1
|
Roberts LE, Mehranbod CA, Bushover B, Gobaud AN, Eschliman EL, Fish C, Zadey S, Gao X, Morrison CN. Trends in police complaints and arrests on New York City subways, 2018 to 2023: an interrupted time-series analysis. Inj Epidemiol 2024; 11:16. [PMID: 38671521 DOI: 10.1186/s40621-024-00501-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Public transportation use is influenced by perceptions of safety. Concerns related to crime on New York City (NYC) transit have risen following NYC's COVID-19 pandemic state of emergency declaration in 2020, leading to declines in subway ridership. In response, the most recent mayoral administration implemented a Subway Safety Plan in 2022. This study aimed to quantify the effects of the COVID-19 pandemic and the Subway Safety Plan on rates of complaints to and arrests by the New York City Police Department (NYPD) Transit Bureau. METHODS Using publicly available data on complaints and arrests, we conducted interrupted time-series analyses using autoregressive integrated moving average models applied to monthly data for the period from September 2018 to August 2023. We estimated changes in the rates of complaints to and arrests by the NYPD Transit Bureau before and after: (1) the COVID-19 pandemic state of emergency declaration (i.e., March 2020), and (2) the announcement of the Subway Safety Plan (i.e., February 2022). We also examined trends by complaint and arrest type as well as changes in proportion of arrests by demographic and geographic groups. RESULTS After the COVID-19 pandemic declaration, there was an 84% increase (i.e., an absolute increase of 6.07 per 1,000,000 riders, CI 1.42, 10.71) in complaints to the NYPD Transit Bureau, including a 99% increase (0.91 per 1,000,000 riders, CI 0.42, 1.41) in complaints for assault and a 125% increase in complaints for harassment (0.94 per 1,000,000 riders, CI 0.29, 1.60). Following the Subway Safety Plan there was an increase in the rate of arrests for harassment (0.004 per 1,000,000 riders, CI 0.001, 0.007), as well as decreases in the proportion of arrests for individuals racialized as White (- 0.02, CI - 0.04, - 0.01) and proportion of arrests in the borough of Manhattan (- 0.13, CI - 0.17, - 0.09). CONCLUSIONS The increased rates of complaints to the NYPD Transit Bureau following the onset of the COVID-19 pandemic remained elevated following the enactment of the Subway Safety Plan. Further evaluation efforts can help identify effective means of promoting safety on public transportation.
Collapse
Affiliation(s)
- Leah E Roberts
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, Rm 505, New York, NY, 10032, USA
| | - Christina A Mehranbod
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, Rm 505, New York, NY, 10032, USA
| | - Brady Bushover
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, Rm 505, New York, NY, 10032, USA
| | - Ariana N Gobaud
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, Rm 505, New York, NY, 10032, USA
| | - Evan L Eschliman
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, Rm 505, New York, NY, 10032, USA
| | - Carolyn Fish
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, Rm 505, New York, NY, 10032, USA
| | - Siddhesh Zadey
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, Rm 505, New York, NY, 10032, USA
| | - Xiang Gao
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, Rm 505, New York, NY, 10032, USA
| | - Christopher N Morrison
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, Rm 505, New York, NY, 10032, USA.
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
| |
Collapse
|
2
|
Moss L, Wu K, Tucker A, Durbin-Matrone R, Roude GD, Francois S, Richardson L, Theall KP. A Qualitative Exploration of the Built Environment as a Key Mechanism of Safety and Social Cohesion for Youth in High-Violence Communities. J Urban Health 2024:10.1007/s11524-024-00861-z. [PMID: 38609700 DOI: 10.1007/s11524-024-00861-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 04/14/2024]
Abstract
The characteristics of a neighborhood's built environment may influence health-promoting behaviors, interactions between neighbors, and perceptions of safety. Although some research has reported on how youth in high-violence communities navigate danger, less work has investigated how these youth perceive the built environment, their desires for these spaces, and how these desires relate to their conceptions of safety and perceptions of other residents. To fill this gap, this study used focus group data from 51 youth ages 13-24 living in New Orleans, Louisiana. Four themes were developed using reflexive thematic analysis: community violence is distressing and disruptive, youth use and want to enjoy their neighborhood, systemic failure contributes to negative outcomes, and resources and cooperation create safety. This analysis indicates that young people desire to interact with the built environment despite the threat of community violence. They further identified built environment assets that facilitate socialization and recreation, such as local parks, and social assets in the form of cooperation and neighbor-led civic engagement initiatives. In addition, the youth participants demonstrated awareness of structural inequities that influence neighborhood health and violence-related outcomes. This study contributes to efforts to understand how youth with high levels of community violence exposure understand and interact with the built and social environments.
Collapse
Affiliation(s)
- Lolita Moss
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
| | - Kimberly Wu
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Amber Tucker
- Violence Prevention Institute, Tulane University, New Orleans, LA, USA
| | - Reanna Durbin-Matrone
- Partners for Advancing Health Equity, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | | | | | | | - Katherine P Theall
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| |
Collapse
|
3
|
Stasiak M, Witek P, Adamska-Fita E, Lewiński A. Response to Osilodrostat Therapy in Adrenal Cushing's Syndrome. Drug Healthc Patient Saf 2024; 16:35-42. [PMID: 38616817 PMCID: PMC11011623 DOI: 10.2147/dhps.s453105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/20/2024] [Indexed: 04/16/2024] Open
Abstract
Cushing's disease (CD) is the most common cause of endogenous hypercortisolism. Osilodrostat was demonstrated to be efficient in treating CD, and the mean average dose required for CD control was <11 mg/day. Potential differences in osilodrostat treatment between cortisol-producing adenoma (CPA) and CD have not been reported. The aim of this study was to present two patients with CPA in whom significant differences in the response to therapy compared to CD were found. We demonstrated a case of inverse response of cortisol levels with adrenal tumor progression during the initial dose escalation (Case 1). Simultaneously, severe exaggeration of hypercortisolism symptoms and life-threatening hypokalemia occurred. A further rapid dose increase resulted in the first noticeable cortisol response at a dose of 20 mg/day, and a full response at a dose of 45 mg/day. We also present a case that was initially resistant to therapy (Case 2). The doses required to achieve the first response and the full response were the same as those for Case 1. Our study demonstrated that osilodrostat therapy in patients with CPA may require a different approach than that in CD, with higher doses, faster dose escalation, and a possible initial inverse response or lack of response.
Collapse
Affiliation(s)
- Magdalena Stasiak
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital—Research Institute, Lodz, Poland
| | - Przemysław Witek
- Department of Internal Medicine, Endocrinology and Diabetes, Medical University of Warsaw; Mazovian Brodnowski Hospital, Warszawa, Poland
| | - Emilia Adamska-Fita
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital—Research Institute, Lodz, Poland
| | - Andrzej Lewiński
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital—Research Institute, Lodz, Poland
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
4
|
Hadland SE, Schmill DM, Bagley SM. Anticipatory Guidance to Prevent Adolescent Overdoses. Pediatrics 2024; 153:e2023065217. [PMID: 38563066 PMCID: PMC11035151 DOI: 10.1542/peds.2023-065217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 04/04/2024] Open
Affiliation(s)
- Scott E. Hadland
- Mass General for Children, Division of Adolescent and Young Adult Medicine, Boston, Massachusetts
- Harvard Medical School, Department of Pediatrics, Boston, Massachusetts
| | | | - Sarah M. Bagley
- Division of Health Services Research, Department of Pediatrics, Boston University Chobanian & Avedisian SOM, Boston, Massachusetts
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedisian SOM, Boston, Massachusetts
- Grayken Center for Addiction, Boston Medical Center, Boston, Massachusetts
| |
Collapse
|
5
|
Kroshus E, Chrisman SPD, Hunt T, Hays R, Garrett K, Peterson A, Rivara FP, Chiampas G, Ramshaw D, Glang A. Stakeholder-Engaged Development of a Theory-Driven, Feasible, and Acceptable Approach to Concussion Education. Health Educ Behav 2024; 51:197-203. [PMID: 35703397 PMCID: PMC9751226 DOI: 10.1177/10901981221099886] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Concussion education is widely mandated and largely ineffective. Recent consensus guidance on concussion education asserts the importance of (1) theory-driven programming that targets the team as a system and (2) working with end users throughout the development process, and considering issues such as feasibility, acceptability, and sustainability. Consistent with this guidance, and in collaboration with youth sport stakeholders in two regions of the United States, we developed a novel approach to concussion education: Pre-game safety huddles. Safety huddles have the following two core components: (1) athletes, coaches, and other stakeholders come together before the start of each game and (2) opinion leaders (coaches, referees) affirm the importance of care seeking for suspected concussion. The aim of this article is to provide an overview of the collaborative process through which we refined the safety huddle concept into an acceptable and feasible intervention with potential for sustainable implementation in diverse youth sports settings with minimal resource demands. In describing our process and discussing challenges and opportunities, we hope to provide an example for others seeking to develop and implement injury prevention interventions in youth sports settings.
Collapse
Affiliation(s)
| | | | - Tamerah Hunt
- Georgia Southern University, Statesboro, GA, USA
| | | | | | - Alexis Peterson
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | - Ann Glang
- University of Oregon, Eugene, OR, USA
| |
Collapse
|
6
|
Luna MJ, Abram KM, Aaby DA, Welty LJ, Teplin LA. Inequities in Mental Health Services: A 16-Year Longitudinal Study of Youth in the Justice System. J Am Acad Child Adolesc Psychiatry 2024; 63:422-432. [PMID: 37516236 PMCID: PMC10818024 DOI: 10.1016/j.jaac.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/30/2023] [Accepted: 07/20/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVE To examine: (1) if youth who have mental health disorders receive needed services after they leave detention-and as they age; and (2) inequities in service use, focusing on demographic characteristics and type of disorder. METHOD We used data from the Northwestern Juvenile Project, a longitudinal study of 1,829 youth randomly sampled from detention in Chicago, Illinois in 1995. Participants were re-interviewed up to 13 times through 2015. Interviewers assessed disorders using structured diagnostic interviews and assessed service use using the Child and Adolescent Service Assessment and the Services Assessment for Children and Adolescents. RESULTS Less than 20% of youth who needed services received them, up to median age 32 years. Female participants with any disorder had nearly twice the odds of receiving services compared with male participants (OR: 1.82; 95% CI: 1.41, 2.35). Compared with Black participants with any disorder, non-Hispanic White and Hispanic participants had 2.14 (95% CI: 1.57, 2.90) and 1.50 (95% CI: 1.04, 2.15) times the odds of receiving services. People with a disorder were more likely to receive services during childhood (< age 18) than during adulthood (OR: 2.29; 95% CI: 1.32, 3.95). Disorder mattered: participants with an internalizing disorder had 2.26 times and 2.43 times the odds of receiving services compared with those with a substance use disorder (respectively, 95% CI: 1.26, 4.04; 95% CI: 1.49, 3.97). CONCLUSION Few youth who need services receive them as they age; inequities persist over time. We must implement evidence-based strategies to reduce barriers to services.
Collapse
Affiliation(s)
- María José Luna
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Karen M Abram
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - David A Aaby
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Leah J Welty
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Linda A Teplin
- Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| |
Collapse
|
7
|
Helpingstine CE, Jadue Zalaquett VC, Murphy CA, Merrick MT, Fickler W, Bernier J, Klika JB. Prevention of child sexual abuse in the United States: Scoping review of United States legislative policies. Child Abuse Negl 2024; 152:106747. [PMID: 38552558 DOI: 10.1016/j.chiabu.2024.106747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/22/2024] [Accepted: 03/09/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND States in the United States (US) have passed and enacted legislation for the purpose of preventing child sexual abuse (CSA) since 2000, but it is unknown whether these legislative policies reduce adult-perpetrated CSA. OBJECTIVE Review the literature from 2000 to 2023 to understand which US CSA prevention policies have been evaluated, the effectiveness of these policies, study populations, and barriers and facilitators associated with the implementation of CSA prevention policies. METHODS The study protocol was published prior to undertaking the review: PMC10603531. The review follows Joanna Briggs Institute methodology and is reported according to the PRISMA-ScR Checklist. We searched 27 databases, hand searched reference lists of included studies, and sent notice via listserv to other researchers in the field. Articles were included if the content focused on CSA prevention policies and the effects. No limits to methodology were applied. Methodological rigor was assessed. RESULTS 2209 potentially relevant articles were identified; 20 articles advanced to full-text review, three satisfied the inclusion criteria. Three eligible studies focused on CSA prevention education policies, while the other focused on mandated reporting policies. Effects of these policies were mixed in relation to CSA reporting and substantiation rates. No study considered child demographics. CONCLUSIONS Despite decades of legislative action for CSA prevention across the US, only a few studies have assessed the effects of these policies. These findings highlight the need for additional research to ensure that CSA prevention policies such as CSA prevention education in schools and mandated reporting practices are working as intended.
Collapse
Affiliation(s)
| | | | | | | | - Wade Fickler
- National State Conference of State Legislators, United States
| | | | | |
Collapse
|
8
|
Sinnott AM, Collins CL, Boltz AJ, Robison HJ, Pinapaka H, Mihalik JP. Comparison of Kinematics for Head Impacts Initiated by Helmets and Shoulder Pads Among High School American Football Athletes. Ann Biomed Eng 2024:10.1007/s10439-024-03485-1. [PMID: 38507140 DOI: 10.1007/s10439-024-03485-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 02/25/2024] [Indexed: 03/22/2024]
Abstract
Helmets and shoulder pads are required equipment intended to protect American football athletes by attenuating collision forces during participation. Surprisingly, research differentiating kinematics from head impacts initiated by helmets from those initiated by shoulder pads among adolescent athletes has not been completed. The current study's purpose was to determine the effects of equipment on head impact kinematics. Sixty-nine male American football athletes from three high schools wore helmets equipped with Head Impact Telemetry (HIT) System instrumentation to quantify peak linear (g) and rotational (rad/s2) accelerations. Data were extracted for video-confirmed impacts during two competitions. Separate multivariable linear regressions using ordinary least squares were conducted to determine if equipment type (helmet vs. shoulder pad) was associated with log-transformed linear and rotational accelerations. In total, 1150 video-confirmed impacts involved helmet (N = 960) or shoulder pad (N = 190) initiated contact. Linear (p = 0.809) and rotational (p = 0.351) acceleration were not associated with equipment type. Head impact kinematics were similar between impacts initiated by either helmets or shoulder pads and suggests an opponent's shoulder pads and helmet can deliver comparable forces to the struck player. Equipment manufacturers may need to consider the unintended role shoulder pads may contribute to head injury risk.
