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Oh S, Salas-Wright CP, Vaughn MG, Zapcic I. Substance Misuse Profiles of Women in Families Receiving Temporary Assistance for Needy Families (TANF) Benefits: Findings from a National Sample. J Stud Alcohol Drugs 2020; 81:798-807. [PMID: 33308410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVE Women in families receiving Temporary Assistance for Needy Families (TANF) cash assistance are twice as likely to have a substance use disorder (SUD) than their non-TANF counterparts in the past year. However, evidence is limited about substance misuse patterns and comorbid mental health problems among women in TANF families. METHOD Data from the 2015-2018 National Survey on Drug Use and Health were used to examine the prevalence of substance misuse and use disorders among women age 18 or older in TANF families. We used latent class analysis to identify subgroups of distinctive substance misuse behaviors and tested the associations between SUD/serious psychological distress (SPD) and the group classification. RESULTS Despite higher odds of having an SUD in all substance categories than their non-TANF counterparts, more than 84% of the women in TANF families were considered to have low substance misuse risks. Of the three identified at-risk groups, the polysubstance and the prescription pain reliever and alcohol misuse groups reported higher risks of having an SUD and SPD than the low-risk group. Individuals at risk of marijuana and alcohol misuse, represented by young, Black mothers, reported the lowest rates of treatment receipt despite having past-year SUD, SPD, or both. CONCLUSIONS Although special attention needs to be paid to integrated care for those at risk of multiple substance misuse, additional efforts are required to increase substance abuse and mental health treatment among women at risk of marijuana and alcohol misuse.
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Cano M, Oh S, Salas-Wright CP, Vaughn MG. Cocaine use and overdose mortality in the United States: Evidence from two national data sources, 2002-2018. Drug Alcohol Depend 2020; 214:108148. [PMID: 32702620 PMCID: PMC7423708 DOI: 10.1016/j.drugalcdep.2020.108148] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/24/2020] [Accepted: 06/27/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cocaine-involved overdose mortality has recently risen in the United States (US), yet it is unclear to what extent patterns in cocaine-involved overdose mortality parallel patterns in cocaine use. This study: examined time trends (2002-2018) in past-year cocaine use and cocaine-involved overdose mortality in the US; and compared demographics and drug involvement of adults who reported past-year cocaine use versus adults who died of a cocaine-involved overdose. METHODS Data from two sources were utilized: (1) the National Survey on Drug Use and Health (n = 1,334 adults self-reporting cocaine use in 2018); and (2) the Multiple Cause of Death dataset of the National Center for Health Statistics (N = 14,630 adults who died of a cocaine-involved overdose in 2018). The study examined prevalence of past-year cocaine use, mortality rates for cocaine-involved overdose, 2002-2018 trends, demographic characteristics, and involvement of other drugs. RESULTS Results of Joinpoint Regression indicated that the prevalence of past-year cocaine use increased after 2011, with an annual percent change of 5.13, while age-adjusted cocaine-involved overdose mortality rates escalated after 2012, with an annual percent change of 26.54. In 2018, prevalence of past-year cocaine use did not significantly differ (p = 0.09) by racial/ethnic group, yet Non-Hispanic Blacks had an age-adjusted cocaine-involved overdose mortality rate more than double the rate in Non-Hispanic Whites and significantly higher (p < 0.001) than in any other group. CONCLUSIONS While the prevalence of cocaine use has increased modestly, cocaine-involved overdose mortality has risen dramatically. Cocaine-involved overdose mortality is disproportionately affecting individuals who are Black, older, or with lower educational attainment.
