deeply into society despite drastic attempts to curtail its popularity. As we continue to move forward in the advancements of science and medicine, it is becoming vastly apparent how impactful and consequential alcohol consumption is in many aspects of our everyday lives.
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Affiliation(s)
- Rodrigo Garcia
- Parkdale Center for Professionals, 350 Indian Boundary Road, Chesterton, IN 46304, USA.
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50
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Moore KE, Wyatt JP, Phillips S, Burke C, Bellamy C, McKee SA. The role of substance use treatment in reducing stigma after release from incarceration: A qualitative analysis. HEALTH & JUSTICE 2023; 11:25. [PMID: 37191937 PMCID: PMC10186797 DOI: 10.1186/s40352-023-00225-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 04/14/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND People with substance use disorders (SUD) who have been involved in the legal system often experience stigma upon reentry into the community after incarceration. Although substance use treatment can sometimes be a source of stigma, it may also reduce stigma by facilitating connections with providers, reducing distress, or helping people feel more integrated in their community. However, research has rarely examined the potential for treatment to reduce stigma. METHODS This study examined stigma experiences and the degree to which substance use treatment reduced stigma among 24 people with SUDs who were receiving care in an outpatient treatment facility after release from incarceration. Qualitative interviews were conducted and analyzed using a content analysis approach. RESULTS Participants reported negative self-judgements as well as perceiving negative judgments from the community upon reentry. With regard to stigma reduction, themes emerged around substance use treatment repairing strained family relationships and reducing participants' self-stigma. Aspects of treatment that reportedly reduced stigma included the treatment facility having a nonjudgmental atmosphere, patients trusting the staff, and working with peer navigators who had lived experience of SUD and incarceration. CONCLUSIONS Results from this study suggest that substance use treatment has the potential to decrease the negative impacts of stigma upon release from incarceration, which continues to be a major barrier. Though more research on stigma reduction is needed, we suggest some preliminary considerations for treatment programs and providers.
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Affiliation(s)
- Kelly E Moore
- East Tennessee State University, 420 Rogers-Stout Hall, P.O. Box 70649, Johnson City, TN, 37614, USA.
| | - Janan P Wyatt
- Yale University School of Medicine, 2 Church St. South, #109, New Haven, CT, 06519, USA
| | - Sarah Phillips
- Yale University School of Medicine, 2 Church St. South, #109, New Haven, CT, 06519, USA
| | - Catherine Burke
- Yale University School of Medicine, 2 Church St. South, #109, New Haven, CT, 06519, USA
| | - Chyrell Bellamy
- Yale University School of Medicine, 2 Church St. South, #109, New Haven, CT, 06519, USA
| | - Sherry A McKee
- Yale University School of Medicine, 2 Church St. South, #109, New Haven, CT, 06519, USA
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