Collapse
Affiliation(s)
- Aaron M Sinnott
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, 2207 Stallings-Evans Sports Medicine Center, Campus Box 8700, Chapel Hill, NC, 27599-8700, USA
| | - Christy L Collins
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN, USA
| | - Adrian J Boltz
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN, USA
| | - Hannah J Robison
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN, USA
| | - Hari Pinapaka
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, 2207 Stallings-Evans Sports Medicine Center, Campus Box 8700, Chapel Hill, NC, 27599-8700, USA
| | - Jason P Mihalik
- Matthew Gfeller Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, 2207 Stallings-Evans Sports Medicine Center, Campus Box 8700, Chapel Hill, NC, 27599-8700, USA.
| |
Collapse
|
9
|
Hughto J, Rich J, Kelly P, Veno S, Silcox J, Noh M, Pletta D, Erowid E, Erowid F, Green T. Preventing Overdoses Involving Stimulants: The POINTS Study Protocol. Res Sq 2024:rs.3.rs-3993989. [PMID: 38559156 PMCID: PMC10980162 DOI: 10.21203/rs.3.rs-3993989/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background In recent years, overdoses involving illicit cocaine, methamphetamine, and other stimulants have increased in the U.S. The unintentional consumption of stimulants containing illicit fentanyl is a major risk factor for overdoses, particularly in Massachusetts and Rhode Island. Understanding the drug use patterns and strategies used by people who use stimulants (PWUS) to prevent overdose is necessary to identify risk and protective factors for stimulant-involved overdoses. Mixed-methods research with people who distribute drugs (PWDD) can also provide critical information into the mechanisms through which fentanyl may enter the stimulant supply, and the testing of drug samples can further triangulate PWUS and PWDD perspectives regarding the potency and adulteration of the drug supply. These epidemiological methods can inform collaborative intervention development efforts with community leaders to identify feasible, acceptable, and scalable strategies to prevent fatal and non-fatal overdoses in high-risk communities. Methods Our overall objective is to reduce stimulant and opioid-involved overdoses in regions disproportionately affected by the overdose epidemic. To meet this long-term objective, we employ a multi-pronged approach to identify risk and protective factors for unintentional stimulant and opioid-involved overdoses among PWUS, and use these findings to develop a package of locally tailored intervention strategies that can be swiftly implemented to prevent overdoses. Specifically, this study aims to [1] Carry out mixed-methods research with incarcerated and non-incarcerated people who use or distribute illicit stimulants to identify risk and protective factors for stimulant and opioid-involved overdoses; [2] Conduct drug checking to examine the presence and relative quantity of fentanyl and other adulterants in the stimulant supply; and [3] Convene a series of working groups with community stakeholders involved in primary and secondary overdose prevention in Massachusetts and Rhode Island to contextualize our mixed-methods findings and identify multilevel intervention strategies to prevent stimulant-involved overdoses. Discussion Completion of this study will yield a rich understanding of the social epidemiology of stimulant and opioid-involved overdoses in addition to community-derived intervention strategies that can be readily implemented and scaled to prevent such overdoses in two states disproportionately impacted by the opioid and overdose crises: Massachusetts and Rhode Island.
Collapse
|
10
|
Fleckman JM, Ford J, Eisenberg S, Taylor CA, Kondo M, Morrison CN, Branas CC, Drury SS, Theall KP. From neighborhood to household: connections between neighborhood vacant and abandoned property and family violence. Res Sq 2024:rs.3.rs-4022003. [PMID: 38559063 PMCID: PMC10980094 DOI: 10.21203/rs.3.rs-4022003/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Rates of family violence, including intimate partner violence (IPV) and child maltreatment, remain high in the U.S. and contribute to substantial health and economic costs. How neighborhood environment may influence family violence remains poorly understood. We examine the association between neighborhood vacant and abandoned properties and family violence, and the role collective efficacy may play in that relationship. Data were used from a longitudinal cohort of 218 maternal-child dyads in a southern U.S. city known for elevated rates of violence. Women were matched on their propensity score, for living in a neighborhood with elevated vacant and cited properties. Analyses accounting for clustering in neighborhood and matched groups were conducted to examine the association between neighborhood vacant and abandoned property and family violence, and the potential mediating relationship of collective efficacy. The likelihood of experiencing child maltreatment at 12-months of age was more than twice as high for children living in neighborhoods with a high vacant and cited property rates compared to women living in neighborhoods with fewer vacant and cited properties (OR=2.11, 95% CI=1.03, 4.31). Women living in neighborhoods characterized by high levels of vacant and cited properties were also more than twice as likely to report IPV (OR=2.52, 95% CI=1.21, 5.25). Associations remained mostly stable after controlling for key covariates. Collective efficacy did not act as a mediator in the relationship between vacant and cited properties and family violence. Reducing neighborhood vacant and cited properties may be an important target for interventions focused on reducing family violence.
Collapse
Affiliation(s)
| | | | | | | | - Michelle Kondo
- Northern Research Station USDA Forest Service: USDA Forest Service Northern Research Station
| | | | | | - Stacy S Drury
- Boston Childrens Hospital: Boston Children's Hospital
| | | |
Collapse
|
11
|
Durrance CP, Austin AE, Runyan CW, Runyan DK, Martin SL, Mercer J, Shanahan ME. Affordable housing through the Low-Income Housing Tax Credit program and opioid overdose emergency department visits. J Subst Use Addict Treat 2024; 158:209249. [PMID: 38081542 DOI: 10.1016/j.josat.2023.209249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/13/2023] [Accepted: 12/04/2023] [Indexed: 03/18/2024]
Abstract
INTRODUCTION The United States continues to experience an opioid overdose crisis. As a key social determinant of health, housing insecurity may contribute to initiation of substance use and can threaten outcomes for those with substance use disorders by increasing stress, risky substance use, discontinuity of treatment, and return to use, all of which may increase the risk of overdose. The Low-Income Housing Tax Credit (LIHTC) program supports access to rental housing for low-income populations. By facilitating access to affordable housing, this program may improve housing security, thereby reducing overdose risk. METHODS We used data from LIHTC Property Data and the State Emergency Department Database (SEDD) to identify the number of LIHTC units available and opioid overdoses discharged from the emergency department (ED) in 13 states between 2005 and 2014. RESULTS Between 2005 and 2014, mean opioid overdose ED visits were higher in states with fewer LIHTC units (<28 LIHTC units per 100,000 population) at 26.5 per 100,000 population as compared to states with higher LIHTC units (≥28 LIHTC units per 100,000 population) at 21.1 per 100,000. We find that greater availability of LIHTC units was associated with decreased rates of opioid overdose ED visits (RR 0.94; CI 0.90, 1.00). CONCLUSIONS Given the importance of housing as a key social determinant of health, the provision of affordable housing may mitigate substance misuse and prevent nonfatal opioid overdose.
Collapse
Affiliation(s)
| | - Anna E Austin
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States of America; Injury Prevention Research Center, University of North Carolina at Chapel Hill, United States of America
| | - Carol W Runyan
- Department of Epidemiology, Colorado School of Public Health, United States of America; Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States of America
| | - Desmond K Runyan
- Department of Pediatrics and Kempe Center, University of Colorado School of Medicine, United States of America
| | - Sandra L Martin
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States of America
| | - Jeremy Mercer
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, United States of America
| | - Meghan E Shanahan
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States of America; Injury Prevention Research Center, University of North Carolina at Chapel Hill, United States of America
| |
Collapse
|
12
|
Mehranbod CA, Gobaud AN, Bushover BR, Morrison CN. Individuals' travel to alcohol outlets: The fallacy of the local bar. Drug Alcohol Rev 2024; 43:799-809. [PMID: 38206756 PMCID: PMC10922491 DOI: 10.1111/dar.13808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/22/2023] [Accepted: 12/14/2023] [Indexed: 01/13/2024]
Abstract
INTRODUCTION Studies relating alcohol outlet density around homes to alcohol consumption produce mixed results. One possible explanation is that people travel to outlets away from their homes. This study aims to characterise individuals' trips to outlets, describe these trip locations relative to other activities and estimate associations between alcohol outlet density and trips to outlets. METHODS This cross-sectional study used 2014-2018 household travel data from the Victoria Integrated Survey of Travel and Activity. We estimated the average change in the cumulative travel characteristics associated with each additional trip to bars and liquor stores, accounting for complex trips to multiple destinations. Logistic regression models estimated odds that individuals travelled to outlets in relation to outlet density in their home local government area (LGA). RESULTS Among 23,512 respondents, 378 (1.6%) travelled to any bar and 79 (0.3%) any liquor store the survey day. Bar trips added 8.2 km (95% confidence interval [CI] 4.6, 11.8) and 18.1 min (95% CI 13.6, 22.6) to cumulative travel; 41% of attended bars were co-located in participants' home LGA. Greater bar and liquor store density within the home LGA were associated with overall trips to these outlet types. DISCUSSION AND CONCLUSIONS Individuals travel beyond their residential area to bars, but travel to liquor stores closer to home. Bar and liquor store density within individuals' home LGA were associated with trips to outlets. Trips to local bars in near home comprised a minority of trips to bars in this sample. Studies of retail alcohol access should account for trips to bars away from home.
Collapse
Affiliation(s)
- Christina A. Mehranbod
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Ariana N. Gobaud
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Brady R. Bushover
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Christopher N. Morrison
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| |
Collapse
|
13
|
Cochran G, Smid MC, Krans EE, Yu Z, Carlston K, White A, Abdulla W, Baylis J, Charron E, Okifugi A, Gordon AJ, Lundahl B, Silipigni J, Seliski N, Haaland B, Tarter R. Patient navigation for pregnant individuals with opioid use disorder: Results of a randomized multi-site pilot trial. Addiction 2024; 119:544-556. [PMID: 37859587 DOI: 10.1111/add.16364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 09/14/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND AND AIMS Patient navigation (PN) may benefit pregnant individuals with opioid use disorder (OUD) by improving treatment adherence. We examined participant enrollment, session delivery and assessment feasibility for a PN intervention among pregnant participants and compared PN preliminary effectiveness for OUD treatment engagement with participants in usual care (UC). DESIGN This study was a pilot single-blinded multi-site randomized trial. SETTING Two academic medical centers in Pennsylvania (n = 57) and Utah (n = 45), United States participated. PARTICIPANTS One hundred and two pregnant adult participants unestablished (fewer than 6 weeks) on medication for OUD (MOUD) were randomized to PN (n = 53) or UC (n = 49). INTERVENTION PN was composed of 10 prenatal sessions (delivered after baseline but before the prenatal assessments) and four postnatal sessions (delivered before the 2- and 6-month postpartum assessments) focused upon OUD treatment and physical/mental health needs. UC involved brief case management. MEASUREMENTS Feasibility assessments included consent, session delivery and assessment rates. Mixed-effect models for intent-to-treat (ITT) and per protocol (PP, received six or more sessions) populations were estimated to compare outcomes of MOUD use, secondary outcomes of substance use disorder (SUD) treatment attendance and non-prescribed opioid use, and exploratory outcome of overdose at baseline, predelivery and 2 and 6 months postpartum. FINDINGS We consented 87% (106 of 122) of the proposed target, delivered ~60% of sessions delivered and completed ≥ 75% assessments. PN ITT and PP had better MOUD adherence, SUD treatment attendance, non-prescribed opioid use and overdose outcomes than UC. Notable changes included good evidence for greater percentage change in days for PN PP MOUD use from baseline to 2 months postpartum [PN = 28.0 versus UC = -10.9, 95% confidence interval (CI) = 9.7, 62.1] and some evidence for baseline to 6 months postpartum (PN = 45.4 versus UC = 23.4, 95% CI = -0.7, 48.2). PN PP percentage change in days for SUD treatment attendance also showed good evidence for improvements from baseline to prenatal assessment (PN = 7.4 versus UC = -21.3, 95% CI = 3.3, 53.5). PN compared to UC participants reported fewer overdoses at 2 months (PN = 11.9%/UC = 16.1%) and at 6 months postpartum (PN = 3.8%/UC = 6.2%). CONCLUSIONS Patient navigation appears to be associated with improvements in opioid use disorder treatment engagement and overdoses during pregnancy. This pilot trial shows the feasibility of the intervention and a future large-scale trial.
Collapse
Affiliation(s)
- Gerald Cochran
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA
| | - Marcela C Smid
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Utah Health, Salt Lake City, UT, USA
| | - Elizabeth E Krans
- Department of Obstetrics, Gynecology and Reproductive Sciences, UPMC, Pittsburgh, PA, USA
| | - Ziji Yu
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Kristi Carlston
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Ashley White
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Walitta Abdulla
- Department of Obstetrics, Gynecology and Reproductive Sciences, UPMC, Pittsburgh, PA, USA
| | - Jacob Baylis
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Elizabeth Charron
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Akiko Okifugi
- Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Adam J Gordon
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA
| | - Brad Lundahl
- College of Social Work, University of Utah, Salt Lake City, UT, USA
| | - John Silipigni
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Utah Health, Salt Lake City, UT, USA
| | - Natasha Seliski
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Benjamin Haaland
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Ralph Tarter
- School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
14
|
Taghavi S, Campbell A, Engelhardt D, Duchesne J, Shaheen F, Pociask D, Kolls J, Jackson-Weaver O. Dimethyl malonate protects the lung in a murine model of acute respiratory distress syndrome. J Trauma Acute Care Surg 2024; 96:386-393. [PMID: 37934622 PMCID: PMC10922501 DOI: 10.1097/ta.0000000000004184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
BACKGROUND Succinate is a proinflammatory citric acid cycle metabolite that accumulates in tissues during pathophysiological states. Oxidation of succinate after ischemia-reperfusion leads to reversal of the electron transport chain and generation of reactive oxygen species. Dimethyl malonate (DMM) is a competitive inhibitor of succinate dehydrogenase, which has been shown to reduce succinate accumulation. We hypothesized that DMM would protect against inflammation in a murine model of ARDS. METHODS C57BL/6 mice were given ARDS via 67.7 μg of intratracheally administered lipopolysaccharide. Dimethyl malonate (50 mg/kg) was administered via tail vein injection 30 minutes after injury, then daily for 3 days. The animals were sacrificed on day 4 after bronchoalveolar lavage (BAL). Bronchoalveolar lavage cell counts were performed to examine cellular influx. Supernatant protein was quantified via Bradford protein assay. Animals receiving DMM (n = 8) were compared with those receiving sham injection (n = 8). Cells were fixed and stained with FITC-labeled wheat germ agglutinin to quantify the endothelial glycocalyx (EGX). RESULTS Total cell counts in BAL was less for animals receiving DMM (6.93 × 10 6 vs. 2.46 × 10 6 , p = 0.04). The DMM group had less BAL macrophages (168.6 vs. 85.1, p = 0.04) and lymphocytes (527.7 vs. 248.3; p = 0.04). Dimethyl malonate-treated animals had less protein leak in BAL than sham treated (1.48 vs. 1.15 μg/μl, p = 0.03). Treatment with DMM resulted in greater staining intensity of the EGX in the lung when compared with sham (12,016 vs. 15,186 arbitrary units, p = 0.03). Untreated animals had a greater degree of weight loss than treated animals (3.7% vs. 1.1%, p = 0.04). Dimethyl malonate prevented the upregulation of monocyte chemoattractant protein-1 (1.66 vs. 0.92 RE, p = 0.02) and ICAM-1 (1.40 vs. 1.01 RE, p = 0.05). CONCLUSION Dimethyl malonate reduces lung inflammation and capillary leak in ARDS. This may be mediated by protection of the EGX and inhibition of monocyte chemoattractant protein-1 and ICAM-1. Dimethyl malonate may be a novel therapeutic for ARDS.