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Salas-Wright CP, Vaughn MG, Oh S. Commentary on Allen et al. (2020): Cannabis use during pregnancy-the importance of a life-course health disparities framework. Addiction 2020; 115:1717-1718. [PMID: 32428325 PMCID: PMC7574792 DOI: 10.1111/add.15094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/22/2020] [Indexed: 11/30/2022]
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Salas-Wright CP, Schwartz SJ, Cohen M, Maldonado-Molina MM, Vaughn MG, Sanchez M, Rodriguez J, AbiNader M, John R, Oliveros K, Andrade P. Cultural Stress and Substance Use Risk among Venezuelan Migrant Youth in the United States. Subst Use Misuse 2020; 55:2175-2183. [PMID: 32703078 PMCID: PMC7487208 DOI: 10.1080/10826084.2020.1795684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Since 2015, more than four million Venezuelans have fled their once prosperous nation, prompting an ever-intensifying refugee crisis. Recent research with Venezuelan parents suggests that many are exposed to elevated migration-related stress, experience behavioral health problems, and express profound concern for their children's post-migration wellbeing. We examine the relationships between stress, family functioning, and substance use risk with a cultural stress theoretical lens. Methods: Survey data were collected between November 2018 and June 2019 from 402 recently-arrived Venezuelan immigrant youth ages 10-17. Outcomes include perceived discrimination, negative context of reception, family support/communication, and substance use intentions and normative beliefs. Structural equation modeling was used to examine the relationships between variables. Results: Structural equation modeling results indicated that negative context of reception was associated with permissive substance use norms (via family communication; B = 0.070, p < .01) and intentions to use (via family support; B = 0.051, p < .01). Discrimination was not mediated by family functioning, rather it exerted a direct effect on substance use norms (β = 0.20, p < .01) and intentions (β = 0.33, p < .001). Discussion: We see clear evidence that negative context of reception and discrimination are related to substance use risk, both directly (in the case of discrimination) and indirectly (in the case of negative context of reception). Given the manifold stressors faced by Venezuelan immigrants both prior to migration and in the process of resettling in the US, it is critical that practitioners and policymakers support this rapidly-growing population.
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John RS, Salas-Wright CP, Amodeo M, Chassler D, Alford DP. Faculty education in addiction training (FEAT): Evaluating an online training program for multidisciplinary health professions educators. Subst Abus 2020; 41:292-296. [PMID: 32697174 DOI: 10.1080/08897077.2020.1783739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Many health professionals lack adequate training needed to effectively address alcohol and other drug (AOD)-related problems. Building upon our previously successful in-person faculty training programs, we designed and pilot tested the brief online Faculty Education in Addiction Training (FEAT) Program for social work and internal medicine residency faculty. The present study examines baseline and post-FEAT Program AOD knowledge and teaching confidence and preparedness among faculty participants. Methods: The FEAT Program curriculum included didactic videos, online engagement with content experts, recommended readings, and a live virtual classroom experience. Participants completed self-assessments of knowledge and teaching confidence and preparedness pre- and post-FEAT program. Results: In this pilot test, thirty faculty completed the FEAT program: 15 social work and 15 internal medical residency program faculty. Both groups showed significant improvement (p < 0.001) in overall AOD-related knowledge with medium-to-large effects (Cohen's d = 1.83 [social work], 0.72 [medicine]). Both groups showed significant increases in teaching confidence (p < 0.001) for all items with large effects (Cohen's d values range from 1.08 to 1.92) and significant increases and large effects for all teaching preparedness items for social work (at least p < 0.01 | Cohen's d range = 1.03-1.56) and internal medical residency faculty (p < 0.001 | Cohen's d range = 1.08-1.69). Conclusions: Multidisciplinary health professions educators' AOD knowledge and teaching confidence and preparedness can be improved by participation in a brief online program designed to circumvent the logistical and fiscal challenges presented by in-person programs.
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Schwartz SJ, Martinez CR, Meca A, Szabó Á, Ward C, Cobb CL, Cano MÁ, Unger JB, Salas-Wright CP. Toward a micro-level perspective on acculturation among U.S. Hispanic college students: A daily diary study. J Clin Psychol 2020; 77:121-144. [PMID: 32632991 DOI: 10.1002/jclp.23009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 05/22/2020] [Accepted: 06/04/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The present study introduces a daily, micro-level perspective on acculturation using a sample of Hispanic college students in Miami. METHODS We conducted a 12-day diary study with a sample of first- and second-generation Hispanic college students in Miami. Outcome variables were measured on Days 1 and 12, and acculturation components (practices, identities, and values) were measured on Days 2-11. Daily fluctuations in acculturation components between Days 2 and 11 were examined as predictors of well-being, internalizing symptoms, and externalizing problems on Day 12. RESULTS Fluctuations in comfort with speaking English negatively predicted three of the four well-being outcomes and positively predicted all of the internalizing and externalizing indicators. Fluctuations in collectivist values predicted two of the well-being outcomes and both anxiety and depressive symptoms, and fluctuations in ethnic identity predicted anxiety and depressive symptoms. CONCLUSION Daily volatility in comfort with English, collectivist values, and ethnic identity appear to be most distressing.
