1
|
Mestre-Bach G, Granero R, Casalé-Salayet G, Fernández-Aranda F, Müller A, Brand M, Gómez-Peña M, Moragas L, Sánchez I, Camacho-Barcia L, Villena A, Lara-Huallipe ML, Jiménez-Murcia S. Motherhood and Treatment Outcome in Female Patients with Compulsive Buying-Shopping Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127075. [PMID: 35742322 PMCID: PMC9222626 DOI: 10.3390/ijerph19127075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/02/2022] [Accepted: 06/06/2022] [Indexed: 02/05/2023]
Abstract
Motherhood has been proposed as an internal facilitating factor for the recovery of women with mental disorders. However, at the same time, there are significant barriers that may be interfering with the access and adherence to treatment for these women. The present longitudinal study aimed to deepen the sociodemographic and clinical profile of women with children and compulsive buying–shopping disorder (CBSD), and to explore the association between motherhood and response to treatment. The total sample included 77 women with a diagnosis of CBSD (n = 49 mothers) who received cognitive behavioral therapy (CBT) for 12 weeks. No association between psychopathology and motherhood was observed. The group of mothers reported an older age of onset of the CBSD, a lower amount of money spent per compulsive-buying episode, and a higher likelihood of family support for the CBSD. Moreover, this group showed lower risk of relapse. The findings support the theoretical proposal that considers motherhood as an internal facilitating factor for recovery and treatment adherence of mothers with addictions.
Collapse
Affiliation(s)
- Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, 26006 Logroño, Spain;
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28015 Madrid, Spain; (R.G.); (F.F.-A.); (I.S.); (L.C.-B.)
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (M.G.-P.); (L.M.); (M.L.L.-H.)
| | | | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28015 Madrid, Spain; (R.G.); (F.F.-A.); (I.S.); (L.C.-B.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (M.G.-P.); (L.M.); (M.L.L.-H.)
- Department of Psychiatry, Bellvitge University Hospital, 08907 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08007 Barcelona, Spain
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, 30625 Hannover, Germany;
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, 47057 Duisburg, Germany;
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, 45141 Essen, Germany
| | - Mónica Gómez-Peña
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (M.G.-P.); (L.M.); (M.L.L.-H.)
- Department of Psychiatry, Bellvitge University Hospital, 08907 Barcelona, Spain
| | - Laura Moragas
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (M.G.-P.); (L.M.); (M.L.L.-H.)
- Department of Psychiatry, Bellvitge University Hospital, 08907 Barcelona, Spain
| | - Isabel Sánchez
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28015 Madrid, Spain; (R.G.); (F.F.-A.); (I.S.); (L.C.-B.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (M.G.-P.); (L.M.); (M.L.L.-H.)
- Department of Psychiatry, Bellvitge University Hospital, 08907 Barcelona, Spain
| | - Lucía Camacho-Barcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28015 Madrid, Spain; (R.G.); (F.F.-A.); (I.S.); (L.C.-B.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (M.G.-P.); (L.M.); (M.L.L.-H.)
- Department of Psychiatry, Bellvitge University Hospital, 08907 Barcelona, Spain
| | - Alejandro Villena
- Unidad Sexología Clínica y Salud Sexual, Consulta Dr. Carlos Chiclana, 28003 Madrid, Spain;
| | - Milagros L. Lara-Huallipe
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (M.G.-P.); (L.M.); (M.L.L.-H.)
- Department of Psychiatry, Bellvitge University Hospital, 08907 Barcelona, Spain
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28015 Madrid, Spain; (R.G.); (F.F.-A.); (I.S.); (L.C.-B.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (M.G.-P.); (L.M.); (M.L.L.-H.)