Collapse
Affiliation(s)
- Sharven Taghavi
- Tulane University School of Medicine, Department of Surgery, New Orleans, Louisiana
| | - Alexandra Campbell
- Tulane University School of Medicine, Department of Surgery, New Orleans, Louisiana
| | - David Engelhardt
- Tulane University School of Medicine, Department of Surgery, New Orleans, Louisiana
| | - Juan Duchesne
- Tulane University School of Medicine, Department of Surgery, New Orleans, Louisiana
| | - Farhana Shaheen
- Tulane University School of Medicine, Department of Surgery, New Orleans, Louisiana
| | - Derek Pociask
- Tulane University School of Medicine, Department of Medicine, New Orleans, Louisiana
| | - Jay Kolls
- Tulane University School of Medicine, Center for Translational Research in Infection and Inflammation, New Orleans, LA
| | - Olan Jackson-Weaver
- Tulane University School of Medicine, Department of Surgery, New Orleans, Louisiana
| |
Collapse
|
15
|
Caton L, Short N, Goetzinger A, Chidgey B, Austin A. "My Goal is…to get Through the Day Without Pain": A Qualitative Study on Chronic Pain Experiences and Treatment Needs Among Child Caregiving Women. Matern Child Health J 2024:10.1007/s10995-024-03915-5. [PMID: 38401026 DOI: 10.1007/s10995-024-03915-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
INTRODUCTION We aimed to understand connections between pain, caregiving, physical and behavioral health treatment needs, and motivations for prescription opioid use among child caregiving women with chronic pain. METHODS We conducted in-depth, semi-structured interviews with 12 women (average age 48 years; 58% Black) in child caregiving roles, including women who were pregnant or trying to become pregnant and were caring for children or grandchildren < 18 years, and who received treatment at an outpatient pain management clinic. We used thematic text analysis to identify qualitative themes related to caregiving, pain, treatment, substance use, coping strategies, and sources of support. RESULTS A diverse sample of women reported high levels of stress and pain, substance use, interpersonal violence, depression, and financial strain. Most described difficulties at work, interacting with children or grandchildren, and engaging routine, daily activities due to their pain. Most indicated that they spent less time with family and friends due to their pain and had limited sources of support to help them navigate both caregiving and pain. Many described barriers to receiving appropriate healthcare, including prescription opioids, due to stigma or logistics, though most also reported positive healthcare experiences. Women also reported added daily-life, physical, mental health, and interpersonal stressors and difficulty navigating the healthcare system to receive needed care. DISCUSSION For women with chronic pain in child caregiver roles, results highlight the importance of care tailored to the physical needs of child caregiving and of trauma-informed approaches given the prevalence of comorbid conditions and trauma.
Collapse
Affiliation(s)
- Lauren Caton
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nicole Short
- Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV, USA
- Department of Anesthesiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amy Goetzinger
- Department of Anesthesiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brooke Chidgey
- Department of Anesthesiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anna Austin
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, 401 Pittsboro St, CB #7445, Chapel Hill, NC, 27599- 7445, 623-7578, USA.
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| |
Collapse
|
16
|
Stout CD, Ybarra ML, Mitchell KJ, Nelson KM. "An escape from the isolation": Youth thoughts about the impact of COVID-19 on adolescent sexual behavior and alcohol use. J Adolesc 2024. [PMID: 38311967 DOI: 10.1002/jad.12303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/06/2024]
Abstract
INTRODUCTION The COVID-19 pandemic likely affected adolescent sexual behaviors and alcohol use, although how is not well understood. METHOD Youth were sampled from the national, online longitudinal Growing up with Media study. They responded via text messaging to open-ended questions about how the COVID-19 pandemic may have impacted the sexual behavior and alcohol use of adolescents. Conventional content analysis summarized open-ended responses. RESULTS 416 responses were analyzed from 335 participants (aged 15-30, US residents), 81 of whom provided data for both topics. Participants suggested that the pandemic affected some youths' sexual health precautions (increased and varying) and attitudes about sex (positive and negative). They discussed how adolescents met partners during the pandemic, including increased use of online platforms. Participants also suggested researchers investigate sexual risk in the realm of COVID-19 transmission and the practice of "safe sex." Many participants believed adolescents were drinking alcohol more as a result of the pandemic, both alone and with friends; however, others perceived adolescents were drinking less. Participants proposed researchers investigate adolescent drinking habits during the pandemic, as well as how this compares to before the pandemic and the type and quantity of alcohol consumed. CONCLUSIONS Young people believe adolescent sexual relationships and drinking behaviors changed due to the pandemic, though how varied. Future research could examine the contexts and individual differences that shape these varying behaviors. Overall, this study highlights the importance of directly asking youth about their pandemic experiences and the diversity of views on how the pandemic has influenced adolescent behavior.
Collapse
Affiliation(s)
- Claire D Stout
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michele L Ybarra
- Center for Innovative Public Health Research, San Clemente, California, USA
| | - Kimberly J Mitchell
- Crimes against Children Research Center, University of New Hampshire, Durham, New Hampshire, USA
| | - Kimberly M Nelson
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
- Department of Psychiatry, The Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| |
Collapse
|
17
|
Mielenz TJ, Jia H, DiGuiseppi C, Molnar LJ, Strogatz D, Hill LL, Andrews HF, Eby DW, Jones VC, Li G. Impact of driving cessation on health-related quality of life trajectories. Health Qual Life Outcomes 2024; 22:13. [PMID: 38302929 PMCID: PMC10835934 DOI: 10.1186/s12955-024-02231-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Trajectories of health-related quality of life (HRQoL) after driving cessation (DC) are thought to decline steeply, but for some, HRQoL may improve after DC. Our objective is to examine trajectories of HRQoL for individuals before and after DC. We hypothesize that for urban drivers, volunteers and those who access alternative transportation participants' health may remain unchanged or improve. METHODS This study uses data from the AAA Longitudinal Research on Aging Drivers (LongROAD) study, a prospective cohort of 2,990 older drivers (ages 65-79 at enrollment). The LongROAD study is a five-year multisite study and data collection ended October 31, 2022. Participants were recruited using a convenience sample from the health centers roster. The number of participants approached were 40,806 with 7.3% enrolling in the study. Sixty-one participants stopped driving permanently by year five and had data before and after DC. The PROMIS®-29 Adult Profile was utilized and includes: 1) Depression, 2) Anxiety, 3) Ability to Participate in Social Roles and Activities, 4) Physical Function, 5) Fatigue, 6) Pain Interference, 7) Sleep Disturbance, and 8) Numeric Pain Rating Scale. Adjusted (age, education and gender) individual growth models with 2989 participants with up to six observations from baseline to year 5 in the models (ranging from n = 15,041 to 15,300) were utilized. RESULTS Ability to participate in social roles and activities after DC improved overall. For those who volunteered, social roles and activities declined not supporting our hypothesis. For those who accessed alternative transportation, fatigue had an initial large increase immediately following DC thus not supporting our hypothesis. Urban residents had worse function and more symptoms after DC compared to rural residents (not supporting our hypothesis) except for social roles and activities that declined steeply (supporting our hypothesis). CONCLUSIONS Educating older adults that utilizing alternative transportation may cause initial fatigue after DC is recommended. Accessing alternative transportation to maintain social roles and activities is paramount for rural older adults after DC especially for older adults who like to volunteer.
Collapse
Affiliation(s)
- Thelma J Mielenz
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.
- Center for Injury Science and Prevention, Columbia University Irving Medical Center, New York, NY, 10032, USA.
| | - Haomiao Jia
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Carolyn DiGuiseppi
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Lisa J Molnar
- University of Michigan Transportation Research Institute, Ann Arbor, MI, 48109, USA
| | | | - Linda L Hill
- School of Public Health, University of California San Diego, La Jolla, CA, 92093, USA
| | - Howard F Andrews
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA
| | - David W Eby
- University of Michigan Transportation Research Institute, Ann Arbor, MI, 48109, USA
| | - Vanya C Jones
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Guohua Li
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
- Center for Injury Science and Prevention, Columbia University Irving Medical Center, New York, NY, 10032, USA
- Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA
| |
Collapse
|
18
|
Kim H, Song EJ, Windsor L. Evidence-Based Home Visiting Provisions and Child Maltreatment Report Rates: County-Level Analysis of US National Data From 2016 to 2018. Child Maltreat 2024; 29:176-189. [PMID: 35678142 PMCID: PMC9844259 DOI: 10.1177/10775595221107533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This observational ecological study examined county-level associations between evidence-based home visiting (EHV) provisions and child maltreatment report (CMR) rates, using national county-level data from 2016-2018. We found that longitudinal changes of EHV provisions were significantly negatively associated with county CMR rates while controlling for potential confounders. Our model estimated that after EHV provisions were launched in counties, their CMR rates decreased (or after they were ceased, rates increased) by 2.21 per 1000 children overall, 2.88 per 1000 children aged 0-5, 2.59 per 1000 children aged 6-11, 2.13 per 1000 male children, and 2.24 per 1000 female children. When limiting attention to EHV provisions funded by the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program, we found no significant association perhaps because MIECHV-funded EHV provisions were a small subset of all EHV provisions. These findings propose potential protective impacts of county EHV provisions on overall county CMR rates. Yet, the small effect sizes suggest that EHV provisions should be considered as a part of a complete response to child maltreatment rather than in isolation. Given that EHV is provided to a very small part of the population, nevertheless, our findings suggest that expanding coverage would increase effect sizes.
Collapse
Affiliation(s)
- Hyunil Kim
- School of Social Work, University Illinois at Urbana-Champaign, Urbana, Illinois
| | - Eun-Jee Song
- School of Social Work, University Illinois at Urbana-Champaign, Urbana, Illinois
| | - Liliane Windsor
- School of Social Work, University Illinois at Urbana-Champaign, Urbana, Illinois
| |
Collapse
|
19
|
Speed TJ, Hanna MN, Xie A. The Personalized Pain Program: A New Transitional Perioperative Pain Care Delivery Model to Improve Surgical Recovery and Address the Opioid Crisis. Qual Manag Health Care 2024; 33:61-63. [PMID: 38157257 PMCID: PMC10764066 DOI: 10.1097/qmh.0000000000000450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Affiliation(s)
- Traci J Speed
- Department of Psychiatry and Behavioral Sciences (Dr Speed), Department of Anesthesiology and Critical Care Medicine (Drs Hanna and Xie), and Armstrong Institute for Patient Safety and Quality (Dr Xie), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | | |
Collapse
|
20
|
Kreski NT, Askari MS, Cerdá M, Chen Q, Hasin DS, Martins SS, Mauro PM, Olfson M, Keyes KM. Changing adolescent activity patterns and the correlation of self-esteem and externalizing mental health symptoms across time: results from the USA from 1991 through 2020. Psychol Med 2024; 54:169-177. [PMID: 37183659 DOI: 10.1017/s0033291723001150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Common adolescent psychiatric symptoms cluster into two dominant domains: internalizing and externalizing. Both domains are linked to self-esteem, which serves as a protective factor against a wide range of internalizing and externalizing problems. This study examined trends in US adolescents' self-esteem and externalizing symptoms, and their correlation, by sex and patterns of time use. METHODS Using Monitoring the Future data (N = 338 896 adolescents, grades:8/10/12, years:1991-2020), we generated six patterns of time use using latent profile analysis with 17 behavior items (e.g. sports participation, parties, paid work). Groups were differentiated by high/low engagement in sports and either paid work or high/low peer socialization. Within each group, we mapped annual, sex-stratified means of (and correlation between) self-esteem and externalizing factors. We also examined past-decade rates of change for factor means using linear regression and mapped proportions with top-quartile levels of poor self-esteem, externalizing symptoms, or both. RESULTS We found consistent increases in poor self-esteem, decreases in externalizing symptoms, and a positive correlation between the two across nearly all activity groups. We also identified a relatively constant proportion of those with high levels of both in every group. Increases in poor self-esteem were most pronounced for female adolescents with low levels of socializing, among whom externalizing symptoms also increased. CONCLUSIONS Rising trends in poor self-esteem are consistent across time use groups, as is the existence of a group facing poor self-esteem and externalizing symptoms. Effective interventions for adolescents' poor self-esteem/co-occurring symptoms are needed broadly, but especially among female adolescents with low peer socialization.
Collapse
Affiliation(s)
- Noah T Kreski
- Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 W 168th St, R733, New York, NY 10032, USA
| | - Melanie S Askari
- Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 W 168th St, R733, New York, NY 10032, USA
| | - Magdalena Cerdá
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue 4-16, New York, NY 10016, USA
| | - Qixuan Chen
- Department of Biostatistics, Columbia University, Mailman School of Public Health, 722 West 168th Street, R644, New York, NY 10032, USA
| | - Deborah S Hasin
- Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 W 168th St, R733, New York, NY 10032, USA
- Department of Psychiatry, New York State Psychiatric Institute, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, 722 W. 168th Street, Room 228F, New York, NY 10032, USA
| | - Silvia S Martins
- Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 W 168th St, R733, New York, NY 10032, USA
| | - Pia M Mauro
- Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 W 168th St, R733, New York, NY 10032, USA
| | - Mark Olfson
- Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 W 168th St, R733, New York, NY 10032, USA
- Department of Psychiatry, New York State Psychiatric Institute, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, 722 W. 168th Street, Room 228F, New York, NY 10032, USA
| | - Katherine M Keyes
- Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 W 168th St, R733, New York, NY 10032, USA
| |
Collapse
|
21
|
McCrary LM, Cox ME, Roberts KE, Knittel AK, Jordan RA, Proescholdbell SK, Schranz AJ. Endocarditis, drug use and biological sex: A statewide analysis comparing sex differences in drug use-associated infective endocarditis with other drug-related harms. Int J Drug Policy 2024; 123:104280. [PMID: 38103457 PMCID: PMC10843756 DOI: 10.1016/j.drugpo.2023.104280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/20/2023] [Accepted: 11/25/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES Hospitalizations for drug use-associated infective endocarditis (DUA-IE) have risen sharply across the United States over the past decade. The sex composition of DUA-IE remains less clear, and studies have indicated a possible shift to more females. We aimed to compare more recent statewide hospitalization rates for DUA-IE in females versus males and contextualize them among other drug-related harms in North Carolina (NC). METHODS This study was a retrospective analysis using public health datasets of all NC hospital discharges for infective endocarditis from 2016 to 2020. Drug use-related hospitalizations were identified using ICD-10-CM codes. Discharge rates by year and sex for DUA-IE and non-DUA-IE were calculated and compared to fatal overdoses and acute hepatitis C (HCV). Temporal, demographic, and pregnancy trends were also assessed. RESULTS Hospitalizations rates for DUA-IE were 9.7 per 100,000 over the five-year period, and 1.2 times higher among females than males. Females composed 57% of DUA-IE hospitalizations over the period. Conversely, fatal overdose, acute HCV, and non-DUA-IE hospitalization rates were higher among males. Age, county of residence, and pregnancy status did not explain the higher DUA-IE among females. CONCLUSION Females now comprise the majority of DUA-IE hospitalizations in NC, unlike other drug-related harms. No clear demographic or geographic associations were found, and further research is needed to explain this phenomenon. Preventing invasive infections among females who inject drugs should be prioritized.