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Vaughn MG, AbiNader M, Salas-Wright CP, Holzer K, Oh S, Chang Y. Trends in cannabis use among justice-involved youth in the United States, 2002-2017. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2020; 46:462-471. [PMID: 32515239 DOI: 10.1080/00952990.2020.1732398] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Little is known regarding trends in cannabis use among justice-involved youth. We hypothesize that cannabis use will be higher over time among justice-involved youth who, on average, are more likely to be exposed to and seek out cannabis. OBJECTIVES The present study compares trends in cannabis use among justice-involved youth (past year) with youth in the general population age 12-17 who have not been arrested in the past year. METHODS Public-use data as part of the 2002-2017 National Survey on Drug Use and Health (NSDUH), which does not include state-level identifiers, was used. Males constitute 51% of the total sample. Among justice-involved youth, 66.4% were males. We employed logistic regression analyses with survey year as an independent variable and past-year cannabis use as the dependent variable. A series of logistic regressions examined the association between cannabis use and psychosocial and behavioral factors. RESULTS The prevalence of past-year cannabis use among justice-involved youth (3.09% of the sample) steadily increased from 54% in 2002 to 58% in 2017 (AOR = 1.018, 95% CI = 1.004-1.034), while the concurrent prevalence of cannabis use among youth with no past year arrests decreased from a high of 14% in 2002 to 12% in 2017 (AOR = 0.993, 95% CI = 0.990-0.997). CONCLUSION Study findings suggest that cannabis use is increasing among justice-involved youth.
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Salas-Wright CP, Vaughn MG, Goings TC, Oh S, Marsiglia F, Cohen M, John R, Andrade P, Schwartz S. Disconcerting levels of alcohol use among Venezuelan immigrant adolescents in the United States. Addict Behav 2020; 104:106269. [PMID: 31978757 DOI: 10.1016/j.addbeh.2019.106269] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/14/2019] [Accepted: 12/17/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND It is estimated that more than 4 million Venezuelans have left their country as a direct result of their nation's widespread social and economic challenges. Although recent research identifies Venezuela as one of the nations with the highest rates of harmful alcohol consumption in the Americas, no research has been conducted on alcohol use among Venezuelan youth in diaspora. METHODS Data was collected between November 2018 and June 2019 from 373 Venezuelan immigrant youth ages 12-17 in the United States. The prevalence of past-month and lifetime alcohol use among Venezuelan youth is compared to that of other Hispanic and immigrant youth from the National Survey on Drug Use and Health (NSDUH), and the Construyendo Oportunidades Para Adolecentes Latinos (COPAL) study using independent sample t tests. RESULTS The prevalence of past-month and lifetime alcohol use was significantly higher among Venezuelan immigrant youth (15% and 52%, respectively) compared to other Hispanic (9% and 28%) and immigrant (4.5% and 28%) youth in the NSDUH, and youth ages 14-17 in the COPAL study (4.0% and 22%). Among Venezuelan youth reporting alcohol use initiation, 1.5% of youth ages 12-14 and 19% ages 15-17 report lifetime alcohol intoxication. DISCUSSION Although preliminary, results indicate that a disconcerting proportion of Venezuelan crisis migrant youth in the US report lifetime alcohol initiation and past-month use. These findings suggest the importance of future research to examine the prevalence and correlates of alcohol use in this population using recruitment and sampling methods that will allow for population-level estimates.
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Salas-Wright CP, Vaughn MG, Goings TC, Oh S, Delva J, Cohen M, Schwartz SJ. Trends and mental health correlates of discrimination among Latin American and Asian immigrants in the United States. Soc Psychiatry Psychiatr Epidemiol 2020; 55:477-486. [PMID: 31811317 DOI: 10.1007/s00127-019-01811-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 11/28/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To examine the national trends and mental health correlates of discrimination among Latin American and Asian immigrants in the United States. METHODS We examine data from the National Epidemiologic Survey on Alcohol and Related Conditions collected between 2004 and 2013. Recurrent discrimination was measured by respondent reports of adverse experiences such as receiving poor treatment in restaurants or being called a racist name. RESULTS Rates of perceived discrimination increased by more than 80 percent among immigrants from Latin America (from 14% in 2004 to 25% in 2013), but remained unchanged among Asian immigrants (20-22%). Large percentage point (pp) increases were observed among Latin American immigrants with less than a high school education (pp increase = 13.5) and residing in households earning $20-35,000 annually (pp increase = 14.0). CONCLUSIONS Findings raise concern both because of the inherent iniquitousness of discrimination and because identity-based mistreatment is linked with mental health problems.