- Department of Psychiatry, Bellvitge University Hospital, 08907 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08007 Barcelona, Spain
- Correspondence: ; Tel.: +34-9-326079
| |
Collapse
|
2
|
Williams JR, McCabe BE, de Tantillo L, Levoy K, Behar-Zusman V. Health Correlates of Abuse History and Moderating Effect of Parenting Stress for Mothers with Mental Disorders. Issues Ment Health Nurs 2021; 42:555-563. [PMID: 32965137 PMCID: PMC8020494 DOI: 10.1080/01612840.2020.1820121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Parenting stress is common and may lead to worsening health, particularly in the context of other risk factors such as mental disorders or a history of abuse. This study investigated how parenting-related stress impacts the effect of abuse experiences on health among mothers with mental health disorders. Survey data was analyzed from 172 predominantly Hispanic mothers receiving outpatient behavioral health services. Most (80.2%) mothers had experienced abuse. Those reporting childhood abuse had 3.82 greater odds of experiencing abuse in adulthood. Findings demonstrated worse health outcomes among those experiencing abuse in both childhood and adulthood and those with a greater number of abuse experiences. Caregiving load intensified the relationship between abuse and anxiety and sleep disturbance. Parenting self-agency intensified the relationship between abuse and cigarette use. These findings have important implications for mental health nursing practice by identifying parenting-stress as an important target for interventions to improve health among women with histories of abuse and mental health disorders.
Collapse
Affiliation(s)
- Jessica R. Williams
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brian E. McCabe
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, Alabama, USA
| | - Lila de Tantillo
- Keigwin School of Nursing, Jacksonville University, Jacksonville, Florida, USA
| | - Kristin Levoy
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Victoria Behar-Zusman
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| |
Collapse
|
3
|
Sachar R, Landau AJ, Ray WZ, Brogan DM, Dy CJ. Social Support and Coping Strategies in Patients with Traumatic Brachial Plexus Injury. HSS J 2020; 16:468-474. [PMID: 33380981 PMCID: PMC7749904 DOI: 10.1007/s11420-020-09814-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 09/28/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Emotional and social characteristics may influence rehabilitation and recovery after traumatic brachial plexus injury. PURPOSES We sought to investigate if traumatic brachial plexus injury patients have different levels of social support and employ distinct coping strategies from uninjured control subjects. In addition, we studied which coping strategies are more commonly used among traumatic brachial plexus injury patients. METHODS Questionnaires for social support (Interpersonal Support Evaluation List and Social Support Questionnaire) and coping strategies (Brief-Coping Orientation to Problems Experienced) were administered to traumatic brachial plexus injury patients and an age- and sex-matched volunteer cohort (without brachial plexus injury). RESULTS There were no differences in interpersonal support (mean [SD] = 26.0 [8.6], 26.5 [6.8]), number of persons available for emotional support, and satisfaction with support between traumatic brachial plexus injury patients (n = 36) and volunteers (n = 43). The following coping strategies were more common among traumatic brachial plexus injury patients: active coping, self-distraction, denial, behavioral disengagement, venting, planning, self-blame, and acceptance. CONCLUSION Patients with traumatic brachial plexus injury have similar levels of social support as healthy volunteers but are more likely to use an array of coping strategies. Surgeons and other clinicians should be aware of coping strategies favored by patients, particularly the potential for behaviors detrimental to recovery such as behavioral disengagement, self-blame, and denial. This work will inform future investigations into the influence of social support and coping strategies on clinical outcomes after traumatic brachial plexus injury.