Collapse
Affiliation(s)
- L Madeline McCrary
- Washington University School of Medicine in St. Louis, Department of Medicine, 4523 Clayton Ave MSC 8051-0043-15, St. Louis, MO 63110
| | - Mary E Cox
- North Carolina Department of Health and Human Services, Division of Public Health, 2001 Mail Service Center, Raleigh, NC 27699, USA
| | - Kate E Roberts
- Bryn Mawr College, Graduate School of Social Work and Social Research, 300 Airdale Rd, Bryn Mawr, PA 19010, USA
| | - Andrea K Knittel
- University of North Carolina, Department of Obstetrics and Gynecology, 3009 Old Clinic Building, CB #7570, Chapel Hill, NC 27599, USA
| | - Robyn A Jordan
- University of North Carolina, Department of Psychiatry, 1101 Weaver Dairy Rd Ste 102, Chapel Hill 27514, USA
| | - Scott K Proescholdbell
- North Carolina Department of Health and Human Services, Division of Public Health, 2001 Mail Service Center, Raleigh, NC 27699, USA
| | - Asher J Schranz
- University of North Carolina, Department of Medicine, 130 Mason Farm Rd, CB #7030, Chapel Hill, NC 27599, USA.
| |
Collapse
|
22
|
Ellyson AM, Schleimer JP, Dalve K, Gause E, Weybright EH, Kuklinski MR, Oesterle S, Rowhani-Rahbar A. The association of alcohol use and heavy drinking with subsequent handgun carrying among youth from rural areas. J Rural Health 2024; 40:181-191. [PMID: 37534942 PMCID: PMC11000423 DOI: 10.1111/jrh.12789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023]
Abstract
PURPOSE Alcohol use and handgun carrying are more prevalent among youth in rural than urban areas and their association may be stronger among rural adolescents. Alcohol use may be modifiable with implications for reducing handgun carrying and firearm-related harm. We examined the association between lagged alcohol use and subsequent handgun carrying in rural areas and examined variation in the association by developmental stages, hypothesizing that it would be stronger among adolescents than youth adults. METHODS We used a longitudinal sample of 2,002 adolescents from ages 12 to 26 growing up in 12 rural communities in 7 states with surveys collected from 2004 to 2019. We estimated the association of lagged past-month alcohol use on handgun carrying in the subsequent 12 months using population-average generalized estimating equations with logistic regression on multiply imputed data. FINDINGS During adolescence (ages 12-18), those who drank heavily had 1.43 times the odds (95% CI = [1.01, 2.03]) of subsequent handgun carrying compared to those who did not drink alcohol, and those who consumed alcohol but did not drink heavily had 1.30 times the odds of subsequent handgun carrying compared to those who did not drink (95% CI = [0.98, 1.71]). During young adulthood (ages 19-26), associations of alcohol use (OR = 1.28; 95% CI = [0.94, 1.63]) and heavy drinking (OR = 1.38; 95% CI = [1.08, 1.68]) were similar to adolescence. CONCLUSIONS Alcohol use and subsequent handgun carrying were positively associated during adolescence and young adulthood among individuals who grew up in rural areas, similar to findings in urban areas. Reducing alcohol use may be an important strategy to prevent handgun carrying and firearm-related harm among young people in rural areas.
Collapse
Affiliation(s)
- Alice M. Ellyson
- Department of Pediatrics, University of Washington 1959 NE Pacific St. Box 356320, Seattle, WA 98195-6320, United States
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute M/S CW8-5, PO BOX 5371, Seattle, WA 98145-5005, United States
| | - Julia P. Schleimer
- Department of Epidemiology, University of Washington Box 351619, Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Kimberly Dalve
- Department of Epidemiology, University of Washington Box 351619, Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Emma Gause
- Department of Epidemiology, University of Washington Box 351619, Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Elizabeth H. Weybright
- Department of Human Development, Washington State University 512 Johnson Tower, PO Box 644852, Pullman, WA 99164-4852, United States
| | - Margaret R. Kuklinski
- Social Development Research Group, School of Social Work, University of Washington 9725 Third Ave NE, Ste 401, Seattle, WA 98115, United States
| | - Sabrina Oesterle
- Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University 201 N Central Ave, Floor 33, Phoenix, AZ 85004, United States
| | - Ali Rowhani-Rahbar
- Department of Pediatrics, University of Washington 1959 NE Pacific St. Box 356320, Seattle, WA 98195-6320, United States
- Department of Epidemiology, University of Washington Box 351619, Department of Epidemiology, University of Washington, Seattle, WA, United States
| |
Collapse
|
23
|
Duan K, Chambers LC, Basta M, Scagos RP, Roberts-Santana C, Hallowell BD. Prior Emergency Medical Services Utilization Among People Who Had an Accidental Opioid-Involved Fatal Drug Overdose-Rhode Island, 2018-2020. Public Health Rep 2024; 139:48-53. [PMID: 36891978 PMCID: PMC10905757 DOI: 10.1177/00333549231154582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
OBJECTIVE To help understand whether decreased emergency medical services (EMS) utilization due to the COVID-19 pandemic contributed to increased accidental fatal drug overdoses, we characterized recent EMS utilization history among people who had an accidental opioid-involved fatal drug overdose in Rhode Island. METHODS We identified accidental opioid-involved fatal drug overdoses among Rhode Island residents that occurred from January 1, 2018, through December 31, 2020. We linked decedents by name and date of birth to the Rhode Island EMS Information System to obtain EMS utilization history. RESULTS Among 763 people who had an accidental opioid-involved fatal overdose, 51% had any EMS run and 16% had any opioid overdose-related EMS run in the 2 years before death. Non-Hispanic White decedents were significantly more likely than decedents of other races and ethnicities to have any EMS run (P < .001) and any opioid overdose-related EMS run (P = .05) in the 2 years before death. Despite a 31% increase in fatal overdoses from 2019 through 2020, corresponding with the onset of the COVID-19 pandemic, EMS utilization in the prior 2 years, prior 180 days, or prior 90 days did not vary by time frame of death. CONCLUSION In Rhode Island, decreased EMS utilization because of the COVID-19 pandemic was not a driving force behind the increase in overdose fatalities observed in 2020. However, with half of people who had an accidental opioid-involved fatal drug overdose having an EMS run in the 2 years before death, emergency care is a potential opportunity to link people to health care and social services.
Collapse
Affiliation(s)
- Kailai Duan
- Rhode Island Department of Health, Providence, RI, USA
| | - Laura C. Chambers
- Rhode Island Department of Health, Providence, RI, USA
- The Miriam Hospital, Providence, RI, USA
| | - Melissa Basta
- Rhode Island Department of Health, Providence, RI, USA
| | | | | | | |
Collapse
|
24
|
Mennicke A, Bush HM, Brancato CJ, Haley G, Meehan E, Coker AL. Effectiveness of a Bystander Intervention Program to Increase Bystander Behaviors Across Latent Risk Groups of High Schoolers. J Interpers Violence 2024; 39:59-86. [PMID: 37650390 DOI: 10.1177/08862605231194637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Bystander intervention programs have established efficacy to increase bystander behaviors to prevent interpersonal violence (IPV). Little research has investigated intervention efficacy among latent risk classes among high school students. Data from a five-year randomized control trial were used to conduct multigroup path analyses to assess the association between type of training received and bystander outcomes moderated by risk groups identified via latent profile analysis (LPA). LPA was used to identify risk based on six indicators related to violence exposure, association with aggressive friends, and alcohol use. Bystander training received was the primary independent variable characterized as: no training, overview speech alone, or skills training. Outcomes included (a) observed bystander behaviors; (b) reactive bystander behaviors; or (c) proactive bystander behaviors. Three risk groups were identified via LPA: low risk, moderate risk witnesses of IPV, and highest risk victims and perpetrators. Of the bystander trainings received, overview speeches only increased reactive bystander behaviors among low risk students. The skills training was effective at increasing most bystander outcomes among all risk groups, with the largest effect sizes observed among the highest risk victims and perpetrators profile. Findings suggest that tailoring or modifying bystander training based on the risk profiles of youth may lead to greater potential to increase bystander behaviors to reduce risk of violence. Specifically, overview speech trainings should be targeted to low risk youth, while skills training primarily delivered to higher risk youth. These skills trainings could incorporate content related to trauma-informed care as well as associations with alcohol use, which may enhance their effectiveness further.
Collapse
Affiliation(s)
| | | | | | | | - Erin Meehan
- University of North Carolina at Charlotte, USA
| | | |
Collapse
|
25
|
Thulin EJ, Florimbio AR, Philyaw-Kotov ML, Walton MA, Bonar EE. Measuring Electronically Shared Rape Myths: Scale Creation and Correlates. J Interpers Violence 2024; 39:369-392. [PMID: 37650611 DOI: 10.1177/08862605231197140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Increased access to information online (e.g., social media) provides opportunities for exposure to rape myths (i.e., false beliefs about incidents of sexual assault). Social media, in particular, may serve a critical role in shaping rape culture. Thus, it is important to identify ways to assess online exposure to rape myths, especially given the influence online exposure may have on offline behaviors. Data were analyzed from 2,609 18-25-year-old participants (mean age = 20.9 years; 46.1% male; 71.6% White) recruited in 2017 through social media to complete an online survey on experiences and perceptions of sexual violence. We used exploratory and confirmatory factor analyses (EFA, CFA) to evaluate the relatedness of nine items adapted to reflect rape myths posted by friends on social media. We split the sample into training (50%) and testing (50%) sets for the EFA and CFA, respectively, then evaluated the correlation between experiences of sexual violence, substance use, and social media use and exposure to online rape myths. Eigenvalues (1-factor: 5.509; 2-factor: 0.803; 3-factor: 0.704; 4-factor: 0.482), factor loadings, fit statistics (RMSEA: 0.03; CFI: 0.99; TLI: 0.99; SRMR: 0.057), interpretability, and existing theory supported a 1-factor solution, which was supported by CFA fit statistics (RMSEA: 0.021; CFI: 0.99; TLI: 0.99; SRMR: 0.038). Cronbach's alpha of the nine items was .77. Greater exposure to online rape myths was associated with greater likelihood of attempted rape perpetration (β = .052, SE = .016, p < .005), rape victimization (β = .045, SE = .009, p < .005), use of illicit drugs (β = .021, SE = 0.008, p < .05), being male (β = .017, SE = .008, p < .05), and being younger (β = -.008, SE = .002, p < .005). Our findings support assessing exposure to online rape myths, which may be important for informing sexual violence prevention and intervention efforts.
Collapse
Affiliation(s)
- Elyse J Thulin
- University of Michigan, Ann Arbor, MI, USA
- Michigan Data Science, Ann Arbor, MI, USA
| | | | | | | | | |
Collapse
|
26
|
Kim H, Kim YY, Song EJ, Windsor L. Policies to Reduce Child Poverty and Child Maltreatment: A Scoping Review and Preliminary Estimates of Indirect Effects. Child Youth Serv Rev 2024; 156:10.1016/j.childyouth.2023.107311. [PMID: 38031557 PMCID: PMC10683790 DOI: 10.1016/j.childyouth.2023.107311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
This study includes a scoping review of prior studies investigating the effects of policy changes on child poverty rates. It further conducts an empirical analysis to estimate the relationship between child poverty rates and child maltreatment report (CMR) rates, utilizing national county-level data. The study then calculates the indirect effects of policy changes on CMR rates, mediated through child poverty rates, by integrating information from previous studies with its own empirical findings. Among the policy changes explored in prior studies, those related to a child allowance and a fully refundable Child Tax Credit demonstrate the largest indirect effects but also the highest costs. The expansion of in-kinds and near-cash benefits, such as the Supplemental Nutrition Assistance Program benefits and housing vouchers, shows moderate effects with moderate costs. Tax credits like the Earned Income Tax Credit exhibit lower effects and costs when targeted at the lowest earners, and moderate effects and costs for broader expansion. Focused tax credits, such as the Child and Dependent Care Tax Credit, had lower effects and costs, even if made fully refundable. Despite certain limitations, the study's approach yields consistent estimates with a recent simulation study, indicating its potential validity. While some proposed policy changes may seem expensive, implementing them is anticipated to substantially reduce CMR rates, with the benefits outweighing the associated costs. Overall, the findings suggest that addressing child poverty to reduce CMRs is an attractive strategy with numerous potential benefits.
Collapse
Affiliation(s)
- Hyunil Kim
- School of Social Work, University Illinois at Urbana-Champaign, Urbana, Illinois
| | - Yun Young Kim
- School of Social Work, University Illinois at Urbana-Champaign, Urbana, Illinois
| | - Eun-Jee Song
- School of Social Work, University Illinois at Urbana-Champaign, Urbana, Illinois
| | - Liliane Windsor
- School of Social Work, University Illinois at Urbana-Champaign, Urbana, Illinois
| |
Collapse
|
27
|
Frank M, Daniel L, Hays CN, Shanahan ME, Naumann RB, McNaughton Reyes HL, Austin AE. Association of Food Insecurity With Multiple Forms of Interpersonal and Self-Directed Violence: A Systematic Review. Trauma Violence Abuse 2024; 25:828-845. [PMID: 37009984 PMCID: PMC10666476 DOI: 10.1177/15248380231165689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Economic stress, broadly defined, is associated with an increased likelihood of multiple forms of violence. Food insecurity is a distinct economic stressor and material hardship that is amenable to programmatic and policy intervention. To inform intervention and identify gaps in the current evidence base, we conducted a systematic review to synthesize and critically evaluate the existing literature regarding the association between food insecurity and five forms of interpersonal and self-directed violence: intimate partner violence (IPV), suicidality, peer violence and bullying, youth dating violence, and child maltreatment, in high-income countries. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and searched six electronic databases from their start date through February of 2022. We included studies that examined food insecurity as the exposure and an outcome measure of IPV, suicide, suicidality, peer violence, bullying, youth dating violence, or child maltreatment; were peer-reviewed and published in English; reported quantitative data; and took place in a high-income country. We identified 20 relevant studies. Nineteen studies found that food insecurity was associated with an increased likelihood of these forms of violence. Results highlight the potential for programs and policies that address food insecurity to function as primary prevention strategies for multiple forms of violence and underscore the importance of trauma-informed approaches in organizations providing food assistance. Additional theory-driven research with validated measures of food insecurity and clearly established temporality between measures of food insecurity and violence is needed to strengthen the existing evidence base.