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Salas-Wright CP, Vaughn MG, Cohen M, Schwartz SJ. The Sequelae of Premigration Hunger Among Venezuelan Immigrant Children in the U.S. Am J Prev Med 2020; 58:467-469. [PMID: 31839267 PMCID: PMC7039741 DOI: 10.1016/j.amepre.2019.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/27/2019] [Accepted: 10/28/2019] [Indexed: 11/26/2022]
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Cano MÁ, Castro FG, De La Rosa M, Amaro H, Vega WA, Sánchez M, Rojas P, Ramírez-Ortiz D, Taskin T, Prado G, Schwartz SJ, Córdova D, Salas-Wright CP, de Dios MA. Depressive Symptoms and Resilience among Hispanic Emerging Adults: Examining the Moderating Effects of Mindfulness, Distress Tolerance, Emotion Regulation, Family Cohesion, and Social Support. Behav Med 2020; 46:245-257. [PMID: 31935162 PMCID: PMC7358125 DOI: 10.1080/08964289.2020.1712646] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Emerging adulthood has been described as a difficult stage in life and may be particularly stressful for Hispanic emerging adults who are disproportionately exposed to adversity and chronic sociocultural stressors. To better prevent and treat depressive disorders among Hispanic emerging adults, more research is needed to identify and understand modifiable determinants that can help this population enhance their capacity to offset and recover from adversity and sociocultural stressors. As such, this study aimed to (1) examine the association between resilience and depressive symptoms among Hispanic emerging adults, and (2) examine the extent to which intrapersonal resources (e.g., mindfulness, distress tolerance, emotion regulation strategies) and interpersonal resources (e.g., family cohesion, social support) moderate the association between resilience and depressive symptoms. To examine these aims, 200 Hispanic emerging adults (ages 18-25) from Arizona (n = 99) and Florida (n = 101) completed a cross-sectional survey, and data were analyzed using hierarchical multiple regression and moderation analyses. Findings from the hierarchical multiple regression indicate that higher resilience was associated with lower depressive symptoms. Findings from the moderation analyses indicate that family cohesion, social support, and emotion regulation strategies (e.g., cognitive reappraisal and expressive suppression) functioned as moderators; however, mindfulness and distress tolerance were not significant moderators. Findings from this study add to the limited literature on resilience among Hispanics that have used validated measures of resilience. Furthermore, we advance our understanding of who may benefit most from higher resilience based on levels of intrapersonal and interpersonal resources.
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Salas-Wright CP, John R, Vaughn MG, Eschmann R, Cohen M, AbiNader M, Delva J. Trends in cannabis use among immigrants in the United States, 2002-2017: Evidence from two national surveys. Addict Behav 2019; 99:106029. [PMID: 31593886 DOI: 10.1016/j.addbeh.2019.106029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 06/12/2019] [Accepted: 06/17/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND AIMS Findings from recent studies suggest that, among the general population of adults, the prevalence of cannabis use has increased over the last decade in the United States (US). And yet, there is much we do not know regarding the trends in cannabis use among immigrants. We address this important shortcoming by examining data on immigrants vis-à-vis US-born individuals using two national surveys. METHODS We examine trend data from the National Epidemiologic Study on Alcohol and Related Conditions (NESARC, 2001-2013) and the National Survey on Drug Use and Health's Restricted Data Analysis System (NSDUH, 2002-2017). Main outcomes were past year cannabis use and cannabis use disorder with survey adjusted prevalence estimates generated for immigrants and US-born individuals. RESULTS In the NESARC, significant increases in the past year prevalence of cannabis use were observed both among US-born (2001-2002: 4.53%, 2012-2013: 10.74%) and immigrant participants (2001-2002: 1.67%, 2012-2013: 3.32%). We also found significant increases among immigrants arriving before age 12 and among immigrants from Latin America and Europe. In the NSDUH, we observed a significantly higher prevalence of cannabis use in 2016-2017 (6.3%) when compared to 2002-2003 (4.4%). CONCLUSIONS Findings make clear that cannabis use among US-born individuals has consistently been higher than that of immigrants since the early 2000s. However, while rates of cannabis use have declined among US-born adolescents in recent years, the prevalence of cannabis use has remained stable among immigrant adolescents. At the same time, cannabis use increased two-fold among both US-born and immigrant adults.