Collapse
Affiliation(s)
- Ryan Sachar
- Department of Orthopaedic Surgery, Division of Hand and Microsurgery, Washington University School of Medicine, 4291 Parkview Place, St. Louis, MO USA
| | - Andrew J. Landau
- Department of Orthopaedic Surgery, Division of Hand and Microsurgery, Washington University School of Medicine, 4291 Parkview Place, St. Louis, MO USA
| | - Wilson Z. Ray
- Department of Neurological Surgery, Washington University School of Medicine, 1 Barnes Jewish Hospital Plaza, St. Louis, MO USA
| | - David M. Brogan
- Department of Orthopaedic Surgery, Division of Hand and Microsurgery, Washington University School of Medicine, 4291 Parkview Place, St. Louis, MO USA
| | - Christopher J. Dy
- Department of Orthopaedic Surgery, Division of Hand and Microsurgery, Washington University School of Medicine, 4291 Parkview Place, St. Louis, MO USA
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO USA
| |
Collapse
|
4
|
McCabe BE, Gonzalez-Guarda R, de Tantillo L, Mitrani VB. A Mental Health-Physical Health-Violence (MPV) Syndemic Factor in Women with Mental Disorders. STIGMA AND HEALTH 2019; 4:383-390. [PMID: 33094162 PMCID: PMC7575040 DOI: 10.1037/sah0000152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study extended research on syndemics for women with mental disorders by including self-reported mental and physical health conditions. Syndemics explain complex relationships among co-occurring conditions, and the social circumstances that influence their overlap. Data were from the baseline assessment of a randomized trial of Healthy Home, a nursing home-visit intervention for women with children. 172 adult women who were in mental health or substance use treatment completed measures (in Spanish or English) of anxiety, depression, violence during adulthood, physical health, and cigarette use. Structural Equation Modeling was used to evaluate a single-factor syndemic, and to test the relationships of theoretical predictors of the syndemic: income, number of children, women's abuse during childhood, mental health stigma, social support, and stress. Results supported a single factor syndemic model that explained variation in mental health, physical health, and violence during adulthood. Stress, β = .45, p < .001, and stigma, β = .22, p = .007, were related to the syndemic factor. There was evidence that self-reported mental and physical health share covariation, which suggested that integrated services for women with mental disorders may have synergistic effects on health. Findings suggest the need to develop and test interventions that address stress and stigma as a means of reducing health disparities for women with mental disorders.
Collapse
Affiliation(s)
- Brian E McCabe
- School of Nursing and Health Studies, University of Miami
| | | | | | | |
Collapse
|
5
|
Abstract
The purpose of this review was to understand research about treatment adherence among mothers in the US who are living with HIV. Treatment adherence included Antiretroviral Therapy and attending medical care appointments. A scoping review was conducted, and five peer-reviewed databases were searched with predetermined search terms for the period of 2006-2016. Thirty-five articles were identified for the review, including (n = 17) quantitative studies, (n = 6) qualitative studies, (n = 4) reviews and (n = 8) conceptual/theoretical articles. The most frequently identified theme among the articles was prevention of mother-to-child transmission of HIV. Authors disagreed about whether parenting children was a burden or a source of strength for the affected women. Implications identified for practice included a more longitudinal approach to care for mothers, rather than focusing narrowly on prevention of transmission to infants.
Collapse
|
6
|
Levi-Minzi MA, Surratt HL, O'Grady CL, Kurtz SP. Finding what works: Predicting health or social service linkage in drug using, African American, female sex workers in Miami, FL. Health Care Women Int 2016; 37:744-59. [PMID: 26933839 DOI: 10.1080/07399332.2016.1158262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Female sex workers (FSWs) encounter numerous challenges in accessing health and social services. In this study of drug using, African American FSWs, the authors examine specific factors associated with health or social service linkage among participants in a randomized intervention trial. Respondent linkage was significantly associated with individual factors (living alone, severe internal mental distress, and traumatic victimization) and project-related variables (attending five case management sessions and client engagement rating). In the multivariate model, higher client engagement and session attendance remained significant. The researchers conclude by discussing the importance of intervention attendance and engagement as key contributors to health and social service linkage among FSWs.
Collapse
Affiliation(s)
- Maria A Levi-Minzi
- a Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University , Miami , Florida , USA
| | - Hilary L Surratt
- a Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University , Miami , Florida , USA
| | - Catherine L O'Grady
- a Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University , Miami , Florida , USA
| | - Steven P Kurtz
- a Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University , Miami , Florida , USA
| |
Collapse
|
7
|
Villegas NA, Chodhury SM, Mitrani VB, Guerra J. Mothers in Substance Abuse Recovery: Perspectives on Motivators, Challenges and Family Involvement. INTERNATIONAL JOURNAL OF HIGH RISK BEHAVIORS & ADDICTION 2016; 6. [PMID: 30873391 PMCID: PMC6412135 DOI: 10.5812/ijhrba.32558] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Most women in substance abuse treatment are of childbearing age, and many of them have children who both are affected by and influence the mother's substance abuse and treatment behaviors. Objectives This qualitative study (n = 13) was conducted in two drug treatment centers in southern Florida and explored the perspectives of mothers currently or recently in substance abuse treatment regarding their recovery motivators and challenges, as well as their attitudes and preferences regarding family involvement in their treatment. Patients and Methods We used a qualitative descriptive approach. In-depth interviews were conducted with the participants and centered on 3 major themes: (a) motivators for recovery, (b) challenges for recovery, and (c) attitudes and preferences for family involvement in recovery. Results Findings revealed that family plays an important role in the recovery of these mothers, and that mothers are willing to incorporate their families in their recovery process. Women expressed a positive attitude towards family therapy, and they believed that it could benefit their recovery, and their relationship with their children and families. Conclusions The findings of this study can contribute to the development of a family-based substance abuse treatment aftercare intervention that might benefit women in substance abuse treatment.