Collapse
Affiliation(s)
- Madeline Frank
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Leah Daniel
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Caroline N. Hays
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | | | - Anna E. Austin
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
28
|
DeGue S, Ray CM, Bontempo D, Niolon PH, Tracy AJ, Estefan LF, Le VD, Little TD. Prevalence of Violence Victimization and Perpetration During Middle and High School in Underresourced, Urban Communities. Violence Vict 2023; 38:839-857. [PMID: 37949460 PMCID: PMC10953482 DOI: 10.1891/vv-2022-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
This study describes rates of violence victimization, perpetration, and witnessing in 6th-11th grade for a multisite sample (N = 3,466) of predominantly Black and Hispanic middle- and high-school students from urban areas with high rates of crime and economic disadvantage. Students completed surveys in middle and high school assessing teen dating violence, stalking, sexual violence and harassment, bullying, cyberbullying, and physical violence perpetration and victimization, as well as witnessing violence. The highest prevalence rates are observed most often in 8th or 9th grade. Youth reported high rates of witnessing serious assault and severe community violence throughout adolescence. These findings suggest that efforts to prevent violence among youth living in under-resourced communities need to start early and address community-level socioeconomic disparities.
Collapse
Affiliation(s)
- Sarah DeGue
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Colleen M Ray
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Daniel Bontempo
- College of Education, Texas Tech University, Lubbock, TX, USA
| | - Phyllis Holditch Niolon
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Allison J Tracy
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lianne Fuino Estefan
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Vi D Le
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Todd D Little
- College of Education, Texas Tech University, Lubbock, TX, USA
- Optentia Research Focus Area, North-West University, Vanderbijlpark, South Africa
| |
Collapse
|
29
|
Zang X, Walley AY, Chatterjee A, Kimmel SD, Morgan JR, Murphy SM, Linas BP, Nolen S, Reilly B, Urquhart C, Schackman BR, Marshall BDL. Changes to opioid overdose deaths and community naloxone access among Black, Hispanic and White people from 2016 to 2021 with the onset of the COVID-19 pandemic: An interrupted time-series analysis in Massachusetts, USA. Addiction 2023; 118:2413-2423. [PMID: 37640687 PMCID: PMC10986189 DOI: 10.1111/add.16324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 07/07/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND AND AIMS The onset of the coronavirus disease 2019 (COVID-19) pandemic was associated with a surge in opioid overdose deaths in Massachusetts, particularly affecting racial and ethnic minority communities. We aimed to compare the impact of the pandemic on opioid overdose fatalities and naloxone distribution from community-based programs across racial and ethnic groups in Massachusetts. DESIGN Interrupted time-series. SETTING AND CASES Opioid overdose deaths (OODs) among non-Hispanic White, non-Hispanic Black, Hispanic and non-Hispanic other race people in Massachusetts, USA (January 2016 to June 2021). MEASUREMENTS Rate of OODs per 100 000 people, rate of naloxone kits distributed per 100 000 people and ratio of naloxone kits per opioid overdose death as a measure of naloxone availability. We applied five imputation strategies using complete data in different periods to account for missingness of race and ethnicity for naloxone data. FINDINGS Before COVID-19 (January 2016 to February 2020), the rate of OODs declined among non-Hispanic White people [0.2% monthly reduction (95% confidence interval = 0.0-0.4%)], yet was relatively constant among all other population groups. The rate of naloxone kits increased across all groups (0.8-1.2% monthly increase) and the ratio of naloxone kits per OOD death among non-Hispanic White was 1.1% (0.8-1.4%) and among Hispanic people was 1.0% (0.2-1.8%). After the onset of the pandemic (March 2020+), non-Hispanic Black people experienced an immediate increase in the rate of OODs [63.6% (16.4-130%)], whereas rates among other groups remained similar. Trends in naloxone rescue kit distribution did not substantively change among any groups, and the ratio of naloxone kits per OOD death for non-Hispanic Black people did not compensate for the surge in OODs deaths in this group. CONCLUSIONS With the onset of the COVID-19 pandemic, there was a surge in opioid overdose deaths among non-Hispanic Black people in Massachusetts, USA with no compensatory increase in naloxone rescue kit distribution. For non-Hispanic White and Hispanic people, opioid overdose deaths remained stable and naloxone kit distribution continued to increase.
Collapse
Affiliation(s)
- Xiao Zang
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Alexander Y Walley
- Department of Medicine, Section of General Internal Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
| | - Avik Chatterjee
- Department of Medicine, Section of General Internal Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
| | - Simeon D Kimmel
- Department of Medicine, Section of General Internal Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
- Section of Infectious Diseases, Boston Medical Center, Boston, MA, USA
| | - Jake R Morgan
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | - Sean M Murphy
- Department of Population Health Sciences, Weill Cornell Medical College, New York City, NY, USA
| | - Benjamin P Linas
- Section of Infectious Diseases, Boston Medical Center, Boston, MA, USA
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Shayla Nolen
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Brittni Reilly
- Massachusetts Department of Public Health, Boston, MA, USA
| | | | - Bruce R Schackman
- Department of Population Health Sciences, Weill Cornell Medical College, New York City, NY, USA
| | - Brandon D L Marshall
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| |
Collapse
|
30
|
Miller AB, Oppenheimer CW, Chew RF, Weitzel KJ, D'Arcangelo B, Barnes A, Lowe A, Yaros AC. Exploring whether mental health crisis text conversations that include discussion of firearms differ from those without firearms. Prev Med 2023; 177:107783. [PMID: 37980956 PMCID: PMC10783174 DOI: 10.1016/j.ypmed.2023.107783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 10/10/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Firearm violence represents a public health crisis in the United States. Yet, there is limited knowledge about how firearms are discussed in the context of mental health emergencies representing a major gap in the current research literature. This study addresses this gap by examining whether the content of mental health crisis text conversations that mention firearms differ from those that do not mention firearms in a large, unique dataset from a national crisis text line. METHODS We examined data from over 3.2 million conversations between texters to Crisis Text Line and volunteer crisis counselors between September 2018 and July 2022. We used a study developed text classification machine learning algorithm that builds on natural language processing to identify and label whether crisis conversations mentioned firearms. We compared the frequency of psychosocial factors between conversations that mention firearms with those that did not. RESULTS Results from a generalized linear mixed-effects model demonstrated that. conversations mentioning firearms more frequently were associated with suicide, racism, physical, sexual, emotional, and unspecified abuse, grief, concerns about a third party, substance use, bullying, gender and sexual identity, relationships, depression, and loneliness. Further, conversations mentioning firearms were less likely to be related to self-harm and eating/body image. CONCLUSIONS These results offer an initial glimpse of how firearms are mentioned in the context of acute mental health emergencies, which has been completely absent in prior literature. Our results are preliminary and help sharpen our understanding of contextual factors surrounding mental health emergencies where a firearm is mentioned.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Ashley Lowe
- RTI International, Research Triangle Park, NC, USA
| | - Anna C Yaros
- RTI International, Research Triangle Park, NC, USA
| |
Collapse
|
31
|
Elmore AL, Salemi JL, Kirby RS, Sappenfield WM, Lowry J, Dixon A, Lake-Burger H, Tanner JP. Evaluation of Administrative Data for Identifying Maternal Opioid Use at Delivery in Florida. Matern Child Health J 2023; 27:44-51. [PMID: 37199857 PMCID: PMC10692249 DOI: 10.1007/s10995-023-03669-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVES Studies have shown significant increases in the prevalence of maternal opioid use. Most prevalence estimates are based on unverified ICD-10-CM diagnoses. This study determined the accuracy of ICD-10-CM opioid-related diagnosis codes documented during delivery and examined potential associations between maternal/hospital characteristics and diagnosis with an opioid-related code. METHODS To identify people with prenatal opioid use, we identified a sample of infants born during 2017-2018 in Florida with a NAS related diagnosis code (P96.1) and confirmatory NAS characteristics (N = 460). Delivery records were scanned for opioid-related diagnoses and prenatal opioid use was confirmed through record review. The accuracy of each opioid-related code was measured using positive predictive value (PPV) and sensitivity. Modified Poisson regression was used to calculate adjusted relative risks (aRR) and 95% confidence intervals (CI). RESULTS We found the PPV was nearly 100% for all ICD-10-CM opioid-related codes (98.5-100%) and the sensitivity was 65.9%. Non-Hispanic Black mothers were 1.8 times more likely than non-Hispanic white mothers to have a missed opioid-related diagnosis at delivery (aRR:1.80, CI 1.14-2.84). Mothers who delivered at a teaching status hospital were less likely to have a missed opioid-related diagnosis (p < 0.05). CONCLUSIONS FOR PRACTICE We observed high accuracy of maternal opioid-related diagnosis codes at delivery. However, our findings suggest that over 30% of mothers with opioid use may not be diagnosed with an opioid-related code at delivery, although their infant had a confirmed NAS diagnosis. This study provides information on the utility and accuracy of ICD-10-CM opioid-related codes at delivery among mothers of infants with NAS.
Collapse
Affiliation(s)
- Amanda L Elmore
- Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, MDC56, Tampa, FL, 33612-3805, USA.
| | - Jason L Salemi
- Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, MDC56, Tampa, FL, 33612-3805, USA
| | - Russell S Kirby
- Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, MDC56, Tampa, FL, 33612-3805, USA
| | - William M Sappenfield
- Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, MDC56, Tampa, FL, 33612-3805, USA
| | - Joseph Lowry
- Florida Department of Health, Florida Birth Defects Registry, Tallahassee, USA
| | - Ashley Dixon
- Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, MDC56, Tampa, FL, 33612-3805, USA
| | - Heather Lake-Burger
- Florida Department of Health, Florida Birth Defects Registry, Tallahassee, USA
| | - Jean Paul Tanner
- Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, MDC56, Tampa, FL, 33612-3805, USA
| |
Collapse
|
32
|
Nesoff ED, Aronowitz SV, Milam AJ, Furr-Holden CDM. Development of a systematic social observation tool for monitoring use of harm reduction supplies. Int J Drug Policy 2023; 122:104235. [PMID: 37890392 PMCID: PMC10842406 DOI: 10.1016/j.drugpo.2023.104235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Harm reduction services such as safer injection supply distribution are essential to reducing morbidity and mortality among people who use drugs (PWUD); however, local use of harm reduction supplies (e.g., tourniquets, saline solution) is difficult to routinely and systematically monitor. The purpose of this study was to develop and validate a systematic social observation tool designed to assess use of harm reduction supplies at the street block level. METHODS Data collection took place on a random sample of 150 blocks located throughout the Kensington neighborhood of North Philadelphia from November 2021 to January 2022. We measured inter-rater reliability by two-way mixed-effects intra-class correlation coefficients (ICC) with the consistency agreement definition and internal consistency reliability using Cronbach's alpha and McDonald's omega. Exploratory factor analysis with principal component extraction and promax rotation assessed internal consistency. We validated scales against locations of public syringe disposal boxes, a proxy measure for areas of concentrated drug use, using logistic regression. RESULTS Naloxone canisters, syringe caps, saline and sterile water solution bottles showed the highest reliability (ICC≥0.7). Items also showed high internal consistency (alpha, omega>0.7). Exploratory factor analysis identified one, three-item scale with high internal consistency: syringe caps, vials, and baggies (alpha = 0.85; omega = 0.85)-all supplies used concurrently with drug injection but not discarded in syringe disposal boxes. Drug use (OR = 1.78, 95 % CI = (1.48, 2.23)), harm reduction (OR = 3.53, 95 % CI = (2.20, 6.12)), and EFA scales (OR = 1.85, 95 %CI = (1.51, 2.34)) were significantly and positively associated with being within walking distance (≤0.25 miles or 0.4 km) of a syringe disposal box. CONCLUSION This study provides an efficient tool with high reliability and validity metrics to assess community uptake of harm reduction supplies designed for use by community organizations, policy makers, or other groups providing resources to PWUD.
Collapse
Affiliation(s)
- Elizabeth D Nesoff
- University of Pennsylvania Perelman School of Medicine; Department of Biostatistics, Epidemiology, and Informatics; 423 Guardian Dr, Philadelphia, PA 19104, USA.
| | - Shoshana V Aronowitz
- University of Pennsylvania School of Nursing; Department of Family and Community Health; 418 Curie Boulevard, Philadelphia, PA 19104, USA
| | - Adam J Milam
- Mayo Clinic; Department of Anesthesiology and Perioperative Medicine; 5777 E. Mayo Blvd, Phoenix, AZ 85054, USA
| | - C Debra M Furr-Holden
- NYU School of Global Public Health; Department of Epidemiology; 708 Broadway, New York, NY 10003, USA
| |
Collapse
|
33
|
Engel-Rebitzer E, Dolan A, Shofer FS, Schapira MM, Hess EP, Rhodes KV, Bellamkonda VR, Msw EG, Bell J, Schwarz L, Schiller E, Lewis-Salley D, McCollum S, Zyla M, Becker LB, Graves RL, Meisel ZF. The association between specific narrative elements and patient perspectives on acute pain treatment. Am J Emerg Med 2023; 74:84-89. [PMID: 37797399 PMCID: PMC10924766 DOI: 10.1016/j.ajem.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 09/05/2023] [Accepted: 09/12/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Narratives are effective tools for communicating with patients about opioid prescribing for acute pain and improving patient satisfaction with pain management. It remains unclear, however, whether specific narrative elements may be particularly effective at influencing patient perspectives. METHODS This study was a secondary analysis of data collected for Life STORRIED, a multicenter RCT. Participants included 433 patients between 18 and 70 years-old presenting to the emergency department (ED) with renal colic or musculoskeletal back pain. Participants were instructed to view one or more narrative videos during their ED visit in which a patient storyteller discussed their experiences with opioids. We examined associations between exposure to individual narrative features and patients' 1) preference for opioids, 2) recall of opioid-related risks and 3) perspectives about the care they received. RESULTS Participants were more likely to watch videos featuring storytellers who shared their race or gender. We found that participants who watched videos that contained specific narrative elements, for example mention of prescribed opioids, were more likely to recall having received information about pain treatment options on the day after discharge (86.3% versus 72.9%, p = 0.02). Participants who watched a video that discussed family history of addiction reported more participation in their treatment decision than those who did not (7.6 versus 6.8 on a ten-point scale, p = 0.04). CONCLUSIONS Participants preferentially view narratives featuring storytellers who share their race or gender. Narrative elements were not meaningfully associated with patient-centered outcomes. These findings have implications for the design of narrative communication tools.