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Salas-Wright CP, Carbone JT, Holzer KJ, Vaughn MG. Prevalence and correlates of cannabis poisoning diagnosis in a national emergency department sample. Drug Alcohol Depend 2019; 204:107564. [PMID: 31568933 PMCID: PMC6887107 DOI: 10.1016/j.drugalcdep.2019.107564] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 07/03/2019] [Accepted: 07/14/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND One of the primary cannabis-related reasons individuals seek emergency medical care is accidental cannabis poisoning. However, our understanding of the incidence and characteristics of those who receive emergency medical care due to cannabis poisoning remains limited. We address this gap by examining up-to-date information from a national study of emergency department (ED) data. METHODS The data source used for this study is the Nationwide Emergency Department Sample (NEDS). An International Classification of Diseases (ICD-10-CM) diagnostic code was used to identify accidental poisoning by cannabis (T40.7 × 1A) as specified by healthcare providers. Logistic regression was employed to examine the relationship between ED admission for cannabis poisoning, sociodemographic factors, and mental health disorders. RESULTS In 2016, an estimated 16,884 individuals were admitted into EDs in the United States due to cannabis poisoning, representing 0.014% of the total ED visits for individuals ages 12 and older. Individuals who sought care for cannabis poisoning were more likely to be young, male, uninsured, experience economic hardship, reside in urban central cities, and experience mental health disorders as compared to individuals admitted for other causes. Among cases that included the cannabis-poisoning code, many also had codes for accidental poisoning due to other substances such as heroin (4.7%), amphetamine (10.8%), cocaine (12.9%), and benzodiazepine (21.3%). CONCLUSIONS Despite the limitations of ICD-10 data, findings provide new evidence suggesting that practitioners be attuned to the prevention and treatment needs of high-risk subgroups, and that screening for mental health problems should be standard practice for individuals diagnosed with cannabis poisoning.
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Salas-Wright CP, AbiNader MA, Vaughn MG, Schwartz SJ, Oh S, Delva J, Marsiglia FF. Trends in Substance Use Prevention Program Participation Among Adolescents in the U.S. J Adolesc Health 2019; 65:426-429. [PMID: 31277992 PMCID: PMC6708775 DOI: 10.1016/j.jadohealth.2019.04.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/05/2019] [Accepted: 04/17/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of the article was to examine national trends in adolescent participation in substance use prevention programs (SUPP). METHODS We examine 15 years of cross-sectional data (2002-2016) from the National Survey on Drug Use and Health. Main outcomes were participation in past-year school and community-based SUPP (no/yes). Logistic regression was used to examine trends in the prevalence of participation. RESULTS Participation in school-based SUPP decreased significantly from 48% among adolescents in 2002-2003 to 40% in 2015-2016, a 16.5% proportional decline. Significant declines for school-based participation were observed in all demographic and drug involvement subgroups examined. Youth participation in community-based SUPP also decreased significantly. However, this downward trend was significant only among younger teens, females, youth in very low (<$20,000) and moderate ($40,000-$74,999) income households and in rural areas. CONCLUSIONS Participation in SUPP has decreased since the early 2000s, with noteworthy declines among Latino youth and youth from rural areas and socioeconomically disadvantaged backgrounds.
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Salas-Wright CP, AbiNader MA, Vaughn MG, Sanchez M, De La Rosa M. Trends in participation in teen pregnancy and STI prevention programming, 2002-2016. Prev Med 2019; 126:105753. [PMID: 31220508 PMCID: PMC6697591 DOI: 10.1016/j.ypmed.2019.105753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/11/2019] [Accepted: 06/16/2019] [Indexed: 12/28/2022]
Abstract
Programs designed to help youth prevent early/unwanted pregnancy and sexually transmitted infection (STI) have been shown to yield a positive impact on youth behavior and key outcomes. However, recent evidence suggests that youth participation in prevention programming for health-risk behavior may be declining. The aim of the present study is to provide up-to-date information on the national trends in adolescent participation in prevention programming targeting early pregnancy and STI in the United States. We examined fifteen years of cross-sectional data (2002-2016, N = 234,803) from the National Survey on Drug Use and Health. Our main outcome was youth self-reported (no/yes) past-year participation in a pregnancy or STI prevention program. Survey adjusted prevalence estimates and logistic regression analysis were used to examine trends in participation. Youth participation in pregnancy and STI prevention programming decreased significantly from a high of 15% in 2003 to a low of 7% in 2016. Representing a 53% proportional decline in youth participation, this downward trend was significant even when controlling for age, gender, race/ethnicity, household income, and urbanicity (AOR: 0.947, 95% CI: 0.943-0.951). The downward trend in participation was observed across racial/ethnic subgroups. A consistent pattern of differences in prevalence was observed with African-American youth reporting the highest levels of participation followed by Hispanic, and then White youth. It is incumbent upon concerned citizens, scientists, and policymakers to push for change that can shift the trend line in adolescent participation in teen pregnancy and STI prevention programming to an upward tilt.