Collapse
Affiliation(s)
- Natalia A. Villegas
- School of Nursing and Health Studies, University of Miami, Miami, USA
- Corresponding author: Natalia A. Villegas, School of Nursing and Health Studies, University of Miami, 5030 Brunson Ave, Miami, USA. Tel: +1-3052849069,
| | | | | | - Jessica Guerra
- School of Nursing and Health Studies, University of Miami, Miami, USA
| |
Collapse
|
8
|
Mitrani VB, McCabe BE, Gonzalez-Guarda RM, Florom-Smith A, Peragallo N. Participation in SEPA, a sexual and relational health intervention for Hispanic women. West J Nurs Res 2013; 35:849-66. [PMID: 23493674 DOI: 10.1177/0193945913480276] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
HIV and intimate partner violence (IPV) risks are linked in Hispanic women, so integrated interventions can efficiently produce meaningful change. Integrated interventions for Hispanic women are promising, but factors that put Hispanic women at risk for HIV and violence may also impede engagement with interventions. This study examined barriers and facilitators of engagement in a group educational intervention, SEPA (Salud, Educación, Prevención y Autocuidado [Health, Education, Prevention, and Self-Care]), for Hispanic women. A total of 274 Hispanic women from South Florida in the SEPA condition of a randomized controlled trial completed baseline measures of violence, depression, familism, Hispanic stress, acculturation, and demographics, and 57% of the women engaged (attended two of five sessions). Education, IPV, and acculturation predicted engagement. Understanding engagement advances intervention development/refinement. Hispanic women who experience relationship violence are open to group interventions. Further program development and outreach work are needed to connect women with low education, who are particularly vulnerable.
Collapse
Affiliation(s)
- Victoria B Mitrani
- Center of Excellence for Health Disparities Research, El Centro School ofNursing and Health Studies, University of Miami, Coral Gables, FL 33146, USA.
| | | | | | | | | |
Collapse
|
9
|
Eustace RW. A discussion of HIV/AIDS family interventions: implications for family-focused nursing practice. J Adv Nurs 2012; 69:1660-72. [PMID: 22989222 DOI: 10.1111/jan.12006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2012] [Indexed: 01/11/2023]
Abstract
AIM This article presents a discussion on the role of family interventions in HIV/AIDS disease prevention and care. BACKGROUND Although HIV/AIDS epidemic and its impact on the society traditionally has been measured in terms of individual risk behaviours and individual-level HIV prevention, HIV/AIDS family-focused prevention and management strategies are increasingly becoming a priority. However, little is known as to what constitutes a HIV/AIDS family intervention. DATA SOURCES The search was limited to English and published literature starting in the year 1983 to date. CINAHL and PubMed were emphasized using a combination of text words and subject headings. Cochrane Library, PsycInfo, Scopus, and the ISI Web of Science databases were also searched using keywords and in the case of PsycInfo, subject headings were used. The main keywords were 'nurse', or 'nursing', 'HIV/AIDS', 'family interventions', 'family support' and 'family education', and/or 'family subsystems'. DISCUSSION The process of theorizing about 'family interventions' and 'HIV/AIDS-family interventions' is critical for putting forth essential components unique for designing culturally specific HIV/AIDS family interventions. In addition, any proposed design of HIV/AIDS family intervention should consider the impact of HIV/AIDS on the family across the family life span, disease trajectory, and from an interdisciplinary perspective. CONCLUSION Training needs of family nurses should be met when designing multidisciplinary HIV/AIDS-FIs. Furthermore, nurses should be proactive in advocating for HIV/AIDS family intervention and HIV/AIDS family policies to improve outcomes in family functioning, processes, and relationships. More needs to be done in regard to research on families, family interventions, effectiveness, and cost of family-focused approaches.