Collapse
Affiliation(s)
- Eden Engel-Rebitzer
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA, USA; Brigham and Women's Hospital, Boston, MA, USA.
| | - Abby Dolan
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA, USA; Urban Health Lab at the Penn Medicine Center for Health Justice, Perelman School of Medicine at the University of Pennsylvania, USA; Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Frances S Shofer
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA, USA; Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Marilyn M Schapira
- Center for Health Equity Research and Promotion (CHERP), Philadelphia VA Medical Center, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; University of Pennsylvania Department of General and Internal Medicine, Philadelphia, PA, USA
| | - Erik P Hess
- Department of Emergency Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA; Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN, USA
| | - Karin V Rhodes
- Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Venkatesh R Bellamkonda
- Department of Emergency Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Erica Goldberg Msw
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA, USA
| | - Jeffrey Bell
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA, USA
| | - Linda Schwarz
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA, USA
| | - Elise Schiller
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA, USA
| | - Dena Lewis-Salley
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA, USA
| | - Sharon McCollum
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael Zyla
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA, USA
| | - Lance B Becker
- Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Rachel Lynn Graves
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA, USA
| | - Zachary F Meisel
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA, USA; Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Penn Injury Science Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| |
Collapse
|
34
|
Kelley CJ, Niznik JD, Ferreri SP, Schlusser C, Armistead LT, Hughes TD, Henage CB, Busby-Whitehead J, Roberts E. Patient Perceptions of Opioids and Benzodiazepines and Attitudes Toward Deprescribing. Drugs Aging 2023; 40:1113-1122. [PMID: 37792262 PMCID: PMC10768261 DOI: 10.1007/s40266-023-01071-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Opioids and benzodiazepines (BZDs) pose a public health problem. Older adults are especially susceptible to adverse events from opioids and BZDs owing to an increased usage of opioids and BZDs, multiple comorbidities, and polypharmacy. Deprescribing is a possible, yet challenging, solution to reducing opioid and BZD use. OBJECTIVE We aimed to explore older adult patients' knowledge of opioids and BZDs, perceived facilitators and barriers to deprescribing opioids and BZDs, and attitudes toward alternative treatments for opioids and BZDs. METHODS We conducted 11 semi-structured interviews with patients aged 65+ years with long-term opioid and/or BZD prescriptions. The interview guide was developed by an interprofessional team and focused on patients' knowledge of opioids and BZDs, perceived ability to reduce opioid or BZD use, and attitudes towards alternative treatments. RESULTS Three patients had taken opioids, either currently or in the past, three had taken BZDs, and five had taken both opioids and BZDs. Generally, knowledge of opioids and BZDs was variable among patients; yet facilitators and barriers to deprescribing both opioids and BZDs were consistent. Facilitators of deprescribing included patient-provider trust and slow tapering of medications, while barriers included concerns about re-emergence of symptoms and a lack of motivation, particularly if medications and symptoms were stable. Patients were generally unenthusiastic about pursuing alternative pharmacologic and non-pharmacologic alternatives to opioids and BZDs for symptom management. CONCLUSIONS Our findings indicate that patients are open to deprescribing opioids and BZDs under certain circumstances, but overall remain hesitant with a lack of enthusiasm for alternative treatments. Future studies should focus on supportive approaches to alleviate older adults' deprescribing concerns.
Collapse
Affiliation(s)
- Casey J Kelley
- Division of Geriatric Medicine and Center for Aging and Health, School of Medicine, University of North Carolina at Chapel Hill, 5003 Old Clinic, CB# 7550, Chapel Hill, NC, 27599, USA
| | - Joshua D Niznik
- Division of Geriatric Medicine and Center for Aging and Health, School of Medicine, University of North Carolina at Chapel Hill, 5003 Old Clinic, CB# 7550, Chapel Hill, NC, 27599, USA.
- Division of Pharmaceutical Outcomes and Policy, University of North Carolina at Chapel Hill, Eshelman School of Pharmacy, Chapel Hill, NC, USA.
- Center for Health Equity Research and Promotion, Veterans Affairs (VA) Pittsburgh Healthcare System, Pittsburgh, PA, USA.
| | - Stefanie P Ferreri
- Division of Practice Advancement and Clinical Education, University of North Carolina at Chapel Hill, Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Courtney Schlusser
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lori T Armistead
- Division of Practice Advancement and Clinical Education, University of North Carolina at Chapel Hill, Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Tamera D Hughes
- Division of Practice Advancement and Clinical Education, University of North Carolina at Chapel Hill, Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Cristine B Henage
- Division of Geriatric Medicine and Center for Aging and Health, School of Medicine, University of North Carolina at Chapel Hill, 5003 Old Clinic, CB# 7550, Chapel Hill, NC, 27599, USA
| | - Jan Busby-Whitehead
- Division of Geriatric Medicine and Center for Aging and Health, School of Medicine, University of North Carolina at Chapel Hill, 5003 Old Clinic, CB# 7550, Chapel Hill, NC, 27599, USA
| | - Ellen Roberts
- Division of Geriatric Medicine and Center for Aging and Health, School of Medicine, University of North Carolina at Chapel Hill, 5003 Old Clinic, CB# 7550, Chapel Hill, NC, 27599, USA
| |
Collapse
|
35
|
Maguire-Jack K, Park Y, Feely M, Schneider W, Pace GT, Klika JB, Thibodeau E. Childcare Subsidy Employment and Copayment Requirements and Child Maltreatment. Child Maltreat 2023:10775595231218174. [PMID: 37989270 DOI: 10.1177/10775595231218174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
Economic support programs for low-income families may play an important role in preventing child abuse and neglect. In the United States, childcare subsidies are provided to low-income families who meet certain requirements to offset the high cost of childcare. States have flexibility in setting many policies related to the provision of childcare subsidies, which results in a great deal of variation in how the programs operate between states. One policy dimension on which states vary is the number of employment hours required to receive childcare subsidies. A small body of work has begun to investigate the ways in which these state policy variations might relate to child maltreatment. Using 11 years of administrative data from the United States, the current study sought to estimate the relationship between two sources of variation in childcare subsidy policies: employment requirements and copayment size; and child neglect, physical abuse, and emotional abuse substantiations. The study found a nuanced relationship between required employment and neglect substantiations. Specifically, requiring some level of work was not associated with neglect substantiations, but requiring 30 hours of employment was associated with higher rates. The study did not find a relationship between copayment size and maltreatment substantiations.
Collapse
Affiliation(s)
| | | | - Megan Feely
- School of Social Work, University of Connecticut, Hartford, CT, USA
| | | | - Garrett T Pace
- School of Social Work, University of Nevada Las Vegas, Las Vegas, NV, USA
| | | | | |
Collapse
|
36
|
Perkins DD, Mihaylov NL, Bess KD. Organizational and coalition strategies for youth violence prevention: A longitudinal mixed-methods study. Am J Crim Justice 2023; 48:1105-1131. [PMID: 37970533 PMCID: PMC10642199 DOI: 10.1007/s12103-022-09708-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/05/2022] [Indexed: 11/17/2023]
Abstract
This longitudinal study identifies espoused change orientations and actual youth violence prevention (YVP) practices over five years by 99 public and nonprofit organizations in one city. Annual key informant interviews provided both qualitative and quantitative data, including organizational collaborative network data. Data were also obtained on participation in a citywide YVP coalition, juvenile arrests and court referrals. On average, organizations both in and outside the coalition adopted a problem-focused as often as a strengths-based change orientation, and were only marginally more oriented toward empowering community members than professionals and changing communities than individual youth. Most surprisingly, YVP coalition members adopted more of a tertiary (reactive/rehabilitative) than primary prevention orientation compared to nonmembers. The number of different YVP strategies implemented increased over five years from mainly positive youth development and education interventions to those strategies plus mentoring, youth activities, events and programs, and counseling youth. Network analysis reveals dense initial collaboration with no critical gatekeepers and coalition participants more central to the city-wide organizational network. Coalition participation and total network collaboration declined in Years 3-5. Youth violence arrests and court referrals also declined. The coalition was marginally involved in successful community-collaborative, school-based interventions and other strategies adopted, and it disbanded a year after federal funding ended. Despite, or possibly due to, both national and local government participation, the coalition missed opportunities to engage in collective advocacy for local YVP policy changes. Coalitions should help nonprofit and public organizations develop more effective change orientations and implement commensurate strategies at the community level.
Collapse
Affiliation(s)
- Douglas D. Perkins
- Vanderbilt University, Human and Organizational Development, Nashville, USA
| | | | - Kimberly D. Bess
- Vanderbilt University, Human and Organizational Development, Nashville, USA
| |
Collapse
|
37
|
Blackburn NA, Ramos S, Dorsainvil M, Wooten C, Ridenour TA, Yaros A, Johnson-Lawrence V, Fields-Johnson D, Khalid N, Graham P. Resilience-Informed Community Violence Prevention and Community Organizing Strategies for Implementation: Protocol for a Hybrid Type 1 Implementation-Effectiveness Trial. JMIR Res Protoc 2023; 12:e50444. [PMID: 37934578 PMCID: PMC10664006 DOI: 10.2196/50444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Community violence is a persistent and challenging public health problem. Community violence not only physically affects individuals, but also its effects reverberate to the well-being of families and entire communities. Being exposed to and experiencing violence are adverse community experiences that affect the well-being and health trajectories of both children and adults. In the United States, community violence has historically been addressed through a lens of law enforcement and policing; the impact of this approach on communities has been detrimental and often ignores the strengths and experiences of community members. As such, community-centered approaches to address violence are needed, yet the process to design, implement, and evaluate these approaches is complex. Alternatives to policing responses are increasingly being implemented. However, evidence and implementation guidance for community-level public health approaches remain limited. This study protocol seeks to address community violence through a resilience framework-Adverse Community Experiences and Resilience (ACE|R)-being implemented in a major US city and leveraging a strategy of community organizing to advance community violence prevention. OBJECTIVE The objective of this research is to understand the impact of community-level violence prevention interventions. Furthermore, we aim to describe the strategies of implementation and identify barriers to and facilitators of the approach. METHODS This study uses a hybrid type 1 effectiveness-implementation design. Part 1 of the study will assess the effectiveness of the ACE|R framework plus community organizing by measuring impacts on violence- and health-related outcomes. To do so, we plan to collect quantitative data on homicides, fatal and nonfatal shootings, hospital visits due to nonaccidental injuries, calls for service, and other violence-related data. In Part 2 of the study, to assess the implementation of ACE|R plus community organizing, we will collect process data on community engagement events, deliver community trainings on community leadership and organizing, and conduct focus groups with key partners about violence and violence prevention programs in Milwaukee. RESULTS This project received funding on September 1, 2020. Prospective study data collection began in the fall of 2021 and will continue through the end of 2023. Data analysis is currently underway, and the first results are expected to be submitted for publication in 2024. CONCLUSIONS Community violence is a public health problem in need of community-centered solutions. Interventions that center community and leverage community organizing show promise in decreasing violence and increasing the well-being of community members. Methods to identify the impact of community-level interventions continue to evolve. Analysis of outcomes beyond violence-specific outcomes, including norms and community beliefs, may help better inform the short-term and proximal impacts of these community-driven approaches. Furthermore, hybrid implementation-effectiveness trials allow for the inevitable contextualization required to disseminate community interventions where communities drive the adaptations and decision-making. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50444.
Collapse
Affiliation(s)
| | - Stefany Ramos
- RTI International, Research Triangle Park, NC, United States
| | | | - Camara Wooten
- RTI International, Research Triangle Park, NC, United States
- University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Ty A Ridenour
- RTI International, Research Triangle Park, NC, United States
- University of Pittsburgh, Pittsburgh, PA, United States
- University of North Carolina, Chapel Hill, NC, United States
| | - Anna Yaros
- RTI International, Research Triangle Park, NC, United States
| | | | | | | | - Phillip Graham
- RTI International, Research Triangle Park, NC, United States
| |
Collapse
|
38
|
Hoover DB, Korthuis PT, Waddell EN, Foot C, Conway C, Crane HM, Friedmann PD, Go VF, Nance RM, Pho MT, Satcher MF, Sibley A, Westergaard RP, Young AM, Cook R. Recent Incarceration, Substance Use, Overdose, and Service Use Among People Who Use Drugs in Rural Communities. JAMA Netw Open 2023; 6:e2342222. [PMID: 37943559 PMCID: PMC10636631 DOI: 10.1001/jamanetworkopen.2023.42222] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/26/2023] [Indexed: 11/10/2023] Open
Abstract
Importance Drug use and incarceration have a substantial impact on rural communities, but factors associated with the incarceration of rural people who use drugs (PWUD) have not been thoroughly investigated. Objective To characterize associations between recent incarceration, overdose, and substance use disorder (SUD) treatment access among rural PWUD. Design, Setting, and Participants For this cross-sectional study, the Rural Opioid Initiative research consortium conducted a survey in geographically diverse rural counties with high rates of overdose across 10 US states (Illinois, Wisconsin, North Carolina, Oregon, Kentucky, West Virginia, Ohio, Massachusetts, New Hampshire, and Vermont) between January 25, 2018, and March 17, 2020, asking PWUD about their substance use, substance use treatment, and interactions with the criminal legal system. Participants were recruited through respondent-driven sampling in 8 rural US regions. Respondents who were willing to recruit additional respondents from their personal networks were enrolled at syringe service programs, community support organizations, and through direct community outreach; these so-called seed respondents then recruited others. Of 3044 respondents, 2935 included participants who resided in rural communities and reported past-30-day injection of any drug or use of opioids nonmedically via any route. Data were analyzed from February 8, 2022, to September 15, 2023. Exposure Recent incarceration was the exposure of interest, defined as a report of incarceration in jail or prison for at least 1 day in the past 6 months. Main Outcomes and Measures The associations between PWUD who were recently incarcerated and main outcomes of treatment use and overdose were examined using logistic regression. Results Of 2935 participants, 1662 (56.6%) were male, 2496 (85.0%) were White; the mean (SD) age was 36 (10) years; and in the past 30 days, 2507 (85.4%) reported opioid use and 1663 (56.7%) reported injecting drugs daily. A total of 1224 participants (41.7%) reported recent incarceration, with a median (IQR) incarceration of 15 (3-60) days in the past 6 months. Recent incarceration was associated with past-6-month overdose (adjusted odds ratio [AOR], 1.38; 95% CI, 1.12-1.70) and recent SUD treatment (AOR, 1.62; 95% CI, 1.36-1.93) but not recent medication for opioid use disorder (MOUD; AOR, 1.03; 95% CI, 0.82-1.28) or currently carrying naloxone (AOR, 1.02; 95% CI, 0.86-1.21). Conclusions and Relevance In this cross-sectional study of PWUD in rural areas, participants commonly experienced recent incarceration, which was not associated with MOUD, an effective and lifesaving treatment. The criminal legal system should implement effective SUD treatment in rural areas, including MOUD and provision of naloxone, to fully align with evidence-based SUD health care policies.