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Vaughn MG, Holzer KJ, Carbone JT, Salas-Wright CP. Arthropod Bites and Stings Treated in Emergency Departments: Recent Trends and Correlates. Wilderness Environ Med 2019; 30:394-400. [PMID: 31405548 DOI: 10.1016/j.wem.2019.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/15/2019] [Accepted: 05/28/2019] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Despite increasing health effects of arthropod bites and associated costs, research on their frequency is limited, especially at the population level. The aim of this study was to estimate the prevalence, correlates, and recent trends in visits to US emergency departments related to arthropod bites and stings. METHODS The prevalence of arthropod bites, including information regarding location of the bite, was calculated for years 2010 through 2014 using data from the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample. Sex- and age-stratified multivariate logistic regression analyses were conducted with "arthropod bite" as the dependent variable and patient and hospital characteristics as independent variables. RESULTS Overall, there were significant increases in bites over the study period with higher rates of bites in the summer months (June-August), especially among children. Individuals who seek treatment for arthropod bites in the emergency department are more likely to reside in zip codes with lower median household income and to be without insurance coverage or with Medicaid rather than private insurance. The cost of care related to arthropod bites increased approximately 40% over the study period. CONCLUSIONS These results provide updated surveillance on the prevalence and correlates of arthropod bites and stings in the US population.
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Salas-Wright CP, Vaughn MG, Miller DP, Hahm HC, Scaramutti C, Cohen M, Delva J, Schwartz SJ. Overeating and binge eating among immigrants in the United States: new terrain for the healthy immigrant hypothesis. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1007-1017. [PMID: 30806725 PMCID: PMC6675658 DOI: 10.1007/s00127-019-01677-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 02/12/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Prior research indicates that, compared to individuals born in the United States (US), immigrants are less likely to experience mental health and inhibitory control problems. However, our understanding of overeating and binge eating-both related to mental health and inhibitory control-among immigrants in the US remains limited. Drawing from a large national study, we report the prevalence of overeating and binge eating among immigrants vis-à-vis the US-born. METHODS The data source used for the present study is the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III, 2012-2013), a nationally representative survey of 36,309 civilian, non-institutionalized adults ages 18 and older in the US. Logistic regression was employed to examine the relationship between immigrant status and key outcomes. RESULTS The prevalence of any (immigrants = 7.8%, US-born = 17.0%) and recurrent overeating (immigrants = 2.9%, US-born = 5.3%) was lower among immigrants than US-born individuals. Among those reporting recurrent overeating, the prevalence of binge eating with loss of control was comparable among immigrant (37.2%) and US-born participants (39.9%), in general. However, stratified analyses revealed that risk of binge eating with loss of control was lower among immigrant women compared to US-born women (AOR 0.54, 95% CI 0.29-0.98). CONCLUSIONS Findings from the present study provide clear results that immigrants are substantially less likely to overeat as compared to US-born individuals and that, among women but not men, immigrant status is associated with lower risk of binge eating with loss of control.
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Clark Goings T, Salas-Wright CP, Belgrave FZ, Nelson EJ, Harezlak J, Vaughn MG. Trends in binge drinking and alcohol abstention among adolescents in the US, 2002-2016. Drug Alcohol Depend 2019; 200:115-123. [PMID: 31121494 DOI: 10.1016/j.drugalcdep.2019.02.034] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/11/2019] [Accepted: 02/12/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Binge drinking accounts for several adverse health, social, legal, and academic outcomes among adolescents. Understanding trends and correlates of binge drinking and alcohol abstention has important implications for policy and programs and was the aim of this study. The current study examined trends in adolescent binge drinking and alcohol abstention by age, gender, and race/ethnicity over a 15-year period. METHODS Respondents between the ages of 12 and 17 years who participated in the National Survey on Drug Use and Health (NSDUH) between 2002 and 2016 were included in the sample of 258,309. Measures included binge drinking, alcohol abstention, and co-morbid factors (e.g., marijuana, other illicit drugs), and demographic factors. RESULTS Logistic regression analyses were conducted to examine the significance of trend changes by sub-groups while controlling for co-morbid and demographic factors. Findings indicated that binge drinking decreased substantially among adolescents in the US over the last 15 years. This decrease was shown among all age, gender, and racial/ethnic groups. In 2002, Year 1 of the study, 26% of 17-year-olds reported past-month binge drinking; in 2016, past-month binge drinking dropped to 12%. Findings also indicated comparable increases in the proportion of youth reporting abstention from alcohol consumption across all subgroups. Black youth reported substantially lower levels of binge alcohol use and higher levels of abstention, although the gap between Black, Hispanic and White youth narrowed substantially between 2002 and 2016. CONCLUSION Study findings are consistent with those of other research showing declines in problem alcohol- use behavior among youth.