Collapse
Affiliation(s)
- Rosemary W Eustace
- College of Nursing and Health, Wright State University, Dayton, Ohio, USA.
| |
Collapse
|
10
|
Mitrani VB, McCabe BE, Burns MJ, Feaster DJ. Family mechanisms of structural ecosystems therapy for HIV-seropositive women in drug recovery. Health Psychol 2012; 31:591-600. [PMID: 22708519 PMCID: PMC3884197 DOI: 10.1037/a0028672] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Examined the effects of Structural Ecosystems Therapy (SET), a family intervention for women living with HIV or AIDS, compared to a psycho-educational health group (HG) intervention, and reciprocal relationships between women and family members. METHOD Women (n = 126) and their family members (n = 269) were randomized to one of two conditions and assessed every 4 months for 12 months. Family functioning, drug use, and psychological distress was reported by multiple family members. RESULTS Multilevel growth curve modeling showed a different family functioning trajectory between SET and HG, B = -0.05, SE = 0.02, p < .01. There was no intervention effect on the trajectory of family-level drug abstinence or psychological distress, but there was a significant difference in the trajectory of psychological distress after controlling for change in family functioning, B = -0.28, SE = 0.13, p < .05. There was an indirect effect from treatment through change in family functioning to change in psychological distress, B = 0.29, SE = 0.12, p < .05. With respect to reciprocal effects, family drug abstinence significantly predicted women's abstinence 4 months later, B = 0.22, SE = 0.06, p < .001. CONCLUSION Findings demonstrated the interdependence of family members and the impact of family in relapse prevention and partially supported SET's potential for maintaining family functioning and well-being for women living with HIV or AIDS in drug recovery.
Collapse
Affiliation(s)
- Victoria B Mitrani
- Center of Excellence for Health Disparities Research: El Centro, School of Nursing and Health Studies, University of Miami, Coral Gables, FL 33124, USA.
| | | | | | | |
Collapse
|
11
|
Freeman A, Newman J, Hemingway-Foday J, Iriondo-Perez J, Stolka K, Akam W, Balimba A, Kalenga L, Mbaya M, Mfangam Molu B, Mukumbi H, Niyongabo T, Woelk G, Kiumbu M, Atibu J. Comparison of HIV-positive women with children and without children accessing HIV care and treatment in the IeDEA Central Africa cohort. AIDS Care 2011; 24:673-9. [DOI: 10.1080/09540121.2011.630364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- A. Freeman
- a Statistics and Epidemiology , RTI International , Research Triangle Park , NC , USA
| | - J. Newman
- a Statistics and Epidemiology , RTI International , Research Triangle Park , NC , USA
| | - J. Hemingway-Foday
- a Statistics and Epidemiology , RTI International , Research Triangle Park , NC , USA
| | - J. Iriondo-Perez
- a Statistics and Epidemiology , RTI International , Research Triangle Park , NC , USA
| | - K. Stolka
- a Statistics and Epidemiology , RTI International , Research Triangle Park , NC , USA
| | - W. Akam
- b Limbé Provincial Hospital , Limbé , Cameroon
| | - A. Balimba
- c Hôpital Militaire , Yaoundé , Cameroon
| | | | | | | | | | - T. Niyongabo
- h Centre Hospitalo-Universitaire de Kamenge , Bujumbura , Burundi
| | - G. Woelk
- a Statistics and Epidemiology , RTI International , Research Triangle Park , NC , USA
| | - M. Kiumbu
- i Kinshasa School of Public Health , Kinshasa , DRC
| | - J. Atibu
- i Kinshasa School of Public Health , Kinshasa , DRC
| |
Collapse
|
12
|
Mitrani VB, McCabe BE, Robinson C, Weiss-Laxer NS, Feaster DJ. Structural Ecosystems Therapy for recovering HIV-positive women: child, mother, and parenting outcomes. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2010; 24:746-755. [PMID: 21171773 PMCID: PMC3051342 DOI: 10.1037/a0021638] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study presents results of a subgroup analysis from a randomized trial to examine whether Structural Ecosystems Therapy (SET), a family intervention intended to improve medication adherence and reduce drug relapse of HIV-seropositive (HIV+) women recovering from drug abuse, provided benefits for families with children. Data from 42 children and 25 mothers were analyzed at baseline, and 4, 8, and 12 months post-baseline. Results of longitudinal Generalized Estimating Equations analyses suggested that SET was more efficacious than the Health Group (HG) control condition in decreasing children's internalizing and externalizing problems and reducing mothers' psychological distress and drug relapse. Children in SET reported improvements in positive parenting as compared to the children in HG, but there were no differences in mother-reported positive parenting, or parental involvement as reported by either the children or mothers. These findings suggest that family interventions such as SET may be beneficial for mothers and children. An adaptation of SET specifically for families with children could further enhance benefits and improve acceptability and cost-effectiveness.