Collapse
Affiliation(s)
- Daniel B Hoover
- Department of Medicine, Section of Addiction Medicine, Oregon Health & Science University, Portland
| | - P Todd Korthuis
- Department of Medicine, Section of Addiction Medicine, Oregon Health & Science University, Portland
- Oregon Health & Science University-Portland State University School of Public Health, Portland
| | - Elizabeth Needham Waddell
- Department of Medicine, Section of Addiction Medicine, Oregon Health & Science University, Portland
- Oregon Health & Science University-Portland State University School of Public Health, Portland
| | - Canyon Foot
- Division of General Internal Medicine, Oregon Health & Science University, Portland
| | | | - Heidi M Crane
- Department of Medicine, University of Washington, Seattle
| | - Peter D Friedmann
- Office of Research, University of Massachusetts Chan Medical School-Baystate, Baystate Health, Springfield
| | - Vivian F Go
- Department of Health Behavior, University of North Carolina-Chapel Hill, Chapel Hill
| | - Robin M Nance
- Department of Medicine, University of Washington, Seattle
| | - Mai T Pho
- Department of Medicine, Section of Infectious Diseases and Global Health, University of Chicago, Chicago, Illinois
| | - Milan F Satcher
- Department of Community & Family Medicine, Dartmouth Health and Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire
| | - Adams Sibley
- Department of Health Behavior, University of North Carolina-Chapel Hill, Chapel Hill
| | | | - April M Young
- College of Public Health, University of Kentucky, Lexington
| | - Ryan Cook
- Division of General Internal Medicine, Oregon Health & Science University, Portland
| |
Collapse
|
39
|
Kaufman EJ, Whitehorn G, Orji W, Chreiman K, Jackson S, Holena D, Lane-Fall M, Jacoby SF. Patient Experiences of Acute and Postacute Care After Trauma. J Surg Res 2023; 291:303-312. [PMID: 37506429 DOI: 10.1016/j.jss.2023.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/13/2023] [Accepted: 06/19/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION Traumatic injury can transform a healthy, independent individual into a patient with complex health needs. Little is known about how injured patients understand their health and healthcare needs during postacute recovery, limiting our ability to optimize care. This multiple-methods study explored injured patients' experiences of care up to 30 days after discharge. METHODS Injured adults admitted to an urban, Level I trauma center August 1, 2019-November 30, 2020 were sampled purposively to balance blunt and penetrating injuries. Patient experience and health status were assessed at baseline and 30 days postdischarge using the Quality of Trauma Care Patient-Reported Experience Measure. Fifteen qualitative interviews were conducted with a purposive subset and analyzed using qualitative content analysis. RESULTS Of 67 participants (76% male, 73% Black, 51% penetrating, median age 34 years), 37 completed follow-up surveys. Quality of acute care was rated 9-10/10 by 81% of the sample for acute and 65% for postacute care (P = 0.09). Thirty percent described fair or poor mental health, but only mental health concerns were addressed for only 2/3. Pain control was inadequate in 31% at baseline and for 46% at follow-up (P = 0.09). Qualitative analysis revealed general satisfaction with acute care but challenges in recovery with unmet needs for communication and care coordination. CONCLUSIONS Trauma patients appreciated the quality of their acute care experiences but identified opportunities for improvement in prognostic communication, pain management, and mental health support. Unmet mental and physical care needs persist at least 1 month after hospital discharge and reinforce the need for interventions that optimize postacute trauma care.
Collapse
Affiliation(s)
- Elinore J Kaufman
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
| | - Gregory Whitehorn
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Whitney Orji
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Kristen Chreiman
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Sunny Jackson
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Daniel Holena
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Meghan Lane-Fall
- Department of Anesthesiology and Critical Care Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Sara F Jacoby
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| |
Collapse
|
40
|
Sah E, Asher A, Houtsma C, Constans JI. The Firearm Implicit Association Test: A Validation Study. J Pers Assess 2023; 105:770-778. [PMID: 36507628 DOI: 10.1080/00223891.2022.2153253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/17/2022] [Indexed: 12/15/2022]
Abstract
Firearm violence causes significant public health burden, but there is a lack of research concerning motivations for firearm access despite clear epidemiological risk. Developing robust tools to measure attitudes toward firearms and firearm-related behaviors can improve our ability to conduct firearm violence research. We aimed to develop a feasible and effective tool that could indirectly measure firearm beliefs. A total of 274 undergraduates were recruited from two southern universities and completed an implicit association test (IAT) designed to indirectly assess attitudes toward firearms (Firearm IAT). Participants also completed self-report measures, including Attitude Toward Guns Scale (ATGS) and Gun Beliefs and Behavior Scale (GBBS) to examine explicit attitudes toward firearms. Demographic and firearm-related data were also assessed. The Firearm IAT revealed an association between firearms and negatively valenced words. The Firearm IAT had a good internal consistency and construct validity with a D score that is significantly different from 0 and a reliability score of 0.84. The Firearm IAT showed significant positive correlations with ATGS and GBBS suggesting this measure could serve as an indirect assessment of firearm attitudes.
Collapse
Affiliation(s)
- Eric Sah
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, Louisiana
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Annie Asher
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, Louisiana
- School of Science and Engineering, Tulane University, New Orleans, Louisiana
| | - Claire Houtsma
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, Louisiana
- Education and Clinical Center (MIRECC), South Central Mental Illness Research, New Orleans, Louisiana
- School of Medicine, Louisiana State University, New Orleans, Louisiana
- School of Medicine, Tulane University, New Orleans, Louisiana
| | - Joseph I Constans
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, Louisiana
- School of Medicine, Louisiana State University, New Orleans, Louisiana
- School of Medicine, Tulane University, New Orleans, Louisiana
| |
Collapse
|
41
|
Wagner KD, Fiuty P, Page K, Tracy EC, Nocera M, Miller CW, Tarhuni LJ, Dasgupta N. Prevalence of fentanyl in methamphetamine and cocaine samples collected by community-based drug checking services. Drug Alcohol Depend 2023; 252:110985. [PMID: 37826988 PMCID: PMC10688611 DOI: 10.1016/j.drugalcdep.2023.110985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/19/2023] [Accepted: 09/28/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Overdose deaths involving stimulants and opioids simultaneously have raised the specter of widespread contamination of the stimulant supply with fentanyl. METHODS We quantified prevalence of fentanyl in street methamphetamine and cocaine, stratified by crystalline texture, analyzing samples sent voluntarily to a public mail-in drug checking service (May 2021-June 2023). Samples from 77 harm reduction programs and clinics originated in 25 US states. Sample donors reported expected drug and physical descriptions. Substances were identified by gas chromatography-mass spectrometry. Negative binomial models were used to calculate fentanyl prevalence, adjusting for potential confounders related to sample selection. We also examined if xylazine changed donors' accuracy of detecting fentanyl. RESULTS We analyzed 718 lab-confirmed samples of methamphetamine (64%) and cocaine (36%). The adjusted prevalence of fentanyl was 12.5% (95% CI: 2.2%, 22.9%) in powder methamphetamine and 14.8% (2.3%, 27.2%) in powder cocaine, with notable geographic variation. Crystalline forms of both methamphetamine (Chisq=57, p<0.001) and cocaine (Chisq=18, p<0.001) were less likely to contain fentanyl: less than 1% of crystal methamphetamine (2/276) and no crack cocaine (0/53). Heroin was present in 6.6% of powder cocaine samples. Xylazine reduced donors' ability to detect fentanyl, with correct classification dropping from 92% to 42%. CONCLUSIONS Fentanyl was detected primarily in powder forms of methamphetamine and cocaine. Recommended interventions include expanding community-based drug checking, naloxone and fentanyl test strip distribution for people who use stimulants , and supervised drug consumption sites. New strategies to dampen variability in street drug composition are needed to reduce inadvertent fentanyl exposure.
Collapse
Affiliation(s)
- Karla D Wagner
- Department of Health Behavior, Policy, and Administration Sciences, School of Public Health, University of Nevada, Reno, NV 89557, USA.
| | | | - Kimberly Page
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA.
| | - Erin C Tracy
- Injury Prevention Research Center, University of North Carolina, CB 7505, 725 Martin Luther King Jr. Blvd, Chapel Hill, NC 27599, USA.
| | - Maryalice Nocera
- Injury Prevention Research Center, University of North Carolina, CB 7505, 725 Martin Luther King Jr. Blvd, Chapel Hill, NC 27599, USA.
| | - Colin W Miller
- Injury Prevention Research Center, University of North Carolina, CB 7505, 725 Martin Luther King Jr. Blvd, Chapel Hill, NC 27599, USA.
| | - Lina J Tarhuni
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA; Department of Pharmacy, University of Washington, Seattle, WA 98195, USA.
| | - Nabarun Dasgupta
- Injury Prevention Research Center, University of North Carolina, CB 7505, 725 Martin Luther King Jr. Blvd, Chapel Hill, NC 27599, USA.
| |
Collapse
|
42
|
Austin AE, Naumann RB, Shanahan ME, Frank M. State expansion of Supplemental Nutrition Assistance Program eligibility and rates of foster care entries. Child Abuse Negl 2023; 145:106399. [PMID: 37591049 DOI: 10.1016/j.chiabu.2023.106399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/02/2023] [Accepted: 08/09/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND State expansion of Supplemental Nutrition Assistance Program (SNAP) eligibility under broad-based categorical eligibility (BBCE) is associated with decreases in household poverty and food insecurity, child protective services investigations, and mental health and substance use disorders among adults, key contributors to foster care entry. OBJECTIVE To examine the association of state expansion of SNAP eligibility under BBCE with rates of foster care entries. PARTICIPANTS Foster care entries among children ages <18 years. METHODS We used 2005-2019 data from the SNAP Policy Database and the Adoption and Foster Care Analysis and Reporting System (AFCARS). We conducted difference-in-differences analyses and generated event study plots adjusting for state economic conditions (percent population unemployed, median household income) and policies (minimum wage, refundable Earned Income Tax Credits, maximum Temporary Assistance for Needy Families benefit for a family of 3). RESULTS On average, there were 1.8 fewer foster care entries (95 % confidence interval (CI) -2.8, -0.8) per 1000 children per year in states that expanded SNAP eligibility than there would have been if they had not expanded eligibility. Average decreases in foster care entries were similar among young (-1.7 per 1000 children per year, 95 % -3.1, -0.3) and school-age (-1.8 per 1000 children per year, 95 % CI -2.7, -0.8) children and larger among Black non-Hispanic (-5.6 per 1000 children per year, 95 % CI -9.1, -2.0) than among White non-Hispanic (-1.4 per 1000 children per year, 95 % CI -2.2, -0.6) children. The magnitude of these decreases increased with greater time since policy adoption. CONCLUSIONS Results add to growing evidence that programs and policies that support and stabilize household economic and material conditions may contribute to reductions in foster care entries at the population-level.
Collapse
Affiliation(s)
- Anna E Austin
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States of America; Injury Prevention Research Center, University of North Carolina at Chapel Hill, United States of America.
| | - Rebecca B Naumann
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, United States of America; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States of America
| | - Meghan E Shanahan
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States of America; Injury Prevention Research Center, University of North Carolina at Chapel Hill, United States of America
| | - Madeline Frank
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States of America; Injury Prevention Research Center, University of North Carolina at Chapel Hill, United States of America; School of Social Work, University of North Carolina at Chapel Hill, United States of America
| |
Collapse
|
43
|
Fliss MD, Cox ME, Proescholdbell S, Patel A, Smith M. Tying Overdose Data to Action: North Carolina's Opioid and Substance Use Action Plan Data Dashboard. J Public Health Manag Pract 2023; 29:831-834. [PMID: 37498535 PMCID: PMC10526884 DOI: 10.1097/phh.0000000000001796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
From 2000 to 2020, more than 28 000 North Carolina (NC) residents died of drug overdose. In response, NC Department of Health and Human Services worked with community partners to develop an Opioid and Substance Use Action Plan (OSUAP), now in its third iteration. The NC OSUAP data dashboard brings together data on 15 public health indicators and 16 local actions across 8 strategies. We share innovations in design, data structures, user tasks, and visual elements over 5 years of dashboard development and maintenance, with a special focus and supplemental material covering the technical details and techniques that dashboard design and implementation teams may benefit from.
Collapse
Affiliation(s)
- Mike Dolan Fliss
- University of North Carolina Injury Prevention Research Center, Chapel Hill, North Carolina (Dr Fliss); and Injury & Violence Prevention Branch, NC Division of Public Health, Raleigh, North Carolina (Dr Fliss, Mss Cox, Patel, and Smith, and Mr Proescholdbell)
| | | | | | | | | |
Collapse
|
44
|
Hultgren BA, Guttmannova K, Cadigan JM, Kilmer JR, Delawalla MLM, Lee CM, Larimer ME. Injunctive Norms and Driving Under the Influence and Riding With an Impaired Driver Among Young Adults in Washington State. J Adolesc Health 2023; 73:852-858. [PMID: 37530684 DOI: 10.1016/j.jadohealth.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/18/2023] [Accepted: 06/09/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE Alcohol- and cannabis-impaired driving behaviors remain a public health concern especially among young adults (i.e., ages 18-25). Limited updates to prevention efforts for these behaviors may be due, in part, to limited understanding of malleable psychosocial predictors. The current study assessed associations between perceived injunctive norms (i.e., acceptability) of driving under the influence of alcohol (DUI-A) and cannabis (DUI-C), and riding with a driver under the influence of alcohol (RWI-A) and cannabis (RWI-C) in Washington State young adults. METHODS Participants included 1,941 young adults from the 2019 cohort of the Washington Young Adult Health Survey. Weighted logistic regressions assessed the associations between peer injunctive norms and impaired driving-related behaviors. RESULTS A weighted total of 11.5% reported DUI-A, 12.4% DUI-C, 10.9% RWI-A, and 20.9% RWI-C at least once in the past 30 days. Overlap between the outcomes was observed, indicating some young adults had engaged in multiple impaired driving-related behaviors. After controlling for substance use frequency, weighted logistic regressions indicated more positive perceived injunctive norms were associated with nearly 2 ½ times higher odds of DUI-A, 8 times higher odds of DUI-C, 4 times higher odds of RWI-A and six and a half times higher odds of RWI-C. DISCUSSION Results increase the understanding of how injunctive norms-a potentially malleable psychosocial factor-are associated with four impaired driving-related outcomes. Prevention programs that focus on assessing and addressing the norms of these outcomes individually and collectively, such as normative feedback interventions and media campaigns, may be helpful in reducing these behaviors.