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Vaughn MG, Salas-Wright CP, Jackson DB. The complex genetic and psychosocial influences on polysubstance misuse. Curr Opin Psychol 2019; 27:62-66. [DOI: 10.1016/j.copsyc.2018.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/07/2018] [Accepted: 08/29/2018] [Indexed: 11/16/2022]
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Vaughn MG, Salas-Wright CP, John R, Holzer KJ, Qian Z, Veeh C. Traumatic Brain Injury and Psychiatric Co-Morbidity in the United States. Psychiatr Q 2019; 90:151-158. [PMID: 30465326 DOI: 10.1007/s11126-018-9617-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The objective of the present study was to provide a nationally representative psychiatric epidemiologic investigation of traumatic brain injury (TBI) and its co-morbid conditions. Data from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC-III) collected between 2012 and 2013 was used. Results indicated that TBI was significantly associated with any lifetime mental health (AOR = 2.32, 95% CI = 1.65-3.70), substance use disorder (AOR = 1.57-1.01-2.42), and violent (AOR = 1.65, 95% CI = 1.03-2.65) and nonviolent (AOR = 1.84, 95% CI = 1.25-2.70) criminal behaviors. In our study, TBI was highly comorbid with psychiatric disorders and especially antisocial behaviors, both violent and non-violent.
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Salas-Wright CP, Oh S, Vaughn MG, Muroff J, Amodeo M, Delva J. Trends and correlates of perceived access to heroin among young adults in the United States, 2002-2016. Drug Alcohol Depend 2018; 193:169-176. [PMID: 30384325 PMCID: PMC6239938 DOI: 10.1016/j.drugalcdep.2018.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/17/2018] [Accepted: 09/09/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND We are at a unique moment in United States (US) history as heroin overdose rates are higher than at any time in recent memory. Based on prior research and the developmental risks faced by young adults (ages 18-25), we examine the trends and correlates of perceived access to heroin among this group over a 15-year period. METHODS We analyzed national trend data from the National Survey on Drug Use and Health (2002-2016) on young adults' (N = 247,679; ages 18-25) perceived access to heroin. We conducted logistic regression analyses with survey year specified as an independent variable and heroin access specified as the dependent variable while controlling for sociodemographic factors. RESULTS A majority of respondents reported that it would be difficult or impossible to obtain heroin, if desired. Young adult reports that it would be "probably impossible" to access heroin increased significantly from 31% in 2002 to 41% in 2016. The upward trend in the perceived lack of access was most robust among African Americans and Hispanics as well as those reporting no past-year substance use or drug/criminal justice system involvement. CONCLUSIONS In the midst of a very serious opioid epidemic, the present study found that most young adults in the US consider that it would be "probably impossible" to obtain heroin. This trend was observed across young adulthood and across gender, racial/ethnic, and family income differences. However, we found that these trends are largely driven by those at relatively low risk of drug misuse and deviant behaviors generally.
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Salas-Wright CP, Vaughn MG, Goings TC, Miller DP, Chang J, Schwartz SJ. Alcohol-related problem behaviors among Latin American immigrants in the US. Addict Behav 2018; 87:206-213. [PMID: 30055450 DOI: 10.1016/j.addbeh.2018.06.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 06/27/2018] [Accepted: 06/27/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Prior research indicates that Latino immigrants are less likely than US-born individuals to use alcohol and meet criteria for an alcohol use disorder. However, our understanding of alcohol-related problem behaviors among Latino immigrants remains limited. We report the prevalence of alcohol-related problem behaviors among Latino immigrants vis-à-vis the US-born and examine the relationship between alcohol-related problem behavior and key migration-related factors and injury/receipt of emergency medical care. METHODS The data source used for the present study is the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III, 2012-2013), a nationally representative survey of 36,309 civilian, non-institutionalized adults ages 18 and older in the US. Logistic regression was employed to examine the relationship between immigrant status and key outcomes. RESULTS Foreign-born Latinos were less likely to report one or more alcohol-related problems compared to US-born Latinos (AOR = 0.41, 95% CI = 0.33-0.50) and the US-born general population (AOR = 0.38, 95% CI = 0.32-0.46). Latino immigrants arriving as children were, compared to those arriving later in life, significantly more likely to report alcohol-related problem behaviors, and experiences of discrimination were linked with greater risk of alcohol-related problem behavior as well. Latino immigrants reporting recurrent injury/emergency medical care utilization were more likely to report alcohol-related problem behavior. CONCLUSIONS Latino immigrants are significantly less likely than US-born Latinos and the US-born general population to operate a vehicle under the influence of alcohol, take part in risky behaviors or fight while drinking, or to be arrested due to alcohol consumption.