Collapse
Affiliation(s)
- Victoria B Mitrani
- Center of Excellence for Health Disparities Research: El Centro, University of Miami School of Nursing and Health Studies, Coral Gables, FL 33126, USA.
| | | | | | | | | |
Collapse
|
13
|
Feaster DJ, Mitrani VB, Burns MJ, McCabe BE, Brincks AM, Rodriguez AE, Asthana D, Robbins MS. A randomized controlled trial of Structural Ecosystems Therapy for HIV medication adherence and substance abuse relapse prevention. Drug Alcohol Depend 2010; 111:227-34. [PMID: 20538417 PMCID: PMC2950218 DOI: 10.1016/j.drugalcdep.2010.04.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2009] [Revised: 04/26/2010] [Accepted: 04/30/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Substance abuse in women with HIV/AIDS overshadows other priorities, including health care. Substance abuse may cause women to avoid health care systems and not adhere to their medication regimen. METHODS A randomized controlled trial tested the efficacy of Structural Ecosystems Therapy (SET) relative to a psychoeducational Health Group (HG) in 126 HIV+ women in recovery. SET, a 4-month intervention, focused on building family support for relapse prevention and HIV medication adherence. Over 12-month follow-up, women were assessed for drug use and medication adherence every 2 months; CD4 T-cell count and HIV viral load were assessed every 4 months. RESULTS Levels of drug use did not differ by condition. There was a significant difference in curvature of the rates of change in drug use with SET increasing and then decreasing and HG decreasing and then increasing. Women in SET were more likely to increase substance abuse services in response to relapse and separate from drug using household members than were women in HG. These two changes explained the decline in drug use observed within SET between 6 and 12 months. SET showed declines in medication adherence but increases in CD4 T-cell count relative to HG. The increase in CD4 T-cell count in SET was related to increasing proportions of women in SET taking antiretroviral medications. CONCLUSION The results of the trial were mixed. Women in SET did not show better drug use or medication adherence outcomes, but did show improvement in CD4 T-cell count and theoretical mechanisms of action on drug relapse.
Collapse
Affiliation(s)
- Daniel J. Feaster
- Center for Family Studies, Department of Epidemiology and Public Health, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Victoria B. Mitrani
- School of Nursing and Health Studies, University of Miami, P.O. Box 248153, Coral Gables, FL 33124, United States
| | - Myron J. Burns
- Department of Psychology, Nevada State College, Henderson, NV, 89002, United States
| | - Brian E. McCabe
- School of Nursing and Health Studies, University of Miami, P.O. Box 248153, Coral Gables, FL 33124, United States
| | - Ahnalee M. Brincks
- Center for Family Studies, Department of Epidemiology and Public Health, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Allan E. Rodriguez
- Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Deshratn Asthana
- Department of Psychiatry and Behavioral Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Michael S. Robbins
- Oregon Research Institute, 1715 Franklin Boulevard, Eugene, OR 97403, United States
| |
Collapse
|