Collapse
Affiliation(s)
- Brittney A Hultgren
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, School of Medicine, University of Washington, Seattle, Washington.
| | - Katarina Guttmannova
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, School of Medicine, University of Washington, Seattle, Washington
| | - Jennifer M Cadigan
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, School of Medicine, University of Washington, Seattle, Washington
| | - Jason R Kilmer
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, School of Medicine, University of Washington, Seattle, Washington; Department of Psychology, University of Washington, Seattle, Washington
| | - Miranda L M Delawalla
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, School of Medicine, University of Washington, Seattle, Washington
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, School of Medicine, University of Washington, Seattle, Washington
| | - Mary E Larimer
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, School of Medicine, University of Washington, Seattle, Washington; Department of Psychology, University of Washington, Seattle, Washington
| |
Collapse
|
45
|
Kaur A, Williams J, Recker R, Rose D, Zhu M, Yang J. Subsequent risky driving behaviors, recidivism and crashes among drivers with a traffic violation: A scoping review. Accid Anal Prev 2023; 192:107234. [PMID: 37556998 PMCID: PMC10634619 DOI: 10.1016/j.aap.2023.107234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 06/29/2023] [Accepted: 07/22/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE Drivers who have committed a traffic violation are a particularly high-risk group, yet studies conducted among this group are scarce. We analyzed and synthesized the current literature concerning subsequent risky driving behaviors, recidivism, and crashes among drivers with a traffic violation. METHODS We searched PubMed, Education Resources Information Center (ERIC), Academic Search Complete, Web of Science, and Scopus for articles published in English between January 1, 1999, and May 31, 2023. A total of 25 articles met the selection criteria and were included in the final analysis. Two coders independently extracted and analyzed the selected articles to identify common categories across the articles, including study design, study population, type of traffic violation, and study outcomes including subsequent driving behaviors, recidivism, and crash risks. RESULTS Of the 25 selected articles, 19 (76%) involved both male and female participants. Fourteen (56%) studies were interventions/evaluation studies, with the other 11 (44%) being observational. Nineteen (76%) studies included alcohol-impaired driving violations, and 23 (92%) studies examined recidivism as an outcome measure. Over half of the observational studies demonstrated that traffic offenders were more likely to commit a subsequent traffic violation or had elevated risk of crashes. Most of the intervention/evaluation studies demonstrated a significant reduction in driving under the influence (DUI) of alcohol among the study participants. However, such positive effects observed during the active intervention period were not always sustained. CONCLUSIONS Traffic offenders are a high-risk group for subsequent violations and crashes. Evidence from this review calls for more effective interventions implemented following a traffic violation to prevent recidivism, crashes, and crash-related injuries and deaths.
Collapse
Affiliation(s)
- Archana Kaur
- Center for Injury Research and Policy at the Abigail Wexner Research Institute, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States
| | - Jada Williams
- Center for Injury Research and Policy at the Abigail Wexner Research Institute, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States
| | - Robyn Recker
- Center for Injury Research and Policy at the Abigail Wexner Research Institute, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States
| | - Dominique Rose
- Center for Injury Research and Policy at the Abigail Wexner Research Institute, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States
| | - Motao Zhu
- Center for Injury Research and Policy at the Abigail Wexner Research Institute, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Jingzhen Yang
- Center for Injury Research and Policy at the Abigail Wexner Research Institute, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, United States.
| |
Collapse
|
46
|
Mullet N, Waterman EA, Edwards KM, Banyard V, Valente TW. Social networks and violence victimization and perpetration among youth: A longitudinal analysis. Am J Community Psychol 2023. [PMID: 37890006 DOI: 10.1002/ajcp.12716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/11/2023] [Accepted: 09/20/2023] [Indexed: 10/29/2023]
Abstract
Interpersonal violence (IV) is a serious concern for adolescents in the United States that has devastating impacts for individuals and communities. Given the increased importance placed on friendships during adolescence, the purpose of the current study was to examine the extent to which IV experiences cluster within youths' friendship networks. Participants were students (N = 1303) in grades 7th to 10th who completed surveys at the beginning and end of an academic year. Results showed that friends' average perpetration (i.e., the percentage of the friends they nominated who perpetrated IV) was strongly associated with likelihood of individual perpetration at baseline but not at the follow-up. For victimization, friends' average report of victimization (i.e., the percentage of the friends they nominated who were victimized) was associated with higher likelihood reporting of victimization (at both baseline and follow-up). Although future research is needed to understand explanatory mechanisms underlying these findings, it is possible that the effectiveness of prevention initiatives may be enhanced by incorporating peer group information.
Collapse
Affiliation(s)
- Natira Mullet
- Human Development and Family Science, North Dakota State University, Fargo, North Dakota, USA
| | - Emily A Waterman
- Developmental Psychology, Bennington College, Bennington, Vermont, USA
| | - Katie M Edwards
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Victoria Banyard
- School of Social Work, Rutgers University, New Brunswick, New Jersey, USA
| | - Thomas W Valente
- Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
47
|
Seymour RB, Wally MK, Hsu JR. Impact of clinical decision support on controlled substance prescribing. BMC Med Inform Decis Mak 2023; 23:234. [PMID: 37864226 PMCID: PMC10588193 DOI: 10.1186/s12911-023-02314-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 09/29/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Prescription drug overdose and misuse has reached alarming numbers. A persistent problem in clinical care is lack of easy, immediate access to all relevant information at the actionable time. Prescribers must digest an overwhelming amount of information from each patient's record as well as remain up-to-date with current evidence to provide optimal care. This study aimed to describe prescriber response to a prospective clinical decision support intervention designed to identify patients at risk of adverse events associated with misuse of prescription opioids/benzodiazepines and promote adherence to clinical practice guidelines. METHODS This study was conducted at a large multi-center healthcare system, using data from the electronic health record. A prospective observational study was performed as clinical decision support (CDS) interventions were sequentially launched (January 2016-July 2019). All data were captured from the medical record prospectively via the CDS tools implemented. A consecutive series of all patient encounters including an opioid/benzodiazepine prescription were included in this study (n = 61,124,172 encounters; n = 674,785 patients). Physician response to the CDS interventions was the primary outcome, and it was assessed over time using control charts. RESULTS An alert was triggered in 23.5% of encounters with a prescription (n = 555,626). The prescriber decision was influenced in 18.1% of these encounters (n = 100,301). As the number of risk factors increased, the rate of decision being influenced also increased (p = 0.0001). The effect of the alert differed by drug, risk factor, specialty, and facility. CONCLUSION The delivery of evidence-based, patient-specific information had an influence on the final prescription in nearly 1 in 5 encounters. Our intervention was sustained with minimal prescriber fatigue over many years in a large and diverse health system.
Collapse
Affiliation(s)
- Rachel B Seymour
- Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, 1000 Blythe Boulevard, Charlotte, NC, 28203, USA.
- Atrium Health Musculoskeletal Institute, 2001 Vail Avenue, 6th floor, Charlotte, NC, 28207, USA.
| | - Meghan K Wally
- Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, 1000 Blythe Boulevard, Charlotte, NC, 28203, USA
| | - Joseph R Hsu
- Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, 1000 Blythe Boulevard, Charlotte, NC, 28203, USA
| |
Collapse
|
48
|
Helpingstine CE, Murphy CA, Merrick MT, Klika JB. Prevention of child sexual abuse in the USA: a scoping review protocol of US legislative policies. BMJ Open 2023; 13:e073182. [PMID: 37857546 PMCID: PMC10603531 DOI: 10.1136/bmjopen-2023-073182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 09/11/2023] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION Child sexual abuse (CSA) poses a significant threat to the health and well-being of children in the USA and globally. Many states have introduced or implemented policies to address and prevent CSA, but little research has linked the effects of this legislation on the reduction of adult-perpetrated CSA. The objective of this scoping review is to identify US policies which aim to prevent CSA, explain the components of these types of legislation, review evidence of effectiveness, describe the populations included in the literature, and identify barriers and facilitators to the implementation of said policies. METHODS AND ANALYSIS This scoping review will follow Joanna Briggs Institute methodology for scoping reviews and will use the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. Sources of peer-reviewed evidence from January 2000 to July 2023 will be included. Relevant publications will first be searched in PubMed/MEDLINE database, then 25 other databases. The reference lists of included studies and high-yield journals will be hand searched. Articles which focus on the types of CSA prevention policies and their effects will be included. Studies must clearly demonstrate a connection between policies and CSA outcomes. Title, abstract, full-text screening and extraction will be completed by a team of three researchers. Critical appraisal of the included studies will be performed. Extracted data will be displayed in tabular form and a narrative summary will describe the results of the review. ETHICS AND DISSEMINATION This scoping review will provide an extensive overview of legislative policies which aim to prevent CSA in the USA. Results of this review will inform future CSA prevention policies in the USA, particularly regarding policy development, evaluation and implementation. Results will be disseminated through a peer-reviewed publication.
Collapse
Affiliation(s)
| | - Catherine A Murphy
- Research Department, Prevent Child Abuse America, Chicago, Illinois, USA
| | - Melissa T Merrick
- Research Department, Prevent Child Abuse America, Chicago, Illinois, USA
| | - J Bart Klika
- Research Department, Prevent Child Abuse America, Chicago, Illinois, USA
| |
Collapse
|
49
|
Abstract
Importance Educational attainment in the US is associated with life expectancy. As the opioid crisis worsens, it is critical to understand how overdose death rate trends evolve across education groups. Objective To investigate the association between educational attainment and overdose death rates, with emphasis on trends during the COVID-19 pandemic. Design, Setting, and Participants This cross-sectional study used National Vital Statistics System Mortality Multiple Cause-of-Death data describing overdose death rates in the US by educational attainment from January 1, 2000, to December 31, 2021, with a focus on 2018 to 2021. Overdose deaths were aggregated by year and educational level for decedents aged 25 years or older. Exposure Educational attainment, categorized as no high school (HS) diploma, HS diploma (or General Educational Development) but no college, some college but no bachelor's degree, and bachelor's degree or more. Main Outcomes and Measures The main outcomes were rates of all overdose deaths, overdose deaths involving opioids, and overdose deaths involving synthetic opioids. Results Of 912 057 overdose deaths with education information from 2000 to 2021 (mean [SD] age at death, 44.9 [12.3] years; 64.1% male), there were 625 400 deaths (68.6%) among individuals with no college education and 286 657 deaths (31.4%) among those with at least some college. The overdose death rate was 19.9 per 100 000 population. From 2018 to 2021, there were 301 557 overdose deaths, including 58 319 (19.3%) among individuals without an HS diploma, 153 603 (50.9%) among people with an HS diploma, 64 682 (21.4%) among individuals with some college, and 24 953 (8.3%) among individuals with a bachelor's degree. There were 3324 overdose deaths (1.1%) among American Indian or Alaska Native individuals, 2968 (1.0%) among Asian American or Pacific Islander individuals, 49 152 (16.3%) among Black individuals, 31 703 (10.5%) among Hispanic individuals, 211 359 (70.1%) among White individuals, and 3051 (1.0%) among multiracial individuals. From 2018 to 2021, the overdose death rate was 33.4 per 100 000 population, the opioid-related overdose death rate was 24.2 per 100 000 population, and the synthetic opioid overdose death rate was 19.1 per 100 000 population. From 2018 to 2021, the overdose death rate for those without a HS diploma increased by 35.4 per 100 000 population compared with 1.5 per 100 000 population for those with a bachelor's degree. This differential growth was primarily due to increased rates of death involving synthetic opioids. Conclusions and Relevance In this cross-sectional study, lower educational attainment was found to be associated with higher growth in overdose deaths. As the opioid crisis has transitioned to fentanyl and polysubstance use, overdose deaths have become more prevalent in groups with lower socioeconomic status, potentially exacerbating existing life-expectancy disparities.
Collapse
|
50
|
Samuel D, O'Malley F, Brink FW, Crichton KG, Duffy B, Letson MM, Michaels NL. Characterizing child maltreatment fatalities among child victims with disabilities in the United States, 2010-2019. Child Abuse Negl 2023; 144:106354. [PMID: 37517210 DOI: 10.1016/j.chiabu.2023.106354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND There has been little research on child maltreatment-related fatalities among children with disabilities. Despite being a minority of children in the United States, children with disabilities experience higher rates of victimization. OBJECTIVE To characterize fatalities due to child maltreatment among children with disabilities in the United States. METHODS Data from the National Violent Death Reporting System from 2010 to 2019 were analyzed to describe child maltreatment-related deaths among children with disabilities aged birth to 17 years. RESULTS There were 106 fatalities meeting the study criteria. The average age of the victims was 5.9 years old and 74.6 % were male. The most frequent suspected perpetrators of maltreatment-related fatalities were biological mothers (35.2 %), and most perpetrators were White (55.7 %). Analyses showed a statistically significant relationship between fatalities caused by neglect and diagnoses of attention deficit hyperactivity disorder, autism spectrum disorder, cerebral palsy, and/or traumatic brain injury. Overall, physical abuse and/or neglect resulting in a fatality among children with disabilities were significantly correlated with the relationship of the perpetrator to the victim. CONCLUSIONS Children with disabilities who died as a result of abuse were more likely to have autism spectrum disorder, a developmental disability, or other physical impairment, with physical abuse being the most prevalent type of abuse that resulted in death. To decrease the likelihood of abuse of disabled children, healthcare practitioners and caseworkers should work together to create strategies to help caregivers cope with the financial, mental, and physical stress that comes with raising children with disabilities.
Collapse
Affiliation(s)
- Devona Samuel
- Meharry Medical College, 1005 Dr DB Todd Jr Blvd, Nashville, TN 37208, United States of America
| | - Fiona O'Malley
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America
| | - Farah W Brink
- The Center for Family Safety and Healing, Nationwide Children's Hospital, 655 E Livingston Ave, Columbus, OH 43205, United States of America; The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210, United States of America
| | - Kristin G Crichton
- The Center for Family Safety and Healing, Nationwide Children's Hospital, 655 E Livingston Ave, Columbus, OH 43205, United States of America; The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210, United States of America
| | - Bridget Duffy
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America
| | - Megan M Letson
- The Center for Family Safety and Healing, Nationwide Children's Hospital, 655 E Livingston Ave, Columbus, OH 43205, United States of America; The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210, United States of America
| | - Nichole L Michaels
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America; The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210, United States of America.
| |
Collapse
|