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Córdova D, Lua FM, Ovadje L, Fessler K, Bauermeister JA, Salas-Wright CP, Vaughn MG, Leadership Council Y. Adolescent Experiences of Clinician-Patient HIV/STI Communication in Primary Care. HEALTH COMMUNICATION 2018; 33:1177-1183. [PMID: 28686489 PMCID: PMC5756695 DOI: 10.1080/10410236.2017.1339379] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Effective clinician-patient communication is linked to positive patient health outcomes in adults, yet the research on adolescent populations remains limited. We describe adolescent experiences of clinician-patient HIV/STI communication through qualitative interviews with predominantly African-American adolescent women from a youth-centered primary care clinic. Participants described acknowledging clinicians are professionals, the importance of confidentiality to foster clinician-adolescent communication, and calling for clinician-initiated HIV/STI communication. Adolescents expressed the necessity for clinicians to engage youth in these challenging conversations through an open and understanding approach. Additionally, adolescents described experiences of perceived judgment and uncomfortableness from clinicians, and non-disclosure of HIV/STI risk behaviors to their clinician. Findings underscore the adolescents' desire to engage in HIV/STI communication with healthcare providers, while highlighting important strategies for clinicians. Results can inform health communication research and practice, and the development of interventions aimed at increasing clinician-adolescent HIV/STI communication.
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Salas-Wright CP, Vaughn MG, Goings TC, Miller DP, Schwartz SJ. Immigrants and mental disorders in the united states: New evidence on the healthy migrant hypothesis. Psychiatry Res 2018; 267:438-445. [PMID: 29980122 PMCID: PMC6131041 DOI: 10.1016/j.psychres.2018.06.039] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 05/15/2018] [Accepted: 06/14/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Despite experiencing migration-related stress and social adversity, immigrants are less likely to experience an array of adverse behavioral and health outcomes. Guided by the healthy migrant hypothesis, which proposes that this paradox can be explained in part by selection effects, we examine the prevalence and comorbidity of mental disorders among immigrants to the United States (US). METHODS Findings are based on the National Epidemiologic Survey on Alcohol and Related Conditions (2012-2013), a nationally representative survey of 36,309 adults in the US. RESULTS Immigrants were significantly less likely than US-born individuals to meet criteria for a lifetime disorder (AOR = 0.63, 95% CI = 0.57-0.71) or to report parental history of psychiatric problems. Compared to US-born individuals, the prevalence of mental disorders was not significantly different among individuals who immigrated as children; however, differences were observed for immigrants who arrived as adolescents (ages 12-17) or as adults (age 18+). DISCUSSION Consistent with the healthy migrant hypothesis, immigrants are less likely to come from families with psychiatric problems, and those who migrate after childhood-when selection effects are most likely to be observed-have the lowest levels of psychiatric morbidity.
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Oh S, Salas-Wright CP, Vaughn MG. Trends in depression among low-income mothers in the United States, 2005-2015. J Affect Disord 2018; 235:72-75. [PMID: 29655077 DOI: 10.1016/j.jad.2018.04.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/06/2018] [Accepted: 04/04/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Prior research has examined the association between low-income status and maternal depression; however, important questions remain in terms of trends in the prevalence of major depressive episodes (MDE) and treatment seeking among mothers in the United States. The objective of the present study is to examine trends in MDE among low-income mothers and explore perceived barriers to mental health treatment seeking. METHODS Using data from the National Survey on Drug Use and Health (NSDUH; 2005-2015), we examined the prevalence of past-year MDE among mothers living in poverty (0-99% federal poverty line [FPL]; n = 23,264) and near-poverty (100-200% FPL; n = 21,655). Consistent with the Center for Disease Control and Prevention (CDC) guidelines, we conducted survey-adjusted logistic regression analyses to examine the significance of survey year in relation to MDE while controlling for key social demographic correlates. RESULTS The overall decreasing MDE trend was found only among mothers in near-poverty, not mothers in poverty. Only for mothers in poverty, financial (AOR = 0.70, 95% CI = 0.52-0.95) and information barriers (AOR = 0.53, 95% CI = 0.39-0.73) were associated with mental health service use. LIMITATIONS Self-reports of depressive symptoms and service receipt may have led to over or underreporting due to recall or social desirability bias. Additionally, NSDUH data are cross-sectional and thereby limit our ability to make causal inferences. CONCLUSIONS Greater attention should be paid to the prevention/treatment of depression among mothers in poverty. Efforts may include expanding financial assistance for mental health service use and educational campaigns to increase awareness of services available.
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